Workplace Civility Index: A Reliable Tool for Measuring Civility Competence in the Workplace

Purpose: Harm from disrespect and incivility in health care has been identified as the next frontier in patient safety efforts, especially since harm stemming from uncivil acts may lead to life-threatening mistakes, preventable complications, or injury to a patient. Some individuals may not know or realize how their actions impact others. They lack self-awareness and a true understanding as to which behaviors and interactions others might find uncivil or disrespectful. This study describes the development and psychometric testing of the Workplace Civility Index (WCI), a reliable tool to measure civility acumen, enhance self-awareness, and generate discussion about the perceived state of civility in the work environment.

Methods: The WCI involved a thorough review of the literature; consultation with three content experts; and extensive pilot testing with more than 2000 practice-based nurses and nursing faculty who did not participate in this study. The WCI is an original, 20-item, Likert-type survey consisting of 20 essential elements related to workplace civility and respectful coworker interactions. Respondents assess the perceived frequency of civil workplace interactions using the following response categories: 1 = never, 2 = rarely, 3 = sometimes, 4 = usually, and 5 = always. Scores range from 20 to 100 and indicate the respondents’ overall perception of civil workplace interactions: 90 to 100 = very civil; 80 to 89 = civil; 70 to 79 = moderately civil; 60 to 69 = minimally civil; 50 to 59 = uncivil; and less than 50 = very uncivil. A total score ranging from 20–100 can be calculated by summing all items on the WCI to indicate the overall perceived level of civility. Calculating scores may be done to evaluate the sample or to conduct comparisons across individual items and total scores.

Results: After obtaining IRB approval, 393 nursing faculty and practice-based nurses throughout the United States and Canada in various workplace settings completed the WCI. Total possible scores ranged from 20 to 100 and were approximately normally distributed. The mean total score for this sample was 85.66 (SD = 6.34), indicating that respondents perceived their behavior and interactions in the workplace as civil. The factor analysis results provided robust evidence for internal validity of this scale. Cronbach’s alpha for the WCI is .82 indicating an internally consistent scale for this sample.

Conclusion: The WCI is a psychometrically sound instrument used to measure perceptions of workplace civility competence, enhance self-awareness, and generate discussion about the perceived state of civility in the work environment. The WCI may be completed as an individual exercise or completed by all members of a team to compare perceptions of workplace civility and determine areas of strength and improvement. It has been used in dozens of practice and academic work environments domestically and abroad to improve healthcare workers’ awareness of the impact of incivility on workplace culture and patient safety.