J Educ Eval Health Prof.  2020;17:23. 10.3352/jeehp.2020.17.23.

Nurse educators’ experiences with student incivility: a meta-synthesis of qualitative studies

• Park EJ
• Kang H

• KMID: 2507071
• DOI: http://doi.org/10.3352/jeehp.2020.17.23

Abstract

This study aimed to synthesize the best available qualitative research evidence on nurse educators’ experiences with student incivility in undergraduate nursing classrooms. A meta-synthesis of qualitative evidence using thematic synthesis was conducted. A systematic search was performed of 12 databases for relevant literature published by March 31, 2019. Two reviewers independently conducted critical quality appraisals using the checklist for qualitative research developed by the Joanna Briggs Institute. Eleven studies that met the inclusion criteria were selected for review. From the pooled study findings, 26 descriptive themes were generated and categorized into the following 5 analytical themes: (1) factors contributing to student incivility, (2) management of student incivility, (3) impact: professional and personal damage, (4) impact: professional growth, and (5) initiatives for the future. Many nurse educators became confident in their role of providing accountability as both educators and gatekeepers and experienced professional growth. However, others experienced damage to their personal and professional life and lost their motivation to teach. Nurse educators recommended the following strategies for preventing or better managing student incivility: institutional efforts by the university, unified approaches for student incivility within a nursing program, a faculty-to-faculty network for mentoring, and better teaching and learning strategies for individual educators. These strategies would help all nurse educators experience professional growth by successfully preventing and managing student incivility.

Keyword

Education; Incivility; Qualitative research; Students; Systematic review

Figure

• 

  Fig. 1. Flowchart of the study selection process. a)PubMed 57+CINAHL 1,275+EMBASE 82+Web of Science 57+SCOPUS 38+ProQuest Education 1,353+ProQuest Psychology 1,044+ProQuest Education Source 513+ProQuest Social Science 462+ABI/INFORM 532+ProQuest Sociology 333+ERIC 4. b)Google Scholar 3+ProQuest Dissertation and Thesis Global 934+OpenGrey 0+Deep Blue Library 0. c)2 Included dissertation were published to 2 journal articles and 1 journal article.

Reference

References

1. Schmidt BJ, McArthur EC. Professional nursing values: a concept analysis. Nurs Forum. 2018; 53:69–75. https://doi.org/10.1111/nuf.12211.

2. Robertson JE. Can’t we all just get along?: a primer on student incivility in nursing education. Nurs Educ Perspect. 2012; 33:21–26. https://doi.org/10.5480/1536-5026-33.1.21.

3. Clark CM, Davis Kenaley BL. Faculty empowerment of students to foster civility in nursing education: a merging of two conceptual models. Nurs Outlook. 2011; 59:158–165. https://doi.org/10.1016/j.outlook.2010.12.005.

4. Wagner B, Holland C, Mainous R, Matcham W, Li G, Luiken J. Differences in perceptions of incivility among disciplines in higher education. Nurse Educ. 2019; 44:265–269. https://doi.org/10.1097/NNE.0000000000000611.

5. Small SP, English D, Moran G, Grainger P, Cashin G. “Mutual respect would be a good starting point:” students’ perspectives on incivility in nursing education. Can J Nurs Res. 2019; 51:133–144. https://doi.org/10.1177/0844562118821573.

6. Aul K. Who’s uncivil to who?: perceptions of incivility in pre-licensure nursing programs. Nurse Educ Pract. 2017; 27:36–44. https://doi.org/10.1016/j.nepr.2017.08.016.

7. Fowler MD, Davis AJ. Ethical issues occurring within nursing education. Nurs Ethics. 2013; 20:126–141. https://doi.org/10.1177/0969733012474290.

8. Clark CM, Juan CM, Allerton BW, Otterness NS, Jun WY, Wei F. Faculty and student perceptions of academic incivility in the People’s Republic of China. J Cult Divers. 2012. 19:85–93. [cited 2019 Apr 10]. Available from: https://www.researchgate.net/profile/Cynthia_Clark3/publication/233533441_Faculty_and_student_perceptions_of_academic_incivility_in_the_People's_Republic_of_China/links/55b0ec1708aec0e5f430e058/Faculty-and-student-perceptions-of-academic-incivility-in-the-Peoples-Republic-of-China.pdf.

9. Eka NG, Chambers D, Narayanasamy A. Perceived uncivil behaviour in Indonesian nursing education. Nurse Educ Pract. 2016; 20:99–108. https://doi.org/10.1016/j.nepr.2016.07.007.

10. Rad M, Karimi Moonaghi H. Strategies for managing nursing students’ incivility as experienced by nursing educators: a qualitative study. J Caring Sci. 2016; 5:23–32. https://doi.org/10.15171/jcs.2016.003.

11. De Gagne JC, Kang HS, Hyun MS. Psychometric properties of the Korean version of the incivility in nursing education-revised (INE-R) survey. Nurs Health Sci. 2016; 18:425–434. https://doi.org/10.1111/nhs.12285.

12. Natarajan J, Muliira JK, van der Colff J. Incidence and perception of nursing students’ academic incivility in Oman. BMC Nurs. 2017; 16:19. https://doi.org/10.1186/s12912-017-0213-7.

13. White SJ. Student nurses harassing academics. Nurse Educ Today. 2013; 33:41–45. https://doi.org/10.1016/j.nedt.2011.11.004.

14. Sweetnam C. Aberrant behavior: a phenomenological study on incivility in nursing education [dissertation]. Phoenix (AZ): University of Phoenix;2014.

15. Luparell S. Critical incidents of incivility by nursing students: how uncivil encounters with students affect nursing faculty [dissertation]. Lincoln (NE): University of Nebraska;2003.

16. Olive D. Nursing student incivility: the experience of nursing faculty [dissertation]. Chester (PA): Widener University;2006.

17. Luparell S. Faculty encounters with uncivil nursing students: an overview. J Prof Nurs. 2004; 20:59–67. https://doi.org/10.1016/j.profnurs.2003.12.007.

18. Abas NA, Ahmi A, Lin MH, Perveen A. Global trend on incivility research. Indian J Public Health Res Dev. 2019; 10:1229–1234. https://doi.org/10.5958/0976-5506.2019.01754.6.

19. Noyes J, Popay J, Pearson A, Hannes K, Booth A. Chapter 20: qualitative research and Cochrane reviews. In : Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editors. Cochrane handbook for systematic reviews of interventions: version 6.0 [Internet]. London: Cochrane;2019. [cited 2020 Jan 12]. Available from: https://training.cochrane.org/handbook/current.

20. Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol. 2008; 8:45. https://doi.org/10.1186/1471-2288-8-45.

21. Baldwin A, Mills J, Birks M, Budden L. Role modeling in undergraduate nursing education: an integrative literature review. Nurse Educ Today. 2014; 34:e18–e26. https://doi.org/10.1016/j.nedt.2013.12.007.

22. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010; 8:336–341. https://doi.org/10.1016/j.ijsu.2010.02.007.

23. Gallo VJ. Incivility in nursing education: a review of the literature. Teach Learn Nurs. 2012; 7:62–66. https://doi.org/10.1016/j.teln.2011.11.006.

24. Jonna Briggs Institute. The Joanna Briggs Institute critical appraisal tools for use in JBI systematic reviews: checklist for qualitative research [Internet]. Adelaide: Jonna Briggs Institute;2017. [cited 2019 Apr 10]. Available from: https://joannabriggs.org/sites/default/files/2019-05/JBI_Critical_Appraisal-Checklist_for_Qualitative_Research2017_0.pdf.

25. Hannes K, Lockwood C, Pearson A. A comparative analysis of three online appraisal instruments’ ability to assess validity in qualitative research. Qual Health Res. 2010; 20:1736–1743. https://doi.org/10.1177/1049732310378656.

26. Luparell S. The effects of student incivility on nursing faculty. J Nurs Educ. 2007; 46:15–19. https://doi.org/10.3928/01484834-20070101-04.

27. Sprunk EA, LaSala KB, Wilson VL. Student incivility: nursing faculty lived experience. J Nurs Educ Pract. 2014; 4:1–12. https://doi.org/10.5430/jnep.v4n9p1.

28. Sprunk EA. Student incivility: nursing faculty lived experience [dissertation]. Greeley (CO): University of Northern Colorado;2013.

29. Williamson MM. Nurse educators’ lived experiences with student incivility [dissertation]. Tuscaloosa (AL): University of Alabama;2011.

30. Leech LA. Male nurse educators’ lived experiences with nursing student incivility [dissertation]. Indiana (PA): Indiana University of Pennsylvania;2017.

31. Vink H, Adejumo O. Factors contributing to incivility amongst students at a South African nursing school. Curationis. 2015; 38:1464. https://doi.org/10.4102/curationis.v38i1.1464.

32. Rad M, Karimi Moonaghi H, Ildarabadi E. Can nurse teachers manage student incivility by guided democracy?: a grounded theory study. BMJ Open. 2017; 7:e014639. https://doi.org/10.1136/bmjopen-2016-014639.

33. Masoumpoor A, Borhani F, Abbaszadeh A, Rassouli M. Nursing instructors’ perception of students’ uncivil behaviors: a qualitative study. Nurs Ethics. 2017; 24:483–492. https://doi.org/10.1177/0969733015611071.

34. Brooks R, Byford K, Sela K. Students’ unions, consumerism and the neo-liberal university. Br J Sociol Educ. 2016; 37:1211–1228. https://doi.org/10.1080/01425692.2015.1042150.

35. Bunce L, Baird A, Jones SE. The student-as-consumer approach in higher education and its effects on academic performance. Stud High Educ. 2017; 42:1958–1978. https://doi.org/10.1080/03075079.2015.112790.

36. Mercer-Mapstone L, Dvorakova SL, Matthews KE, Abbot S, Cheng B, Felten P, Knorr K, Marquis E, Shammas R, Swaim K. A systematic literature review of students as partners in higher education. Int J Stud Partn. 2017; 1:1–23. https://doi.org/10.15173/ijsap.v1i1.3119.

37. Candela L, Gutierrez AP, Keating S. What predicts nurse faculty members’ intent to stay in the academic organization?: a structural equation model of a national survey of nursing faculty. Nurse Educ Today. 2015; 35:580–589. https://doi.org/10.1016/j.nedt.2014.12.018.

38. Clark CM. An evidence-based approach to integrate civility, professionalism, and ethical practice into nursing curricula. Nurse Educ. 2017; 42:120–126. https://doi.org/10.1097/NNE.0000000000000331.

39. Knepp KA. Understanding student and faculty incivility in higher education. J Eff Teach [Internet]. 2012. 12:33–46. [cited 2019 Apr 10]. Available from: https://files.eric.ed.gov/fulltext/EJ1092106.pdf.

40. Rad M, Mirhaghi A, Shomoossi N. Self-assertiveness interfacing incivility in student nurses: possible outcomes. Nurse Educ Today. 2015; 35:e6. https://doi.org/10.1016/j.nedt.2015.07.016.

41. Williams SC, Lauerer J. Implementing a nursing civility code: implications for education. J Nurs Educ. 2013; 52:165–170. https://doi.org/10.3928/01484834-20130218-01.

42. Schneider EF, Jones MC, Farris KB, Havrda D, Jackson KC 2nd, Hamrick TS. Faculty perceptions of appropriate faculty behaviors in social interactions with student pharmacists. Am J Pharm Educ. 2011; 75:70. https://doi.org/10.5688/ajpe75470.

43. Finfgeld-Connett D. Generalizability and transferability of meta-synthesis research findings. J Adv Nurs. 2010; 66:246–254. https://doi.org/10.1111/j.1365-2648.2009.05250.x.