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Organizational behavior, whether in a healthcare organization or another organization, is concerned with behavior that occurs under the conditions found in an organizational setting.(Buchbinder, Nancy H. Shanks (2017).

While a specific organization setting may create unique challenges or certain sets of problems, the behaviors of interest are like those of individuals, groups, and often organizations in other settings or industries(Weick, 1969). Thus, healthcare organizational behavior does not create unique management issues so much as certain issues are more prevalent in healthcare and can occur along with other challenges (Shortell & Kaluzny, 2000).

Health organizations are staffed with a professional workforce and impose exacting requirements on how work is organized and accomplished. The complex work of healthcare has a high risk of serious or deadly error, which necessitates extremely reliable systems of practice at all organizational levels (Buchbinder, Nancy H. Shanks (2017).

Scope of organizational behavior

Scope Of Organizational Behavior

Sophisticated technical expertise with a highly educated, efficient, and well-coordinated workforce is required for further technical and medical systems demand. Professional healthcare workforce especially physicians work with a great deal of autonomy and control over the technical and clinical aspects of care delivery.

As a result, healthcare managers are responsible for facilitating the delivery of complex medical services that must be carefully coordinated by autonomous professionals over whom the manager has little direct authority – all within an industry system that is facing extreme financial and policy challenges (Buchbinder, Nancy H. Shanks ,2017).

To achieve organizational behavior goals, the healthcare manager must orchestrate the collective work of employees and colleagues, so that healthcare can meet many demands. Managers with organizational behavior skills can unleash the talents of others to help their organizations thrive in a demanding industry.

Social cognition and socio-emotional intelligence

Humans are social beings who need to be connected to other people. Recent work in cognition, neuroscience, and management underscores the importance of understanding how we think in social situations because it dramatically affects how we perceive, judge, and influence others (Fiske & Taylor, 2008). Many of the previously described distortions also arise when we interact with others. In social settings, we still rely on our automatic thinking mode, our perceptions are selectively filtered, and our judgments of others are guided by existing mental representations.

There are FOUR factors affecting social thinking. They are: –

  • Attributions
  • Common biases
  • Social categorization
  • Emotional factors

Types of attributions

To attribute is to make an inference, or to explain what causes something. According to attribution theory, our brains intuitively seek to explain the causes of behavior and outcomes. Attributions are a specific form of social judgment in which the presumed cause of observed behavior is attributed to either a person’s disposition and personality (internal factors), or to the situation (external factors) in which the behavior occurs (Buchbinder, Nancy H. Shanks, 2017).

Attribution error

Fundamental attribution error is a cognitive bias in which an observer makes incorrect causal attributions about the presumed cause of another’s behavior. In fundamental attribution error, we erroneously attribute another’s behavior to their internal disposition, rather than external circumstances. When we presume those dispositional factors are under the other’s control, we hold them responsible for the behavior, when the behavior may really be due to situational factors beyond their control.

For instance, if a stranger cuts in line ahead of you at the movies or in traffic, you may conclude that the action is intentional and decide the person is rude, even though it could have occurred because directional signs were not clear to the person who went ahead of you. In healthcare, physicians who label a patient with a negative stereotype (e.g., smokers, obese, alcoholics, homeless) risk erroneously attributing the patient’s health concerns to risky behavior brought upon themselves (Groopman, 2007).

Managers are susceptible to fundamental attribution error when judging employees’ performance, sometimes blaming an employee for poor performance that may be caused by circumstances beyond the employee’s control. 

 Attribution Theory Framework

For example, attribution error occurs when a manager decides an employee performing a task poorly is lazy or incompetent, rather than recognizing that the employee needs training, clear incentives, or improved work equipment.

To avoid making an erroneous performance attribution the manager must understand how the work setting affects employee performance. We can’t read the minds of others, so a manager should ask an employee how he or the work setting affects job performance before inferring reasons for performance, she sees as poor (Buchbinder, Nancy H. Shanks, 2017).

Types of biases

Our perceptions of others can be biased in multiple ways,

  1.  How we relate to them (affinity),
  2.  Belonging to the same social group (in-group), 
  3. Prior knowledge of someone (halo). 

We then make inferences about the qualities or traits they possess and make decisions that favor them instead of using concrete information to support our conclusions. It is well-documented that we often cannot recognize our own biases because they are unconscious (bias blindness), and we are better able to see others’ biases.

Affinity biases

Affinity biases mean favoring people we like, they are several related biases centered on preferring others because we see them as likable, like us, or part of our social group. Affinity bias. For example, an interviewer may spend more time with an applicant who is engaging, or we may gravitate towards outgoing personalities. 

Similar-to-me bias

Similar-to-me bias refers to favoring those we see as being most like us. For example, we favor people or the opinions of others in our same college major or line of work. 

In-Group Bias

In-group bias (also called “us vs. them” or “in-group vs. out-group”) means we make a positive judgment about someone when we both belong to the same social group, they are from “our side.” 

Halo effect

The halo effect occurs when positive or negative information about others on one-dimension colors our judgment about them on a different dimension. For example, we may infer that an outgoing person will be a good leader or that a member of a chess club is good at math when neither is necessarily true. We could also negatively infer that a quiet person will not be an effective team member, which is not necessarily true (Buchbinder, Nancy H. Shanks, 2017). 

The halo effect is a special concern in appraisals because the reviewer may automatically rate an employee favorably or unfavorably simply based on performance in just one category, rather than rate each performance dimension independent of other categories.

Bias blind spot

A bias blind spot occurs when we believe others are more influenced by biases than we are (Pronin, Gilovich, & Ross, 2004). It is very difficult for individuals to correct their own biases. When we believe our own view is objective, we may dismiss differing views because we think they are biased, not us. Describing this belief in our own objectivity as think, therefore it’s true” mindset, researchers found managers who believed they were unbiased were more, rather than less, likely to be influenced by stereotypes in the hiring process (Uhlmann & Cohen, 2007).

Social categorization and biases

Social categorization means grouping people into social categories, and then implicitly stereotyping, or assuming individuals possess the traits of everyone in that category. Examples of some common social categorizations include:

  • Gender, race, orientation, age, religion, national origin,
  • Disability, physical characteristics (height, weight), 
  • personality (e.g., introversion, extroversion), 
  • accents, social status

Recent research makes distinctions among cognitive biases (stereotypes), emotional biases (prejudice), and behavioral biases (discrimination) (Talaska, Fiske, & Chaiken, 2008). Stereotypes are generalized beliefs about the expected attributes of individuals who belong to a group. The cognitive error of stereotyping is that we overgeneralize, thinking an entire has the same characteristics, rather than recognizing individual differences and the real person behind the stereotype. 

Discrimination is treating members of a group differently (which may also be illegal). Stereotypes, prejudice, and discrimination are in different ways: 

Cognitive stereotype example: assuming women are not as strong as men;

Emotional prejudice example: expressing negative attitudes about women employ in construction.

Discriminatory behavior example: actively discouraging women from employment.

Explicit vs. implicit bias

Our understanding of social biases today is more sophisticated than when non-discrimination practices were codified in employment law. We now distinguish between explicit and implicit bias (Fiske, 2010).

  • Explicit bias traditional prejudice is overt and the actors are consciously aware of stereotyping or discrimination.
  • Implicit bias-today’s ‘hidden bias is subtle and unconscious, hidden from the actor’s direct awareness, and seldom noticed in the decision process. Implicit bias has been documented in lab studies and organizational settings (schools, academia, medicine, law enforcement, courts, and even politics), in a range of organizational (hiring, interviews, leadership, participation, performance evaluation), and social (policing, housing, and housing pricing) decisions, as well as across many social categories (Staats, 2014).

In health care, implicit biases of physicians and other providers can affect treatment outcomes and contribute to health disparities(Sabin, Nosek, Greenwald & Rivara, 2009).

Managers are increasingly concerned with implicit biases because these biases affect employees in social categories beyond the protected groups traditionally recognized by law. 

Implicit biases may hinder an organization’s diversity efforts, leading to exclusion, isolation, reduced teamwork, low morale, and higher turnover. Training managers and strengthening human resource practices (hiring, promotion, training and development, appraisal, and compensation) can reduce implicit bias. By addressing implicit bias, employers can engage the talents of all workers, thereby improving business decisions and performance, workplace climate, and employee satisfaction and retention (Ernst & Young, 2013).

Empathy and socio-emotional intelligence

In the last decade, there has been a surge of interest in non-cognitive intelligences-both social intelligence, and emotional intelligence. The two overlap and are jointly called “socio-emotional intelligence” here. Socio-emotional intelligence is the ability to sense, understand, and effectively respond to others’ emotions (Zautra, Zautra, Rivers, & Rivers, 2012).

Emotional intelligence (EI)

Emotional intelligence (EI) is characterized as “the intelligent use of emotions” (Seal, Naumann, Scott, & Royce-Davis, 2011, p. 5)

Socio-Emotional intelligent

A socio-emotional intelligent person is self-aware, aware of others’ emotions, and can establish meaningful relations with others. Studies find the various forms of socio-emotional intelligence benefit organizational collaboration, problem-solving, creativity, and innovation in organizations. 

Socio-emotional intelligence smooths employee interactions; strengthens the manager-employee relationship; and builds a positive, supportive workplace climate. Daniel Goleman, who popularized emotional intelligence (1995), concludes that high-performing managers are high in emotional intelligence and that El is a better predictor of a manager’s performance than IQ (intelligence quotient).

Empathy

Empathy is a fundamental skill identified by studies of socio-emotional intelligence that fosters reciprocity and connection in relationships. Empathy is being sensitive to the emotional state of others. Empathy takes three progressively more evolved forms.

Emotional empathy

Emotional empathy is sharing another’s feelings (emotional “contagion”).

Cognitive empathy

Cognitive empathy is knowing and understanding another’s perspective, and Empathic perspective-taking is cognitive understanding plus shared emotions, which supports taking appropriate action in response to those emotions (de Waal, 2008).

“The importance of empathy in health care and other organizations has prompted major
efforts to teach and develop empathy in clinicians, managers, and employees.” – (Buchbinder, Nancy H. Shanks, 2017)

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