Kendyl conducted a research study to compare marital satisfaction scores before and after participation in Gottman's relationship retreat program. She used the Enrich Marital Satisfaction Scale to measure marital satisfaction. Based on simulated data entered into SPSS, Kendyl used a paired samples t-test to analyze whether there was a statistically significant difference in pre- and post-retreat marital satisfaction scores. The SPSS output suggests the correct statistical test was used. The statistical test that Kendyl should use to analyze her data and answer the research question is a paired samples t-test. A paired samples t-test is used to determine whether there is a statistically significant mean difference between two sets of scores that are paired or related

1. Discussion Post
Incivility in health care settings can have a detrimental impact
on individuals, teams, and organizations (Clark, 2018). The
American Nurses Association (ANA) Code of Ethics for Nurses
with Interpretive Statements clearly articulates the nurse's
obligation to foster safe, ethical, civil workplaces (Clark, 2015).
Description Work Environment Assessment Results
The Clark healthy workplace inventory results revealed
that I work in a very unhealthy work environment. After
completing the assessment, my total score was less than 50. A
score of less than 50 indicates a very unhealthy work
environment. In the patient care environment, an unhealthy
work environment can provoke uncertainty and self-doubt,
weaken self-confidence, and compromise critical thinking and
clinical judgment skills (Clark, Olender, Cardoni, & Kenski,
2011). I was not entirely surprised that the assessment revealed
an unhealthy work environment because it is entirely accurate,
as evidenced by the results. My workplace is characterized by
rude, discourteous, and lack of regard for others, creating low
morale among employees, stress, and hostility, and thus
incivility. This abnormality has been adopted as the norm, thus
forming a culture of bullying, rudeness, and other incivility set
by a dictatorial head of the organization, trickling down through
the ranks (Bar-David S. 2018). Employees' efforts and input are
not being recognized and appreciated.
Incivility experienced in the workplace
I have experienced incivility at my workplace in many
forms, patterns, shapes, and sizes. One example of my
experience is when one of my patients was incontinent. I work
in a mental health care facility, so we seldom have incontinent
patients. We were short-staffed as usual, and I was busy passing
meds and providing care for other patients in order to catch up.
The assigned tech walked up to me to tell me that my patient

2. needs to be changed. At first, I thought she needed help with
changing the patient, so I offered to help when I finish passing
meds. However, she told me that she does not need help, but she
is wants me to go change my patient-delegating with quite an
attitude-rolling her eyes. I quietly walked to the manager's
office to make a report about how unruly and unprofessional the
tech had conducted herself. The manager called her in the office
to ask what happened. She narrated the same event. Without
reprimanding her, the manager turned to me yelling that tech
has not received training on how to change patients and that I
should go do it since I went to school, and I have a license. She
also reminded me that techs do not have any license to be
revoked by the BON as nurses do. I felt very disappointed and
frustrated, but I went ahead and changed the patient and
continued my day in fear of losing my license if I do not do as
ordered. Having the managers reminding the nurses consistently
that they could lose their nursing license creates the most
significant stress and anxiety in my workplace. The managers'
mastermind gossips, favoritism, and unruly behaviors by the
techs. They remain partial in their judgment, especially when it
involves the staff member the prefer.
One of the reasons why I chose to go back to school to
obtain my master's degree is due to the ongoing incivility at my
workplace. One may wonder if it is that bad, why work there? I
love what I do, and I know that the patients need me, and I
choose to remain there for the sake of my patients. As nurses,
we need to learn and practice skills to address uncivil
encounters, organization leaders and managers must create an
environment where nurses feel free and empowered to speak up,
especially regarding patient safety issues. All of us must strive
to create and sustain healthy work environments where we
communicate clearly and effectively and manage conflict in a
respectful, responsible way (Clark, 2018).

3. References
Bar-David S. (2018). What's in an eye roll? It is time we
explore the role of workplace incivility in healthcare. Israel
journal of health policy research, 7(1), 15.
https://doi.org/10.1186/s13584-018-0209-0
Clark, C. M. (2018). Combining cognitive rehearsal, simulation,
and evidence-based scripting to address incivility. Nurse
Educator. doi:10.1097/NNE.0000000000000563
Clark, Cynthia, PhD, RN, Olender, Lynda, MS, RN, ANP, NEA-
BC, Cardoni, Cari, et al. (2011). Fostering Civility in Nursing
Education and Practice: Nurse Leader Perspectives. Journal of
Nursing Administration, 41, 324-330.
https://doi.org/10.1097/NNA.0b013e31822509c4
Clark, C.M. (2015). Conversations to inspire and promote a
more civil workplace. American Nurse Today, 10(11),
18-23. Retrieved from
https://www.americannursetoday.com/wp-
content/uploads/2015/11/ant11-CE-Civility-
1023.pdf
COUC 515
Case Scenario
Step 1: Inquiry.
Kendyl is interested in investigating the efficacy of counseling
programs that are associated with enhanced relationship
satisfaction. She wants to know which is the best program to
refer her clients to for additional support for those presenting
for relationship counseling.
Step Two: She began reviewing literature and programs.
She heard that John Gottman is the foremost counseling expert
for couples, he has written prolifically on the topic and has

4. several New York Times Bestsellers. He also conducts research
on the topic. She read more about his retreat at the following
website: https://www.gottman.com/couples/private-couples-
retreats/. However, while she was reading over this she noticed
that the retreat and the workshops were very expensive. So, she
was wondering if there was a statistically significant difference
in the marital satisfaction outcomes of those participating in the
retreat when comparing their scores before and after.
She knows several students who became certified in the
Prepare/Enrich marriage mentoring program and she knows that
it is lower cost and may be conducive to a faith based approach.
She read more about the Prepare/Enrich programs at the
following website: https://www.prepare-
enrich.com/webapp/pe/couples/template/DisplaySecureContent.
vm;pc=1490974778325;jsessionid=9129257A6FE8F15C0A625D
B4AE0CD1C8?id=pe*couples*for_couples.html&xlat=Y&emb_
org_id=0&emb_sch_id=0&emb_lng_code=ENGLISH. However,
she has read that the Gottman sources have a very large number
of research studies supporting them, and his research has been
performed on a large and very diverse population. As Kendyl
was reviewing the literature she also came across an article that
discussed Olson and colleagues work indicated that many
couples completing the PREPARE program did so at a clergy
members suggestion as part of a premarital program, this was
associated with a primarily Caucasian and Christian sample.
Kendyl noticed Gottman’s work tended to use more diverse
samples, so she wanted to look at the efficacy of a weekend
workshop on marital satisfaction scores of couples (Fowers,
Montel, & Olson, 1996).
Step 3: Kendyl identified a gap and crafted a purpose statement
and a research question (see below).
She crafted the research question below to investigate this
further and to conduct a research study, as she would like to
give the most up to date information to her clients, she would

5. also like to have evidence to guide her referrals if possible.
Step 4: Kendyl identified a valid and reliable assessment to use.
Kendyl decided to use the Enrich Marital Satisfaction Scale,
because she read, “The scale was found to be reliable and to
have strong correlations with other measures of marital
satisfaction and moderate relationships with measures of family
satisfaction and consideration of divorce” (Fowers & Olson,
1993).”
Kendyl’s research question is:
Is there a statistically significant difference in couples
satisfaction as measured by the “Enrich Marital Satisfaction
Scale” (Fowers & Olson, 1993) before participating in the
Gottman retreat and one week after participating in the retreat?
References
Fowers, B. J., Montel, K. H., & Olson, D. H. (1996). Predicting
marital success for premarital couple types based on PREPARE.
Journal of Marital and Family Therapy, 22(1), 103. Retrieved
from
http://ezproxy.liberty.edu/login?url=http://search.proquest.com/
docview/220975271?accountid=12085
Fowers, B. J. & Olson, D. H. (1993). ENRICH Marital
Satisfaction Scale: A brief research and clinical tool. Journal of
Family Psychology, 7(2), 176-185.
http://dx.doi.org/10.1037/0893-3200.7.2.176
Step 5: Kendyl found the actual assessment.
Kendyl went to a 1993 article written by one of the developers
of Prepare/Enrich David Olson and one of his colleagues and
found the assessment itself in the article.
See:

6. http://ezproxy.liberty.edu/login?url=http://psycnet.apa.org/journ
als/fam/7/2/176
She found the items listed there and typed them into a word
document. Please review the link to the article and see
Appendix A for the assessment.
Step 6: Kendyl read the scoring instructions found in Appendix
B of the Fowers & Olson (1993) article.
The scoring instructions indicated which items should be
reverse scored and other instructions (see Appendix B of the
article).
Step 7: Kendyl scored the EMS scales.
See Appendix A of the article for her scoring procedures for
two sample participants. She reverse scored the items,
calculated the percentile scores, corrected for idealization, and
also tabulated scores for Percentage Couple Agreement (PCA).
Step 8: Kendyl put her scores into SPSS.
She estimated how she thought others would answer the
assessments and simulated (meaning she estimated and plugged
in scores in her hypothesized range) for couples before
Gottman’s retreat and after, and for couples participating in the
Prepare/Enrich curriculum.
Step 9: Kendyl contemplated her research question and
identified the correct statistical test.
Kendyl used a decision tree to identify the correct statistical
test to be used. She labeled the variables “EMS_PreGottman”
and “EMS_PostGottman” to represent Enrich Marital
Satisfaction Scores before the Gottman workshop and after the
Gottman workshop.
Step 10: Kendyl analyzed her SPSS output and wrote up here
APA style results. Kendyl was then finished with her class
assignment! However, Kendyl found the results and research

7. procedure fascinating and decided to collaborate with Dr.
Knight to conduct the study. They sought IRB approval and
began work on a single case design study (this was beyond the
scope of the class).
After reviewing the case scenario, answer the following
questions:
Questions to Answer:
· Which statistical test should Kendyl use to analyze her data
and answer the research question?
· Based on the SPSS output that you see below, did Kendyl use
the correct statistical test?
Please provide a rationale and references to the course
textbook, presentations, and/or outside sources to explain your
reasoning as well as a current APA results section.
(SPSS Output below)
Data Analysis Assignment Rubric
Criteria
Levels of Achievement
Content
Advanced
Proficient
Developing

8. Not present
Content
(70%; 35)
32 - 35 points
All of the following items are completed with excellence:
· Rationale is provided for opinion on whether the correct
statistical test was used.
· Textbook and other relevant sources are cited
· Rationale is provided for opinion on whether the correct
statistical test was used.
· A clear explanation is given for how the answers were
reached.
· The decision to reject or fail to reject the null is stated clearly
and correctly (in terms of the null hypothesis).
· The relevant components of a results and discussion section
are provided
29 - 31 points
The following items are completed with one or two items
incomplete or incorrect:
· Rationale is provided for opinion on whether the correct
statistical test was used.
· Textbook and other relevant sources are cited
· Rationale is provided for opinion on whether the correct
statistical test was used.
· A clear explanation is given for how the answers were
reached.
· The decision to reject or fail to reject the null is stated clearly
and correctly (in terms of the null hypothesis).
· The relevant components of a results and discussion section
are provided
1-28 points
The following items are completed with two or more items
missing, incomplete or incorrect:
· Rationale is provided for opinion on whether the correct

9. statistical test was used.
· Textbook and other relevant sources are cited
· Rationale is provided for opinion on whether the correct
statistical test was used.
· A clear explanation is given for how the answers were
reached.
· The decision to reject or fail to reject the null is stated clearly
and correctly (in terms of the null hypothesis).
· The relevant components of a results and discussion section
are provided
0 points
Not present
Structure
Advanced
Proficient
Developing
Not present
Grammar and Spelling, APA formatting
(30%; 15)
14 - 15 points
All of the following items are addressed with excellence:
· Citations are in current APA style.
· The results and discussion follow APA guidelines.
11 - 13 points
There are one or two errors with the following items:
· Citations are in current APA style.
· The results and discussion follow APA guidelines.
1 - 10 points
There are three or more errors with the following times:
· Citations are in current APA style.
· The results and discussion follow APA guidelines.

10. 0 points
Not present
Total (50)
Advanced 46-50 Points
Proficient 41-45 Points
Developing 1 - 40 Points
Not Present
Professor
Comments
Data Analysis Assignment Instructions
Before you complete the Data Analysis Assignment, you must
first review either the “Case Scenario” Word document, or the
“Data Analysis Assignment Case Scenario”
After reviewing the case scenario, answer the following
questions:
· Which statistical test should Kendyl use to analyze her data
and answer the research question?
· Based on the SPSS output that you see, did Kendyl use the
correct statistical test?
Provide a rationale and references to the course textbook,
presentations, and/or outside sources to explain your reasoning.
You must also include a current APA results section that clearly
states your decision to reject or fail to reject the null.
Reference Books: Jackson, S. L. (2016). Research methods and
statistics: A critical thinking approach (5th ed.). Boston, MA:
Cengage. ISBN: 9781305257795.
Knight, A., & Tetrault, D. (2017). Research and program
evaluation key concepts: A study guide. Kona Publishing &
Media Group. ISBN: 9781945628245.