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Enhancing Undergraduate Nursing Students’ Knowledge and Self-Efficacy

About Workplace Bullying: A Quasi-experimental Study Abeer Alraja RN, MSN, PhD (c); Donna Martin, RN, PhD, Associate Professor;

College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Canada

Introduction

Workplace bullying (WB) among nurses is a prevalent

and serious problem in health care settings around

the world with detrimental physical, psychological and

organizational consequences.1-4

In Canada:

• 30% of nurses reported that they were physically

assaulted by a patient.2

• 44% experienced emotional abuse from a patient.2

• 88.72% of nursing students reported experiencing

at least 1 act of bullying.10

Intervention

Methodology

Design: Quasi-experimental, using a 1 group

pre-test/post-test.

Sample: Second, third and fourth year

undergraduate nursing students at 3 Canadian

schools of nursing were invited to participate.

Dependent variables: Knowledge, Self-efficacy

of WB, & Intent to Intervene.

Independent variable: Completion of 3 online

educational modules.

Measurements: Sociodemographic

characteristics, The Self-efficacy to Respond to

Disruptive Behaviours (SERDB) questionnaire11,

& WB knowledge assessment test.

Data Analysis:

Descriptive statistical techniques were used to

describe the sample.

A paired sample t-test analyzed the difference

in summed scores for the items on the pre-test

and post-test.

Preliminary Results

Acknowledgments

References

•Western and North-Western Region Canadian Association of Schools of Nursing

(WNRCASN) Graduate Student Research Award.

•College of Nursing Endowment Fund Graduate Student Research Grant.

•College of Nursing Endowment Fund Graduate Student Travel Award.

“Nursing truly is one of the most difficult professions out

there. We are constantly exposed to diseases, ridicule,

and unmanageable circumstances” Newly graduated nurse

Research Objective

Significance

To evaluate the effectiveness of an online evidence-

based educational intervention in enhancing

knowledge, self-efficacy, and intent to intervene

related to WB among undergraduate nursing students

in three Canadian schools of nursing.

• Including education on workplace bullying is

highly recommended in nursing curricula.5

• The Canadian Nurses Association and the

Canadian Federation of Nurses Unions strongly

support violence-free workplaces.6

• There is a scarceness of interventional research

aimed at educating nursing students on effective

and appropriate responses to WB.7

Discussion and Conclusion

• What is Workplace Bullying? • Introducing the topic of WB including definition,

descriptions of acts and sources of WB as well as its antecedents and consequences on personal health, patient safety, and healthcare organizations.

Module 1

• How to Address Workplace Bullying? • Providing information about nursing students' and

nurses' legal rights and responsibilities with relation WB and strategies to manage bullying acts in the workplace.

Module 2

• Application of Knowledge. • Involves five practice scenarios to further facilitate

nursing students' abilities to implement the strategies they learned in the previous modules.

Module 3

The content of the modules was developed from a

review of the literature and guided by critical social

theory and cognitive social learning theory.8-9

1. Lindsey B. Anderson & Melanie Morgan (2017). An Examination of Nurses’ Intergenerational Communicative Experiences in

the Workplace: Do Nurses Eat Their Young? Communication Quarterly, 65:4, 377-401.

2. Laschinger, H. K., & Nosko, A. (2015). Exposure to workplace bullying and post-traumatic stress disorder symptomology: The

role of protective psychological resources. Journal of Nursing Management, 23(2), 252–262. https://doi.org/10.1111/jonm.12122

3. Sauer, P. A., & McCoy, T. P. (2017). Nurse bullying: Impact on nurses’ health. Western Journal of Nursing Research, 39(12),

1533–1546. https://doi.org/10.1177/0193945916681278

4CNA code of ethics

5. Sanner-Stiehr, E. (2017). Using simulation to teach responses to lateral violence: Guidelines for nurse educators. Nurse

Educator, 42(3), 133–137.

6. Canadian Nurses Association, & Canadian Federation of Nurses Unions (CFNU). (2014). Workplace Violence and Bullying:

Joint Position Statement.

7. Mellor, P., Gregoric, C., & Gillham, D. (2017). Strategies new graduate registered nurses require to care and advocate for

themselves: A literature review. Contemporary Nurse, 53(3), 390–405. https://doi.org/10.1080/10376178.2017.13489038

Browne, 2000

8. Browne, A. J. (2000). The potential contributions of critical social theory to nursing science. Canadian Journal of Nursing

Research, 32(2), 35-55.

9. Bandura, A. (1986). Social Foundations of Thought and Action. Cliff, NJ: Prentice Hall, Englewood.

10. Clarke, C. M., Kane, D. J., Rajacich, D. L., & Lafreniere, K. D. (2012). Bullying in undergraduate clinical nursing education.

Journal of Nursing Education, 51(5), 269–276.

11. Sanner-Stiehr, E. (2018). Responding to disruptive behaviors in nursing: A longitudinal, quasi- experimental investigation of

training for nursing students. Nurse Education Today 68, 105–111.

• Preliminary results indicate that completion of the

online educational modules had a significant

influence in enhancing nursing students’ knowledge,

self-efficacy, and intent to intervene in future events

of WB.

• Results highlight the importance of including

evidence-based educational modules in nursing

curricula to educate nursing students about WB.

Participants were predominantly between 20

and 30 years old (83.3%; n=30).

Females comprised 77.8% (n=28) and 22.2%

(n=8) were male.

Participants were distributed through the

program with 30.6% (n=11) in their 2nd year,

36.1% (n=13) in their 3rd year, & 33.3% (n=12)

in their 4th year.

SERDB Pre/post-test mean scores and paired t-test results

at CI=95%

Instrument Items Pre-

test

Mean

Post-

test

Mean

t Sig.

Confidence in ability to respond effectively 4.49 7.36 7.69 0.000*

Previous engagement in effective responses 3.83 4.53 1.719 0.095

Responding effectively is important 8.31 9.14 2.643 0.012*

I know how to respond effectively 4.43 7.5 6.619 0.000*

Responding effectively will end the behaviors 7.03 8.22 3.319 0.002*

Overall self-efficacy in stressful situational context 4.06 6.69 6.541 0.000*

Overall self-efficacy in normal situational context 5.37 7.75 5.67 0.000*

I believe in my ability to respond effectively 4.53 7.42 6.809 0.000*

Responding effectively is a valuable skill 8.54 9.25 2.225 0.033*

I care about being able to respond effectively 8.14 9.06 3.357 0.002*

* Significant results with P<0.05

Mean t Sig.

Pre-test Score - Post-test Score 2.971 4.932 0.000*

Knowledge Paired t-test results at CI=95%

* Significant results with P<0.05

* Significant results with P<0.05

Intent to Intervene Paired t-test results at CI=95%

Mean t Sig.

Pre-test Score - Post-test Score 2.229 5.181 0.000*

Workplace

Bullying

Verbal abuse

Threats of harm

Refusing to cooperate

Demeaning remarks

Intimidation and

Undermining

Hampering another's

performance