Development of Instrument of Bullying Behaviors in Nursing Education based on Structured Equation Modeling

Summary: Purpose: Bullying behaviors experienced during nursing education negatively affect students, educators, quality of training, and patient care. The purpose of this study was to develop a valid, reliable, short, and comprehensive scale to measure the bullying behaviors of nursing students in the education environment. Methods: The Bullying Behaviors in Nursing Education (BBNE) tool was developed by adapting the Workplace Psychological Violence Behaviors scale. The data were collected from 442 nursing students from April to May 2017. The BBNE was tested using structural equation modeling, and validity and reliability results were obtained. Moreover, complementary statistics were determined, and the violence behaviors experienced by nursing students were reported. Results: The full BBNE scale, with 30 items and four factors, was not verified (χ2/df = 4.31); 12 items were excluded, and the modified structure with 18 items and four factors was verified (χ2/df = 2.60; root-mean-square error of approximation = .06). The scale's Cronbach's α coefficient is .88, and the structure reliability is .92. Twenty-five percent of the 442 students scored 1 or higher in the total scale, showing that they were subject to bullying behaviors. Conclusion: The BBNE scale can be used to measure the bullying behaviors of nursing students in the education environment. When such behaviors are identified, students can struggle on the personal and organization level. Providing a safer and comfortable education environment for nursing students who are the guarantee of the future of health care will positively affect the quality of education and patient care in parallel. Keywords: bullying, nursing, prevalence, reproducibility of results, students