So let us begin anew—remembering on both sides that civility is not a sign of weakness, and sincerity is always subject to proof.

—John Fitzgerald Kennedy

In the second installment of this series, I discussed several important reasons for fostering civility and highlighted the critical role that nurse leaders play in creating a respectful learning environment. Nursing faculty, specifically, play a crucial and important role.

Dealing with student incivility in the academic environment is challenging and a bit like parenting. When children act out, especially teenagers, our initial response may be to withdraw rather than engage. Parents may avoid dealing with unacceptable behavior for a variety of reasons: They want to be liked, fear retaliation or are uninformed about ways to address the problem.

The same can be said for unruly and disruptive students. It may seem easier, at first, to avoid the problem, since addressing it takes a certain amount of courage and know-how, as well as a considerable amount of tact and finesse. My fundamental belief—and that of most nurses—is that investing time in preventing an undesirable event is much more effective than reacting to it. Here are several strategies to create a culture of civility in nursing education.

Focus on the academy
Ernest Boyer (1990) wrote eloquently about the important role of higher education in developing a civil society. He contended that college campuses must be open communities where freedom of expression “is uncompromisingly protected and where civility is powerfully affirmed” (p. 17). Boyer also said that college campuses should be caring communities “where the well-being of each member is sensitively supported and where service to others is encouraged” (p. 47).

Today, perhaps more than ever, student behavior tests faculty resolve and, in some cases, contributes to academic incivility. Many college students face challenges that include lack of career clarity, an ailing economy and soaring jobless rates that may require a change in career path, and increasing costs of higher education accompanied by dwindling funding sources. All of these factors contribute to a student’s stress level and, consequently, how he or she behaves.

College students are also stressed by assignment deadlines and critical feedback from faculty that may not agree with their opinion of themselves. Other stressors include a competitive, high-stakes academic environment and competing demands of school, work and family. Ever-expanding technology can also be taxing.

Since stress is closely linked to uncivil behavior, it is important to implement strategies for stress reduction, such as spending time with family, friends and pets; exercising regularly; getting fresh air and sunshine; eating healthy foods; drinking lots of water; and getting adequate sleep. Positive visualization, reflective exercises, talking with supportive people and listening to music can also help reduce stress.

An ounce of prevention
A preventive approach to classroom management can go a long way in reducing stress and averting potential problems. Faculty can implement several strategies to promote student success. To start the term on a positive note, faculty can arrive early, prepare the classroom ahead of time and greet students as they arrive. It is important to dress professionally, start and end class on time, and set an inclusive and respectful tone.

I also suggest providing a user-friendly syllabus to serve as a road map for the course. Include key elements to guide your syllabus review, such as a brief description of your teaching philosophy, a statement of shared values and the role of social discourse, links to important policies (e.g., conflict resolution, academic dishonesty) and ways for students to be successful in the course. Be clear about course objectives, and include a “behavioral” objective related to professional conduct. I also like to have students write expectations of what they hope to learn from the course. Be sure to show enthusiasm for the course content, refer to your own research or expertise, and cover essential content on the first day of class.

Co-creating class norms is one of the most important activities to accomplish on the first day of class. Establishing and revisiting norms are the bedrock of a respectful and civil teaching/learning environment. When faculty and students work together to create classroom [and clinical] norms for desired behavior, both parties are more likely to abide by them. I like to begin the “norming” session by proceeding from macro to micro. In other words, we want to develop norms that are in line with the university at large, as well as the department of nursing.

We begin by reflecting on the mission of the university and by reviewing campus commitment to civility and the statement of shared values. For example, one element of our university mission is to achieve a “vibrant culture” that fosters inclusion, responsiveness and diversity. Our statement of shared values describes campus commitment to creating and maintaining a civil community that supports respectful discourse, openness to opposing points of view and passionate argument. We also discuss norms used by nursing department faculty and staff. These documents—mission and statement of shared values—guide development of our classroom norms. This process takes about 30 minutes of class time and is worth every second. Once we establish our norms, I type them up, glue them onto small index cards and distribute them to each student the next time we meet. We revisit our norms throughout the semester, as needed, and use them to guide class discussions and activities.

It’s about learning
Students (and faculty) have different and distinct learning styles—and knowing your students’ learning styles, as well as your own, can contribute to their success. Several learning style inventories are available, all designed to help students understand their dominant way of learning and capitalize on their strengths.

Recently, I had a student who knitted from the moment class began until it ended three hours later. Although the other students didn’t seem to mind, I found her behavior curious. She tended to sit alone, seldom took notes and rarely opened the textbook. On the other hand, she readily engaged in small group work, successfully completed assignments and actively participated in classroom activities, all the while knitting, whenever possible. It became clear that this student was an auditory learner; she learned best from verbal discussions, talking about ideas and concepts, and listening. By recognizing and appreciating that each student learns differently, I could put her knitting into perspective.

It’s about teaching
Because students learn differently, using a variety of teaching approaches is important. Engaging students in active learning, using real-world examples with application to practice and encouraging students to solve complex problems, helps prevent student passivity, at best, and incivility, at worst. It is important to remember that, like nursing, teaching is both an art and a science, and being a good clinician does not necessarily make one a good teacher.

In his riveting book The Courage to Teach, Parker J. Palmer (2007) reminds us that good teachers possess a capacity for connectedness, weaving a complex web of connections among themselves, the subject matter and the students, so that students can weave a world for themselves. This weaving and connecting takes time, presence and talent. Palmer expounds, “Good teachers dwell in the mystery of good teaching until it dwells in them” (p. 11). They explore teaching alone and with others, and they discover and develop teaching methods that emerge from their own integrity. Thus, using teaching skills that help students learn is essential.

Interactive teaching skills include problem-based learning methods (a student-focused instructional strategy where students collaborate to solve problems), reflection exercises and inviting students to teach a course topic or part of a class. I also like to ask students to identify books they have read recently and their favorite music, and to relate their responses to the class. Also very important are evaluating completed assignments using grading rubrics to enhance objectivity and reduce subjectivity, being responsive and available, incorporating reflection exercises, and expecting and praising student contributions.

Creating conversation
Teaching techniques, skills, tactics and tools are very important for engaging students in the learning process and for fostering civility. However, at the end of the day, what really matters is the time we spend together in critical dialogue and meaningful conversation. Communication is a learnable skill and, with practice, we get better and better. When faculty and students communicate and seek solutions, the possibilities for change are endless. When we work together to resolve conflict and coalesce to produce change, the result is a safer, richer and more respectful learning environment for everyone. So, let’s begin or continue the conversation and work together to create a culture of civility and regard for one another in nursing education. RNL 

This article is the third in a series on civility in nursing education and practice. Other articles:

“The sweet spot of civility: My story”
“Why civility matters”
“What students can do to promote civility” 
“From incivility to civility: Transforming the culture”

References:
Boyer, E. (1990). Campus life: In search of community. Princeton, NJ: The Carnegie Foundation for the Advancement of Teaching.

Palmer, P. J. (2007). The courage to teach: Exploring the inner landscape of a teacher's life. San Francisco, CA: Jossey-Bass Publishers.