Validating a Tool to Measure Nursing Student’s Experiences with Incivility in Clinical Nursing Education

Marshall, Katherine, Joanne Yastik, and Maureen Anthony


Clinical nursing education is stressful for students. This stress can be compounded when students find themselves targets of incivility by staff in the clinical environment. The impact of incivility cannot only affect the student’s clinical experience but the quality of patient care that is delivered. A qualitative study by Yastik and Anthony (2009) explored student experiences with incivility in clinical nursing education. Results from four focus groups (n=21) yielded three themes: Exclusionary (“We were in the way”); Hostile/Rude (“We were always in tears”); and Dismissive (“They just walk away”). From these findings, the Uncivil Behavior in Clinical Nursing Education tool (UBCNE) was developed to quantify these behaviors. The UBCNE tool addresses frequency and nature of various uncivil interactions, the student’s perceived value and level of stress during the clinical rotation, and the quality of care provided on the clinical unit.  Students are asked to rate their level of comfort in dealing with conflict or uncivil interactions and are also asked to identify what strategies might be helpful in learning how to deal with uncivil behavior in the clinical environment.



The purpose of this research is to continue the second phase of an ongoing program of research involving the testing and validation of the UBCNE tool.  Validation, enhancement and use of the tool will ultimately produce data that will provide insight into student experiences with incivility in the clinical environment.



Approval from the UDM IRB has been obtained. Pilot testing began in March. The tool will be administered to all senior level students in the MSON in the NUR 4420, 4450, 4910 & 4980 courses. This will yield approximately 150 subjects.



Demographic information including age, gender, program type (accelerated second degree or traditional BSN), hospital, unit type, shift and hours worked will be analyzed using descriptive statistics. Factor analysis and tests of internal consistency will be performed. Modifications can then be made to the tool based on the student feedback and identification of additional areas of concern.


Implications/Future Research:

Following validation of the UBCNE, a larger scale investigation is planned for fall 2010. Future research will focus on interventions and strategies that can be used by students to cope with uncivil treatment in the clinical setting.