Cognitive Rehearsal Training for Upskilling Undergraduate Nursing Students Against Bullying: A Qualitative Pilot Study

Abstract

The purpose of this qualitative study is to examine the effectiveness of an anti-bullying intervention called cognitive rehearsal training (CRT) using a workshop format to increase third year nursing students’ knowledge and confidence to address bullying behaviour. A lanyard card identifying ten common bullying behaviours and possible phrases to stand up to bullying was used as a tool to Stop! Reflect! and Respond! as a process to resolve conflict (Griffin, 2004; Griffin & Clark, 2014). Although similar bullying interventions have been studied among practising nurses, few studies exist that involve students within their pre-licensure training program (Iheduru-Anderson, 2014; Thomas, 2010) and none in Canada. Fifty-eight third-year undergraduate nursing students in two classrooms took part in an anti-bullying workshop introducing the use of CRT as a tool to address bullying behaviour, and provided feedback regarding the utility of the CRT tool.

One significant theme was that confidence and competence are inextricably linked, and lack of confidence to address conflict was reported to result in absenteeism, depression, thoughts of quitting school, and withdrawal from school-related responsibilities. Another key theme was that faculty profoundly impact the outcomes of bullying; students expect faculty to be knowledgeable about bullying and to have the skills to mediate conflict. A third theme was that power is an integral element in bullying dynamics, and participants commonly described feelings of vulnerability, powerlessness, and a reluctance to respond assertively to conflict, and the belief that catastrophic things would happen if they did. The findings of the study support the use of the CRT tool and its integration into undergraduate nursing curricula.