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.

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.

Role of workplace bullying and workplace incivility for employee performance: Mediated-moderated mechanism.

Workplace events play a significant role in shaping the performance of employees and organizations. Negative events, in particular, require careful attention due to their severe impact on employee wellbeing and performance. Workplace bullying and incivility are two negative events that can cause significant harm to employees and contribute to poor performance. This study examines the effects of workplace bullying and incivility on employee performance in the presence of perceived psychological wellbeing (PWB), with the moderating role of perceived organizational support (POS) considered for both independent variables and employee performance (EP). The study focuses on female nurses working in the healthcare sector of Azad Jammu and Kashmir. The results of the study indicate that workplace bullying and incivility have adverse effects on employee performance and that PWB mediates these relationships. Moreover, perceived organizational support moderates the relationship between both predictors and the employee performance criterion. In conclusion, the findings of this study highlight the importance of creating a positive and supportive work environment to mitigate the negative effects of workplace bullying and incivility on employee performance.

Incivility in the Online and Hybrid Learning Environment During the COVID-19 Pandemic Era.

ABSTRACT: With the surge in online learning since the onset of the COVID-19 pandemic, fostering civil behavior in this environment is essential. This mixed-methods study examined online incivility among faculty and students at two schools of nursing using a quantitative survey instrument with several open-ended questions addressing the impact of the pandemic. Survey results suggested that faculty ( n = 23) and students ( n = 74) experienced a low frequency of online incivility that remained potentially disruptive. Qualitative analyses suggested that the pandemic placed considerable strain on nursing faculty and students while providing increased flexibility for working and learning.

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.

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.

Incivility in healthcare: the impact of poor communication.

Incivility is a common issue within healthcare in the UK and internationally. Experienced by at least one-third of staff within the UK National Health Service, incivility has been demonstrated to have significant negative implications on both patient care and healthcare staff. These include contributing to direct medical errors, diagnostic inaccuracy and team communication, with a large associated cost burden, while for staff it has significant negative impacts on retention, productivity and morale. Proposed methods do already exist to both prevent and address incivility, and it is in the interest of healthcare institutions, for their patients and staff, to investigate incivility and adopt these methods. This review explores existing literature on the effects of incivility, researched strategies to address it, as well as the proposed ways of integrating these. Through raising awareness and exploring these issues, our aim is to increase recognition of incivility, as well as inspire healthcare managers and leaders to collectively take efforts to reduce the rates of incivility.

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.

Improving Formal Incivility Reporting in Ambulatory Oncology: Implementing the CIVIC Duty Program.

The aim of this quality improvement project was to increase formal reporting of incivility events committed by patients and their visitors on an ambulatory oncology infusion unit. Evidence-based interventions of providing edu.

Eyes on incivility in surgical teams: Teamwork, well-being, and an intervention.

Incivility in surgery is prevalent and negatively impacts effectiveness and staff well-being. The purpose of this study was to a) examine relationships between incivility, team dynamics, and well-being outcomes, and b) explore a low-cost intervention of 'eye' signage in operating theater areas to reduce incivility in surgical teams. A mixed methods design was used in an orthopedic hospital. Surveys of incivility, teamwork, and well-being were administered three months apart in a small private hospital. An intervention of signage with eyes was placed in the theater area after administration of the first survey, using a pretest-posttest design. Participants also responded to an open-ended question about suggestions for improvements at the end of the survey which was then thematically analyzed. At the individual level (n = 74), incivility was statistically significantly related to team dynamics which in turn was significantly related to burnout, stress, and job attitudes. At the aggregate level, reported incivility was statistically significantly lower after the 'eye' sign intervention. Thematic analysis identified core issues of management behaviors, employee appreciation, communication, and work practices. Incivility in surgical teams has significant detrimental associations with burnout, stress, and job attitudes, which occurs through its impact on decreased team dynamics and communication. A simple intervention that evokes perceptions of being observed, such as signage of eyes in theater areas, has the potential to decrease incivility at least in the short term, demonstrating that incivility is amenable to being modified. Additional research on targeted interventions to address incivility are needed to improve teamwork and staff well-being.

Interventions to address unprofessional behaviours between staff in acute care: what works for whom and why? A realist review.

BACKGROUND: Unprofessional behaviour (UB) between staff encompasses various behaviours, including incivility, microaggressions, harassment, and bullying. UB is pervasive in acute healthcare settings and disproportionately impacts minoritised staff. UB has detrimental effects on staff wellbeing, patient safety and organisational resources. While interventions have been implemented to mitigate UB, there is limited understanding of how and why they may work and for whom. METHODS: This study utilised a realist review methodology with stakeholder input to improve understanding of these complex context-dependent interventions. Initial programme theories were formulated drawing upon scoping searches and reports known to the study team. Purposive systematic searches were conducted to gather grey and published global literature from databases. Documents were selected if relevant to UB in acute care settings while considering rigour and relevance. Data were extracted from these reports, synthesised, and initial theories tested, to produce refined programme theories. RESULTS: Of 2977 deduplicated records, 148 full text reports were included with 42 reports describing interventions to address UB in acute healthcare settings. Interventions drew on 13 types of behaviour change strategies and were categorised into five types of intervention (1) single session (i.e. one off); (2) multiple session; (3) single or multiple sessions combined with other actions (e.g. training sessions plus a code of conduct); (4) professional accountability and reporting programmes and; (5) structured culture change interventions. We formulated 55 context-mechanism-outcome configurations to explain how, why, and when these interventions work. We identified twelve key dynamics to consider in intervention design, including importance of addressing systemic contributors, rebuilding trust in managers, and promoting a psychologically safe culture; fifteen implementation principles were identified to address these dynamics. CONCLUSIONS: Interventions to address UB are still at an early stage of development, and their effectiveness to reduce UB and improve patient safety is unclear. Future interventions should incorporate knowledge from behavioural and implementation science to affect behaviour change; draw on multiple concurrent strategies to address systemic contributors to UB; and consider the undue burden of UB on minoritised groups. STUDY REGISTRATION: This study was registered on the international database of prospectively registered systematic reviews in health and social care (PROSPERO): https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021255490 .

Recognizing and Addressing Ghosting of Nursing Candidates.

Ghosting of applicants in nursing recruitment can be considered uncivil behavior. Ghosting, or cutting off communication with another person without explanation, is a problem that can be addressed by setting organizational and industry standards for the handling of nursing applicants. This column reviews the phenomenon of ghosting in the recruitment process and offers suggestions to ensure this experience does not occur.

Faculty-to-faculty incivility in nursing academia: A qualitative systematic review.

BACKGROUND: There is limited research evidence to show that faculty-to-faculty incivility exists in nursing academia. PURPOSE: This systematic literature review aimed to synthesize the current qualitative evidence on experiences of incivility between faculty colleagues. METHODS: A meta-aggregation approach was applied according to guidelines established by the Joanna Briggs Institute. Studies published from inception to January 31, 2022 were searched from the databases including PubMed, CINAHL, Embase, Web of Science, SCOPUS, ERIC, PQDT, Ebook Central, and ProQuest Central Korea. RESULTS: Thirteen qualitative studies were included, resulting in the following six synthesized findings: (1) incivility tactics, (2) nursing academic environment that enabled incivility, (3) individual characteristics that aggravated incivility, (4) reactions to incivility, (5) coping strategies, and (6) impacts of incivility. CONCLUSIONS: Based on the synthesized findings listed above, this study offers the following four recommendations: (1) the academic culture should be improved, (2) institutional policies and procedures should be prepared, (3) faculty members should be educated on respectful communication skills, and (4) better mentoring programs should be provided to newcomers and novice faculty members. As all relevant studies were conducted in Western countries, it is important for future research to focus on issues pertaining to faculty-to-faculty incivility in Eastern culture. REGISTRATION: PROSPERO CRD42022321261.

Promoting civility and safety with cognitive rehearsal.

ABSTRACT: Uncivil behaviors have detrimental consequences that can impact healthcare team cohesion, resulting in conflicts and poor teamwork. This article details civil and uncivil behaviors and how the latter affects healthcare, and provides a tool to prepare nurses for uncivil encounters.

Translation and validation of the Italian version of the incivility in nursing education-revised scale.

BACKGROUND: Incivility in nursing education is present worldwide and impacts all those involved and the teacher-student relationship. The revised Incivility in Nursing Education (INE-R) is a validated and reliable instrument to measure academic incivility, but it is not available in Italian language. The aim of the study was to translate and validate the INE-R tool with an Italian sample. METHODS: The INE-R was translated from English into Italian, culturally adapted and piloted for content and linguistic clarity. The questionnaire was administered online to Nursing Faculty (NF) and Nursing Students (NS) of Sapienza University of Rome to assess uncivil behaviors and their frequency of occurrence. The psychometric properties of the Italian version were investigated. RESULTS: 79 Italians participated, of which 63.3 % were NS. Four-factor models provided the best fit for NF and NS scales. The models explained 78.2 % (NF) and 73.2 % (NS) of the variance of the scales. The Root Mean Square Error of Approximation for both models was 0.07, indicating an acceptable fit. INE-R reliability for all 48 NF and NS incivility items was 0.962 and 0.954, respectively. Measuring the degree of incivility and establishing codes of conduct were recommended. CONCLUSIONS: Incivility in nursing education negatively impacts the teaching-learning environment and could cause emotional or physical distress for those involved. Zero-tolerance policy regarding incivility, routine evaluation, and raising awareness among students and faculty could improve the quality of academic settings. The Italian INE-R is a valid and reliable tool that can be used to evaluate incivility in Italian nursing programs.

Developing and testing a prototype smartphone educational application to address incivility and bullying in nursing workplaces.

BACKGROUND: Incivility and bullying in the nursing workplace may induce psychological trauma and increase staff turnover, however, the effects can be mitigated by cognitive rehearsal therapy. Smartphone education applications have emerged as an important educational tool in recent years. However, to date, no educational applications have been developed that combine cognitive rehearsal approaches with clinical situations. Therefore, in this study an education application (Easy Play Communication) was developed and tested to address incivility and bullying in the nursing workplace. DESIGN/METHODS: This study design was employed in two phases. Phase 1 (February 2020-March 2021) combined analysis, design, development, implementation, and evaluation (ADDIE model) stages in the application development process. This phase involved conducting research into educational training and cognitive rehearsal literature, consultations with seven experts in related fields and administering a user needs questionnaire among 41 nurses. Phase 2 (April 2021-December 2021) was a pilot test phase, where 47 Mandarin and Taiwanese speaking nurses used the application to conduct cognitive rehearsal training. Changes in workplace incivility and bullying were tested using a pretest-posttest design. The posttest was conducted one week after the pretest. RESULTS: Phase 1 showed user satisfaction with the app's accessibility (96.3 %), practicality (81.4 %), willingness to use (92.6 %), information content (88.9 %), information quality (88.9 %), and interface quality (88.9 %). Phase 2 showed that participants' perceived incivility in their interactions with other nurses, physicians, and patients and their family members decreased over the study period. DISCUSSION/IMPLICATIONS: The findings indicate that smartphone applications combining theoretical knowledge with practical exercises can have a positive impact on nurses in the context of workplace incivility and bullying. We also demonstrated a development process that can be used to build applications for clinical nurses.