Disrupting Incivility in Healthcare Through Interprofessional Education

Purpose: Incivility is a well-documented problem in the workplace (Texas A&M University, 2017). In healthcare, incivility can lead to unsafe working conditions, poor patient care, increased medical costs, and increased employee turnover (Clark, 2018; DeVillers & Cohn, 2017). In nursing, specifically, there has been a call to foster civility in nursing education and practice with the goal of creating and promoting a workplace that is conducive to caring (Clark, Olender, Cardoni, & Kenski, 2011). Although much of the incivility research is based on nursing, incivility is also a problem with physicians and other members of the healthcare team (Pattani et al., 2018). Change becomes possible when all members of the healthcare team acknowledge that they are culpable in some way and are invited to lead by example (Bar-David, 2018). The purpose of this presentation is to discuss our experiences with implementing a session on incivility during a leadership seminar with interprofessional undergraduate and graduate health sciences students.

Methods: We chose to implement this with interprofessional students because the goal of interprofessional education (IPE) is to produce a workforce that is poised for collaborative practice (WHO, 2010). At the beginning of this IPE session, students were asked to self-reflect on their experiences with civility by completing the Civility Index, an evidence-based questionnaire designed to assess civility, increase awareness, generate discussion, and identify ways to enhance civility acumen (Clark, 2013). During the session, we provided didactic content about workplace incivility that included: providing definitions of civility and incivility, discussing the Continuum of Incivility (Clark, Barbosa-Leiker, Gill, & Nguyen, 2015), outlining statistics about prevalence in healthcare, and providing strategies to handle incivility. Additionally, we used two video clips from popular culture to reinforce the content. At the end of the didactic content, the students participated in the Marshmallow Challenge (Wujec, n.d.), as a way to facilitate civility, collaboration, and teamwork.

Results: Students (N=18) self-reported a mean Civility Index score of 87.72 (Range = 74-97), indicating moderate civility. The session evaluations were positive, overall. Specific comments from students included a new awareness of incivility and its associated behaviors, an acknowledgement of personal behaviors that could be perceived as uncivil, and perceived value in the teambuilding exercise.

Conclusion: Overall, we found that the content and format was well-received and recommend future application with interprofessional students.