Civility Matters™ Licensed Works Descriptions

The revised Incivility in Nursing Education (INE-R) Survey is based on the original INE (developed in 2004) which has been shown to be extremely valid and reliable. The psychometric analysis of the INE-R is also very robust. Some unique features of the INE-R include:

• Mixed method design structure with quantitative and qualitative items
• Students and faculty complete the same survey to measure both groups’ perceptions of civility and incivility
• Demographic items may be modified to ‘fit’ the study
• May be used as an assessment tool to measure perceived levels of faculty and student incivility and ways to promote civility
• May be used to stimulate dialogue among nursing administrators, faculty, and students about prevention and intervention strategies for addressing incivility in nursing education

A sample of the INE-R is available here. The INE-R may be licensed online in accordance with the Civility Matters™ Copyright License Terms and Conditions (OTT-0035).

SOURCE FOR SCORING THE INE-R:

Clark, C.M., Barbosa-Leiker, C., & Gill, L., Nguyen, D.T. (2015). Revision and Psychometric testing of the Incivility in Nursing Education (INE) Survey: Introducing the INE-R, Journal of Nursing Education, 54(6), 306-315. doi: 10.3928/01484834-20150515-01.

ADDITIONAL SOURCES

Urban, R. W., Smith, J. G., Wilson, S. T., & Cipher, D. J. (2021). Relationships among stress, resilience, and incivility in undergraduate nursing students and faculty during the COVID-19 pandemic: Policy implications for nurse leaders. Journal of Professional Nursing, 37(6), 1063-1070. doi.org/10.1016/j.profnurs.2021.08.011

Kassem, A. H., & Mohammed, B. A. (2019). Incivility behavior and engagement among Technical and Health Institute Nursing Students at the Classroom. International Journal of Nursing Didactics, 9(05), 19-28.

Al-Jubouri, M. B., Samson-Akpan, P., & Jaafar, S. A. (2019). Validity and Reliability of the Arabic Version of the Incivility in Nursing Education-Revised Scale. International journal of nursing education scholarship, 16(1), https://doi.org/10.1515/ijnes-2019-0074

Abedini, Z., & Parvizy, S. (2019). The Effects of Group Discussion and Self-Learning on Nursing Students’ Civility. Iranian Journal of Nursing and Midwifery Research, 24(4), 268–273. https://doi.org/10.4103/ijnmr.IJNMR_212_18

Pyles, M. (2016). How nurse educators cope with incivility. American Journal of Nursing Research. 4(3), 56-68. doi: 10.12691/ajnr-4-3-2

De Gagne, J. C., Kang, H. S., & Hyun, M. S. (2016). Psychometric properties of the Korean version of the incivility in nursing education-revised (INE-R) survey. Nursing & health sciences, 18(4), 425–434. doi.org/10.1111/nhs.12285

Clark, C. M., Farnsworth, J., & Landrum, R. E. (2009). Development and description of the Incivility in Nursing Education (INE) survey. Journal of Theory Construction and Testing, 13(1), 7–15.

The IHE survey was first developed by Dr. Clark in 2007. It was adapted from the Incivility in Nursing Education (INE) survey, and later revised (2015).  The IHE-R is essentially a carbon copy of the Incivility in Nursing Education-Revised (INE-R)—the survey reflects higher education in general versus being nursing-specific. It may be used to measure differences in perceptions of academic incivility between and among disciplines in higher education.

A sample of the IHE-R is available here. The IHE-R may be licensed online in accordance with the Civility Matters™ Copyright License Terms and Conditions (OTT-0035).

SOURCE FOR SCORING THE IHE-R (Same scoring as the INE-R)

Clark, C.M., Barbosa-Leiker, C., & Gill, L., Nguyen, D.T. (2015). Revision and Psychometric testing of the Incivility in Nursing Education (INE) Survey: Introducing the INE-R, Journal of Nursing Education, 54(6), 306-315. doi: 10.3928/01484834-20150515-01.

Wagner, B., Holland, C., Mainous, R., Matcham, W., Li, G., & Luiken, J. (2019). Differences in perceptions of incivility among disciplines in higher education. Nurse Educator, 44(5), 265–269.

ADDITIONAL SOURCES:

Stephens, K. (2020). An evaluation of incidence and perceptions of incivility among dental hygiene students and Faculty/Administrators (Order No. 28086388). Dissertation. Available from ProQuest Central.

Smith, D. L. (2018). Exploring incivility among nursing and health science students: A descriptive study (Order No. 10839592). Dissertation. Available from ProQuest Central.

Allari, R. S. (2016). Psychometric properties of the Arabic version of incivility in higher education survey (IHE-R). Journal of International Academic Research for Multidisciplinary, 4(6), 207-216.

The Incivility in Online Learning Environments© Survey was developed by Dr. Clark in 2011; the IOLE measures student and faculty perceptions of incivility in the online learning environment and ways to effectively address the problem.

A sample of the IOLE is available here. The IOLE may be licensed online in accordance with the Civility Matters™ Copyright License Terms and Conditions (OTT-0035).

SOURCES FOR SCORING THE IOLE:

Clark, C. M., Ahten, S. M., & Werth, L. (2012). Cyber-bullying and incivility in the online learning environment: Part Two – Promoting student success in the virtual classroom. Nurse Educator, 37(5),192-197. doi: 10.1097/NNE.0b013e318262eb2b.

Clark, C. M., Werth, L., & Ahten, S. (2012). Cyber-bullying and incivility in the online learning environment: Part One – Addressing faculty and student perceptions. Nurse Educator, 37(4), 150-156. doi: 10.1097/NNE.0b013e31825a87e5.

ADDITIONAL SOURCES:

Farid, H., Hasan, S.J., Naveed, A., Hyder, P.R., Shaikh, G.M., & Pasha, L. (2022). Incivility in online learning environment: Perception of dental students and faculty. Journal of Dental Education, 1-11. https://doi.org/10.1002/jdd.13031

Cain, L. B. (2017). Relationship between age, gender, and incivility in online registered nurses to Bachelor of Science in nursing degree classes (Order No. 10259128). Dissertation. Available from ProQuest Central.

McNeill, J., Dunemn, K., Einhellig, K. S., & Clukey, L. (2016). Exploring nursing student and faculty perceptions of incivility in the online learning environment. Journal of Nursing Education and Practice, 7(5), 45. doi.org/10.5430/jnep.v7n5p45

Dr. Clark developed the Workplace Incivility/Civility Survey (WICS) in 2014 to measure perceptions of and frequency with workplace incivility from a broad co-worker perspective and includes ways to foster civility and healthy workplaces.  The WICS has been used in numerous studies including a national study to measure civility and incivility in nursing education.

A sample of the WICS is available here. The WICS may be licensed online in accordance with the Civility Matters™ Copyright License Terms and Conditions (OTT-0035).

SOURCE FOR SCORING THE WICS:

Clark, C.M. Landis, T., Barbosa-Leiker, C. (2021). National study on faculty and administrators’ perceptions of civility and incivility in nursing education. Nurse Educator, 46(5):276-283. doi: 10.1097/NNE.0000000000000948.

ADDITIONAL SOURCES:

McGee, P. L. (2021). A descriptive study of faculty-to-faculty incivility in nursing programs in the United States. Journal of Professional Nursing, 37(1), 93-100. doi.org/10.1016/j.profnurs.2020.07.004

Lindquist, K. S. (2019). Faculty incivility and academic nurse administrator job satisfaction (Order No. 13884055). Dissertation. Available from ProQuest Central.

Chihak, C. (2018). Faculty to faculty incivility in Iowa nursing education programs, Dissertations and Theses @ UNI. 601. https://scholarworks.uni.edu/etd/601

The Clark Workplace Civility Index (CWCI)© is a 20-item psychometrically sound instru­ment used to measure perceptions of workplace civility among individuals and groups within work environments. The index may be completed as an individual or group/team exercise to improve self-awareness, give and receive constructive feedback, and form the basis for discovering and continuing strengths and addressing areas for improvement.

A sample of the CWCI is available here. The CWCI may be licensed online in accordance with the Civility Matters™ Copyright License Terms and Conditions (OTT-0035).

SOURCE:

Clark, C.M., Barbosa-Leiker, C., Sattler, V. (2018). Development and psychometric testing of the Workplace Civility Index: A reliable tool to assess workplace civility, Journal of Continuing Education in Nursing, 49(9), 400-406.

The Clark Everyday Civility Index (CECI)© is a 20-item survey designed to measure civility in everyday interactions. The index measures the perceived level of civility which encompasses not only the workplace, but home, community, neighborhood, society, and the public square.

A sample of the CECI is available here. The CECI may be licensed online in accordance with the Civility Matters™ Copyright License Terms and Conditions (OTT-0035).

SOURCES:

Clark, C.M. (2022). Core competencies of civility in nursing & healthcare. Sigma Theta Tau International Publishing.

Clark, C.M. (2020, October 18). The Imperative of Civility and Community in Uncertain Times, Plenary Session, American Association of Colleges of Nursing (AACN), Academic Nursing Leadership Conference.

The Clark Civility Index for Faculty (CCIF)© is a 20-item evidence-based survey used to measure perceptions of faculty civility within the faculty role. The index is designed to raise awareness and determine strengths and opportunities for civility improvement within the learning environment. The index may be completed as an individual self-reflection exercise or completed with a colleague to garner another perspective of one’s civility acumen.

A sample of the CCIF is available here. The CCIF may be licensed online in accordance with the Civility Matters™ Copyright License Terms and Conditions (OTT-0035).

SOURCES:

Clark, C.M. (2022). Core competencies of civility in nursing & healthcare. Sigma Theta Tau International Publishing.

Clark, C. M. (2017). Creating and sustaining civility in nursing education, 2nd ed., Indianapolis, IN: Sigma Theta Tau International Publishing.

The Clark Civility Index for Students and Classmates (CCISC)© is a 20-item evidence-based tool that can be completed individually by students to assess civility acumen in the student role, and/or used to assess their classmates’ perceived level of civility and incivility within the learning environment. The purpose of the survey is to raise awareness, generate discussion, discuss varying perceptions of civility and incivility, and develop ways to improve civility acumen.

A sample of the CCISC is available here. The CCISC may be licensed online in accordance with the Civility Matters™ Copyright License Terms and Conditions (OTT-0035).

SOURCES:

Clark, C.M. (2022). Core competencies of civility in nursing & healthcare. Sigma Theta Tau International Publishing.

Clark, C. M. (2017). Creating and sustaining civility in nursing education, 2nd ed., Indianapolis, IN: Sigma Theta Tau International Publishing.

The Clark Healthy Work Environment Inventory (CHWEI)© is a 20-item psychometrically sound instrument used to measure perceptions of work environment health, to determine areas of workplace strength and improvement, and to form the basis for interviewing questions.

A sample of the CHWEI is available here. The CHWEI may be licensed online in accordance with the Civility Matters™ Copyright License Terms and Conditions (OTT-0035).

SOURCES:

Clark, C.M., Sattler, V. P., Barbosa-Leiker, C (2016). Development and testing of the Healthy Work Environment Inventory (HWEI): A reliable tool for assessing work environment health and satisfaction, Journal of Nursing Education, 55(10), 555-562.

Bernard, Sanford, A., Duffy, A., Rechenberg, K., Lopez, M., & Brown, K. (2022). Evaluating the impact of a school of nursing civility team. Nurse Educator, 47(3), 180-183. doi: 10.1097/NNE.0000000000001120.

Based on empirical research, Dr. Clark developed a conceptual model to illustrate the intricate and complex “dance” of incivility and civility in nursing education. The large, oval circle depicts the reciprocal nature of faculty and student encounters. The center of the model displays a midpoint where high levels of faculty and student stress intersect. This high stress intersection is influenced by several factors including attitudes of student entitlement and faculty superiority, demanding student and faculty workloads, faculty balancing teaching acumen with clinical competence, technology overload, and a general lack of skills in managing conflict. While encounters between faculty and students occur constantly and consistently even when stress levels are low; however, when stress levels are heightened, the encounters can be more intense and may result in disruptive or threatening behaviors. These behaviors combined with heightened stress levels and ineffective coping may increase the potential for incivility and are displayed on the model. The double-sided arrow in the center of the model represents the dynamic continuum of ongoing opportunities for faculty and student engagement to prevent or deescalate a potentially volatile situation. The left side of the model illustrates an escalating spiral of incivility that may occur when remedies, encounters, and opportunities to resolve the conflict are missed, avoided, or poorly managed. When these omissions or avoidances occur, the result may be a culture of incivility. Conversely, the right side of the model illustrates how seizing, implementing, and managing opportunities for engagement and communication well, can lead to a culture of civility. When faculty and students work together to resolve conflict, the potential for the dance of civility is enhanced and a safer, more civil learning environment is created. Incivility, whether initiated by faculty, students, or by a combination of both, presents opportunities for engagement. When faculty and students effectively communicate and actively engage with one another, a culture of civility is fostered.

A sample of the CMFCNE is available here. The CMFCNE may be licensed online in accordance with the Civility Matters™ Copyright License Terms and Conditions (OTT-0035).

SOURCES:

Clark, C.M. (2022). Core competencies of civility in nursing & healthcare. Sigma Theta Tau International Publishing.

Clark, C.M. (2013). Creating and sustaining civility in nursing education, Indianapolis, IN, Sigma Theta Tau International Publishers.

Clark, C. M., & Davis-Kenaley, B. L. (2011). Faculty empowerment of students to foster civility in nursing education: A merging of two conceptual models. Nursing Outlook, 59(3), 158-165.

Clark, C.M. (2008). The dance of incivility in nursing education as described by nursing faculty and students, Advances in Nursing Science, 31(4), E37-E54.

Clark (2008) developed a conceptual model to illustrate how heightened levels of nursing faculty and student stress, combined with attitudes of student entitlement and faculty superiority, work overload, and a lack of knowledge and skills contribute to incivility in nursing education. This conceptual model has been adapted by Clark and Olender (2011) to reflect the stressors that contribute to incivility in both nursing education and practice environments. Factors that contribute to stress in nursing practice are similar to the stressors experienced in nursing education including work overload, unclear roles and expectations, organizational conditions, and a lack of knowledge and skills. Moreover, in both the practice and academic arenas, stress is mitigated by leaders who role model professionalism and utilize effective communication skills. The importance of modeling effective communication and related education to address incivility cannot be underestimated, can reduce its incidence and effects, and can assist in fostering cultures of civility.

A sample of the CMFCNE-AP is available here. The CMFCNE-AP may be licensed online in accordance with the Civility Matters™ Copyright License Terms and Conditions (OTT-0035).

SOURCES:

Clark, C.M. (2022). Core competencies of civility in nursing & healthcare. Sigma Theta Tau International Publishing.

Clark, C. M., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering civility in nursing education and practice: Nurse leader perspectives. Journal of Nursing Administration, 41(7/8), 324-330.

The ‘Conceptual Model of Student Perceptions of Uncivil Faculty Behavior in Nursing Education’ illustrates the students’ entry into the nursing program, their perceived experiences with uncivil faculty behavior, the emotional impact of the uncivil behavior, and students’ behavioral response to incivility. The box to the reader’s left shows how students enter the nursing program with expectations of completing their nursing education and fulfilling their goal of becoming a professional nurse. In most cases, students are not exposed to acts of faculty incivility; however, in some instances, students may encounter uncivil faculty behaviors. The top box in the model illustrates how some students report various forms of uncivil faculty behavior including demeaning and belittling students, treating students unfairly, and pressuring them to conform to unreasonable faculty demands. The next box in the conceptual model refers to the students’ emotional response to perceived uncivil faculty behavior. When uncivil faculty behavior occurs, and especially if it persists over time, students describe being emotionally traumatized, experiencing a sense of powerlessness and helplessness, and feeling angry. The last box in the conceptual model denotes the students’ behavioral response to perceived faculty incivility which caused them to behave in one of three ways. Students either stayed in the program and conformed as expected (loyalty), or stayed in the program and attempted to effect change (voice), or left the program altogether (exit). These findings are consistent with Hirschman (1970) who identified three possible courses of action for people who are dissatisfied with their position in an organization.

A sample of the CMSPUFBNE is available here. The CMSPUFBNE may be licensed online in accordance with the Civility Matters™ Copyright License Terms and Conditions (OTT-0035).

SOURCE:

Clark, C. M. (2008). Student voices on faculty incivility in nursing education: A conceptual model. Nursing Education Perspectives, 29(5), 284–289.

The Continuum of Workplace Aggression (CWA) FKA the Continuum of Incivility is based on numerous empirical studies and found to be a reliable framework for displaying a range of uncivil or aggressive workplace behaviors. Uncivil behaviors exist along a continuum ranging from disruptive behaviors on one end to threatening and violent behaviors on the other. Behaviors at the left end of the continuum can be expressed by somewhat subtle behaviors, such as eye-rolling, arm-crossing, and walking away.  If left unaddressed, these behaviors may progress to more overt expressions of incivility, such as bullying, taunting, and intimidation.

A sample of the CWA is available here. The CWA may be licensed online in accordance with the Civility Matters™ Copyright License Terms and Conditions (OTT-0035).

SOURCES:

Clark, C.M. (2022). Core competencies of civility in nursing & healthcare. Sigma Theta Tau International Publishing.

Clark, C.M., Barbosa-Leiker, C., & Gill, L., Nguyen, D.T. (2015).Revision and Psychometric testing of the Incivility in Nursing Education (INE) Survey: Introducing the INE-R, Journal of Nursing Education, 54(6), 306-315.

Clark and Kenaley (2011) merged two conceptual models, one of fostering civility and another of empowerment, to illustrate how both frameworks can be combined to foster a culture of civility in nursing education. The model illustrates how the domains of motivation, psychic comfort, problem-solving, and self-direction lead to student empowerment, especially when students and faculty are actively engaged in a constructive reciprocal process to create a safe, civil academic environment. In contrast, when students lack motivation, psychic comfort, problem-solving capacity, and self-direction, they are more likely to disengage, feel insufficiently challenged, and behave in disruptive ways. Thus, it is important to foster student-centered classrooms and encourage positive student teacher relationships to increases student learning and to create civil learning environments.

A sample of the CMFESFC is available here. The CMFESFC may be licensed online in accordance with the Civility Matters™ Copyright License Terms and Conditions (OTT-0035).

SOURCE:

Clark, C. M., & Davis-Kenaley, B. L. (2011). Faculty empowerment of students to foster civility in nursing education: A merging of two conceptual models. Nursing Outlook, 59(3), 158165.