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*1. As a college student, have you ever had an experience where you had been verbally abused. If YES CONTINUE with survey. If NO, go to END of survey. No more questions. Yes No

2. As a college student, which of the following have been sources of verbally abusive statements to you Check any that apply   Patients Patient's family Peer/classmate Physician Nurse Nursing Professor Non-nursing Professor School staff member Other (next question)

2b. If you answered "other" in previous question, please specify below.

3. How would you rate your handling of verbally abusive situations? Choose only one of the following Please choose.. Poor Fair Good Very good

4. Which of the following best describes your feelings following a verbal abusive incident? Choose only one of the following Please choose.. Powerless Fearful Hostile Harasses Embarrassed Angry Confused Determined to problem solve Other (next question)

4b. If you answered "other" in the previous question, please specify below.

5. Was the verbal abuse associated with a high-stress situation for you? Yes No No answer

6. Was the verbal abuse associated with a high-stress situation for the abuser? Choose only one of the following YES NO Do not know No answer

7. As a college student, which of the following is the MOST COMMON source of verbally abusive statements to you? (One answer only) Choose only one of the following Patients Patient's family Peer/classmate Physician Nurse Nursing Professor Non-nursing Professor School staff member Other (next question) No answer

7b. If you answered "other" in the previous question, please specify below.

8. As a college student approximately how many abusive statements were directed towards you (from all sources)? Choose only one of the following Please choose.. 0-5 6-10 11-15 16-20 over 20

9. Have you ever dropped a class due to verbal abuse? Choose only one of the following Please choose.. Yes No

10. What is the gender of the person(s) who MOST FREQUENTLY abused you? Female Male No answer

11. How likely is it that you will drop out of school in the next year as a result of having been verbally abused while at school? Choose only one of the following Please choose.. Not at all likely Somewhat likely Quite likely

12. I often think of quitting school as a result of the verbal abuse. Choose only one of the following Please choose.. Strongly disagree Disagree Slightly disagree Neutral Slightly agree Agree Strongly Agree

13. Was the verbal abuser from a different ethnic group than yours. Choose only one of the following Please choose.. Yes NO

If the answer to the above question was "yes," please specify the "other" group.

14. Was the verbally abusive event witnessed by another person(s)? Choose only one of the following Please choose.. Yes No Do not know

15. If you answered "yes" to the question above, who was/were the witness(es)? Check any that apply   Peer/classmate Faculty Other TWU staff Patients Patient's family Physician Nurse Other (next question)

15b. If you answered "other" in the previous question, please specify below.

16. What was the witness' reaction to the event? CHECK ONE BEST ANSWER. Choose only one of the following Please choose.. Anger Confusion Supportive Embarrassment Powerlessness Shock/Surprise Indifference Ignored event Called for assistance Other (see question below)

16b. If the answer to the question above was "other," please specify below.

17. Was the content of the verbal abuse related to: CHECK ONE BEST ANSWER. Choose only one of the following Please choose.. Age Race Gender Accent/Language Disability Physical Characteristics Other (see question below)

17b. If the answer to the previous question was "other," please specify below.

18. Have you ever reported a verbally abusive incident? Choose only one of the following Please choose.. Yes No

19. Verbal abuse has a negative effect on my morale. Choose only one of the following Please choose.. Yes No

20. Verbal abuse decreases my productivity for a period of time. Choose only one of the following Please choose.. Yes No

21. Verbal abuse impacts my school work for a period of time. Choose only one of the following Please choose.. Yes No

22. Verbal abuse contributes to an increased workload for my classmates for a period of time. Choose only one of the following Please choose.. Yes No

23. Verbal abuse may be a reason students fail or drop out of school. Choose only one of the following Please choose.. Yes No

24. Verbal abuse leads to an increse in errors or mistakes. Choose only one of the following Please choose.. Yes No

25. Verbal abuse has contributed to the shortage of nurses. Choose only one of the following Please choose.. Yes No

Please enter any comments or clarifications you might have to this survey. Would your answers have been different if you would have been asked these questions in a faculty interview?