Although health care professionals recognize the importance of speaking up about communication issues that threaten patient safety, health profession educators may not feel the same urgency regarding the unprofessional behaviors of colleagues in an academic setting. The presence and outcomes of academic incivility in nursing, and more specifically faculty-to-faculty incivility, are well documented, yet speaking up remains a challenge, particularly for those new to the academic setting (Clark, 2013b; Peters, 2014). This article describes a unique faculty development session that explores the perspectives of junior faculty regarding incivility and empowers them to participate in a speak-up culture for the academic setting.
Clark (2013a, 2013b) defines incivility as rude or disruptive behavior often resulting in psychological or physiological distress for those involved with significant impact, both physiologically and psychologically, that can affect self-worth. Academic unprofessionalism and faculty-to-faculty incivility range from the subtle, and perhaps unintentional, territoriality, negative comments, gossip, and condescension, to overt and public rudeness, blaming, and disrespectful behaviors (Clark, 2013a). These behaviors can be isolated events or can constitute a pattern.
There are personal and organizational costs to academic incivility. Individuals can experience decreased satisfaction in their work, diminished emotional and cognitive resources, psychological distress, and a lack of respect for colleagues and administrators who willingly participate, deny, or actively ignore unprofessionalism and incivility in the academic work environment (Clark, 2013a). Furthermore, stress and threat from incivility can adversely impact those who experience it directly or those who simply witness it with tangible costs (Hutchinson, 2009). Communication and teamwork are eroded, morale is weakened, the quality and safety of the learning environment are affected, and ultimately student learning outcomes are impacted, all of which threatens achievement of the academic mission (Clark, 2013a; Dankoski, Bickel, & Gusic, 2014).
Focus on improving organizational culture in health care and recognition of shared responsibility has led to identification of open communication, or “speaking up,” about concerns, from clinical to professional behaviors, as a primary factor affecting patient safety outcomes (Martinez, et al., 2017). For individuals to speak up about concerns, they must: 1) recognize a behavior as unprofessional, 2) have the knowledge and skills to address the behavior either directly with the person or through reporting mechanisms, and 3) be willing to do so, with personal, relational, and contextual factors influencing the decision to speak up, even when the potential harm to a patient is known (Martinez et al., 2017).
In the clinical setting, an overt threat to patient safety such as improper hand hygiene can be more easily recognized than an unprofessional or uncivil behavior (Martinez et al., 2017). Therefore, in the clinical setting, unprofessional or uncivil behaviors may go unrecognized, and even when they are recognized, there may be fewer perceived options for resolution, thus speaking up may be more likely to be influenced by contextual factors such as relationship hierarchy (Martinez et al., 2017).
As the setting for educating future health care professionals, the culture of open communication related to professionalism is also crucial to a healthy work environment in an academic organization (Wright & Hill, 2015). Clark, Olender, Kenski, and Cardoni (2013) noted that incivility by colleagues is a primary reason for leaving a teaching position. Academe is similarly hierarchal as health care settings, and when individuals in relatively unempowered positions are the recipients of incivility, speaking up may be challenging. In contrast to the clinical setting, since patient safety is not directly affected by incivility, faculty in academe who experience or observe incivility and un-professionalism may be even less likely to speak up (Martinez et al., 2017).
Junior Faculty Vulnerability
Junior faculty can be particularly vulnerable to academic in-civility (Peters, 2014). Transitioning from practice to academia and navigating the demands of teaching, scholarship, and service is a challenge under the best of circumstances (McDonald, 2010). In the presence of academic incivility, the challenge may be insurmountable. Those who experience or witness negative and unprofessional encounters with colleagues may feel decreased job satisfaction or even feel rejected and threatened in the work environment. These feelings ultimately may lead them to leave their academic role (Peters, 2014).
If junior faculty opt to stay in an academic role, they can use coping behaviors such as avoidance, which can exacerbate feelings of isolation and adversely affect growth and advancement in the role. For junior faculty in underrepresented minority groups, the isolating effects may be more prominent (Dankoski et al., 2014). Worse, such observations and experiences can be viewed as the unwritten rules of academia. Thus, unprofessional behaviors may not be recognized as disruptive and may be accepted as the norm, adopted and even perpetuated by junior faculty, becoming part of an unhealthy organizational culture.
As new members of the organization, junior faculty may be in a better position to recognize incivility but may be hesitant to speak up in the midst of witnessing the unprofessional behaviors of their colleagues for a number of reasons. Perceived hierarchy, power dynamics, fear of rejection or retaliation, uncertainty of accepted organizational norms, and concerns over tenure or promotion review can influence response to incivility (Clark, 2013a, 2013b; Clark et al., 2013; Martinez, et al., 2017; Peters, 2014). In addition, uncertainty of when or how to manage behaviors when witnessed or experienced can influence the desire and ability to speak up (Clark et al., 2013). Speaking up also can be highly dependent on context with multiple variables, such as setting, individuals involved, and perceived severity of the behavior (Martinez et al., 2017).
The session described in this article was initiated by five junior faculty members in a structured development program that is described in more detail in the next section. Managing colleague incivility and unprofessional behaviors was a topic of interest selected by the group. The session is offered as one example of how the topic may be approached with junior faculty as part of faculty development programming. Exploring their experiences in the academic workplace created an opportunity to see the school through a unique lens. Offering initial skills and resources for dealing with unprofessional colleagues and acknowledging their decisional challenges about speaking up also represented an opportunity to support these essential members in their development. Finally, it was a way to identify future opportunities for faculty development activities in the continued enhancement of organizational culture.
Junior Faculty Development Opportunity
The Junior Faculty Teaching Fellowship Nursing Cohort (JFTF-NC) is an immersion program designed to facilitate knowledge, attitudes, and skills in the nurse educator role (Hande et al., 2018). The nurse educator cohort in the fellowship program grew from an established program developed by the university's Center for Teaching to meet the unique needs of the school of nursing faculty teaching in an asynchronous or blended education format.
The JFTF-NC represents a collaborative effort between the school of nursing and the university center for teaching. It offers guided faculty development and peer mentoring to promote professional growth across the domains of scholarship, teaching, and leadership, as well as to support role transformation. Participants who typically are in year 1 to 6 of their faculty appointments apply for this competitive 9-month program. The program participants meet monthly and receive funds to support course revision and implementation. To date, former participants (N = 12) in three cohorts of the JFTF-NC have grown into both formal and informal leadership positions at the school of nursing. These faculty are viewed by colleagues as expert nurse educators.
“Challenging” Colleagues Session
As part of the informal discussion sessions in the 9-month JFTF-NC program, participants requested a topic related to working with “challenging” colleagues. The session was facilitated by the fellowship director from the center for teaching and the assistant dean for non-tenure track faculty affairs and advancement at the school of nursing; neither were involved with performance or promotion evaluation of the fellowship participants. The session was confidential, and specific names were not used in any narrative or discussion. In addition, the session took place at a physical location on campus, but outside the school of nursing.
During the discussion, the five junior faculty participants were asked to describe their perceptions or experiences of in-civility and unprofessional behaviors in the academic work environment. The specific behaviors themselves were generated with no context required, written on paper, crumpled, and tossed into the center of the room. Participants pulled papers from the pile and read aloud the written behaviors, without identifying their own contributions, to generate a list. In doing so, uncomfortable ownership of experiences and individual identification were minimized. The generated list contained instances of witnessed and experienced incivility and unprofessional behavior committed by colleagues at all levels.
Most of the identified behaviors concerned issues of communication with both colleagues and students, such as derogatory comments, dismissive facial expressions, active avoidance, and nonresponsiveness. After reviewing the list, the junior faculty participants then identified the actual and potential outcomes of incivility and unprofessionalism on themselves, their work as educators, students, colleagues, the school of nursing, and health care. Identified outcomes included derailed meetings, lost momentum on projects, missed opportunities for collaboration and connection among colleagues, and deficits in feedback to students, with all resulting in the potential for new faculty to “check out” if situations were not resolved.
The last half of the 90-minute session focused on developing beginning knowledge and initial skills for junior faculty. Identification of unprofessionalism and incivility was addressed through providing definitions and other specific examples not present in the list generated by participants. Participants were supported in a decision making process and options for speaking up specific to organizational policies. Communication and conflict negotiation skills for managing challenging situations such as using “I” statements to describe and express concerns were introduced.
Reinforcement of individual responsibility and organizational support was emphasized through highlighting institutional processes for managing conflict and role performance expectations for professional behaviors. Junior faculty were directed to specific individuals in the school of nursing and university such as the assistant dean involved in the session and the ombudsman identified for the school who would be “safe” to discuss concerns and seek guidance for resolution so they would not feel alone. Opportunities for further information and support at the university level, outside the school of nursing also were provided.
Session Influences and Outcomes
Certain characteristics of the session may have contributed to participants' comfort in discussing potentially sensitive information related to incivility and unprofessionalism. Holding the session outside of the school of nursing and ensuring a safe environment for sharing were critical. In addition, the session occurred later in the fellowship after a sense of camaraderie with peers had developed, and the designated facilitators were those with whom trust had been established. Junior faculty freely discussed their challenges and opportunities for speaking up about incivility in the workplace. An added benefit of sharing this topic in the JFTF-NC session was that it created a cohesive peer support group.
Upon conclusion of the session, the three elements essential to speaking up were addressed. Junior faculty participants (a) could identify and recognize unprofessional and uncivil behaviors in the academic workplace, (b) were made aware of the appropriate mechanisms for managing and reporting unprofessionalism, and (c) felt supported in the practical challenges that influence the decision to speak up as a witness or victim of incivility. Facilitators also were made aware of specific perceived barriers to speaking up, such as retaliation or exclusion, and were able to integrate ideas into further development activities for all faculty related to communication strategies, implicit bias, and cultivating a healthy workplace culture. Inviting participants to share their observations and acknowledging, rather than minimizing or disregarding the participants' experiences, communicated an institutional commitment to an academic culture that values junior faculty and discourages incivility.
After the session, one of the facilitators met with senior administration to discuss identified themes, as well as perceived barriers and facilitators to speaking up, without identifying the individuals involved to explore opportunities for broader faculty development initiatives and evidence-based strategies to address acts of faculty incivility. In addition, at the time of the session, the academic faculty roles and responsibilities for the school of nursing were undergoing revision to align with a new annual faculty evaluation process. As a result, they were able to better reflect and reinforce expectations regarding the professional behaviors of all faculty. To address the specific needs of new faculty, the topic of incivility will be included and evaluated as part of a comprehensive 12-month, 12-session faculty development program for all new faculty at the school of nursing, rather than only the JFTF participants. An introduction to incivility in the academic setting will be presented along with academic faculty roles, responsibilities, and expectations among other topics designed to facilitate transition to the academic role.
Understanding and addressing the issues of incivility and unprofessionalism in the workplace as part of junior faculty development can result in significant and positive impact on the organization. Capitalizing on their enthusiasm for the educator role and a new lens on organizational culture with intentionally focused sessions represents a unique opportunity.
The session described in this article is one example of how to engage junior faculty on the topic of incivility and communication strategies. The experience provided a psychological safe space for discussion of junior faculty's experiences of incivility and options to address it. In addition to the outcomes of the session outlined in this article, future plans for implementation and evaluation include sessions incorporating simulation for cognitive rehearsal of managing faculty incivility and mindfulness-based techniques for self-care (Clark, 2019; Green, 2018). All faculty are encouraged to attend university workshops on conflict management and communication skills in support of speak-up culture.
Although all faculty should feel able to speak up about un-professional behaviors in the academic environment, junior faculty can feel both particularly vulnerable and uncertain of an appropriate response when they encounter incivility. Lack of collegiality and open communication not only impedes professional development of junior faculty in an academic role, it also may discourage them from staying in academe at all. Healthy workplace culture norms that nurture the passion of junior faculty for the educator role, stimulate their intellectual desire for growth in the role, and embrace them in a collaborative faculty community are imperative.
As part of new faculty orientation or faculty development programs targeted toward junior faculty, the topic of incivility must be addressed openly, with the goal of empowerment through knowledge and skills to speak up. It is imperative to recognize the significant challenges and decisional influences faced not only by junior faculty, but also by all faculty in dealing with unprofessional colleagues. Junior faculty must understand both workplace expectations and their individual responsibility for the academic climate. Senior faculty and administration must model civility and actively engage in mentorship (Clark & Springer, 2010).
Institutions must define and uphold behavioral expectations for mutual respect and civility, as well as provide ongoing development opportunities for all faculty on the topic of incivility and empower them with communication skills for engaging in difficult conversations (Clark, 2013a; Clark & Springer, 2010; Dankoski et al., 2014). Any program or activity such as this one for junior faculty must be considered just one part of a larger effort at creating speak-up culture within the institution. It is critical for schools to value and support speaking up with appropriate mechanisms, processes, and accountability measures to demonstrate commitment to a safe, healthy academic environment (Clark & Springer, 2010).
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