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J Dent Educ. 73(1): 119-126 2009
© 2009 American Dental Education Association
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Milieu in Dental School and Practice

Dental Students’ and Faculty Members’ Perceptions of Incivility in the Classroom

Michael L. Rowland, Ph.D.; Kanokraj Srisukho, D.D.S., M.S.

Key words: incivility, uncivil, disruptive behavior, resistance, reactive behavior

Submitted for publication 07/17/08; accepted 10/14/08


   Abstract
Top
 Author information
 Abstract
Definitions of uncivil classroom...
 Methods
 Data analysis
 Results
 Conclusion
 References
 
The purpose of this study was to compare dental students’ and faculty members’ perceptions of classroom incivility and to determine how many students willingly engage in uncivil behavior in the classroom. A web-based survey research design was used to obtain information regarding uncivil classroom behaviors from dental students and full- and part-time dental faculty members at a midwestern U.S. dental school. Responses were received from sixty-eight dental faculty members and 127 third- and fourth-year students. The perceptions of faculty members about what constitutes uncivil classroom behavior differed from those of students. In fact, of the eighteen questions asked of both groups, statistical differences were found for eleven (61 percent).

As health professions faculty and administrators, we expect our students to demonstrate professional behavior beginning with the application process through the white coat ceremony and continuing in and out of the classroom as well as in the clinical setting. Yet, reports of disturbing behaviors of professional students in the classroom have had a profound impact on other students, faculty members, and the environment for teaching and learning. There has been much discussion regarding issues of professionalism in dental education and other health professions programs, with much of the attention focused on issues of academic integrity, dishonesty, and misconduct.1–12 There has been less focus on acts of unprofessional or inappropriate behaviors exhibited by both faculty members and students in the classroom. However, a review of the health professions literature revealed both nursing and pharmacy schools have examined issues of appropriate and inappropriate behaviors, now more commonly known as uncivil classroom behaviors or acts of incivility.14–19

The purpose of our study was to compare dental students’ and faculty members’ perceptions of classroom incivility and to determine how many students willingly engage in uncivil behavior in the classroom. Because the concept of uncivil classroom behaviors has not been fully explored in the dental education literature, this report begins with a review of the literature from other areas of study.


   Definitions of Uncivil Classroom Behaviors
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 Definitions of uncivil classroom...
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The terms "incivility" and "uncivil behavior" have been defined in different ways by different individuals. Feldman defines classroom incivility as "any action that interferes with a harmonious and cooperative learning atmosphere in the classroom."20 Making loud and sarcastic remarks, having emotional outbursts, or being unprepared in class are forms of uncivil behavior by students; fast-paced instruction, indifferent remarks, and surprise tests are actions by instructors that irritate students. Feldman classifies uncivil classroom behavior into four categories: annoyance (e.g., arriving late and leaving early, answering cell phones), classroom terrorism, intimidation, and threats of violence.

Still, Feldman notes that an enhanced classroom learning environment can be created if proper action is taken against uncivil behavior. Proactive and reactive measures can be taken by instructors to avoid uncivil classroom conduct. Proactive measures by instructors include providing specific written instructions regarding class assignments, grading policies, and course objectives to students during the first class period. Also, maintaining a considerate, friendly interaction with students can lead to significant lowering of uncivil behavior. In situations in which students cause annoyance or terrorism in class, the faculty member should immediately take appropriate action and remain calm, composed, unemotional, and analytical in handling the situation.

Feldman notes that, if a student makes a threat or takes violent action, the instructor should seek support from other faculty members on how to handle the situation, while avoiding any physical or verbal reactions that may escalate and make the situation worse. He contends that faculty members in higher education are reluctant to talk about incivility for fear of being viewed as unable to manage their classrooms—traditionally an elementary and secondary school problem. Feldman also notes that faculty members should always document incidents, especially in cases of classroom terrorism, threats, and violence by a student. Such documentation can not only serve as self-protection but, more importantly, can help prepare other faculty members to react appropriately in similar situations.

Morrissette defines incivility as "intentional behavior of students to disrupt the teaching/learning process of others."21 Among the factors that contribute to student incivility are the changing characteristics of college students, emotional disturbances students face, and their personal problems. Morrissette reports that student incivility has not been well documented due to the absence of a standardized reporting system, inadequate support from administration, and fear of student reprisal. Morrissette offers six practical strategies to assist faculty in reducing student incivility: 1) develop effective communication and interpersonal skills to better understand the student perspective; 2) set academic and behavioral expectations by clearly spelling out course objectives and evaluation methods; 3) arrange for midterm teaching feedback to and from students; 4) establish a collaborative learning environment and classroom experience; 5) reframe potential conflicts by responding respectfully, rather than harshly, to students; and 6) establish a student grievance process in which student concerns are prioritized and investigated immediately.

One of the most important studies on incivility is by Boice, who conducted a longitudinal observational study of classroom incivilities (CI) in large, introductory-level survey courses over a five-year period at a large research university.22 Half of the survey courses displayed chronic patterns of CIs. Boice found that high levels of CIs corresponded with low levels of student attentiveness and note-taking and low levels of teacher enthusiasm, clarity, organization, and immediacy. Novice teachers encountered CIs more often than did senior faculty members, who displayed more kinds of positive motivators and expertise.

Sociological Explanations of Classroom Incivility
Bray and Del Favero provide some sociological theories that can help explain how classroom incivilities arise and how they can be handled.23 For example, control theories focus on understanding what keeps people from violating social norms when it may be in their own interest to do so. Deterrence and rational choice models look at costs and rewards associated with uncivil behavior. For example, instructors and students will be less likely to engage in classroom incivilities if the perceived costs for such behaviors outweigh the rewards. Social bond and social disorganization theories focus on the links between individuals within society, asserting that co-curriculum activities are helpful in minimizing uncivil classroom behaviors. Social exchange, bond, and learning theories focus on how the interdependent exchanges of values and bonding among peer groups affect behavior and level of commitment. Bray and Del Favero argue that student-faculty incivilities are linked to the extent to which students believe their behavior will be accepted by their peers; however, incivilities occur less if student-faculty interactions are mutually rewarding. And lastly, conflict and labeling theories remind us that our society exists in a constant state of flux with various interests and values and that behaviors are not inherently inappropriate; rather, we are the ones who label certain behaviors as undesirable. Therefore, they argue, reducing the faculty-student power discrepancy would reduce the occurrence of student incivility.

Alexander-Snow explored the extent to which characteristics such as race, gender, and ethnicity of students and faculty members influence the occurrence of student classroom incivilities.24 She pointed out that everyone in the world is "cultural"; however, not all cultures are equal in power and prestige. Cultural perceptions, defined by stereotypes and social power, play a role in shaping the classroom dynamic between students and their teachers, particularly faculty of color and female faculty. Students’ cultural perceptions are reflected in their evaluations of their teachers’ competence, credibility, and authority. Classroom incivilities can be provoked by a teacher’s initial presentation, or students can have preconceived perceptions about their teachers, which ultimately become the students’ expectations. The less powerful students perceive their teacher to be, the more likely they will be to engage in undermining behavior. For female faculty and faculty of color, students initially try to influence the power, as their cultural perceptions define their expectations of the teacher. As a result of her review of the literature, Alexander-Snow came to the conclusion that female faculty and faculty of color are more prone to experience greater levels of classroom incivilities than their white, male colleagues.

Controlling for five variables (gender, class standing, cumulative grade point average, informal faculty-student interactions, and academic major), Hirschy and Braxton explored students’ perceptions of their academic and intellectual development and subsequent institutional commitment in relation to two classroom incivilities: disrespectful disruption and insolent inattention.25 Their findings were that both forms of classroom incivilities negatively affected students’ perceptions of their own academic and intellectual development and their commitment to their college or university. Students who were a victim of classroom incivilities spent less time thinking critically in class and were less engaged with the course material afterward. Classroom incivilities also led to frustration and isolation, as students felt that their values, beliefs, and attitudes were not integrated with those of others, which led to a decline in students’ persistence to continue their studies.

Studies of Incivilities in Nursing Education
Clark and Springer examined the problem of incivility in university nursing education from the perspectives of both students and faculty.15 Participants in their study completed the Incivility in Nursing Education (INE) survey. Likert scale responses were used to determine uncivil behaviors as perceived by students and faculty. On the whole, faculty members and students reported occurrences of student uncivil behaviors as rare. The majority of responding faculty and students perceived uncivil behavior as only a moderate problem in the nursing academic environment.

Through faculty interviews, Luparell used the critical incident technique to study the effects of uncivil nursing student behavior on twenty-one nursing faculty members.17 These faculty members identified thirty-six instances of incivility that ranged from mild to severe aggression. Faculty members often perceived these threats to have a negative impact on their job security, their physical and emotional well-being, and/or the well-being of their family members. Several types of consequences of uncivil student behavior were identified during the faculty interviews: physical toll (e.g., loss of sleep), injury to self-esteem and confidence, emotional toll and post-traumatic stress, time expenditure to address the CI in follow-up meetings with administrators, financial costs (e.g., attorney costs), cost to the educational process, and, finally, retreat and withdrawal from teaching. Luparell concluded that student incivility remains a significant problem in academic nursing institutions that needs immediate attention for the well-being of the faculty.

Clark and Springer asked faculty members and students to complete a nursing education survey and used qualitative methods to explore the causes of incivility and factors contributing to it.16 Their study categorized student incivility into in-class disruptions and out-of-class disruptions. Making negative remarks and challenging professors during class were cited as in-class student disruptions, and bad-mouthing and discrediting faculty were considered out-of-class disruptions. Making condescending remarks about students, having a poor teaching style and poor communication skills, taking an attitude of superiority, criticizing students in front of the class, and making threats to fail students were examples of uncivil faculty behavior as perceived by the students. While emphasizing the need for immediate action against incivility, both faculty members and students suggested the need for remedial measures, such as sound university policies and strict enforcement of campus codes of conduct.

Lashley and DeMeneses conducted a study to estimate the prevalence of uncivil behavior in nursing programs and its association with several demographic characteristics.18 They conducted a national survey of participants randomly selected from a listing of state-approved schools of nursing. Student inattention in class, absence from class, and late arrival to class were the three most commonly reported disruptive behaviors, while objectionable physical contact with the instructor and verbal abuse of the instructor in a clinical setting or in the laboratory were the least frequently reported objectionable behaviors. Demographic factors included type of nursing program enrollment, parent institution enrollment size, institution type (public/private or religious/non-religious), location (urban, small, rural, or suburban), and geographic region. Respondents at public institutions were more likely to verbally abuse the instructor as compared to respondents at private institutions. In nursing programs of more than 200 students, students were found to be associated with significantly higher rates of cheating on tests or rude behaviors toward staff. In comparing the current quality of undergraduate nursing work and student preparation for class with those of five years ago, over 50 percent of the respondents indicated that student performance has deteriorated over the past five years. Respondents were asked to indicate their reaction to two situations: verbal abuse of the instructor and objectionable physical contact with instructors. The responses varied in increasing order of severity from an initial written warning to verbal warning to a hearing at the institutional level and, finally, in extreme cases, suspension from the program.

Incivilities in Pharmacy
Berger explored the role of faculty in preventing and responding to incivilities when they occur and noted first the importance of faculty members’ examining their own behaviors and attitudes rather than trying to change student behaviors.13 He noted that incivilities occur more often when students and/or faculty members are stressed, have unrealistic expectations, and feel powerless and unsupported. Berger reported two types of incivility: passive incivility (inattention in class, being late, shuffling papers, wearing headsets, talking on a cell phone, and walking in and out of class) and active incivility (challenging a faculty member in a disrespectful manner, using obscene language or gestures directed at the faculty member, or insulting the faculty member in front of other students and making physical threats). Berger suggested that prior planning can help in reducing incivility particularly in large classes, which included arriving to class early, getting to know the students, making the class more interactive, and communicating expectations to students during the first class meeting.

Hammer noted the link between professionalism and civility and states that "civility serves as the foundation upon which professional behavior is rooted, and professional behavior is part of the complex concept of professionalism."27 Hammer contends that strategies for handling incivilities and unprofessional behavior can be grouped into four categories: the negative-punitive approach that involves punishment for bad behavior; the positive-reward approach in which good behavior is rewarded; a combination of the two, which is the strategy many schools use; and finally, the do-nothing strategy, in which there is neither punishment or reward because students have lived up to the norm of professional behavior. Hammer also suggests other ways to combat incivilities and unprofessional behavior and promote civil and professional behavior, such as specifically stating the importance of professionalism and behavior in recruitment and admissions materials and stressing programmatic policies, procedures, and grading policies to students upon arrival.

West attested to the importance of preparing new faculty for CI, as they are often easy targets because of their lack of teaching experience.28 West makes four suggestions for new faculty to help create an environment conducive to promoting civility: 1) find a mentor who can provide essential background information about the university, teaching, and evaluations; 2) be prepared for classes by learning different teaching methodologies and ways of assessing students’ knowledge of the material; and 3) communicate class expectations in the syllabus and include in the syllabus a civility clause or statement about expectations regarding CI.

In addressing this issue in dental education, there is much to be gained from the work of those who have dealt with classroom incivilities and can provide direction for new and inexperienced faculty members.


   Methods
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 Author information
 Abstract
 Definitions of uncivil classroom...
 Methods
Data analysis
 Results
 Conclusion
 References
 
The survey used in this study was partially based on a previous investigation by Paik and Broedl-Zaugg, who used thirty items in three sections to examine the types of behaviors pharmacy students considered uncivil.19 Our study used the items in their first section. We selected a self-administered pencil and paper survey research design to investigate and obtain opinions and information from all 103 third-year and all 102 fourth-year dental students. A web-based survey was selected to investigate opinions from the entire group of 108 full- and part-time faculty members and administrators at a midwestern U.S. dental school. This single-institution study sought to determine the types of classroom behaviors that dental students, faculty, and administrators consider uncivil. The survey instrument consisted of nineteen questions about classroom behavior; students were also asked whether they have participated in CI, and faculty members were asked to indicate their gender and academic rank. Students and faculty responded to all questions that requested an opinion by using a 5-point Likert scale, where 1=strongly disagree, 2=disagree, 3=neutral, 4=agree, and 5=strongly agree.

The faculty questions were as follows:

  1. I feel that students’ using a cell phone during class is uncivil classroom behavior.
  2. I feel that students’ challenging authority in class is uncivil classroom behavior.
  3. I feel that students’ demanding special treatment is uncivil classroom behavior.
  4. I feel that students who have an "I paid for this" mentality is uncivil behavior.
  5. I feel that students’ leaving class early is uncivil classroom behavior.
  6. I feel that students’ making offensive remarks/gestures is uncivil classroom behavior.
  7. I feel that students’ missing deadlines is uncivil classroom behavior.
  8. I feel that students’ prolonged chattering in class is uncivil classroom behavior.
  9. I feel that students’ reading the newspaper/magazines during class is uncivil classroom behavior.
  10. I feel that sleeping in class is uncivil classroom behavior.
  11. I feel that students’ talking out of turn is uncivil behavior.
  12. I feel that arriving late to class is uncivil behavior.
  13. I feel that students’ not paying attention in class is uncivil classroom behavior.
  14. I feel that students’ reluctance to answer questions in class is uncivil classroom behavior.
  15. I feel that students’ using a computer in class to surf the web or for other uses is uncivil classroom behavior.
  16. I feel that students’ challenging the instructor’s knowledge is uncivil classroom behavior.
  17. I feel that students’ cheating in class is uncivil classroom behavior.
  18. I feel that challenging the instructor’s credibility is uncivil classroom behavior.
  19. Is there any other behavior not listed above that you consider uncivil classroom behavior? If so, please list it here. (Faculty question only)
  20. Gender question: Male or Female
  21. Academic rank: Assistant Professor Clinical or Tenure-Track, Associate Professor Clinical or Tenure-Track, or Full Professor Clinical or Tenure-Track (Faculty question only)

The same questions were asked of students; however, the questions were stated differently as in this example, "I feel that using a cell phone during class in an uncivil behavior." In addition, the students were also asked if they had participated in that type of behavior.


   Data Analysis
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 Definitions of uncivil classroom...
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Because of small numbers of responses for each option, the response categories "strongly disagree" and "disagree" were collapsed into one category "disagree." Likewise, the response categories "strongly agree" and "agree" were collapsed into one category "agree." Thus, three response categories were used for data analysis: disagree, neutral, and agree. The chi-square test or Fisher’s exact test (when cell counts included less than five responses) was used to test for statistically significant differences in responses according to gender (for both faculty and student responses) and job title (faculty responses only). Further, the chi-square or Fisher’s exact test was used to test for statistically significant differences in responses between faculty and students. The two-sided level of statistical significance was set at _=0.01 because of the multiple testing involved.


   Results
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Of the 108 faculty members who received the survey by email, sixty-eight (63 percent) completed the survey. There was a fairly even distribution of assistant, associate, and full professor respondents. In this study, the researchers did not differentiate between clinical or tenure-track professors. Twenty-one respondents (32 percent) were assistant professors, twenty-one (32 percent) were associate professors, and twenty-three (35 percent) were full professors; thirty-eight (59 percent) were male, and twenty-six (41 percent) were female. Four respondents chose not to answer the question about gender.

Among the faculty respondents, there were no statistically significant differences among responses according to gender or job status. However, there was a tendency for female faculty members to regard missing deadlines and sleeping in class as uncivil behavior more than did male faculty (P=0.03 and P=0.01, respectively). Over 70 percent of the female faculty members agreed that missing deadlines constituted uncivil behavior, whereas among the male faculty members, nearly 40 percent also agreed but 26 percent were neutral and 34 percent actually disagreed. All of the female faculty members agreed that sleeping in class constituted uncivil behavior, whereas only 76 percent of male faculty members agreed.

Surveys were distributed to 205 third- and fourth-year students and were returned by 127 students (62 percent). There were seventy-seven male student respondents (62 percent) and forty-eight female students (38 percent), with two students who chose not to answer the question regarding gender. We did not ask the students to identify their academic year in dental school.

Among the students, there was a statistically significant difference in perceptions of uncivil behavior between males and females for the following items: challenging authority (P=0.004), the "I paid for this" mentality (P<0.001), and sleeping in class (P=0.001). Of the females, 60 percent considered challenging authority to be uncivil behavior as opposed to only 33 percent of males. Almost half of the males disagreed that the "I paid for this" mentality constituted uncivil behavior, and only 21 percent of the females felt the same with the majority (47 percent) feeling neutral about it. Approximately 55 percent of the males felt that sleeping in class was uncivil behavior, whereas less than half of the females (48 percent) felt that sleeping in class was uncivil behavior.

There were few similarities in viewpoints between faculty members and students in what constitutes uncivil classroom behavior. In fact, of the eighteen questions asked of both groups, no significant differences in response patterns existed for only seven of the items (39 percent). The majority of faculty members and students agreed that demanding special treatment (P=0.69), making offensive remarks (P=0.20), prolonged chattering in class (P=0.12), talking out of turn (P=0.05), and cheating (P=0.09) qualified as uncivil classroom behavior. The majority of both faculty and students disagreed that challenging an instructor’s knowledge (P=0.68) and reluctance to answer questions (P=0.21) were uncivil behavior. In contrast, there were many questions on which a large proportion of faculty respondents agreed that a particular behavior was disruptive, but the students either felt more neutral or disagreed that the behavior was disruptive. For example, all but one of the faculty members said that cell phone use in class was uncivil behavior, whereas only 69 percent of the students agreed (P<0.001). With regards to surfing the web during class, 85 percent of faculty members agreed that this was uncivil behavior, but only half of the students felt the same way (P<0.001). Interestingly, almost 30 percent of faculty respondents did not think that missing a deadline was uncivil classroom behavior, 19 percent were neutral, and 51 percent agreed—compared with 8 percent, 30 percent, and 62 percent, respectively, of students (P<0.001). These are only a few of the discrepancies, but a notable finding was that faculty and students answered almost two-thirds of the questions differently.

Finally, the survey asked the dental faculty members if there were any other student behaviors not listed in the survey that they considered uncivil classroom behavior. Other behaviors they listed included eating in class; discussing hot button or emotionally laden issues such as sexual activity, race, religion, or politics in the preclinical laboratory; walking in and out of the classroom repeatedly; forgetting class assignments; missing classes for valid reasons, such as weddings or family reunions, with the expectation that accommodations would be made; writing unprofessional and personal comments on faculty course evaluations; wearing inappropriate attire or not following the dress code; challenging faculty decisions on grading after the student concerns have been carefully reviewed; signing the attendance chart for someone who is absent; and expecting everything they need to know is in a handout. Yet, one faculty respondent noted that "much of the uncivil behavior that is experienced in classrooms is dependent on the culture that faculty have nurtured" and added that "we the faculty created the uncivil behavior."


   Conclusion
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 Abstract
 Definitions of uncivil classroom...
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Studies have found that incivility in the classroom has increased and is no longer the domain of elementary and secondary education but has pervaded higher and professional education. It has become more important for faculty members in higher and professional education to be very specific with students about expected behaviors in the classroom, beginning with setting and maintaining appropriate ground rules from the first day of class. For example, instructors can use the syllabus as an important mechanism in deterring uncivil behavior by providing specific details regarding course objectives, methods of evaluation, attendance issues, makeup exams, etc. Clinic manuals should provide not only thorough information regarding these processes and procedures but should also include rules of professionalism and behavioral issues.

Administrators can assist by providing workshops and forums for new faculty members regarding issues of incivility in the classroom and appropriate measures to deter the behavior. More experienced faculty members should share their experiences regarding incivility with newer faculty members. It is necessary for all the faculty to document their experiences of uncivil behavior so that an adequate record is maintained. Other investigators who have studied students’ classroom behavior have found that women and people of color are more prone to experience acts of student incivility in the classroom; therefore, administrators should be cautious of this and provide those faculty members in particular with all the necessary tools to develop appropriate skills in handling such behaviors. If incidents of uncivil classroom behavior are more frequent in courses taught by women, minority, and younger faculty, it could be conjectured that these individuals may receive lower evaluations from students. If dental education is serious about recruiting younger faculty who are new to teaching as well as women and minority faculty members, then it is imperative to provide training in handling CI. The findings of our study suggest it is important for dental educators to engage in an open and honest discussion with their students regarding incivilities in the classroom.

A limitation of our study was the small sample size and distribution within a single institution. However, we hope that other dental schools will be able to use this study as a starting point to begin a dialogue with their students regarding incivility in dental education and professional practice since uncivil behavior is not limited to institutions of higher learning but also include the workplace. This dialogue can open the door for faculty and students to create strategies together to enhance the teaching and learning environment for all parties involved.

The literature on this subject suggests it is likely that classroom incivilities will continue, so it is imperative for dental faculty members to be prepared in how to respond to such incidents when they occur. Training is needed to assist new faculty members, faculty members of color, and women faculty members to help them avoid becoming targets of uncivil student behavior and to learn how to respond appropriately to incidents if and when they occur.


   Author Information
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 Author information
Abstract
 Definitions of uncivil classroom...
 Methods
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 References
 
Dr. Rowland is Assistant Professor, Division of Primary Care, and Dr. Srisukho is Assistant Professor, Division of Restorative and Prosthetic Dentistry—both at The Ohio State University College of Dentistry. Direct correspondence and requests for reprints to Dr. Michael L. Rowland, The Ohio State University College of Dentistry, Room 3166 Postle Hall, Columbus, OH 43210; 614-247-8621 phone, 614-247-6599 fax; Rowland.3{at}osu.edu.


   REFERENCES
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 Methods
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