Negative Acts in the Courtroom: Characteristics, Distribution, and Frequency among a National Cohort of Danish Prosecutors.

Danish prosecutors report exposure to negative acts from professional counterparts in courtrooms, which is associated with an increased risk of burnout. However, knowledge of the characteristics of these acts is limited. Based on existing theoretical frameworks, this study aims to characterize these negative acts. A nation-wide survey of Danish prosecutors (response rate: 81%) yielded 687 descriptions of experiences with negative acts from professional counterparts from a career perspective. These were analyzed using theory-directed content analysis based on the Stress-as-Offense-to-Self (SOS) theory by Semmer and colleagues and Cortina and colleagues' characterization of incivility in American courtrooms. We identified a total of 15 types of behavior within the three main themes: illegitimate tasks (n = 22), illegitimate stressors (n = 68), and illegitimate behavior (n = 612). Tentative differences in the distribution of experienced negative acts from a career perspective were found for gender and seniority. Women reported negative acts more frequently than men, and assistant prosecutors reported verbal abuse more frequently than senior prosecutors, who, conversely, more often reported a perceived lack of court management. More prospective research is needed on negative acts experienced by prosecutors to assess the scope of these in Danish courtrooms and how they impact the risk of burnout.

Not all uncivil behaviours are equal: exploring responses to incivility in veterinary practice using vignettes.

Workplace incivility is considered a common workplace stressor, linked to a range of adverse impacts such as reduced wellbeing. However, there is a lack of research focused on how targets of incivility respond. The current study addresses that gap by examining responses to incivility within veterinary practice. Veterinarians and veterinary nurses (n = 132) evaluated six scenarios depicting two types of incivility (direct e.g. demeaning comments/indirect, for example, ignoring someone) across three instigators (clients, co-workers, senior colleagues), reporting their perception and appraisal of the uncivil behaviour depicted along with potential responses. Direct incivility was linked to responses such as reciprocation, exit, and support seeking, whereas indirect incivility was associated with affiliative and ignoring responses. Negative appraisal of incivility predicted a higher likelihood of exit, avoidance, support seeking and reporting responses. These findings suggest that incivility targets utilise a broad range of response options and adapt their response dependent on the situation.

This study investigated the influence of incivility type (direct/indirect) and instigator (client/co-worker/senior colleague) on response selection within veterinary practice. Participant responses were linked to incivility type and instigator status, indicating that utilisation of responses can be variable and adaptive to the situation.

Challenges of Incivility in Dental Practice and Education.

Professional collaboration is a key component of patient care and a source of fulfilment for oral health care providers. However, reports of incivility in employment as well as education are increasing impacting individuals in all settings including patients. Uncivil behavior implies a disregard for others and creates an atmosphere of disrespect, conflict, and stress. In contrast, civility towards others implies polite, respectful behavior towards others. This short report presents case studies in dental hygiene clinical practice and in dental hygiene education with strategies for approaching uncivil behavior.

Health hazards in sports: Exploring the influence of despotic leadership and perceived organizational politics on well-being.

In recent years, the concept of despotic leadership has garnered considerable attention in sports. Despotic leadership significantly reflecting leaders' deviant behavior has today heightened the risk of health hazards in the workplace. In addition, the perceived organizational politics have also yielded a deleterious result on employees' well-being. In the dynamic landscape of healthcare, understanding the implications of organizational behavior on well-being is paramount for risk management. This study elucidates the relationships between despotic leadership, perceived organizational politics, workplace incivility, emotional exhaustion, person-organization unfit, and health harm, which can pose significant risks in a healthcare setting. The quantitative study was conducted using an empirical survey with respondents representing sports organizations. A Partial Least Squares Structural Equation Model (PLS-SEM) was used to analyze data from 429 participants using Smart PLS. The study findings suggest that despotic leadership and perceived organizational politics can lead to increased risks, manifested as workplace incivility, emotional exhaustion, and person-organization unfit. These organizational risks subsequently translate to tangible health harm for employees. Mediation analyses revealed that workplace incivility, emotional exhaustion, and person-organization unfit mediate the detrimental health outcomes rooted in leadership and organizational politics. The study underscores the urgent need for risk management strategies to foster a healthier organizational culture and leadership approach in healthcare settings. This will ensure enhanced employee well-being and a reduction in associated health risks, thus aligning with best practices in healthcare policy.

Grace Under Pressure: a mixed methods impact assessment of a verbatim theatre intervention to improve healthcare workplace culture.

BACKGROUND: Healthcare workplace mistreatment has been documented globally. Poor workplace behaviour, ranging from incivility to bullying and harassment, is common in healthcare, and contributes significantly to adverse events in healthcare, poor mental health among healthcare workers, and to attrition in the healthcare workforce, particularly in junior years. Poor workplace behaviour is often normalised, and is difficult to address. Verbatim theatre, a form of research informed theatre in which plays are created from informants' exact words only, is particularly suited to facilitating workplace culture change by raising awareness about issues that are difficult to discuss. The objective of this study was to assess the impact of the verbatim theatre play 'Grace Under Pressure' on workplace culture in NSW hospitals. METHODS: The intervention was conducted in 13 hospitals from 8 Local Health Districts (LHDs) in NSW, Australia, in October and November 2019, with aggregated impact across all sites measured by a bespoke survey ('Pam McLean Centre (PMC) survey') at the conclusion of the intervention. This study was conducted in 3 Local Health Districts (one urban, one regional, one remote), with data collection conducted in November-December 2019 and December 2020. The study design was a mixed methods assessment of the play's impact using (1) validated baseline measures of psychosocial risk, analysed descriptively, (2) overall findings from the PMC survey above, analysed descriptively, (3) interviews conducted within a month of the intervention, analysed thematically and (4) interviews conducted one year later, analysed thematically. RESULTS: Half (51.5%) of the respondents (n = 149) to the baseline survey had scores indicating high risk of job strain and depressive symptoms. Of 478 respondents to the PMC survey (response rate 57%), 93% found the play important, 92% recommended others see the play, 89% considered that it stimulated thinking about workplace behaviour, and 85% that it made discussing these issues easier. Thematic analysis of interviews within one month (n = 21) showed that the play raised awareness about poor workplace behaviour and motivated behaviour change. Interviews conducted one year later (n = 6) attributed improved workplace culture to the intervention due to improved awareness, discussion and capacity to respond to challenging issues. CONCLUSIONS: Verbatim theatre is effective in raising awareness about difficult workplace behaviour in ways that motivate behaviour change, and hence can be effective in catalysing real improvements in healthcare workplace culture. Creative approaches are recommended for addressing similarly complex challenges in healthcare workforce retention.

The effect of nurses' perceived workplace incivility on their presenteeism and turnover intention: The mediating role of work stress and psychological resilience.

AIM: This study aims to determine the effects of nurses' perceived workplace incivility on nurses' presenteeism and turnover intention and to reveal the mediating role of work stress and psychological resilience in the possible impact. BACKGROUND: Nurses directly contribute to the treatment of patients. The problems nurses encounter in the workplace can negatively affect nurses' attitudes towards work. Therefore, the problems faced by nurses should be determined. METHODS: This study complies with the STROBE checklist. This cross-sectional survey was conducted with 302 nurses working in a university hospital in the Konya province of Turkey. Data were collected in May-July 2021. The questionnaire consisted of six parts: sociodemographic characteristics form, workplace incivility scale, psychological resilience scale, work stress scale, turnover intention scale and presenteeism scale. The data were analysed using descriptive statistical methods and partial least-squares path analysis. RESULTS: It was determined that workplace incivility positively and significantly affected turnover intention, presenteeism and work stress. In contrast, it negatively and significantly affected psychological resilience. In addition, psychological resilience played a mediating role in the effect of workplace incivility on presenteeism. CONCLUSION: The results reveal that the behaviours of incivility encountered by nurses in the workplace increase their presenteeism and turnover intention, and work stress further strengthens these effects. The psychological resilience of nurses is a factor that can help them eliminate their negative emotions and attitudes. Therefore, it is recommended that nursing and health managers first identify the stress factors in the workplace and be determined to fight them. In addition, organizing training and providing psychological support to increase nurses' psychological resilience may enable nurses to develop more positive feelings about their jobs and workplaces. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nursing and health managers must determine workplace incivility behaviours and inform all employees about these behaviours, their consequences and how to deal with such incivility. In addition, nursing and health managers must determine the stress factors in the workplace and be adamant about combating these factors. In addition, nursing and health managers must give importance to training that will increase the psychological resilience of nurses.

[The current situation and influencing factors of depersonalization in clinical nurses].

Objective: To investigate the depersonalization status and to analyze the effect of workplace incivility perception, intrusive rumination and fear of negative evaluation on depersonalization in clinical nurses. Methods: In May 2019, 10 cities were selected as sampling cities by the method of grabbing random ball in Henan Province and Fujian Province. Using the stratified sampling, clinical nurses were selected as the research objects for a questionnaire survey in 22 tertiary hospitals and 23 secondary hospitals, included 1200 nurses. A total of 1200 questionnaires were issued and collected, and 1159 valid questionnaires were collected with effective recovery of 96.6%. Clinical nurses were investigated by Workplace Incivility Scale, Event Related Rumination Inventory, Fear of Negative Evaluation Scale, Maslach Burnout Inventory-General Survey. The demographic characteristics of nurses' depersonalization were compared and analyzed with t test and single factor analysis of variance. The influence mechanism of workplace incivility perception, intrusive rumination and fear of negative evaluation on depersonalization was analyzed with Bootstrap. Results: Depersonalization scores were (9.3±2.6) points, 467 of those had depersonalization symptoms in clinical nurses (40.3%). The scores of depersonalization of those with <3 years of service [ (10.5±2.9) points] was higher than those with 3-10 years [ (9.1±2.8) points] and 11-31 years [ (9.0±2.9) points]. The scores of depersonalization of those with monthly earning of <3000 yuan [ (10.1±2.8) points] was higher than those with 3000-7999 yuan [ (8.4±2.7) points] and 8000-12000 yuan [ (8.0±2.9) points]. The scores of depersonalization of clinical nurses in surgical departments [ (10.0±2.9) points] was higher than those in non-surgical departments [ (8.7±2.6) points]. The scores of depersonalization of clinical nurses in tertiary hospitals [ (10.0±2.7) points] was higher than those in secondary hospitals [ (8.6±2.8) points]. The differences were statistically significant (P<0.05). Workplace incivility perception affected depersonalization through the single mediating role of intrusive rumination, fear of negative evaluation and the chain mediating role of intrusive rumination and fear of negative evaluation (ß=0.16, 0.17, 0.07, 95%CI: 0.15-0.20, 0.15-0.21, 0.03-0.09, P<0.05) . Conclusion: Workplace incivility perception directly or through the independent mediating effects of intrusive rumination or fear of negative evaluation, and the chain mediating effects of intrusive rumination and fear of negative evaluation influences the depersonalization of clinical nurses.

Incivility, Mobbing, and Abusive Supervision: A Tripartite Scale Development Study.

Using qualitative and quantitative methodologies, in three consecutive studies with employed samples, we developed measures of workplace incivility, mobbing, and abusive supervision sensitive to the nuances of a non-Western context (i.e., Türkiye). In Study 1, we first conducted 15 focus groups (N = 149), identified culture-specific and universal themes underlying the focal mistreatment types, and developed the initial scales. We then pilot-tested (N = 427) and refined the scales using exploratory factor analytic procedures. In Study 2, confirmatory factor analyses (N range = 456-524) and associations between the new scales and their widely used counterparts (N = 353) yielded evidence for the construct validity of the scales. Study 2 also involved the development of short forms of relatively long incivility and abusive supervision scales. In Study 3 (N = 482), we first examined the extent to which the three scales were operationally distinct. Second, we examined the scales' ability to predict burnout and organizational commitment. Results supported operational distinctiveness as well as the criterion-related validity of the scales. A dominance analysis revealed that the three scales had equivalent contributions in explaining the two outcome variables, further justifying their distinctiveness. We argue that the use of present scales is not necessarily restricted to the Turkish context and may prove useful more broadly in other neo-traditional contexts.

Incivility experiences of racially minoritised hospital staff, consequences for them and implications for patient care: An international scoping review.

Workplace incivility is a pervasive complex problem within health care. Incivility manifests as subtle disrespectful behaviours, which seem inconsequential. However, evidence demonstrates that incivility can be harmful to targets and witnesses through negative emotions, poorer mental health, reduced job satisfaction, diminished performance and compromised patient care. It is unclear to what extent existing research critically explores how ethnicity, culture and racism influence how hospital staff experience incivility. This global scoping review systematically analysed existing research exploring the specific ways incivility manifests and impacts racially minoritised hospital workers. Of 2636 academic and 101 grey literature articles, 32 were included. Incivility experiences were categorised into four themes: (1) Cultural control, (2) Rejection of work contributions, (3) Disempowerment at work and (4) Managerial indifference. The included articles highlighted detrimental consequences, such as negative emotions, silencing, withdrawal and reduced support-seeking behaviours. Few studies presented evidence regarding the negative impacts of incivility on patient care. Racialisation and racial dynamics are a significant factor for hospital-based incivility. Currently we do not know the extent to which racialised incivility is associated directly or, perhaps either via burnout or disengagement, indirectly with poorer care. This knowledge can inform the creation of comprehensive, evidence-based interventions to address this important issue.

The prevalence of incivility in hospitals and the effects of incivility on patient safety culture and outcomes: A systematic review and meta-analysis.

AIM: Workplace incivility is a barrier to safe and high-quality patient care in nursing workplaces and more broadly in tertiary hospitals. The present study aims to systematically review the existing evidence to provide a comprehensive understanding of the prevalence of co-worker incivility experienced and witnessed by nurses and other healthcare professionals, the effects of incivility on patient safety culture (PSC) and patient outcomes, and the factors which mediate the relationship between incivility and patient safety. METHODS: A systematic review with narrative synthesis and meta-analysis was undertaken to synthesize the data from 41 studies. DATA SOURCES: Databases searched included MEDLINE, PubMed, SCOPUS, CINAHL, PsycInfo, ProQuest, Emcare and Embase. Searches were conducted on 17 August 2021 and repeated on 15 March 2023. RESULTS: The pooled prevalence of experienced incivility was 25.0%. The pooled prevalence of witnessed incivility was 30.1%. Workplace incivility was negatively associated with the PSC domains of teamwork, reporting patient safety events, organization learning/improvement, management support for safety, leadership, communication openness and communication about error. The composite pooled effect size of incivility on these domains of PSC was OR = 0.590, 95% CI [0.515, 0.676]. Workplace incivility was associated with a range of patient safety outcomes (PSOs) including near misses, adverse events, reduced procedural and diagnostic performance, medical error and mortality. State depletion, profession, psychological responses to incivility, information sharing, help seeking, workload and satisfaction with organizational communication were found to mediate the relationship between incivility and patient safety. CONCLUSION: Experienced and witnessed incivility is prevalent in tertiary hospitals and has a deleterious effect on PSC and PSOs. A better understanding of the mechanisms of this relationship will support the development of interventions aimed at reducing both incivility and patient harm. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE IMPACT: This study quantifies the effect of incivility on PSC and outcomes. It provides support that interventions focusing on incivility are a valuable mechanism for improving patient care. It guides intervention design by highlighting which domains of PSC are most associated with incivility. It explores the profession-specific experiences of workplace incivility. REPORTING METHOD: This report adheres to PRISMA reporting guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. The focus of this study is the nursing and healthcare workforce, therefore, patient or public involvement not required.

Acts of xenophobia among nurse educators: A qualitative study.

Background: Xenophobia has been in existence for centuries, though subtle and not too pronounced as of recent years. It has now pervaded all spheres including businesses, academia and industries. Previous studies have found it to be disruptive both to organizations and employees. Purpose: To explore acts of xenophobia among nurse educators, underpinned by the frustration and aggression theory. Method: A qualitative study involving twenty-five nurse educators in Botswana was carried out between July 2019 and August 2020. Open-ended semi-structured questions were used to collect face to face in-depth interviews from participants. Findings: Dehumanizing comments, labelling and discrimination were the three themes that emerged from interpretative analysis. Affected persons were mostly foreign nationals and people of different ethnic groupings. Conclusion: The study concluded that there is need for a policy that addresses acts of xenophobia and an intervention to mitigate acts of xenophobia.

Predicting frontline employees' emotional labor after suffering customer incivility: A job passion perspective.

The phenomenon of customer incivility poses significant challenges for frontline employees whose expression of emotion determines the service experience. Few studies have explored the mediating mechanisms linking customer incivility to frontline employees' emotional labor. Drawing on the dualistic model of job passion theory, we proposed job passion as a feasible mediator of the links from customer incivility to frontline employees' emotional labor. Using data from 1040 frontline employees across the retailing, banking, and hospitality sectors, the results indicate that job passion acts as the psychological mechanism underlying the relationships between customer incivility and frontline employees' emotional labor. Specifically, customer incivility is positively associated with frontline employees' surface acting through both obsessive passion and harmonious passion. Conversely, customer incivility is negatively linked with deep acting only through harmonious passion. Our findings clarify the psychological mechanisms through which customer incivility affects frontline employees' emotional labor from the perspective of job passion. Furthermore, the current study also extends the job passion model to the boundary-spanning context to explain how frontline employees respond to customer incivility. This study sheds light on how service practitioners can support frontline employees in dealing with customer incivility.

Strategies for Developing a Nurturing Environment for the next Generation of Nurses.

With the introduction of more complex health conditions and the changing landscape of the healthcare infrastructure, burnout is increasingly becoming a crisis for the nursing profession and for the public. Recruitment in nursing must consider the concept of a nurturing environment as a key driver of sustainability within the profession. Human beings cannot flourish in hostile and unwelcoming environments. Failure to thrive in nursing is a real phenomenon that is driven by multiple factors, including incivility, workplace bullying, and lack of support. Mitigation requires intentional, strategic interventions toward building nurturing environments in education and practice for the next generation of nurses.

Interventions for Preventing and Resolving Bullying in Nursing: A Scoping Review.

Bullying in the workplace is a serious problem in nursing and has an impact on the well-being of teams, patients, and organisations. This study's aim is to map possible interventions designed to prevent or resolve bullying in nursing. A scoping review of primary research published in English and Italian between 2011 and 2021 was undertaken from four databases (Cochrane Collaboration, PubMed, CINAHL Complete, and PsycInfo). The data were analysed using Arksey and O'Malley's framework, and the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) Checklist was followed to report the study. Fourteen papers met the review eligibility criteria. The analysis revealed four main themes: educational interventions, cognitive rehearsal, team building, and nursing leaders' experiences. Interventions enabled nurses to recognise bullying and address it with assertive communication. Further research is needed to demonstrate these interventions' effectiveness and if they lead to a significant decrease in the short-/long-term frequency of these issues. This review increases the available knowledge and guides nurse leaders in choosing effective interventions. Eradicating this phenomenon from healthcare settings involves active engagement of nurses, regardless of their role, in addition to support from the nurse leaders, the organisations, and professional and health policies.

Family-to-work conflict and instigated incivility: The role of negative affect and family supportive supervisor behaviours.

While prior research has extensively explored outcomes of family to-work conflict (FWC), our understanding of how FWC may impact employees' negative interpersonal behaviours at work such as workplace incivility is limited. Given the serious implications of workplace incivility, the current study seeks to understand the relationship between FWC and instigated incivility via the mediating role of negative affect. The moderating role of family supportive supervisor behaviours (FSSB) is also investigated. We collected data from 129 full-time employees over three waves with six weeks in between. Results revealed that FWC positively predicted instigated incivility, and negative affect mediated this relationship. In addition, the positive effect of FWC on negative affect as well as the indirect effect of FWC on instigated incivility through negative affect were weaker for individuals experiencing more FSSB, suggesting that family related support from supervisors may attenuate the effect of FWC on employees' negative affect and its indirect effect on instigated incivility via negative affect. Theoretical and practical implications are also discussed.

Coping with disruptive patients: Perspectives of primary care employees.

BACKGROUND: The impact of patient aggression on primary health care employees is underexplored, yet imperative to address, given high rates of burnout. OBJECTIVE: We qualitatively explore perceptions of patient aggression among staff in women's health primary care at the Veterans Health Administration (VA). Our objective is to identify coping strategies that staf devised in response to aggressive behavior. METHODS: We conducted semi-structured interviews with 60 VA women's health primary care employees in 2021 and 2022. Informed by the Job Demands-Resources theoretical model, we used rapid qualitative analysis to identify themes related to patient aggression and employee coping strategies. RESULTS: Disruptive behaviors reported by participants included verbal and physical aggression. Staff cited disruptive patient behavior as emotionally draining and perceived a lack of consequences for low-level aggression. Respondents used coping strategies in response to patient aggression at three time points: before, during, and after a negative interaction. At each point, support from team members emerged as a dominant coping mechanism, as well as rapport-building with patients. CONCLUSION: Patient aggression can negatively impact the work experiences of primary care employees. At VA, women's health primary care staff have devised multiple strategies to cope with these interactions. However, the ability to effectively prevent and manage patient aggression is limited by the lack of meaningful repercussions for aggression at the organizational level, which has important implications for employee well-being and retention. Retention of women's health employees in VA is critical given the need for a highly specialized workforce to address the complex health needs of women veterans.

Does adolescent incivility longitudinally predict future bullying?

INTRODUCTION: Adolescent bullying is a complicated behavior that is difficult to prevent. Understanding factors that predict bullying during adolescence can help us minimize such behavior. Classroom incivility is a low-level antisocial behavior that has been discussed in the literature as being a potential predictor of bullying in adolescence. Therefore, the goal of the present study was to examine the longitudinal link between classroom incivility and bullying. METHODS: Data for the current study was collected using quantitative surveys at two-time points, three years apart (November 2019 and November 2022) in southern Ontario, Canada. Our sample comprised 349 adolescents (51.3% boys, 46.4% girls, 0.6% other, and 1.7% preferred not to say) between the ages of 9 and 14 years old (M = 11.92 years; SD = 1.42). We utilized cross-lagged analyses to examine the stability of classroom incivility in adolescence, and the longitudinal association between classroom incivility and bullying. RESULTS: Classroom incivility at Time 1 predicted bullying behavior at Time 2, while bullying at Time 1 did not predict classroom incivility at Time 2. Our results not only support the stability of levels of classroom incivility across time, but also provide empirical support for classroom incivility as a precursor to bullying behavior. CONCLUSION: Our study suggests that classroom incivility can not only negatively impact the learning environment but may also be implicated in contributing to the circumstances that promote bullying behavior in adolescence, highlighting the importance of limiting uncivil behavior before it escalates into more severe forms of behavior.

"It is Essentially About Treating Each Other Well": Insights from Faculty on Incivility in Nursing Education.

STUDY BACKGROUND: Incivility in nursing educational institutions, which may be perpetrated by both students and faculty, is troubling given that such institutions have a mandate to prepare students for caring, relational nursing practice. PURPOSE: The purpose of this study was to contribute to understanding nursing academic incivility through an examination of nursing faculty's perspectives on student and faculty incivility. METHODS: The study was conducted using a mixed methods, descriptive, survey design with collection and analysis of quantitative and qualitative data. The sample consisted of 52 faculty members. RESULTS: A large majority of faculty thought that incivility in the nursing academic environment is a problem, with most considering it to be a mild or moderate problem. Students acted unprofessionally by showing disrespect, displaying superiority, engaging in disruptive behaviors, or not taking responsibility for their role in their learning. Faculty acted unprofessionally by showing disrespect, displaying superiority, or not being supportive. Faculty perceived that stress, personality, failure to deal with incivility, and an attitude of entitlement contributed to incivility. They thought that educational interventions, policies, and an academic environment that is conducive to civility are needed to address the problem. CONCLUSION: Until evidence is available to support the effectiveness of interventions for academic incivility, nursing educational institutions are encouraged to implement strategies suggested by faculty in this study.

Clinician responses to disruptive intraoperative behaviour: patterns and norms identified from a multinational survey.

PURPOSE: Disruptive intraoperative behaviour can have detrimental consequences for clinicians, institutions, and patients. The way victims and witnesses respond to disruptive behaviour can ameliorate or exacerbate consequences. Nevertheless, previous research has neither described the responses of a multinational sample of clinicians nor developed tools to recognize and evaluate responses. METHODS: After obtaining ethics committee approval, 23 perioperative organizations distributed a survey evaluating clinician responses to disruptive behaviour. We grouped responses into four response strategies: passive, assertive, manipulative, and malicious. Thereafter, we derived norms (i.e., percentile distributions) for each response strategy using empirical distribution functions. Latent profile analysis identified groups of clinicians balancing their use of the four response strategies differently (i.e., response pattern groups). We used Chi square tests to examine associations between response pattern groups and respondent demographics. RESULTS: We analyzed 4,789 complete responses. In response to disruptive behaviour, 33.7% of clinicians altered medical care in ways that were unindicated, 54.6% avoided communication with team members, and 12.1% misled the offender. Profile analysis identified five response pattern groups: extreme passive-predominant (30.5% of clinicians), extreme assertive-predominant (20.5%), moderate passive-predominant (18.9%), moderate assertive-predominant (26.5%), and a disparate pattern (greater use of manipulative and malicious responses) (3.5%). Profession, sex, management responsibilities, and sexual orientation predicted the response pattern group (all, P < 0.001). DISCUSSION: The responses of thousands of clinicians involved passivity, manipulativeness, or maliciousness. We present norms and a response pattern classification to help organizations evaluate responses, recognize response patterns, and provide tailored support to victims and witnesses.

RéSUMé: OBJECTIF: Les comportements peropératoires perturbateurs ont des effets délétères tant sur l'équipe clinique que sur les institutions et la patientèle. La façon dont les victimes et les témoins réagissent à un comportement perturbateur peut en atténuer ou exacerber les conséquences. Néanmoins, les recherches antérieures n'ont pas décrit les réponses d'un échantillon multinational de clinicien·nes ni développé d'outils pour reconnaître et évaluer les réponses. MéTHODE: Après l'obtention de l'approbation du comité d'éthique, 23 organisations de soins périopératoires ont distribué un sondage évaluant les réponses des cliniciennes et cliniciens aux comportements perturbateurs. Nous avons regroupé les réponses en quatre stratégies de réponse : passive, assertive, manipulatrice et malveillante. Par la suite, nous avons dérivé des normes (c'est-à-dire des distributions centiles) pour chaque stratégie de réponse à l'aide de fonctions de distribution empiriques. L'analyse des profils latents a permis d'identifier des groupes de clinicien·nes équilibrant différemment leur utilisation des quatre stratégies de réponse (c.-à-d. des groupes de modèles de réponse). Nous avons utilisé des tests du chi carré pour examiner les associations entre les groupes de modèles de réponse et les données démographiques des répondant·es. RéSULTATS: Nous avons analysé 4789 réponses complètes. En réponse à un comportement perturbateur, 33,7 % des clinicien·nes ont modifié les soins médicaux d'une manière qui n'était pas indiquée, 54,6 % ont évité de communiquer avec les membres de l'équipe et 12,1 % ont induit la personne délinquante en erreur. L'analyse du profil a permis d'identifier cinq groupes de modèles de réponse : passif extrême-prédominant (30,5 % des clinicien·nes), affirmation de soi extrême-prédominante (20,5 %), passif modéré-prédominant (18,9 %), affirmation de soi modérée-prédominante (26,5 %) et attitudes disparates (utilisation accrue de réponses manipulatrices et malveillantes) (3,5 %). La profession, le sexe, les responsabilités de gestion et l'orientation sexuelle prédisaient le groupe de type de réponse (tous, P < 0,001). DISCUSSION: Les réponses de milliers de clinicien·nes impliquaient la passivité, la manipulation ou la malveillance. Nous présentons des normes et une classification des modèles d'intervention pour aider les organisations à évaluer les réponses, à reconnaître les modèles d'intervention et à fournir un soutien personnalisé aux victimes et aux témoins.

Perceptions of Incivility Among Dental Hygiene Students and Faculty/Administrators.

Purpose While incivility has been part of higher education for many years, there has been a documented increase as both students and educators have begun to recognize this behavior and its effects on student learning, faculty satisfaction and stress. The purpose of this descriptive study was to investigate the perceptions of incivility among dental hygiene students and faculty/administrators.Methods This study utilized a convenience sample of five dental hygiene programs in California. The Incivility in Higher Education-Revised survey (IHE-R) was adapted to obtain data regarding perceptions of incivility among dental hygiene students and faculty/administrators. The survey required participants to describe incivil encounters and the perceived reasons for and consequences of the incivil behavior. An online survey was used for faculty and a paper survey was administered for dental hygiene students. Data from the open-ended questions were reviewed, summarized, edited for redundancy, and analyzed using categories.Results Of the 196 participants, 81.63% were dental hygiene students (n = 160) and 18.37% were dental hygiene faculty and administrators (n = 36). Data analysis of participant responses related to the primary reason for incivil behavior in dental hygiene education revealed five categories including lack of consequences, personality traits, miscommunication, stress, and lack of professionalism. Upon data analysis of participant responses related to the most significant consequence of incivil behavior in dental hygiene education, five categories emerged including hostile environment, decreased student success, emotional distress, relationship damage, and professional damage.Conclusion Both faculty and students felt there was a lack of consequences for incivil behavior and did not feel adequately equipped to manage these situations when they arose. Dental hygiene institutions and professional organizations need to consider offering advanced training in creating a culture of civility to prevent and address incivil behaviors.