Exploring Nursing Students’ and Faculty Members’ Perspective on Incivility in the Online Learning Environment: A Descriptive Qualitative Study

Background: Incivility is a kind of disrespect to people. Students and faculty members agree on the growing trend of incivility. Uncivil behaviors in online nursing classes are a serious global issue that can influence the learning-teaching process and threaten patient safety in the clinical setting . This study aimed to identify incivility in the online learning environment from the perspective of nursing faculty members and students. Methods: This descriptive qualitative study was conducted in 2021. A total of 20 participants were selected from among nursing students and faculty through purposive sampling. Data were collected using in-depth semi-structured interviews and analyzed via a qualitative content analysis approach. Results: Data analysis revealed five categories including ghost students, unconditional freedom, disruptive learning behaviors, academic dishonesty, and ignoring the rules of the online learning environment. Conclusion: Incivility in the online learning environment disrupts the teaching-learning process and undermines instructor-student relationships. Given that disrespectful and threatening behaviors, even to a small degree, can significantly affect the learning environment, it is essential to recognize such behaviors. As uncivil behaviors in virtual nursing education can affect education by developing inappropriate behavioral and communication patterns in students, leading to the violation of professional ethics and patients’ rights, it is necessary to pay attention to this critical issue by conducting further studies and designing interventions to correct it.


Introduction
The concepts of ethics and morality are deeply rooted in professional nursing (1), and incivility conflicts with nursing ethics. Incivility refers to disruptive or rude behaviors that lead to the development of psychological and physiological disorders in other individuals and, if not dealt with, may result in threatening circumstances (2). Uncivil behaviors might disrupt learning, discourage the instructor from teaching, and reduce students' motivation to contribute to participatory discussions (3,4). In addition, incivility might lead to disrespect and reluctance to listen to others' opinions and divert the instructors from their goals (5).
Incivility occurs in online and in-person classes, and its incidence is increasing (6). One-third of students have experienced online classes, and due to their anonymity, the probability of incivility in these classes is higher (7). Incivility in online classes is also referred to as cyberbullying, through which students use the Internet and mobile phones to send messages to destroy or

Exploring Nursing Students' and Faculty Members' Perspective on Incivility in the Online Learning Environment: A Descriptive Qualitative Study
Maryam Moghimian 1 ID , Sedigheh Farzi 2* ID , Abbas Abbaszadeh 3 ID , Amir Shahzeydi 4 ID , Fatemeh Farzi 5 ID , Amir Musarezaie 6 ID embarrass other individuals (8). According to Kopp and Finney's study, each individual experiences incivility at least once during online courses (9). A study conducted on 439 students to determine the incivility rate found that 6.6% of students had committed uncivil behaviors, 38% of students knew other individuals who had experienced incivility, and 21.9 % of them had received incivility (6). Crosslin and Golman calculated the incivility rate among students between 8% and 21%; however, they believed a large number of students do not express these behaviors and retaliate against them (10). Other studies revealed 8.8% of nurse educators have experienced incivility resulting in low-quality teaching and reduced self-esteem (11).
Creating effective learning in an online learning environment is of particular importance since the lack of face-to-face contact with the instructor and the presence in a tedious environment that disrupts learning may influence education (7). Incivility in online classes includes insulting remarks, challenging the instructor, and not responding to the instructor. Regarding the unfeasibility of face-to-face contact in the online classroom, most behaviors and messages may be considered uncivil due to the lack of a specific tone of voice and body language, which highly depends on the recipient's interpretation of the message (12). Both professors and students commit uncivil behaviors. In a study, the students stated that the professors treated them disrespectfully and considered it a reason for their incivility (13). Incivility has an adverse effect on the online learning environment, and educational administrators can reduce such behaviors by identifying these factors and establishing effective communication (12).
Uncivil behaviors in online nursing classes are a serious global issue that can influence the learning-teaching processes. According to the International Society of Psychiatric-Mental Health Nurses, incivility in online nursing classes leads to stress and threatens the patient's safety in the clinical setting (7). It even results in unethical clinical behaviors in nurses and nursing students, such as recording vital signs or executing orders incorrectly. As a result, it is essential to take into account this issue in nursing education environments, particularly in online classes (13). Due to the COVID-19 outbreak, the use of online learning environments has increased compared to the past. Considering the cultural dimension of the issue and the need for a tailored context-specific approach to addressing incivility (14), identifying uncivil behaviors in any context is critical. Therefore, this study aimed to identify incivility in the online learning environment from the perspective of nursing faculty and students.

Methods
This descriptive qualitative study was conducted in June and July 2021. In qualitative research with an inductive approach, the researcher generally searches for the meaning of a situation (15). In the present study, the participants were selected from among nursing students (undergraduate and master) and faculty members of Isfahan University of Medical Sciences. The inclusion criteria for faculty members were having at least one semester of teaching experience in an online learning environment, encountering students' uncivil behavior, and willingness to participate in the study. The inclusion criteria for students were having at least one semester of learning experience in an online learning environment, having experiences of uncivil behaviors, and willingness to participate in the study. The participants were selected using purposive sampling. Sampling was performed with maximum variation in terms of age, gender, semester, and the number of years of teaching experience. Those who did not fully share their experiences were excluded.
Data were collected using in-depth semi-structured interviews. The interviews lasted 30-45 minutes. The interview time and place were determined at the participants' convenience. All interviews began with a general question to establish a close relationship with the participants. The examples of interview questions are provided in Box 1. Participant selection and sampling continued until data saturation was reached.
The qualitative content analysis approach proposed by Graneheim and Lundman was used for data analysis (16). Recorded interviews were transcribed verbatim. Transcribed interviews were read by the researchers several times, and meaning units were extracted. The identified meaning units were condensed, abstracted, and coded. Finally, similar codes were grouped under subcategories, and the categories were formed using the inductive approach.
Rigor was ensured through conformability, credibility, dependability, and transferability criteria (17). To increase confirmability, various research and data analysis methods were provided. To ensure credibility, member check and peer check methods were used. To this end, the participants were provided with the extracted codes and results to confirm the consistency between the codes and their experiences. In addition, the resulting codes and categories were presented to colleagues. Dependability was achieved through engaging more than one researcher

Questions
Have you ever encountered disrespectful behavior in online learning environment? Can you share your experience with an example of these behaviors? In your opinion, what behavior is considered uncivil? Can you give an example? Please, explain more. What behavior of faculty members or students annoys you?

Box 1. Examples of interview questions
in data analysis and selecting participants with different demographic characteristics enhanced the transferability of the results.

Results
A total of 13 nursing students (undergraduate and master) and 7 faculty members participated in this study. The demographic characteristics of the participants are presented in Table 1. After analyzing the data, 5 categories and 12 subcategories were extracted from the participants' experiences ( Table 2). The main categories included ghost students, unconditional freedom, disruptive learning behaviors, academic dishonesty, and ignoring the rules of the online learning environment.

Ghost students
Participants' experiences indicated a lack of active participation and effective responsiveness in online classes and believed students attended the classes ineffectively. This category was divided into two subcategories including ineffective and inefficient presence and performing non-learning activities.
"Sometimes, students enter an online classroom but are inattentive and engage in non-learning activities, and they're only seemingly present in the classroom," said one professor (Participant 2). One student stated, "I was busy at work, and although I was in an online class, I was checking messages on WhatsApp messenger" (Participant 4).
According to the findings of this study, the students only announced their presence in the online class and did not actively participate in the class. Engaging in personal affairs, private chatting in the classroom, leaving the classroom untimely, and following the course ineffectively were among the students' uncivil behaviors.

Unconditional freedom
Participants' experiences indicated that some students in the virtual classroom behaved informally that sometimes offended other students and the instructor and caused them discomfort. This category was divided into two subcategories including unconventional assertiveness and desecration.
One of the participants stated, "Some students have an inappropriate tone of voice and send inappropriate emojis that upsets me" (Participant 7).
Another student said, "The professor asked me a question, and I didn't know the answer. Some friends said in a belittling tone 'You study so much; how slow you are' and I got very upset" (Participant 12).
Participants' experiences showed calling each other names, mocking the voice and video of the instructor and other students, writing irrelevant messages, wearing inappropriate clothing when turning the webcam on, joking, and sending inappropriate emojis and stickers were some of the instances of uncivil behaviors.

Disruptive learning behaviors
The participants' experiences indicated countless extraneous issues in online classes, which led to distraction from the main subject. This category was classified into two subcategories including paying little attention to learning activities and negative action. "I try to focus on my teaching, but a student distracts me and others by asking an irrelevant question in the chat room or turning on the microphone without permission.

Sometimes a student in unsuitable clothes turns on the webcam and distracts everyone," said one professor (Participant 15).
Another participant said, "When we get bored, sometimes my friends take screenshots from the class and the instructor in a certain pose and send it on WhatsApp messenger. We all start laughing and arguing on these irrelevant issues, so the attention on the class is completely lost" (Participant 8).
Although students were aware of the importance of learning theoretical lessons to acquire clinical skills, the online classroom atmosphere had misdirected their attention to irrelevant issues, and class attendance had become more of a pastime.

Academic dishonesty
Academic dishonesty is the intentional participation in deceptive acts in the academic activity of oneself or others. This category can be divided into three subcategories including cheating, plagiarism, and hacking.
One participant said, "During the exam, we make a group, divide the questions and give shared answers. Sometimes students hack the exam site, and we take the questions earlier, prepare the answers, and complete the test in a short time" (Participant 11).
Another participant stated, "Because the instructor in the online class doesn't pay much attention to the students' presentation and assignments, most of them use ready-made projects for presentations and only remove the author's name. As asking and answering questions are reduced, students don't feel forced to study or extract material from different sources" (Participant 3).
Academic dishonesty was observed in the online learning environment as cheating on the exam, referring to books and pamphlets, creating a group active during the exam, not submitting assignments, copying assignments, and hacking exam questions.

Ignoring the rules of the online learning environment
Participants' experiences showed that some students violated classroom privacy by posting audio, videos, and photos of online classes, exam questions, distorted images of the instructor, and inappropriate captions below the images. This category was divided into three subcategories including violation of class information confidentiality, violation of students' rights, and violation of professors' rights.
One professor said, "When an irrelevant topic is discussed in the class, students immediately record that part and release it with inappropriate captions" (Participant 16).
"The professors sometimes don't give feedback on homework in online education. They only pay attention to certain students or give a test from the content they haven't taught. In this way, they violate the student's rights, and it's an insult to students," said one participant (Participant 14).
The instructors' misbehavior, including injustice and poor classroom and exam management, violates students' rights. The students believed that non-observance of classroom rules, lying, insulting, and disregarding the instructor verbally and non-verbally, had paved the ground for the good students of the class to be exposed to the professor's uncivil behaviors. These behaviors indicated the ignorance of online learning environment rules.

Discussion
This study aimed to investigate incivility in the online learning environment from the perspective of nursing professors and students. One of the main categories identified in this study was ghost students. Professors and students mentioned certain behaviors, including ineffective attendance in the classroom, lack of interaction between students and instructors in teaching, offline presence, unjustified absence, not following the subject, and simultaneous presence in the classroom and workplace as instances of this category. Such behaviors challenge achieving learning goals. In line with the results of this study, Clark et al considered indifference to attending the classroom as an instance of disrespectful behavior. They believed the above-mentioned behaviors in the online classroom can be managed by setting authoritative rules by the professor regarding the presence and absence of students and their continuous participation in class discussions, which requires further attention from instructors (18).
Another category reflecting faculty members' and students' experience of incivility in the online learning environment was unconditional freedom. Behaviors such as inappropriate verbal and non-verbal pranks, informal texts, irrelevant speech, and disrespect for classmates and professors that led to the passivity of other students, were among the instances of unconditional freedom. The lack of a formal learning atmosphere will reduce the student's attention to the instructor's teaching and influence the instructor's motivation for effective teaching. In the study by Clark et al, some of the most critical behaviors that were considered disrespectful by professors were false complaints, offensive behaviors, inattentiveness in the classroom, and misleading the discussions (19), which is consistent with instructors' experiences in this study.
Another category extracted in this study was disruptive learning behaviors. Insufficient and ineffective studying for the exams, hope for cheating, reduced student skills and performance, teachers' and students' indifference to education, and students' lack of critical and creative thinking and problem-solving (20) indicated reduced attention to learning activities. The goal of education is learning, and every educator is gratified by achieving positive learning outcomes (21). Students' inattention in the classroom and committing disruptive learning behaviors are among the behaviors that, from the instructors' point of view, demonstrate students' lack of interest and insufficient motivation to learn, resulting in the lecturers' fatigue and indifference. In the study by Ibrahim et al., from the faculty's perspective, dull and indifferent behaviors, inattention in the classroom, using mobile phones, and unpreparedness to attend online classes have been stated as the most frequent behaviors disrupting the learning process. Likewise, the students believed such behaviors were one of the main causes of academic failure (22).
One of the most thought-provoking experiences of incivility in online classes was academic dishonesty. Non-observance of the principles of academic ethics, such as cheating in online exams, copying assignments, and illegal access to exam questions, were examples of dishonesty in students reported in this study. In fact, participants acknowledged that since their identities were not easily recognizable, they engaged in such disrespectful behaviors in the online learning environment. In their study, Frisbee et al. similarly reported cheating on exams and cell phone use as disrespectful behaviors committed by students. They concluded that cheating in various forms is a threat to learning and an example of academic dishonesty (23).
In this study, ignoring the rules of the online learning environment was another instance of incivility in the online learning environment. The faculty believed that students were violating the confidentiality of class information by publishing audio, videos, and photos of online classes or exam questions. Students, on the other hand, believed that the instructors' unconventional behaviors toward the students, educational injustice, poor classroom management in terms of time and teaching style, disregard for the problems of the virtual environment, disregard for others' privacy, and lack of civility and respect led to the violation of learners' rights. The results of Altmiller's study showed that some faculty members' behaviors, such as delayed arrival at the classroom, unpreparedness to teach, and disregarding some students' rude behaviors are instances of incivility that might lead to the violation of students' rights (24). In the study by Clark et al, behaviors such as underestimating the student, creating fear of the instructor, and unrealistic expectations of the student were introduced as disrespectful behaviors, and students believed that if such behaviors were managed, they could improve the instructor-student relationship and create a healthier educational environment (2).
The results of the studies conducted in Iran also indicated that uncivil behaviors affect the morale, communication, and learning climate and threaten the psychological climate of the academic community (25). These behaviors impair the role of education (26) as uncivilized behaviors are a two-way interaction (27).
The limitation of this study was students' reluctance to fully express instances of incivility. However, attempts were made to overcome this limitation by reassuring participants of information confidentiality.

Conclusion
Nursing students' uncivil behaviors in online education and learning can be considered a general issue not limited to the field of nursing. However, as the civic behaviors learned in the classroom will affect the future relationship between the nursing student and the patient in the real environment, these behaviors gain more importance in the nursing field. The two main issues of civic behavior, namely attention and respect, have been considered by the participants in this study. Among the identified categories, ghost students, disruptive learning behaviors, and ignoring the rules of the online learning environment are related to the issue of indifference, and unconditional freedom and academic dishonesty are mainly related to disrespect. As uncivil behaviors in virtual nursing education can affect education through developing behavioral and communication patterns in students leading to the violation of professional ethics and patients' rights, it is necessary to pay attention to this important issue by conducting further studies and designing interventions to correct it.