Nearly 62% of students and faculty in nursing education have reported incivility in an academic setting. The majority of the evidence in the literature describes Student Incivility as faculty to student or student to faculty. Few studies have identified student to student. It is uncertain how students perceive their level of civility. Incivility between students can impact participation in the class resulting in failure, poor attrition, stress, anxiety, depression, and lack of self-esteem.
Purpose:
The purpose of this study was to identify perceptions of self-reported civility in undergraduate nursing students.
Methods:
This was a cross-sectional descriptive study of undergraduate nursing students at a large, 4-year public institution in the Southeastern United States. There were no inclusion or exclusion criteria. An email was sent to all freshmen, sophomores, juniors and seniors enrolled at the College of Nursing asking them to participate in the survey. The Clark Civility Index for Nursing Students was used to collect data via Qualtrics. IRB approval was obtained.
Results:
1697 emails were sent to students with a response rate of 252 students. Of this number, 202 entries were analyzed. The mean score of self-reported civility was 88.3 (SD = 7.02). There was a significant relationship between incivility with regard to age (p = 0.02) and race (p = 0.08). Age was significantly negatively correlated with overall civility score, r = -0.16, p = 0.02, suggesting that civility scores were generally lower among older individuals. However, further inspection of the data revealed an outlier (9 SDs above the mean on age) that likely biased this result. After removing this individual, the correlation between age and overall civility scores was no longer significant, r = 0.05, p = 0.45. Married and single individuals did not differ significantly in their reported levels of civility, t(200) = -0.94, p = 0.35. Note: The outcome of the test described above may have been affected by the low number of married individuals in the sample (n = 5). An analysis of variance (ANOVA) revealed a marginally significant effect of program of study, F(2, 199) = 2.59, p = 0.08. Tukey post hoc tests indicated that students in the RN-BSN nursing program (M = 78.00, SD = 24.04) scored lower on the CCI than students in the traditional BSN nursing program (M = 88.91, SD = 6.80), though this effect was only marginally significant (p = 0.08). The pre-nursing group (M = 88.03, SD = 6.75) did not differ significantly from either of the other two groups. An ANOVA indicated a marginally significant effect of race, F(3, 198) = 2.29, p = 0.08. However, Tukey post hoc testing did not reveal any significant differences between conditions. Because two of the racial categories were represented by only five or fewer students, race as a variable was recoded into a new variable that contained two categories: (1) Majority group member / White (n = 180), and (2) Minority group member / non-White (n = 22). A t-test using this recoded variable revealed that minority group members (M = 91.91, SD = 5.57) reported higher CCI scores on average compared to majority group members (M = 87.86, SD = 7.07), t(200) = -2.59, p = 0.01. The Cronbach's alpha is 0.853.
Conclusion: Overall findings were that 98% of the undergraduate nursing students were moderately civil to very civil. These findings seem contradictory to the current literature, which reports student incivility at a rate of nearly 62%. There is scant literature on this topic. Our findings could be due to the lack of awareness regarding what incivility is and that the instrument is not valid in a student population. Limitations of the study are self-reporting and findings are from only one university, which cannot be generalizable. Students need to be aware of their behavior and how it impacts their peers. Students must be empowered to understand what student to student incivility is and be able to intervene when it is experienced by students in their classrooms. The issue of incivility exists, yet students’ perceptions at this university are not congruent with the evidence in the literature. It is imperative that students understand how incivility impacts the nursing profession globally.
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