Workplace incivility is a widespread problem in the clinical work environment that affects present and future generations of nurses. The purpose of this study was to determine if a cognitive rehearsal intervention (i.e., TeamSTEPPS® DESC script) would increase senior nursing students' self-efficacy, decrease workplace incivility experienced in the clinical work environment, and if nursing students' pre-intervention self-efficacy level would be indirectly associated with post-intervention workplace incivility. A quasi-experimental, one-group pretest-posttest study was used to measure the effect of a cognitive rehearsal intervention on nursing students' self-efficacy levels and workplace incivility experienced in their clinical rotation at an acute care center. Study participants were recruited from a university in the southeast USA. Data were collected in three phases using four different instruments: Uncivil Behavior in Clinical Nursing Education (UBCNE) measured perceived workplace incivility, General Self-Efficacy (GSE) scale assessed perceived self-efficacy, Centers for Disease Control and Prevention's Delayed Evaluation appraised use of the cognitive rehearsal intervention, and a demographic survey was utilized to obtain personal information on study participants. A total of 64 nursing students met the inclusion criteria and were invited to participate. Thirty-nine students took part in pre-intervention data collection and 27 completed both pre- and post-surveys. Of the 27, most were female (85.2%), 20 to 24 years of age (55.6%), and Black of not Hispanic origin (59.3%). Study participants' ages ranged from 20 to 49. A repeated measures ANOVA was used to compare nursing students' self-efficacy levels and workplace incivility experienced in the clinical work environment between pre- and post-intervention. Findings indicated no significant effect between time1 and time2 in nursing students' self-efficacy levels (Wilks' Lambda = .93, F (1, 25) = 1.89, p = .181) nor workplace incivility (Wilks' Lambda = .99, F (1, 25) = .02, p = .884) while controlling for race and ethnicity. Over 96% of the students stated that they had used some or a lot of the cognitive rehearsal intervention to respond to workplace incivility. Correlation's analysis did not indicate a significant linear relationship (r = -0.19, n = 27, p = .337) between pre- self-efficacy (GSE) and post-workplace incivility (UBCNE) scores. Results of this study illustrate a need for additional research regarding culturally diverse nursing populations, self-efficacy, and workplace incivility. Current levels of workplace incivility experienced by nursing students threatened the profession and patient care. Nursing programs should consider exposing students to more than one session of the DESC script and using different evidence-based cognitive rehearsal interventions such as the Caring Feedback Model or the TeamSTEPPS® CUS script to compare effect size. It is critical to help nursing students address workplace incivility in the clinical work environment before they transition into professional practice and normalize said behavior.


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Graduation Date





Lindo, Jascinth


Doctor of Philosophy (Ph.D.)


College of Nursing



Degree Program





CFE0008824; DP0026103





Release Date


Length of Campus-only Access

1 year

Access Status

Doctoral Dissertation (Open Access)

Included in

Nursing Commons