Clinical Nurse Civility and Professional Identity Formation in Nursing Students

Professional identity (PI) formation is an essential objective for nursing education. In 2010, Benner et al. published a landmark document titled Educating Nurses: A Call for Radical Transformation, which included a transition from teaching roles and developing professionalism to professional identity formation. In 2018, a ‘Thank Tank’ meeting occurred at the University of Kansas to explore professional identity in nursing, which developed into the International Society for Professional Identity in Nursing (ISPIN; Brewington & Godfrey, 2020). The American Association of Colleges of Nursing’s (AACN, 2021) The Essentials included a core competency that called for the “formation and cultivation of a sustainable professional identity” (p. 49). In light of this focus on PI, nursing educators need to understand the process of PI formation, factors that influence its development, and determine ways to promote and support PI formation. The purpose of the study was to determine the relationship between the civility of clinical nurses toward nursing students and PI formation in nursing students. The following research question guided this study: Q1 To what extent does the perceived civility of the clinical nurse toward the nursing student predict the students’ professional identity formation after controlling for age, gender, race/ethnicity, English as a primary or secondary language, type of nursing program, first generation college student status, number of nursing courses with clinical experience, and number of semesters remaining until program completion? This cross-sectional, correlational design study was guided by the conceptual model of PI described by the ISPIN (Joseph et al., 2023), which included four domains of PI: knowledge, values and ethics, nurse as leader, and comportment. Using a random selection from the AACN Enrollments and Graduates in Baccalaureate Programs in Nursing report (Havey et al., 2024), 40 nursing programs were invited to participate. Eleven programs from four regions of the United States agreed to send invitations to students in traditional and accelerated, second-degree Bachelor of Science in Nursing programs, resulting in 116 participants. An investigator-constructed questionnaire solicited demographic information from participants. The independent variable of clinical nurse civility was measured using the Nursing Student Perception of Civil and Uncivil Behaviors scale (Tecza et al., 2015). The dependent variable, professional identity, used professional values as a proxy and was measured using the Nurses Professional Values Scale-3 (Weis & Schank, 2017). A hierarchical linear regression tested the predictive relationship of perceived civility of the clinical nurse toward the nursing student on professional identity, while controlling for demographics. This analysis determined that the demographic variables did not significantly predict PI nor the perceived civility of clinical nurses toward nursing students. There remains a need to understand and support PI formation in nursing students in both academic and clinical settings.