Online Simulation with Actor and Facilitator to Assist IENs Develop Strategies to Address Incivility
Other Titles
Online Simulation with Actors and Facilitators to Assist IENs Develop Strategies to Address Incivility [Title Slide]
Abstract
Internationally educated nurses (IENs) may face obstacles transitioning into the Canadian healthcare environment due to incivility (Cruz, Quicho & Ibañez, 2022). Workplace incivility describes workplace behaviour that is rude, disruptive, and disrespectful and that promotes discord and disharmony (Clark et al., 2020). Incivility has an impact on nurses’ well-being, patient engagement, and patient outcomes (Jackson, Usher, & Cleary, 2024).
We will share the virtual simulation multi-dimensional design, development, and evaluation outcomes that features actors as simulated participants (SPs) and facilitators for the provincially funded Ontario Internationally Educated Nurses Course Consortium concept and competency-bridging program of study for IENs. The learning experience supported and prepared IENs who may face incivility in the future. The goal was to incorporate the knowledge, skill acquisition, and the affective domains of learning in the experience (Duchesne, Caners, Rang, et al., 2023). Based on a literature review on IEN incivility experiences, a survey of IENs, and standards of best practices with SPs, three learning focused and relevant scenarios were developed and reviewed by IENs in practice. These scenarios were: interaction with an authoritarian physician; a disrespectful patient; and a disapproving nurse. The scenarios were shared with IENs in practice for their input. The simulations were delivered synchronously by Zoom. The ERASE method for addressing incivility (Wilkins, Goldenberg, & Cyrus, 2019) was shared with the IEN attendees as an approach they could practice in the simulation experience.
Psychological safety and respectful feedback were important components during and after the simulation. Respectful feedback was provided in the debrief using the PEARL framework (Baja, Meguerdichian, Thoma, et al., 2018). The facilitators and the SPs received orientation to the scenarios and the approach so that they were prepared to be supportive of IEN learning. The presenters will share the design, development, and the outcomes from each scenario and the overall structured evaluation of the experience. There will be opportunities to discuss, with the attendees, ways of integrating incivility simulations into learning and the challenges educators need to consider. Using a SP methodology can provide a meaningful inclusive learning experience to provide IENs with tools they can use in the future when faced with incivility.
Notes
References:
Baja, K., Meguerdichian, M., Thoma, B., et al., (2018). The PEARLS Healthcare Debriefing Tool. Academic Medicine. 93(2):365. doi: 10.1097/ACM.0000000000002035.
Clark, C. (2022). Core Competencies of Civility. Sigma Theta Tau International Honor Society of Nursing.
Cruz, E.V., Quicho, R., Ibañez, E. (2022). Education environment and role transition of internationally educated nurses enrolled in a practical nursing bridging program in Ontario, Canada. Journal of Teaching and Learning, 16(2), 86-106. https://jtl.uwindsor.ca/index.php/jtl/article/view/7014
Duchesne, E., Caners, K., Rang, et al., (2023). Addressing microaggressions with simulation: A novel educational intervention. Canadian Journal of Emergency Medicine. 25(4). doi: 10.1007/s43678-023-00474-6
Jackson, D., Usher, K., & Cleary, M. (2024). Workplace incivility: Insidious, pervasive and harmful. International Journal of Mental Health Nursing. 33(3):483-486. doi: 10.1111/inm.13315
Wilkins, M.N., Goldenberg, K., & Cyrus, K., (2019). ERASE: A new framework for faculty to manage patient mistreatment of trainees. Academic Psychiatry. 43(4):396-399. doi: 10.1007/s40596-018-1011-6.
Sigma Membership
Lambda Pi at-Large
Lead Author Affiliation
York University, Toronto, Ontario, Canada
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
lncivility, Simulation, Teaching and Learning Strategies, Internationally Educated Nurses, International Nursing, Foreign Nurses, Social Behavior, Work Environment, Simulations, Computer Simulation
Recommended Citation
Bradley, Patricia Ann; Patrick, Linda; Mina, Elaine Santa; Woodend, Kirsten; and Bhatti, Ayesha, "Online Simulation with Actor and Facilitator to Assist IENs Develop Strategies to Address Incivility" (2026). International Nursing Research Congress (INRC). 114.
https://www.sigmarepository.org/inrc/2026/presentations_2026/114
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
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. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-03
Online Simulation with Actor and Facilitator to Assist IENs Develop Strategies to Address Incivility
Toronto, Ontario, Canada
Internationally educated nurses (IENs) may face obstacles transitioning into the Canadian healthcare environment due to incivility (Cruz, Quicho & Ibañez, 2022). Workplace incivility describes workplace behaviour that is rude, disruptive, and disrespectful and that promotes discord and disharmony (Clark et al., 2020). Incivility has an impact on nurses’ well-being, patient engagement, and patient outcomes (Jackson, Usher, & Cleary, 2024).
We will share the virtual simulation multi-dimensional design, development, and evaluation outcomes that features actors as simulated participants (SPs) and facilitators for the provincially funded Ontario Internationally Educated Nurses Course Consortium concept and competency-bridging program of study for IENs. The learning experience supported and prepared IENs who may face incivility in the future. The goal was to incorporate the knowledge, skill acquisition, and the affective domains of learning in the experience (Duchesne, Caners, Rang, et al., 2023). Based on a literature review on IEN incivility experiences, a survey of IENs, and standards of best practices with SPs, three learning focused and relevant scenarios were developed and reviewed by IENs in practice. These scenarios were: interaction with an authoritarian physician; a disrespectful patient; and a disapproving nurse. The scenarios were shared with IENs in practice for their input. The simulations were delivered synchronously by Zoom. The ERASE method for addressing incivility (Wilkins, Goldenberg, & Cyrus, 2019) was shared with the IEN attendees as an approach they could practice in the simulation experience.
Psychological safety and respectful feedback were important components during and after the simulation. Respectful feedback was provided in the debrief using the PEARL framework (Baja, Meguerdichian, Thoma, et al., 2018). The facilitators and the SPs received orientation to the scenarios and the approach so that they were prepared to be supportive of IEN learning. The presenters will share the design, development, and the outcomes from each scenario and the overall structured evaluation of the experience. There will be opportunities to discuss, with the attendees, ways of integrating incivility simulations into learning and the challenges educators need to consider. Using a SP methodology can provide a meaningful inclusive learning experience to provide IENs with tools they can use in the future when faced with incivility.
Description
IENs may experience incivility when transitioning into the Canadian healthcare environment. The presentation will share the multi-dimensional design and implementation of a simulated-actor strategy with a cohort of IENs in a competency-based program. The evaluation outcomes demonstrated the efficacy of a simulated-actor pedagogical approach as a meaningful strategy for IENs. The approach was informed by the best practices in the literature.