Developing and testing a prototype smartphone educational application to address incivility and bullying in nursing...

Incivility and bullying in the nursing workplace may induce psychological trauma and increase staff turnover, however, the effects can be mitigated by cognitive rehearsal therapy. Smartphone education applications have emerged as an important educational tool in recent years. However, to date, no educational applications have been developed that combine cognitive rehearsal approaches with clinical situations. Therefore, in this study an education application (Easy Play Communication) was developed and tested to address incivility and bullying in the nursing workplace.

This study design was employed in two phases. Phase 1 (February 2020-March 2021) combined analysis, design, development, implementation, and evaluation (ADDIE model) stages in the application development process. This phase involved conducting research into educational training and cognitive rehearsal literature, consultations with seven experts in related fields and administering a user needs questionnaire among 41 nurses. Phase 2 (April 2021-December 2021) was a pilot test phase, where 47 Mandarin and Taiwanese speaking nurses used the application to conduct cognitive rehearsal training. Changes in workplace incivility and bullying were tested using a pretest-posttest design. The posttest was conducted one week after the pretest.

Phase 1 showed user satisfaction with the app's accessibility (96.3 %), practicality (81.4 %), willingness to use (92.6 %), information content (88.9 %), information quality (88.9 %), and interface quality (88.9 %). Phase 2 showed that participants' perceived incivility in their interactions with other nurses, physicians, and patients and their family members decreased over the study period.

The findings indicate that smartphone applications combining theoretical knowledge with practical exercises can have a positive impact on nurses in the context of workplace incivility and bullying. We also demonstrated a development process that can be used to build applications for clinical nurses.