In an editorial by Cynthia M. Clark, PHD, RN, ANEF, FAAN, the author laments how the institutional mission of college and university campuses has failed in creating open communities where freedom of expression is protected and where civility is powerfully affirmed.

Instead, these institutions have unintentionally provided fertile ground for acts of incivility as they have expanded the use of e-learning, which has inarguably revolutionized higher education while simultaneously putting students' vulnerabilities at risk.

In her editorial in Nurse Education Today (Vol. 85, February 2020), "Cyber-incivility, cyber-bullying, and other forms of online aggression: A call to action for nurse educators," Dr. Clark writes:

Cyber-incivility, cyber-bullying, and other forms of online aggressive behavior by current and future nurses are particularly troubling phenomena, since research (Dang et al., 2016; Institute of Safe Medication Practices, 2013) has firmly established a link between disruptive behavior and a host of negative outcomes, including patient harm. Difficult conversations are needed by nurse educators to discern our role in preventing, mitigating, and remediating cyber-incivility by students as they relate to the profession's responsibility to self-regulate.