NR 621 Intervention: Evaluation Plan
Student Name
Chamberlain University
NR-621: Nurse Educator Concluding Graduate Experience I
Prof. Name
Date
Introduction
Incivility within nursing education is an ongoing challenge observed in both academic and clinical settings. This issue involves various stakeholders, such as clinical preceptors, faculty, students, and even patients. Acts of incivility, whether subtle or overt, negatively influence learning environments and have both physical and psychological consequences for victims. More critically, incivility threatens patient safety by impairing clinical decision-making and encouraging unsafe practices.
Although research on effective solutions to reduce incivility is limited, role-playing has shown potential as an engaging strategy. By simulating real-life interactions, role-playing allows students to practice professional communication, improve empathy, and reflect on their actions in a safe environment. This project aimed to conduct a mixed-methods literature review to explore how role-playing can address incivility among nursing students and to assess the outcomes of these interventions.
Nurse incivility also has broader healthcare implications. Beyond harming professional relationships, it contributes to errors, burnout, and staff turnover. Alarmingly, incivility is linked to poor clinical outcomes, with studies estimating up to 98,000 preventable deaths annually in acute care settings due to communication failures and compromised judgment. Furthermore, healthcare organizations spend approximately 125% of a nurse’s salary to replace those who resign due to incivility, underscoring the financial burden of this issue.
NR 621 Intervention: Evaluation Plan
Professional organizations, such as the American Nurses Association (ANA) and the Joint Commission, stress zero-tolerance policies for disruptive behaviors. They emphasize cultivating respectful, supportive learning and clinical environments. This project proposes role-playing as a teaching tool that equips nursing students with the skills to identify, address, and prevent incivility while reinforcing professional standards.
Role-playing fosters engagement and empathy across disciplines, but its timing is crucial. For maximum impact, sessions should not occur directly before or after exams, when student stress is highest. In this project, role-playing activities were deliberately scheduled away from assessment periods to encourage optimal participation.
Through structured scenarios, students gained opportunities to practice professional communication, strengthen their nursing identity, and build confidence. This aligns role-playing with broader curricular goals of preparing students not only for clinical competence but also for civility in practice.
Project Goals and Stakeholders
Long-Term Goals
The overarching aim of the project is to decrease incivility in nursing education through role-playing. Successful integration of these activities into curricula is expected to improve classroom climate, strengthen student confidence, and ultimately enhance patient safety outcomes. Success will be measured through graduation and NCLEX pass rates as well as faculty observations of improved peer and student-instructor interactions.
Short-Term Goals
In the short term, the project seeks to evaluate role-playing’s impact on:
- Exam performance: Comparison of results before and after role-playing integration.
- Engagement: Participation levels and student feedback.
- Stress management: Reduced anxiety during clinical and classroom interactions.
Stakeholders
Stakeholder involvement is key to sustainability. Five nursing schools were selected for this intervention, with collaboration from:
- Faculty members – responsible for delivering and supervising role-playing sessions.
- Administrators and department chairs – ensuring curriculum support and resource allocation.
- Students – primary participants and beneficiaries.
Table 1: Project Goals and Stakeholders
| Aspect | Details |
|---|---|
| Long-Term Goal | Reduce incivility, improve student learning outcomes, enhance patient care. |
| Short-Term Goal | Measure exam performance, engagement, and stress reduction. |
| Stakeholders | Faculty, administrators, department chairs, nursing students. |
Project Implementation: Role-Playing in Nursing Education
Implementing role-playing requires faculty training, curriculum redesign, and the creation of realistic scenarios. Examples include patient interviews, emergency responses, and clinical assessments.
One case in mental health nursing involved students enacting psychiatric interviews as both clinicians and patients. This allowed them to better understand patient perspectives, fostering empathy and improving communication (Martin & Kahn, 1995). Another innovative simulation had students experience auditory hallucinations via headphones. Debriefing afterward encouraged reflection, leading to deeper insights into mental health challenges and improved clinical communication.
In addition, King, Hill, and Gleason (2015) demonstrated that medical students engaging in role-play scenarios enhanced both knowledge and interpersonal skills. These findings confirm that role-playing supports not just academic learning but also emotional intelligence and resilience—skills essential for future nurses.
Conclusion:
Role-playing has proven valuable in fostering professional identity, building empathy, and addressing incivility among nursing students. Its alignment with active learning and critical pedagogy principles ensures deep engagement, reflection, and long-term behavior change. Continuous evaluation will determine its sustained effectiveness, but early evidence strongly supports role-playing as a transformative approach in nursing education.
NR 621 Intervention: Evaluation Plan
Quasi-Experiment
A quasi-experimental design compared traditional lectures with role-playing interventions. Students began with lectures on patient education, learning objectives, and instructional roles. In subsequent sessions, they created scenarios, practiced role-plays, and evaluated patient teaching programs.
Students performing role-play exercises consistently scored higher on both theoretical tests and practical checklists, confirming role-playing’s superiority over lectures in enhancing comprehension and skill application.
NR 621 Intervention: Evaluation Plan
Table 2: Comparison of Lecture-Based vs. Role-Playing Outcomes
| Teaching Method | Strengths | Limitations | Outcomes |
|---|---|---|---|
| Lecture-Based | Clear delivery of theoretical knowledge. | Limited engagement; passive. | Lower test & checklist scores. |
| Role-Playing | Promotes empathy, active learning, and communication. | Requires training & resources. | Higher scores; better engagement. |
Project Evaluation
Evaluation combined faculty observations with student feedback. Faculty rated session effectiveness, online module organization, and discussion facilitation. Students reported greater self-awareness, empathy, and improved interactions.
Key outcomes included:
- Faculty: Reported improved classroom civility and higher student participation.
- Students: Recognized their own behaviors, improved communication, and demonstrated reduced stress.
Change Model: Force Field and Lewin’s Unfreezing-Change-Refreezing
Lewin’s change model guided the intervention:
- Unfreezing: Breaking reliance on lecture-based methods.
- Change: Adopting role-playing and adjusting perspectives.
- Refreezing: Making role-playing a sustained part of the curriculum.
This structured change ensured long-term adoption while balancing resistance and driving forces (Burnes, 2020).
Self-Reflection
Reflection supported both faculty and students in identifying personal behaviors and adapting to challenges. Educators gained confidence in managing incivility, while students developed awareness of disruptive actions and adopted more professional conduct.
Teaching-Learning Strategy
Effective strategies included:
- Use of diverse teaching methods for inclusivity.
- Transparent and fair evaluation methods.
- Apprenticeship-style learning to accommodate different learning styles.
These strategies contributed to reduced incivility and stronger engagement.
References
Burnes, B. (2020). The origins of Lewin’s three-step model of change. The Journal of Applied Behavioral Science, 56(1), 32–59.
Deborah, O. K. (2018). Lewin’s theory of change: Applicability of its principles in a contemporary organization. Journal of Strategic Management, 2(5), 1–12.
King, J., Hill, K., & Gleason, A. (2015). All the world’s stage: Evaluating psychiatry role-play-based learning for medical students. Australasian Psychiatry, 23(1), 76–79.
Martin, P., & Kahn, J. (1995). Medical students as role-playing patients. Academic Psychiatry, 19(2), 101–107. https://doi.org/10.1007/BF03341538
Mousavinasab, E., Kalhori, S. R. N., Sanaee, N. Z., Rakhshan, M., & Saeedi, M. G. (2020). Nursing process education: A review of methods and characteristics. Nurse Education in Practice, 44, 102886.
Nes, A. A., Fossum, M., Steindal, S. A., Solberg, M. T., Strandell-Line, C., Zlamal, J., & Gjevjon, E. L. (2020). Research protocol: Technology-supported guidance to increase flexibility, quality, and efficiency in the clinical practicum of nursing education. International Journal of Educational Research, 103, 101628.
NR 621 Intervention: Evaluation Plan
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