Incivility in Pre-Registration Nursing Education: a Phenomenological Exploration of the Experiences of Student Nurses, Nurse Tutors and Nurse Mentors in a UK Higher Education Institution

Abstract

This study provides a unique insight into incivility in pre-registration nursing education through a phenomenological exploration of the experiences of student nurses, nurse tutors and nurse mentors. Incivility is the display of intimidating, rude, disruptive or undesirable behaviours which, in the context of nursing education and practice, has the potential to impact negatively on student learning and patient outcomes. However, despite the potential consequences and the fact that it is a globally recognised phenomenon, very little is known about incivility in nursing education in the United Kingdom.

A phenomenological qualitative design was used to explore the experiences of students, mentors and nurse tutors who were assessing, teaching or studying, on a three-year degree level pre-registration nursing programme. Data was collected by conducting twenty-five in-depth, semi-structured, face-to-face interviews which were audio-recorded and transcribed verbatim and the framework for analysis was informed by the work of J. A. Smith, Flowers, & Larkin (2009) and Miles, Huberman, & Saldana (2014). Overall, four major themes emerged (Distraction; Power; Impact on Learning; and Invisibility) along with five minor themes (Emotional Impact, Knowing and Not-knowing; Verbal and Non-verbal Incivilities; Lack of Interest; and Lack of Respect). There were also minor themes specific to the individual participant groups such as Being Nameless (students) and Lateness (mentors).

The findings demonstrate the links between incivility, learning and emotion, and bring to the fore previously unseen dimensions such as Invisibility and Knowing and Not-knowing. They also identify a wide range of potential contributory factors. Of particular importance is the explication of learning impact as this aspect has hitherto been little explored and yet is of great significance to student learning outcomes and therefore ultimately, to patient care. Consequently, the recommendations have policy and resource implications for the providers of nurse education.

The research was conducted in a higher education institution in the south east of England where the researcher, a registered nurse teacher, works in an academic leadership role. It appears to be the first phenomenological exploration of incivility in the context of nursing education in the UK, and as such it provides a rich and contextualised exploration that others working in similar settings can learn from. It also adds a UK perspective to a phenomenon that is reported by nurse educators around the world, and so makes an original knowledge contribution to the global nursing community.