Responding to disruptive behaviors in nursing: A longitudinal, quasi-experimental investigation of training for nursing students

The objective of this study was to determine the impact of a cognitive rehearsal intervention on nursing students' self-efficacy to respond effectively to disruptive behaviors.

This quantitative study was part of a longitudinal, quasi-experimental program of research.

Interventions were conducted on site at facilities provided by participating pre-licensure nursing programs.

A total of 129 nursing students enrolled in their final academic year in three traditional format, pre-licensure nursing programs in the Midwestern United States were recruited to participate in this study.

A cognitive rehearsal intervention was delivered to increase self-efficacy to respond to disruptive behaviors in the nursing workplace. Data were collected in writing immediately prior to and following the intervention. Three months later, data were collected in electronic format through a link sent by text message to their mobile phones. Study data were collected on the Self-efficacy to Respond to Disruptive Behaviors Survey, a 10-point Likert scale measuring self-efficacy and its dimensions: knowledge, previous behavioral engagement, affect, and motivation toward responding effectively to disruptive behaviors.

129 students completed the surveys at pre and post-test; 109 completed the survey three months later. Measures of overall self-efficacy and knowledge (p < 0.000), and both measures of situational self-efficacy (p = 0.002; p = 0.020) remained significantly increased three months after the intervention, compared to pre-test. Past behaviors increased on post-test but returned to baseline at the three-month follow-up. The intervention did not significantly impact affect scores. Changes in motivation toward effective responses were mixed between measurements immediately following the intervention and three months later.

Cognitive rehearsal interventions can increase self-efficacy to respond to disruptive behaviors with sustained effects up to three months later. Further research is needed to determine the effects of self-efficacy to respond once participants have entered the nursing workplace.