Measuring exposure to bullying and harassment in health professional students in a clinical workplace environment: Evaluating the psychometric properties of the clinical workplace learning NAQ-R scale

Abstract

Background: Instruments that measure exposure to bullying and harassment of students learning in a clinical workplace environment (CWE) that contain validity evidence are scarce. The aim of this study was to develop such a measure and provide some validity evidence for its use.

Method: We took an instrument for detecting bullying of employees in the workplace, called the Negative Acts Questionnaire – Revised (NAQ-R). Items on the NAQ-R were adapted to align with our context of health professional students learning in a CWE and added two new factors of sexual and ethnic harassment. This new instrument, named the Clinical Workplace Learning NAQ-R, was distributed to 540 medical and nursing undergraduate students and we undertook a Confirmatory Factor Analysis (CFA) to investigate its construct validity and factorial structure.

Results: The results provided support for the construct validity and factorial structure of the new scale comprising five factors: workplace learning-related bullying (WLRB), person-related bullying (PRB), physically intimidating bullying (PIB), sexual harassment (SH), and ethnic harassment (EH). The reliability estimates for all factors ranged from 0.79 to 0.94.

Conclusion: This study provides a tool to measure the exposure to bullying and harassment in health professional students learning in a CWE.

Keywords:

• Education environment
• undergraduate
• work-based

Acknowledgments

The authors would like to thank all of the Associate Deans of Medical Education for Otago Medical School who assisted with the data collection for this questionnaire, as well as Faculty in The School of Nursing at Otago Polytechnic. We would also like to thank Dr Ella Iosua and Michel de Lange for their initial advice on the analysis of this paper. We would also like to thank the students for their time and effort in completing this questionnaire.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Glossary

Confirmatory factor analysis (CFA): Is a type of structural equation modeling (SEM) that deals specifically with measurement models that is, the relationships between observed measures or indicators (e.g., test items, test scores, behavioral observation ratings) and latent variables or factors” (Brown & Little, 2015, p.1).

Additional information

Funding

The present research was financially supported by Division of Health Sciences, University of Otago.

Notes on contributors

Kelby Smith-Han

Kelby Smith-Han, MHealSc, PhD, is a Postdoctoral and Teaching Fellow, Department of Anatomy and Otago Medical School, University of Otago, Dunedin, New Zealand.

Emma Collins

Emma Collins, MN, is Principal Lecturer, School of Nursing, Otago Polytechnic, Dunedin, New Zealand.

Mustafa Asil

Mustafa Asil, MA, PhD, is a Senior Research Fellow, Educational Assessment Research Unit (EARU), College of Education, University of Otago, Dunedin, New Zealand.

Althea Gamble Blakey

Althea Gamble Blakey, MHealSc, PhD, is a Research Fellow, Otago Medical School, University of Otago, Dunedin, New Zealand.

Lynley Anderson

Lynley Anderson, MHealSc, PhD, is an Associate Professor, Bioethics Centre, University of Otago, Dunedin, New Zealand.

Elizabeth Berryman

Elizabeth Berryman, MHSc, MBChB, is a Resident Medical Officer, Waitemata District Health Board, Auckland, New Zealand.

Tim J. Wilkinson

Tim J. Wilkinson, MBChB, MClinEd, PhD, MD, is Professor, Dean’s Department and Department of Medicine, Otago Medical School, University of Otago, Christchurch, New Zealand.