Module 1
By the end of this module, faculty will be able to:
Differentiate bullying and incivility in immersive learning environments
Explain why immersive learning placements are high-risk for psychological harm
Describe psychological safety and its relevance to student learning and reporting
How Common Is Incivility and Bullying?
Incivility and bullying are not rare outliers in health care environments. Research across professions shows wide variation in prevalence, but consistently meaningful impact on learning, performance, and well-being.
Bullying Among Nursing Students
2017 · Clinical
78.1%
frequency of bullying reported
Setting: Clinical placement
Karatas, Ozturk & Bektas, 2017
Nearly equal gender split (49.5% women, 50.5% men)
Median age 21.58 years
Bullying is not limited by gender — both groups reported similar rates
2024 · Clinical
92%
perceived bullying prevalence
Setting: Clinical placement
Fernández-Gutiérrez, Mosteiro-Díaz, Borges & Franco-Correia, 2024
66.3% given tasks below their competence level
60% had tasks changed to more trivial or unpleasant ones
52% had opinions ignored
49% were excessively supervised
2026 · Classroom
26.3%
prevalence of bullying
Setting: Classroom / University
Alajaimi, Al-Badi, Alhabsi, Al Azri, Al-Ghawi, Alwahaibi, Jaju & Alwahaibi, 2026
Verbal and emotional abuse most frequently reported
Perpetrators were primarily classmates
Occurred in classroom settings — not just clinical
Suggests bullying begins before placement
Bullying in nursing education is not isolated to clinical placements. It spans settings, genders, and cultures — reinforcing the need for systemic prevention strategies that begin before students ever enter a clinical site.
By Health Profession
Who Is the Source?
Clients & Visitors
Coworkers & Colleagues
Supervisors &
Evaluators Major Source
Evaluators Major Source
Clients & Visitors
Coworkers & Colleagues
Supervisors & Evaluators
Power differentials are the true driver — especially in learning environments where supervisors control evaluations, access, and professional futures.
Alshehry et al., 2019 · Elmblad et al., 2014 · Layne et al., 2019
Impact on Professionals
The consequences of incivility and bullying extend far beyond the workplace.
Declines in personal health
Depression and anxiety
Emotional distress, fatigue, GI issues, and insomnia
Burnout and disengagement
Resignation
Decreased job satisfaction and quality of life
Impaired performance and loss of productivity
Potential impact on patient safety
These consequences affect individuals, teams, and patient outcomes — reinforcing why early recognition and response matter.
Alshehry et al., 2019 · Trad & Johnson, 2014 · McPherson & Buxton, 2019