Health Essays - Environmental Cultural Influence
Environmental Cultural Influence
There is ample empirical evidence that environmental and cultural factors influence occupational performance (e.g. Hancock & Vasmatzidis, 1998; Polatajko et al, 2000; Rebeiro, 2001; Buchan, 2002; Bjorklund & Henriksson, 2003; Chiang & Carlson, 2003; Satink et al, 2004). This essay considers task performance within a public health/academic setting. The discussion is structured around Chapparo and Ranka's (1997; Chapparo & Hooper, 2002) Occupational Performance Model (OPM). Occupational performance is defined as "the ability to perceive, desire, recall, plan and carry out roles, routines, tasks and sub-tasks for the purpose of self-maintenance, productivity, leisure and rest in response to demands of the internal and/or external environment" (Chapparo & Ranka, 1997, p.4). The OPM emphasises the impact of environmental, occupational, and personal factors. Culture is one of several environmental features specified.
Task - Problem Solving
As a public health expert working in an academic setting, my role is 'productivity' oriented (Chapparo & Ranka, 1997, p.7); my primary task is to provide services to the local community, notably teaching and clinical research. Both routines require a considerable degree of cognitive and interpersonal proficiency. For example, it is essential to have good memory and reasoning skills when delivering a clinical presentation or writing a research paper. Additionally both roles frequently entail face-to-face discussions with an individual or group. There is usually ample to time to make the necessary preparations and hence perform optimally on these tasks. However, problems do arise from time to time. For example, a clinical research assistant who I had employed to help run a research project on breast cancer was asked to prepare two research reports on specific aspects of breast cancer epidemiology. Unfortunately both reports were substandard and hence awarded a poor percentage mark. A potential problem arose when the assistant became seriously disheartened about her poor performance and began to question her ability to complete the project successfully. She was now on the verge of resigning and requested a meeting to confirm her intentions.
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Losing the assistant at this stage would have seriously jeopardised the project - there was no provision in the budget for recruiting a replacement. Although her report-writing skills were questionable she was an excellent data analyst and presenter, and was highly proficient at conducting literature reviews. Successful resolution of this problem (i.e. convincing her not to leave) was going to require cognitive proficiency in problem solving (e.g., surveying the various options, and appraising their costs and benefits), as well as good interpersonal skills cooperation (ability to compromise, negotiate), empathy (trying to see things from her point of view), and good verbal and non verbal communication (being polite, eye contact, smiling). More importantly, both cognitive and interpersonal task performance may be influenced by environmental and cultural factors. For example, an unfavourable sensory environment, such as a noisy office, high room temperature, or heightened cultural sensitiveness, can negate successful resolution of the problem. The role of the environment and culture are discussed next.
This concerns the level of stimulation emanating from an environment, such as temperature, noise, and distractions (e.g. Hancock & Vasmatzidis, 1998). The meeting was conducted in my office. This environment was well illuminated with moderate room temperature. I normally make a point of shutting the windows, which are double glazed, to minimise traffic and other noises that may filter in from outside. Additionally, any activity outside is not usually visible because the windows are located close to the ceiling, so that one has to stand up fully to see outside. Within the room itself there are few visual distractions - bookshelves, cabinets etc. When the assistant arrived discussions began immediately. The door was shut and the generally calm surroundings seemed to help her relax. Survivability is considered the primary sensory consideration to most people who enter into an environment (Rodahl, 2002). I suspect the assistant felt that room conditions (temperature, noise, distractions) were entirely 'survivable', and ultimately this facilitated a relaxed conversation. Any distractions during the meeting would have been highly unwelcome especially while I was in the process of making a sensitive point.
This refers to the nature of the physical and structural surroundings (Chapparo & Ranka, 1997). For example the physical characteristics of an office setting would include the size and general design of the room, windows, furniture and doorways. My office was a rather small and sparsely furnished room measuring about 700 x 500 centimetres (7 x 5 metres). The high location of the windows resembles a prison cell and hence may create a sense of isolation and 'entrapment'. At face value the physical environment had little if any effect on the proceedings - the assistant had been to this office on numerous occasions and hence was very familiar with the layout. The office walls are a light shade of green and some research suggests that lighter colour shades may improve a persons mood (Barrick et al, 2000; Clara et al, 2001), and hence perhaps their receptivity to compromise and reconciliation.
This denotes the social milieu or network of social interactions that characterise a given environment. Pressures from significant others, notably friends, family and co-workers may all exert a considerable influence on task performance (Ajzen, 1991; Shah, 2003). During a problem-solving routine that entails face-to-face discussions there is continual interaction between the two individuals, such that the each person is influenced by the other, and vice versa. Successful completion of the task is achieved through cooperation, negotiation, compromise, and understanding and effective communication (both verbal and non-verbal). My face-to-face discussion with the clinical assistant was greatly enhanced by the non-confrontational and receptive nature of our dialogue. For example, I made a point of listening carefully to what she had to say, then responding sympathetically and showing a willingness to find common ground. This 'warm' social atmosphere helped establish a quick rapport.
The internal environment
The factors discussed thus far form part of the external environment. Chapparo and Ranka (1997) also specify an internal environment that encapsulates the 'mind', 'body', 'soul', and 'space' and 'time' issues. The 'mind' denotes intellectual ability (conscious or unconscious), 'body' refers to the physical human form, while 'soul' relates to the human need for mystery, hope, and religious experience. 'Space' and 'time' both refer to actual (i.e. physical1) and perceived or 'felt' space and time. Did these factors influence my capacity to solve the problem with the clinical assistant? Possibly. Janis and Mann (1977) suggest that perceptions of time pressure can severely 'cripple' effective decision-making or problem solving. Furthermore, it can be argued that people who are generally optimistic or religious may work harder to achieve compromise and resolution. By contrast, a physical arrangement in which personal space was violated (e.g. placing chairs too close together), or having an unnecessarily prolonged meeting, may easily distract or irritate, with negative implications for task performance.
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The OPM classifies cultural influence as part of the external environment. Culture can be conceptualised as a dichotomy between Western and indigenous (e.g. third-world) cultures (Chiang & Carlson, 2003; Shiraev & Levy, 2004). Individual differences in learned customs, beliefs, and values, can easily facilitate or hamper task performance. Cultural syndromes such as individualism (focus on the self or immediate family), collectivism (concern with wider social groups or society), and ethnocentrism (cultural bias in how we perceive the world) also exert considerable influence (Triandis, 1995). My research assistant was British born and had lived in the UK all her life. By contrast, I had an indigenous background. It is conceivable that the contrasting cultures significantly affected my ability to manage the situation and solve the problem. However, cultural influences can be complex and subtle, and hence difficult to perceive. It could be argued that the clinical assistant, by virtue of her individualist (i.e. Western) orientation may have been somewhat unconcerned about success of a project that is somehow supposed to benefit society. But there was no direct evidence of this.
Empirical evidence suggests that cultural bias can affect occupational performance amongst clinicians. Tripp-Reimer (2001) found that certain presumptions endemic in medical settings could impede the smooth delivery of health care. For example, the patients' culture is frequently viewed as the 'problem', hence any lapses in adherence to clinical recommendations tend to be attributed to the patient, not the clinician. This has echoes of the Barnum "one size fits all" effect (Shiraev & Levy, 2004) in which statements that would apply to most people are ascribed to an individual or group (e.g. "Clinical assistants can sometimes fail to deliver"). This phenomenon may also extend to professionals working in academic settings. Westwood and Low (2003) argues that cultural factors do impinge on cognitive abilities relevant to problem solving, such as creativity and innovation, albeit the relationship is more complex than it initially appears. Overall, it may be arrogant on my part to infer that culture had no effect on my interaction with the assistant.
Problem solving remains a task/activity I regularly perform at work. My dialogue with the clinical assistant was successful as she opted to stay for the remainder of her contract. In general, both environmental and cultural factors do appear to influence my day-to-day occupational performance, especially on tasks or routines that involve face-to-face discussions. Chapparo and Ranka's (1997) model suggests that the environment is multidimensional and incorporates the cultural milieu. The effects of these variables are moderated by: my type of occupation, level of cognitive and interpersonal proficiency, and other less tangible considerations, such as 'spirituality'. In essence, the impact of the environment and culture involve transactional relationships with individual and occupational variables.
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