A critical ethnographic study using Bourdieu's social practice framework to explain vertical and horizontal abuse (VHA) within an undergraduate nurse simulation environment

Background: Vertical and horizontal abuse (VHA) has been reported in the nursing literature for over 30 years. VHA has also been referred to as workplace bullying, incivility, harassment, and mobbing. Previous work has explicitly focussed on VHA in nurses working in the industry, while other studies explore VHA generally in nursing students. However, there has been little attention paid to episodes of VHA, which may occur among nursing students learning in simulated environments.

Aim: This study aimed to identify factors which enabled episodes of VHA among second-year nursing students learning in a simulated hospital environment, through the application of Bourdieu's social practice theory.

Method: This research used a critical ethnographic approach. Methods included observations, and semi-structured interviews with student (n = 40) and academic participants (n = 3) from a second-year undergraduate nursing program.

Results: Episodes of VHA were evident among second-year nursing students and academics learning and teaching in a simulated environment. This study showed that the organizational and the social spaces of learning and teaching had been influenced by healthcare industry culture and the challenge for capital within the university. This has resulted in the simulated laboratory, becoming a space for cultural reproduction.

Conclusion: This study calls for both an educational and organizational response to the findings. An educational response would require a curriculum review to reveal and acknowledge symbolic violence which may be embedded. An organizational response to recognize the symbiotic relationship between the higher education and health care sectors which may result in the reproduction of VHA is also required.