Publication Date

Spring 2021

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Michelle DeCoux Hampton


new graduates, nurse bullying, workplace bullying, civility, incivility, simulation, role-play, cognitive rehearsal, Kirkpatrick levels, Clark Workplace Civility Index, CWCI


Bullying continues to be a widespread, devastating problem in nursing. Research indicates that bullying has a negative, rippling impact on nurses, organizations, and patient care. This evidence-based practice project aimed to enhance new graduate nurses’ abilities to identify and respond to bullying behaviors. The intervention used a mixed educational methodology of didactic, simulation role-play, and cognitive rehearsal. The project was implemented at a large academic healthcare system in Northern California. Outcomes were evaluated using Kirkpatrick levels 1-4 and the Clark Workplace Civility Index (CWCI). Participants reported that the educational intervention met intended learning objectives, enabled them to apply learned behaviors to address bullying behaviors in the practice setting, and that it was favorable, engaging, and relevant. Self-reported civility using the CWCI ranged between 91 and 93% from baseline to post-intervention with a non-significant increase from immediately-post to 2.5, and 5-month post-intervention scores. Factors that may influence civility ratings are survey timeframes, nursing experience, and exposure to job stress. Implementing mixed educational methodologies can improve communication, peer relationships, teamwork, patient safety, and care. Future exploration of effective strategies to eliminate bullying in all settings is warranted.

Included in

Other Nursing Commons


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