Other Titles
PechaKucha Presentation
Abstract
Andersson and Pearson (1999) introduced the concept of workplace incivility as “low-intensity deviant behavior with ambiguous intent to harm the target, in violation of workplace norms for mutual respect” (p. 457). A systematic review of the literature noted nearly two-thirds of healthcare employees have witnessed incivilities perpetuated by nurses and cited a study in which 85% of responding nurses reported experiencing incivilities in the past year (Keller et al., 2020). It has been estimated that 44% of nursing staff have been bullied in the healthcare environment (The Joint Commission, 2021).
While often used interchangeably in practice and in the literature, incivility and bullying are not the same. Incivility lacks clear intentionality on the perpetrator’s part while bullying is characterized by repetitive uncivil or aggressive behaviors (Layne et al., 2019). Because of its pervasive and ambiguous nature, this work focuses on the identification and recognition of workplace incivility to prevent bullying and improve nursing work environments. The purpose of this project is to evaluate the impact of cognitive rehearsal training on the perception and experience of uncivil behaviors among nursing staff in the workplace.
Participants will include certified nursing assistants, licensed vocational nurses, and registered nurses from two units at a pediatric rehabilitation hospital. An education module on incivility and cognitive rehearsal training will be provided during the implementation period between August 2024 and October 2024. According to one systematic review, combining multiple elements of educational training has demonstrated improvement in nurses' self-efficacy in responding to workplace incivility in six studies, and the length of the training program intervention did not impact the outcomes (Armstrong, 2018). Based on this data, the training module intervention will be a PechaKucha presentation with accompanying cueing cards. Participants will verbally rehearse and affirm effective responses to incivility and role-play scenarios in guided groups.
Pre- and post-implementation data will be collected with the Workplace Incivility/Civility Survey, the Clark Workplace Civility Index, and the Clark Healthy Work Environment Inventory. Data will be analyzed with descriptive statistics.
Notes
References: 1. Andersson, L. M., & Pearson, C. M. (1999). Tit for Tat? The spiraling effect of incivility in the workplace. Academy of Management Review, 24(3), 452-471. https://doi.org/10.5465.AMR.1999.2202131
2. Armstrong, N. (2018). Management of nursing workplace incivility in the health care settings. Workplace Health & Safety, 66(8). https://doi.org/10.1177/2165079918771106
3. Keller, S., Yule, S., Zagarese, V., Parker, S. H. (2020). Predictors and triggers of incivility within healthcare teams: A systematic review of the literature. BMJ Open, 10. https://doi.org/10.1136/bmjopen-2019-035471
4. Layne, D. M., Anderson, E., & Henderson, S. (2019). Examining the presence and sources of incivility within nursing. Journal of Nursing Management, 27(7). https://doi.org/10.1111/jonm.12836
5. The Joint Commission. (2021). Bullying has no place in health care. QuickSafety, 24. https://jointcommission.org/-/media/tjc/newsletters/quick-safety-issue-24-June-2016-6-2-21-update.pdf
Sigma Membership
Xi Theta
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Quality Improvement
Research Approach
Translational Research/Evidence-based Practice
Keywords:
Incivility, Stress and Coping, Workforce
Recommended Citation
Wade, Tynesha; Gow, Amy; and Dehom, Salem, "Cognitive Rehearsal Training for Nursing Workplace Incivility: A Quality Improvement Project" (2025). Creating Healthy Work Environments (CHWE). 69.
https://www.sigmarepository.org/chwe/2025/presentations_2025/69
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Phoenix, Arizona, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Cognitive Rehearsal Training for Nursing Workplace Incivility: A Quality Improvement Project
Phoenix, Arizona, USA
Andersson and Pearson (1999) introduced the concept of workplace incivility as “low-intensity deviant behavior with ambiguous intent to harm the target, in violation of workplace norms for mutual respect” (p. 457). A systematic review of the literature noted nearly two-thirds of healthcare employees have witnessed incivilities perpetuated by nurses and cited a study in which 85% of responding nurses reported experiencing incivilities in the past year (Keller et al., 2020). It has been estimated that 44% of nursing staff have been bullied in the healthcare environment (The Joint Commission, 2021).
While often used interchangeably in practice and in the literature, incivility and bullying are not the same. Incivility lacks clear intentionality on the perpetrator’s part while bullying is characterized by repetitive uncivil or aggressive behaviors (Layne et al., 2019). Because of its pervasive and ambiguous nature, this work focuses on the identification and recognition of workplace incivility to prevent bullying and improve nursing work environments. The purpose of this project is to evaluate the impact of cognitive rehearsal training on the perception and experience of uncivil behaviors among nursing staff in the workplace.
Participants will include certified nursing assistants, licensed vocational nurses, and registered nurses from two units at a pediatric rehabilitation hospital. An education module on incivility and cognitive rehearsal training will be provided during the implementation period between August 2024 and October 2024. According to one systematic review, combining multiple elements of educational training has demonstrated improvement in nurses' self-efficacy in responding to workplace incivility in six studies, and the length of the training program intervention did not impact the outcomes (Armstrong, 2018). Based on this data, the training module intervention will be a PechaKucha presentation with accompanying cueing cards. Participants will verbally rehearse and affirm effective responses to incivility and role-play scenarios in guided groups.
Pre- and post-implementation data will be collected with the Workplace Incivility/Civility Survey, the Clark Workplace Civility Index, and the Clark Healthy Work Environment Inventory. Data will be analyzed with descriptive statistics.
Description
Cognitive rehearsal training is a cognitive behavioral technique that has resulted in positive changes when used as an intervention to address workplace incivility, a pervasive and persistent phenomenon in nursing marked by vague terminology and underreporting. This quality project includes the most optimal execution of cognitive rehearsal training with didactic instruction through PechaKucha presentation, phrase rehearsal, and role-play for practice.