Experiences of Nurse Anesthesiology Residents with Clinical Preceptor Incivility: A Mixed Methods Analysis

# Significance The ethical obligation of nurses to create cultures of civility, respect, and dignity has long been an expectation of the profession. While there is a considerable amount of literature on incivility in nursing and nursing academia, the issues of incivility in nurse anesthesiology and the experiences of nurse anesthesiology residents with clinical preceptor incivility have not been widely addressed. # Aim To assess nurse anesthesiology residents’ experiences with clinical preceptor incivility using a mixed-methods approach and recommend strategies to address issues that have been identified. # Methods A descriptive cross-sectional mixed-methods Qualtrics survey combining both closed-ended and open-ended questions was emailed to nurse anesthesiology program directors, assistant program directors, and faculty in the United States for dissemination to nurse anesthesiology residents. A link to the survey was posted on nurse anesthesiology faculty and resident social media forums. Any nurse anesthesiology resident currently enrolled in a Doctor of Nursing Practice Anesthesia program or Doctor of Nurse Anesthesia Practice program was eligible to complete the survey. Quantitative data were analyzed using descriptive and inferential statistics, while qualitative responses underwent thematic analysis. # Results/Findings A total of 313 residents completed the survey. Approximately 77% of respondents reported experiencing or witnessing at least 1 form of clinical preceptor incivility, most commonly dismissive communication, public criticism, and exclusion from learning opportunities. Qualitative analysis revealed 4 central themes: erosion of psychological safety, disruption of professional identity, systemic tolerance and silence, and coping through resilience. Quantitative and qualitative findings converged to demonstrate that higher frequency of incivility was associated with greater perceived negative impact on learning and emotional well-being. # Discussion/Implications for Practice Eliminating or reducing clinical preceptor incivility in nurse anesthesiology requires intentional, coordinated efforts by nurse anesthesiology programs and clinical partners, including structured preceptor development, transparent and non-punitive reporting mechanisms, and a shared commitment to professional accountability. Comprehensive preceptor development workshops offer a powerful strategy to strengthen partnerships between nurse anesthesiology programs and clinical affiliates while fostering shared accountability for professional behavior. These workshops should explicitly address the recognition and prevention of incivility and promote a culture grounded in mutual respect, dignity, and psychological safety—foundations essential to both effective mentorship and resident well-being.