NURSE EDUCATORS’ LIVED EXPERIENCES   WITH STUDENT INCIVILITY     by MYRNA MILWEE WILLIAMSON AARON M. KUNTZ, COMMITTEE CHAIR BECKY ATKINSON SUSAN GASKINS BETH HEMBREE ROY ANN SHERROD A DISSERTATION Submitted in partial fulfillment of the requirements for the degree of Doctor of Education in the Department of Educational Leadership, Policy, and Technology Studies in the Graduate School of The University of Alabama TUSCALOOSA, ALABAMA 2011 Copyright Myrna Milwee Williamson 2011 ALL RIGHTS RESERVED ABSTRACT Incivility is currently a topic of concern in nursing and higher education. There is a serious and growing concern on college campuses across the United States as many forms of incivility are occurring, ranging from offensive language and rude behavior to hostility and violent behavior. The problem this study addresses is the need for specific information from nurse educators about their experiences with student incivility, and the subsequent impact of those experiences on teaching practices, job perception, and interactions with students. This study also addresses the problem by asking nurse educators their thoughts on contributing factors, warning signs, prevention and management, and the impact of incivility on student learning. An interpretive phenomenological approach was used to frame the research. The study employed a purposive sample group consisting of 10 Associate Degree Nurse (ADN) educators having experience with student incivility. Semi-structured interviews were conducted using an interview guide. Interviews were used to elicit individual experiences with incivility and provide a means for those impacted to describe and define the meaning of those experiences. General inductive data analysis was utilized to identify themes followed by thematic analysis to arrive at the various understandings and meanings applied to the experiences. Themes emerged, which aligned with and assisted to answer the research questions. The participants clearly asserted their belief that student incivility in nurse education is a growing and disturbing problem and negatively impacting nurse educators and the teaching and learning dynamic. Identified incivilities encompassed a wide range of behaviors and elicited ii strong emotional responses by many of the participants. Many nurse educators described how student incivility had impacted the perception of their job, their teaching, and interfered with student interactions and student learning. Educators also reported changes with their description, definition, or understanding of student incivility following their experiences. Implications for nursing policy and practice relate to training nurse educators about the expectations of the teaching role and how to address, prevent and manage student incivility. Implications for nursing also include training students about the demanding nature of nurse education and the professional nursing role to promote awareness and prevent incivility. iii DEDICATION Get rid of all bitterness, rage and anger, brawling and slander, along with every form of malice. Be kind and compassionate to one another, forgiving each other, just as in Christ God forgave you. Ephesians 4: 31-32 This work is dedicated to my parents Marlin and Donna Milwee who have been a driving force behind every endeavor throughout my life, educational or otherwise. Dad encouraged my creativity and imagination through personally written poems and pictures for every major event throughout my life. I have copies of his great masterpieces and can quote most, which range from a poem about super chicken when my pet chick drowned to the poem he wrote when I received my Masters Degree in Nursing. He is one of my biggest fans and I am his. My mother is the reason I am so passionate about civility. She is the best person I know. Her beautiful smile on the outside is only a reflection of her true beauty within. Her constant quotation of scriptures, nursery rhymes, stories and songs were a steady source of joy throughout my formative years and a great source of laughter between my siblings and me now. The Bible, especially Ephesians 4:32 and the Golden Rule were her favorite sources. She is the reason I can quote a scripture, sing a song, or recite a nursery rhyme for almost every significant or insignificant event in my life or the lives of my children. She grounded me through her demonstration of love and respect for others and shaped me into who I am. The foundation of my parents lives have been built on the love of God and service to others through that love. This love for God, their love for each other, their family and its impact on countless other lives will only be realized in heaven. I have been a recipient of this love and iv am forever changed because of it. Therefore, it is with great joy that I dedicate this work to my parents. v ACKNOWLEDGMENTS I would like to thank my husband, Jimmy for his support throughout this challenging part of our journey together. I could have never completed the task without you carrying a great deal of the load. I would also like to thank my three beautiful children Jarret, Molly, and John who have supported me continually during some of the most exciting times of their lives. Throughout this process each has graduated high school and began their journey into this big world carrying a part of my heart along. This has been both heartbreaking and glorious to experience. Words can never adequately express my love for all of you and the joy you have brought to my life. My parents Marlin and Donna Milwee have been a driving force behind every endeavor throughout my life, educational or otherwise. Their love and support of me has been invaluable and I love you both very much. My sister Michelle Scott has always been my cheerleader, but the admiration is completely mutual, I love you Shelzy. My brother Dr. Mark Milwee has always supported me. Even though you are far away ministering to others, sharing the love of God you are always close in my heart. I would like to thank my two walking buddies Lucy and Ruthie who helped me stay focused and make it through this process. Your support, friendship and walks at all hours of the day and night, working around my writing and school schedule helped me to hang on. I love you both. For all the prayers offered up on my behalf and the support from family, friends, co- workers, and church family I can only say thank you, your support did not go unnoticed and your prayers sustained me when I was too tired to utter the words. vi I am grateful to my dissertation chairperson Dr. Aaron Kuntz and my committee Dr. Becky Atkinson, Dr. Susan Gaskins, Dr. Roy Ann Sherrod, and Dr. Beth Hembree. Dr. Kuntz’s knowledge and understanding of what I wanted to accomplish and what I needed to do to reach that goal helped to shape this project into something I am extremely proud of. For that and for all the countless hours you spent reviewing my rewrites and revisions, I am forever indebted. Thanks to each of the committee members whose knowledge and thoughtful suggestions strengthened this study from beginning to end. A special thanks to Dr. Hembree, my outside committee member from Jacksonville State University (JSU). Our journey began at JSU and you have been a constant source of support and encouragement from the day I first began graduate work. Thank you for your quick responses and always encouraging me to never give up. I would like to thank those in both the Capstone College of Nursing and the College of Education at The University of Alabama for having the foresight to develop the Nurse Educator Program. This program has been the perfect fit for me and my educational aspirations. The professors and support staff are outstanding and have provided an educational experience of which I am extremely proud to say I am a part of. Lastly, I would like to thank Cohort 1 of the Nurse Educator program here at the University. Only each of you know what we have truly experienced and the strength and support we have drawn from each other. We were told this would be a rigorous program and experienced the truth of this statement. Even though I am the first to defend I know I will not be the last. I will always carry a special place in my heart for all of you. I challenge you to go out, finish the process we all started together, and go on to accomplish great things. I am counting on you Cohort 1. Also, a special thanks to Marsha, Mary, and Stacey, my group members and lifelong friends in Cohort 1, I love you. Roll Tide! vii CONTENTS ABSTRACT .................................................................................................................................... ii DEDICATION ............................................................................................................................... iv ACKNOWLEDGMENTS ............................................................................................................. vi LIST OF TABLES ....................................................................................................................... xiii 1 INTRODUCTION TO THE STUDY ......................................................................................1 Conceptual Framework .2 Problem Statement .............................................................................................................5 Purpose of the Study ...........................................................................................................5 Broad Research Questions ..................................................................................................6 Focused Research Questions ..............................................................................................6 Themes ...............................................................................................................................7 Study Significance and Implications ..................................................................................8 Summary ............................................................................................................................9 2 REVIEW OF THE LITERATURE ........................................................................................11 Incivility in Society ..........................................................................................................12 Workplace Incivility .13 Incivility in Higher Education ..........................................................................................14 Identification of Incivility .15 Contributing Factors .16 Student Impact ............................................................................................................18 viii Unreported Student Incivility .18 Prevention, Intervention, and Management Strategies ...............................................18 Resistance ...................................................................................................................19 Behavioral Conduct Codes .21 Incivility in Nurse Education ...........................................................................................22 Impact of Incivility .....................................................................................................23 Workplace Incivility .26 Identification and Contributing Factors .....................................................................27 Cultural Awareness .30 Generational Differences .30 Prevention, Intervention, and Management of Incivility ...........................................32 Summary ..........................................................................................................................36 3 RESEARCH DESIGN AND METHODOLOGY ..................................................................38 Conceptual Framework .38 Qualitative Design .38 Phenomenology .38 Methodology ....................................................................................................................42 Recruitment and Selection .42 Sample Size, Setting, and Access ...............................................................................44 Interview Protocol .45 Data Collection .................................................................................................................46 Data Analysis ...................................................................................................................48 Trustworthiness/Validity of the Study .............................................................................49 ix