Desmond WilliamsExecutive Consultant to the Chief Operating Officer KFSHRC (Gen. Org.) Jeddah Branch5th March 2014

CULTURAL ASPECTS OF EMOTIONAL INTELLIGENCE A Research Study of three Culturally Distinct Nursing Groups, in a Saudi Arabian Tertiary

Hospital.

• Dr. Tariq Linjawi• Dr. Sandy Lovering• Dr. Estelle Bester• Dr. Bakr Bin Sadiq• Dr. Margareta Sjolund • Mr. Wael Sherbini• And most importantly…

…THE 60 RESEARCH PARTICIPANTS!

Acknowledgements

• The Research Concept & Overview Context, Culture and Research Motivation

• Methodology and Methods• So what are the results, what do they tell us?

The Similarities and Differences between the chosen cultures• What can we conclude about the research?

How does a Culturally Intelligent direct patient care Nurse look like in KFSHRC-J? To what degree are Western “Best Practice” behaviours suitable for KFSHRC-J? Possible Organizational applications What messages does this research reinforce?

Contents

Required for a Masters Degree in International Management, with a Healthcare Specialisation. A hospital approved and funded management research project. Completed over 6 months.

• The Research Concept & Overview – Context

The term emotional intelligence was officially coined in 1989 by Salovey and Mayer.

Based on a threshold level of IQ.

Emotional Intelligence/Quotient is “the capacity for recognizing our own feelings and those of others, for motivating ourselves, and for managing emotions well in ourselves and in our relationships. Emotional intelligence describes abilities distinct from, but complementary to, academic intelligence.” - Daniel Goleman (1998)

http://atrium.haygroup.com/ww/video/video_popup.aspx?id=1What_is_Emotional_Intelligence_480x360.flv&sc=y

• The Research Concept & Overview – What is Emotional Intelligence? (EI)

Culture can be defined as a ‘pattern of values, attitudes and beliefs that impact on the behaviour of a set of individuals within a given region’ (Hofstede 1985, cited in Ronen & Shenkar 2001).

But values, beliefs and ethics are different across cultures…

Therefore it means the ability to modify one’s/behaviour to that of a divergent culture. (Hofstede & Minkov)

Essentially, Emotional Intelligence enables someone to adapt behaviour to suit a divergent culture.

• The Research Concept & Overview - What does Emotional Intelligence in a Cultural context mean?

Hofstede’s Overview of National Cultures

http://geert-hofstede.com/countries.html

‘Cultural values are most positively associated with emotions, with attitudes then behaviour following thereafter.’ (Taras, Kirkman & Steel, 2010)

Adaptation stress - more so with divergent culture types.

4 acculturation types: Integration, Assimilation, Separation and Marginalisation.

•

The Research Concept & Overview - What does the existing research in this area say?

10%

90%

1st time this type of research has been undertaken in the Middle East. Improving our understanding of different cultural nurse behavioural preferences

allows for: A mitigation of acculturation stress – If part of an induction for example. More effective Leadership Development/Recruitment interventions. Better cross cultural understanding of behaviour.

60 Nurse participants gain a better insight into themselves. To “unfreeze” the western concept of “best practice” management.

• The Research Concept & Overview -Why bother doing management research in this area, what’s the benefit?

1. Are there any EI correlations between three distinct cultural groups in a Saudi Arabian tertiary hospital? – Saudi, Filipino & Western (US/Canada/EU/S.Africa/NZ).

2. To what degree are Western “best practice” behaviours are relevant with the Arabic culture in the hospital environment?

• The Research Concept & Overview – What are the relevant research questions?

Methods 60 Direct Patient care nurses, all

female, no age preference, Presentations, email, advertising

and visiting wards to recruit participants.

For each participant: Consent form Completion Psychometric Assessment –

EQi2.0 (35 Minutes) Follow up meeting (40-50

minutes)

Methodology Exploratory, descriptive management

research, using a mixed method approach.

Quantitative element to cater for positivist considerations

Qualitative element to cater for social constructivist considerations.

• Methodology and Methods

Cross-Validation

Research Standards Institutional Review Board (IRB)

approved. University of Liverpool, England. Nursing Research Council approved. Detailed Consent form & F.A.Q. x 60

staff.

• Methodology and Methods - Research Standards & Researcher Credentials

Researcher Credentials Certified psychometric assessor,

(Level A&B) – British Psychological institute (2001).

Certified EI Assessor for the EQi2.0 tool.

US National Institute of Health (NIH), certified for Ethical Human research.

• Emotional Expression• Interpersonal Relationships• Empathy• Social Responsibility

These were the behaviours where significant similarities between the three cultural groups occurred.

Self Regard Self-Actualisation Emotional Self Awareness Emotional Expression Assertiveness Independence Interpersonal Relationships Empathy Social Responsibility Problem Solving Reality Testing Impulse Control Flexibility Stress Tolerance Optimism Happiness

These were the behaviours assessed

• What are the results and what do they tell us?

Interpersonal Composite

EMOTIONAL EXPRESSION

Seems calm & collected, may seem unaffected by Stressors but also appears withdrawn.

Very easily expresses herself. An open book. People know where they stand but can be overly expressive also.

= Saudi

= Filipino

= Western

= Average

Comfortable in expressing emotions, either verbally or non verbally. Is able to find the most appropriate way of expressing most emotions (e.g. Anger, Appreciation, Empathy) in an appropriate way.

• What are the results and what do they tell us?

INTERPERSONAL COMPOSITE

= Saudi

= Filipino

= Western

= Average

Interpersonal Relationships

Empathy

Social Responsibility

Interpersonal Relationships – Generally seeks new relationships, yet maintains existing ones. Understands nature of interpersonal cooperation. In unfamiliar/uncomfortable situations may be more hesitant.

Empathy – you are “tuned in” to how others are feeling. You generally care about the thoughts and feelings of others as much as you do your own. In times of stress or moments of defensiveness, more likely to adopt a less empathic approach, possibly arguing your position without considering the needs of others.

Social Responsibility – are socially conscious and generally concerned with others’ well-being. See yourself as part of your team, your organization, and your community. Generally feels a sense of fulfillment from helping others.

• What are the results and what do they tell us?

Assertiveness Independence Problem Solving Reality Testing Stress Tolerance Happiness

These were the behaviours where statistically* significant differences occurred(*i.e. that generated P-value of ≥0.05)

These were the behaviours assessed

Self Regard Self-Actualisation Emotional Self Awareness Emotional Expression Assertiveness Independence Interpersonal Relationships Empathy Social Responsibility Problem Solving Reality Testing Impulse Control Flexibility Stress Tolerance Optimism Happiness

• What are the results and what do they tell us?

ASSERTIVENESS

• What are the results and what do they tell us?

Team thinking… Consultative Inclusive…Collaboration

Self reliant in making decisions… confident …decisive…self determined

Preference for collaboration, awareness that too much/inappropriate assertiveness would upset the delicate relationship balance. Sometimes favours social/ward cohesion over decisiveness.

Finds it easy to express herself, although sometimes not directly. Not controlled or shy. Is assertive, but has a tendency to use the social landscape or informal organisation to communicate this assertiveness.

Is seen as not being overly controlled or shy. Self directed. Sometimes perceived as being slightly too assertive for this particular cultural context. Strong tendency towards assertive patient advocacy Saudi’s and Filipino see this group “go to” group in this regard.

= Saudi

= Filipino

= Western

INDEPENDENCE

• What are the results and what do they tell us?Prefers high levels of support and protection. Loyal and is good at following a clear structure. Defers to others, often uncertain of own ideas.

Relies on own judgment, strong perception in own ability. May sometimes conflict with the group “norm” behaviour.

Loyal to the organisation and puts her trust in the protective & supportive aspects of the organisation. Lets the group make final decisions. Contributes to social cohesion.

Has a strong affiliation towards the social matrix. Sometimes defers own opinion to that of the group. Will not directly challenge seniors or those in authority, even tough there may be a strong reason to do so.

Anti-bureaucratic. Dislikes limited professional autonomy . Relatively strong tendency towards ‘fresh thinking’, which maybe deemed as sometimes controversial.

= Saudi

= Filipino

= Western

PROBLEM SOLVING

• What are the results and what do they tell us?Intuitive problem solver, rather than methodical. Sees the potential of many solutions and enjoys exploring these solutions. May jump into solution

Systematic, Methodical. Gather information first. Weights up pros and cons

Engages “gut feeling” and a strong intuitive sense of what a solution might be.

Prefers to solve a problem with much input from others, not overly reliant on systematic methods to arrive at a solution.

Strong evidenced -based perspective. Relies on logical deduction and favours less subtle nuance. = Saudi

= Filipino

= Western

Reality Testing

• What are the results and what do they tell us?Tends to be more abstract. May display vision and be able to look at things from a unique perspective

Realistic, can assess life situations more easily.

Values an abstract view in the creation of a vision whilst understanding the possibilities and realities of a given situation.

Is “tuned “into the environment and has a practical understanding of life situations. Sometimes sees things in black and white.

Grounded, understands what is possible and not possible. Reads the environment accurately.

= Saudi

= Filipino

= Western

STRESS TOLERENCE

• What are the results and what do they tell us?Will think through potential stressors and vocalise them. May find it difficult to face unpleasant things. May be more reactive than others. Often will be the first to flag an issue.

Very calm in a crisis. Calms others by being calm. May be perceived by others as not having a sense of urgency. May react later than others.

Is perhaps not used to “normal” stressful situations and therefore has not built up similar coping mechanisms to others. The role of the family “shielding stress” from females, may be contributory from a cultural perspective.

Is comfortable in most stressful situations. Has well defined mechanisms to deal with this stress. Cultural stress mitigators are derived from the close cultural & community support network, often beyond the organisation.

Calm in a crisis. Is open to change and stressful situations. Recognises that cultural stress is a growth cataylst. Main stress stressor from feeling of isolation due to small western community.

= Saudi

= Filipino

= Western

HAPPINESS

• What are the results and what do they tell us?

Team thinking… Consultative Inclusive…Collaboration

Is satisfied with ones life situation and is able to enjoy ones life and have fun. Not to take oneself seriously

May be less concerned with themselves than with others (if they have a strong social responsibility score). Tendency to worry about the future, reasonably happy, sometimes has more frequent thoughts of life dissatisfaction than others.

Content and enthusiastic about life. Is fun loving and has a general mood of happiness. May seem overly positive by those not having the same levels of happiness.

Derives pleasure from life. Generally happy.

= Saudi

= Filipino

= Western

The desire for social cohesion & maintaining individual relationships sometimes outweighs the desire for performance in the Saudi and Filipino cohorts.

The “Shielding” role of family has an influence on the Saudi nurse profile for Independence, Problem Solving and Stress Tolerance.

The Nursing drive for collaborative decision making has impacted the “standard” Filipino profile – i.e. More assertive.

Are there any EI correlations between three distinct cultural groups in a Saudi Arabian tertiary hospital? – Saudi, Filipino & Western (US/Canada/EU/S.Africa/NZ).

Western “Assertive” behaviour does not work well in a collectivist, high power-distance culture. However, patient advocacy requires assertive behaviour.

Patients allow more assertive behaviour from Westerners than from other (collectivist) cultures.

• To what degree are Western “best practice” behaviours relevant to the Arabic culture in the hospital environment?

Therefore…[Nursing] Best Practice + Cultural Context = Best Fit

Recruitment Principles can be applied to all roles in the organization, particularly relevant for leadership roles. Matches values of the organization with the values and behaviors of the candidates.

More informed Cultural Adaptation interventions Induction training for Nurses and Nurse Leaders specifically. The ‘Cultural Preceptor’ model.

Saudi Leader certified in Emotional Intelligence & 60 Nurses have had individual assessment

Nursing Ethics & Cultural Advisory Council. Saudi Career & Development Program (SCDP) Direct Patient Care Nurse Graduate Program Talent Development Profiling…

• How has/can this research add value to the organisation?

Selection of Top Performers e.g. Head

Nurses

Administer the EQi2.0 to 10-20 “Stars.”

Facilitated Focus Group analyses results (e.g. Head

Nurses, Program Directors + Psychometric Facilitator)

Organisation /Staff are clear what behaviours

are needed for this position.

Talent Development & Recruitment Profiling - “STAR” Behavioural Profiling

Head Nurse

STAR Profile

That Cultural Diversity offers valuably different perspectives, allowing for a richer working environment and “balanced behavior”.

That Organisational Culture Change must take account of National Culture preferences.

Self Awareness and respect for others’ behavioural preferences is important to intra-cultural empathy.

• Finally, what positive cultural elements does this research reinforce?

Thank you. Questions? deswilliams29@gmail.com