MILITARY MEDICINE, 164, 3:202, 1999

Measuring Cultural Climate in a Uniformed Services Medical Center

Guarantor: LTC Stephen J. Brannen, MS USA Contributors: LTC Stephen J. Brannen, MS USA*; Karen R. Brannen, MHA CHEt; Thomas W. Colligan, MSW*

The purpose of this study was to determine the employee Background perceptions of the cultural climate at a large uniformed service medical center in the mid-Atlantic region of the United States. Researchconsistentlydemonstrates differences amongvari­

The analyses are based on the responses of 1,751 medical ous groups'perceptionsofequalopportunityand organizational Downloaded from https://academic.oup.com/milmed/article/164/3/202/4832122 by guest on 30 September 2021 center employees, whose demographic characteristics were climate. Brown et allfoundsignificant differences between black representative of the medical center population. Analyses in­ and whitesoldiersin howtheyviewed the "raceproblem" in the dicate the existence of systematic perceptual differences be­ Army." Spicherreportedthat AirForce men perceived a signifi­ tween: (1) the medical center and Department of Defense per­ cantlymorefavorable organizational climatethan women. Fur­ sonnel, and (2) the following cultural groups: (a) male and female personnel, (b) military and civilian personnel, and (c) thermore, he found that officers reported a more favorable majority and minority personnel. Recommendations are pro­ perception of the cultural climate in the Air Force than en­ vided for future areas of research that need to be conducted listed members."A 1996 U.S.Army study reported perceptual with respect to the phenomenon of cultural diversity and the differences between minorities and whites and between offic­ development of positive cultural climates within both the mil­ ers and enlisted soldiers on equal opportunity issues." In a itary and civilian medical settings. Navy study, Bowers found that minorities perceived more discrimination than non-minorities. He also found a negative relationship between perceived discrimination and cultural Introduction climate.8 he cultural composition of the American work force will Although most previous research on race relationsand orga­ T experience revolutionary changeduring the 21st century.In nizational climatein the military primarily targetedracialdiffer­ a 1987study, Worliforce 2000: Workand WorkersJor theTwen­ ences, that focus was expanded in 1980 to include gender is­ ty-First Century, Johnston and Packer predicted that "non­ sues when a Navy surveyof 104women found that virtually all whites, women, and immigrants will make up more than five­ ofthem reportedhavingbeen sexuallyharassed at sometimein sixths of the net additions to the work force between now and their careers."This study also revealed that sexual harassment the year 2000."1 TheBureau ofLaborStatistics projectsthat the had a negative effect on the attitudes of the female service women's labor force will increase 250/0 between1990and 2005, membersand their desire to remain in the service." with the following increases also noted: African Americans, Landis et all criticized previous military equal opportunity 32%; Asians, Pacific Islanders, NativeAmericans, and Alaskan climate surveys for focusing on race relations between blacks natives, 74% ; and Hispanics, 75%. During this same period, and whites.10 Theyargued that this limited focus ignoresother 82°A> of workers leaving the work force will be white, non-His­ minorities and disregards the issues ofintegratingwomen into panic males." the armed forces. Theysummarized previous military research Cultural diversity is especially prevalent in the health care on organizational equal opportunityclimateas follows: (a) there industry, in whicha majorportionofthe workforce is composed were oftendifferences in perceptionsof climate between races, offemales, minorities, and foreign-born employees." For exam­ between sexes,and between ranks; (b)there has been a primary ple,the number offemale physiciansdoubledbetween1980and focus on racial discrimination, particularly discrimination 1992. In the same period, the number of foreign-trained and against blacks; and (c) there may be methodological problems minority physicians more than doubled. Nurses have histori­ deriving from the poor conceptual underpinning of the mea­ cally been recruited from foreign countries, and health care sures used to define climatevariables. 10 service workersmay represent the most culturallydiverse com­ Inan effort to overcome these and other shortcomings, Landis ponent ofthe hospitalworkforce.' Cultural diversity challenges and colleagues developed the Military Equal Opportunity Cli­ health care organizations to make better use of a radically mate Survey (MEOCS) with the assistance ofthe Defense Equal changing labor force." Hospitals can capitalize on this demo­ Opportunity Management Institute (DEOMI).l0 DEOMI cur­ graphic revolution and convertdiversity into a competitive ad­ rentlyassists military organizations in their assessment ofequal vantage by gainingan understanding ofits boundaries.' opportunity climate. 11 The MEOCS is a tool to assist military organizations in improving organizational functioning and effec­ *Departrnent of Family Medicine, Uniformed Services University of the Health tiveness. The medical center used the resources of DEOMI be­ Sciences, Bethesda, MD 20814. cause the MEOCS is widely used withinthe military services as tSterling, VA 20165. a managementtoolin determining the cultural climate withina *School ofSocial Work, University ofMaryland at Baltimore, Baltimore, MD 21201. This manuscript was received for review in April 1998 and was accepted for given command. Thepurpose ofthis study was to determine the publication inJuly 1998. perceived cultural climatewithin the medical center.

Military Medicine, Vol. 164, March 1999 202 Measuring Cultural Climate in a Uniformed Services Medical Center 203

Definitions parable cohort ofDepartment ofDefense (DoD) personnel, and (2) perceptualdifferences existamongmanyethnicand cultural This study analyzed the respondents' perceptions of the de­ groups within the medical center regarding the organization's greetowhichcertainbehaviors occurwithinthe medical center. cultural climate. Thedependentvariable wasoperationally defmed as the respon­ dents' perception ofthe cultural climate. The perception ofcul­ tural climate was measured using 12 factors contained in the Methods and Procedures MEOCS. Thesefactors were: (1) Sexual harassment and discrimination. Rated on the re­ Subjects spondent'sperception that sexually harassing ordiscriminating DEOMI requires organizations with morethan 100assigned actionshad taken placeat the medical centerwithinthe past 30 personnelto surveyat least 500/0 ofthe staff. Thereare approx­ days. imately 5,000individuals currentlyassignedtothe medical cen­

(2) Different command behavior toward minorities. Percep­ ter. For ease of administration, all personnel at the medical Downloaded from https://academic.oup.com/milmed/article/164/3/202/4832122 by guest on 30 September 2021 tions that different treatment ofminority members was likely to center were asked to participatein this study. have occurred at the medical center within the past 30 days Table I displays specific sample characteristics compared (e.g., minority employees were not likely to be offered opportu­ withthe characteristicsofthe personnelassignedtothe medical nities forwork-related training). center. The sample demographic features of each of the three (3) Positive equalopportunity behaviors. How frequently pos­ studiedculturalgroups(gender, ethnicity, and employment sta­ itive equal opportunity actions were likely to have occurred at tus)wereconsistentwiththoseofthe medical centerpopulation. the medical center withinthe past 30 days. Most of the respondents were minority (55.330/0) and male (4) Racist/sexist behaviors. Perceptions of traditional overt (52.73%), whichis consistentwith the population composition racist or sexistbehaviors, such as name calling and jokes. ofminority (56.57%) and male(55.51 %). Thenumber ofmilitary (5) Reverse discrimination (I).How frequently reverse discrim­ and civilian personnel is relatively even in both the medical inationwasthoughtto haveoccurred withinthe medical center. center sample (48.79 vs. 51.21%) and the DoD population Reverse discrimination is the preferential treatmentofwomen or (49.88 vs. 50.12%). minorities at the expense ofwhitemales. (6) Commitment. The respondent'scommitment to the medi­ Instrumentation calcenter.Ahigherscoremeans that the respondentwould like to remain at the medical center. TheMEOCS, a 124-item self-report survey, was developed by (7) Perceived work-group effectiveness. The degree to which DEOMI as a toolfor military commanders to assess the equal the respondentperceived his or her workgrouptobe productive opportunity climate withintheir organizations. It is divided into and effective in accomplishing its mission. five sectionsand takes approximately 45 minutes to complete. 10 (8) Job satisfaction. Thedegree ofsatisfaction the respondent Thefirst sectionmeasures an individual's behavioral percep­ had with his or her current job. tion. It consists of 50 items and contains five distinct factors, (9) Discrimination against minorities and women. Thedegree each consisting of 10items that havebeen derived from princi­ to whichwomen and minorities were generally perceived to be pal components ofanalysis. The five factors are: (1) sexual ha­ discriminated against. rassment and discrimination, (2) different command behaviors (10) Reverse discrimination (II). The respondent's perception toward womanand minorities, (3) positive command behaviors of the prevalence of reverse discrimination in the service and toward equalopportunity, (4) overtracist/sexist behaviors, and American society, not just the medical center. (5) reverse discrimination behaviors. Using a five-point Likert (11) Attitudes toward racial separatism. How much the re­ scale ranging from a "very high chance" (1) to "almost no spondent believed the races should remain separate. (12) Overall equal opportunity climate. A global measure of TABLE I howthe respondentviewed equal opportunity withinthe medi­ cal center. DEMOGRAPHICS DATA The independent variable, operationally defined as the cul­ Medical Center tural groupto whichthe respondentbelonged, consistedoffive Population Sample categories. These categories were: (1) minority personnel, de­ fmed as thosebelonging to the following racialor ethnicgroups: n 0/0 n 0/0 Valid 0/0 African American, Hispanic, AsianAmerican, Pacific Islander, Gender and Native American/Alaskan native; (2) majority personnel, Male 3,080 55.51 841 48.03 52.73 defined as those belonging to any other racial or ethnic group; Female 2,469 44.49 754 43.06 47.27 Missing 156 8.91 (3) gender, defined as male or female; (4) military personnel, Ethnicity defmed as military officers, warrant officers, and enlistedmem­ Majority 2,410 43.43 738 42.15 44.67 bers; and (5) civilian personnel, defmed as federal employees. Minority 3,139 56.57 914 52.20 55.33 Missing 99 5.65 Status Hypotheses Military 2,768 49.88 806 46.03 48.79 Two hypotheses weretested in this study: (1) differences exist Civilian 2,781 50.12 846 48.32 51.21 between the perceptions ofmedical centerpersonneland a com- Missing 99 5.65

Military Medicine, Vol. 164, March 1999 204 Measuring Cultural Climate in a Uniformed Services Medical Center chance" (5), respondents are asked to estimate the likelihood The MEOCS discriminantvalidity has been demonstrated by that an actionmighthaveoccurredduringthe previous 30 days a variety ofmethods. Dansbyand Landis initially reported sig­ withinthe organization. nificantdifferences between various racial/ethnic, gender, and Three measures of organizational functioning are also in­ personnel category groups on each of the 11 factors. 11 These cluded (sections 2-4). The first measure (items 51-62) is an findings support the use of MEOCS as a measure of equal adaptation ofan organizational commitment measure based on opportunity climate. workby Short." Respondents rate their perceptions about the organization using a five-point Likert scale, with responses Procedures ranging from "totally agree" (1) to "totally disagree" (5). The Upon receiving command approval, MEOCS booklets were second measure (items 63-67) evaluateswork-group effective­ distributed to the administrative officer of each of the medical ness satisfaction. Again, respondents' perceptions are ratedusing center directorates and departments. The administrative offic­ a five-point Likert scale, withscores ranging from "totally agree" (1) ers were provided writteninstructions to distribute a surveyto to "totally disagree" (5). In the third measure (items 68-73), re­ each staff member. The surveybooklets were distributed with Downloaded from https://academic.oup.com/milmed/article/164/3/202/4832122 by guest on 30 September 2021 spondents indicate their level ofsatisfaction with specific job-re­ preaddressedreturn envelopes to enablerespondentsto return lated issues. Responses are rated using a five-point Likert scale them through distribution. Respondents were given 4 weeks to ranging from "very satisfied" (1) to "very dissatisfied" (5). complete and return the surveys. The respondents' confidenti­ The fifth section(items 79-101) consists ofa modified Racial alitywere protected by ensuring that no identifying information Attitudesand Perceptions Survey (RAPS). 13TheRAPS measures was collected on anyindividual. Furthermore, participation was an individual's attitude about race and gender discrimination. voluntary forall respondents. Factor analysis established that the RAPS consists offour un­ derlying factors: (1) discrimination against minorities, (2) agree­ Statistical Analyses ment with reverse discrimination, (3) racial separation, and (4) beliefin integration. Using a five-point Likert scale,respondents Dataanalysisconsistedoftwo phases. In phase one,all com­ report howthey feel about their organization. Responses range pletedresponseforms were mailed to DEOMI foranalysis. SPSS from "totally agree" (1) "tototally disagree" (5). PC+was used to analyze the data file and generatereportswith The fmal section of the MEOCS consists of 16 demographic extensive descriptive statistics on the factor scores, including items (items 107-109and 112-124), five global itemsassessing numbers of valid responses, means, standard deviations, the respondents' perceptions regarding whether they had been modes, percentages ofrespondentsabove and below the neutral discriminated against (items 101-106), and two general ques­ points on the scales, minimums, and maximums. Counts, tions regarding the overall equal opportunity climate ofthe or­ means, standard deviations, minimums, and maximums were ganization (items 110and Ill). also provided foreach individual item.Frequency distributions, with histograms, were generated for demographic items. Rele­ Reliability vant subgroups were compared: male and female personnel, military and civilian personnel, and majority and minority per­ The MEOCS subscales have consistently demonstratedvery sonnel; t tests were conducted between allsubgroups.Oneitem respectable levels ofinternal reliability, with a coefficients rang­ to note is that DEOMI analytic procedures dictate the use of ingfrom a low of0.60onthe beliefin integration scaleto 0.91on mean scale scores in all inferential analyses. 10 the discrimination againstminorities scale.Coefficients citedfor Phasetwo ofthe data analysisconsistedofhypothesis testing the remainderofthe scales are: sexual discrimination and ha­ using Stat, a microcomputer software package. Thehypotheses rassment, 0.89; different command behaviors toward women compared meanperceptions between different groupsofrespon­ and minorities, 0.90; positive command equal opportunity be­ dents.Asingle-sample t test wasused to test hypothesis one.An haviors, 0.86; overtracist/sexist, 0.85; reverse discrimination, independentt test ofmeanswas used to test hypotheses two. In 0.79; agreement with reverse discrimination, 0.75; agreement each case, the averaged scale scores (ranging from 1 to 5)were with racial separatism, 0.82; commitment to the organization, used in computing individual t tests. This procedure is consis­ 0.83; work-group effectiveness, 0.87; and job satisfaction, tent withthe procedures used at DEOMI.lO Theprobability level 10 0.80. for all hypothesis tests was set at p ~ 0.05 for the detection of statistically significant results. Validity The authors ofthe MEOCS used several methodsofanalysis Results to establish the instrument's constructValidity, including inter­ nal consistency correlations, factor analysis, and convergent Table IIdisplays the means and SDvaluesofthe perceptions and discriminant validation. Intercorrelations among the 11 ofallmedical centerand a representative sampleofDoD respon­ MEOCS scalesindicatea highdegree ofintercorrelations among dents forthe 12 MEOCS factors. Our analysessuggeststatisti­ scales.Theserange from 0.73 to 0.91, with an average of0.84. cally significant differences between the perceptions ofthe med­ Dansbyand Landisprovide a table listingthe intercorrelations ical center respondents and the DoD respondents for all 12 of the scales.11 Factor analyses, using principal component factors. DoD personnel, in general, had a more favorable per­ analysiswithvarimax rotation, consistently converged to a com­ ception ofsexualharassment and discrimination, different com­ mon solutionconsistingof 11factors. 10 The 12th factor(overall mand behaviors, reverse discrimination (I), organizational com­ equal opportunity climate), consisting of two questions (items mitment, discrimination againstminorities and women, and the 110 and Ill), has not been incorporated into factoranalysis. overall equal opportunity climate. Medical center personnelre-

MilitaryMedicine, Vol. 164, March 1999 Measuring Cultural Climate in a Uniformed Services Medical Center 205

TABLEn MEAN DIFFERENCES BE1WEEN THE MEDICAL CENTERSAMPLE AND THE DEPARTMENT OF DEFENSE POPULATION ON 12 MEOCSFACTORS

Army Facility Factor n Mean SO n Mean SO dJ t Behavioral perceptions Sexual harassment/discrimination 128,207 3.87 0.90 1,628 3.74 0.93 129,833 -5.64a Different command behaviors 128,294 4.13 0.82 1,606 4.01 0.91 129,898 -5.28a Positive equal opportunity behaviors 129,933 3.61 0.83 1,609 3.71 0.85 131,540 4.72 a Racist/sexist behaviors 129,174 3.82 0.85 1,610 3.94 0.85 130,782 5.66 a Reverse discrimination (I) 128,514 3.86 0.79 1,612 3.76 0.82 130,124 -4.90a

Organizational functioning Downloaded from https://academic.oup.com/milmed/article/164/3/202/4832122 by guest on 30 September 2021 Commitment 129,988 3.19 0.85 1,624 3.14 0.84 131,610 -2.40b Work-group effectiveness 129,549 3.77 0.95 1,682 3.98 0.95 131,229 9.07 a Job satisfaction 129,623 3.57 0.87 1,669 3.81 0.84 131,290 11.67a Race and gender discrimination Discrimination, minorities and women 129,260 3.69 0.97 1,656 3.39 1.03 130,914 -11.85a Reverse discrimination (II) 128,705 3.38 1.01 1,668 3.43 0.99 130,371 2.06 b Racial/gender separatism 128,601 4.14 0.85 1,669 4.34 0.75 130,268 11.44a Overall equal opportunity climate 129,538 3.27 1.05 1,651 3.10 1.08 131,187 -6.40a Higher mean scores indicate a more favorable perception of the MEOCSfactor. ap < 0.0001. bp < 0.05. porteda more favorable perception ofpositive equalopportunity crimination, discrimination againstminorities and women, and behaviors, racist and sexist behaviors, work-group effective­ the overall equalopportunity climate. Females were moreposi­ ness,job satisfaction, reverse discrimination (II), and racialand tive in their perceptions ofracist and sexistbehaviors, reverse genderseparatism. discrimination (I), reverse discrimination (II), and racial and Tables III throughVsummarize the results forthe hypotheses genderseparatism. Differences ofperceptions forthe remaining concerned with mean differences between the medical center's 5 factors did not achieve significance. culturalgroups. Again, our analysessuggeststatistically signif­ Military and civilian personnel exhibited significant differ­ icant differences between the perceptions ofmalesand females encesin theirperceptions of6 ofthe 12factors. Military person­ for 7 of the 12 MEOCS factors. Male personnel reported more nel reported more favorable perceptions of different command favorable perceptions regarding sexual harassment and dis- behaviors, positive equal opportunity behaviors, job satisfac-

TABLEill MEAN DIFFERENCES BE1WEEN MALES AND FEMALES ON 12 MEOCSFACTORS

Male Female Factor n Mean SD n Mean SD df t Behavioral perceptions Sexual harassment/discrimination 807 3.84 0.90 717 3.68 0.97 1,522 3.34 a Different command behaviors 796 4.04 0.91 713 4.03 0.90 1,507 0.21 b Positive equal opportunity behaviors 796 3.76 0.83 711 3.71 0.86 1,505 1.15b Racist/sexist behaviors 796 3.86 0.88 715 4.07 0.81 1,509 -4.81c Reverse discrimination (I) 795 3.66 0.86 709 3.89 0.77 1,502 -5.44c Organizational functioning Commitment 802 3.18 0.87 725 3.13 0.83 1,525 1.15b Work-group effectiveness 832 4.00 0.94 742 4.04 0.91 1,572 -0.86b Job satisfaction 824 3.86 0.83 738 3.84 0.81 1,560 0.48 b Race and gender discrimination Discrimination, minorities and women 819 3.53 1.05 742 3.28 1.01 1,559 4.78 c Reverse discrimination (II) 827 3.35 1.04 742 3.54 0.94 1,567 -3.78a Racial/gender separatism 825 4.34 0.75 741 4.44 0.69 1,564 -2.74d Overall equal opportunity climate 831 3.18 1.13 744 3.04 1.04 1,573 2.55e Higher mean scores indicate a more favorable perception of the MEOCSfactor. ap < 0.001. 'Not significant. cp< 0.0001. dp < 0.01. ep< 0.05.

MilitaryMedicine, Vol. 164, March 1999 206 Measuring Cultural Climate in a Uniformed Services Medical Center

TABLEIV MEANS ANDSD VALUES BElWEEN MILITARY AND CIVILIAN PERSONNEL ON 12 MEOCS FACTORS

Military Civilian Factor n Mean SD n Mean SD dJ t Behavioral perceptions Sexual harassment/discrimination 785 3.74 0.89 792 3.76 0.98 1,576 -0.42a Different command behaviors 764 4.12 0.80 794 3.92 0.99 1,556 4.38 b Positive equal opportunity behaviors 773 3.87 0.80 787 3.57 0.86 1,558 7.13 b Racist/sexist behaviors 774 3.91 0.80 788 3.98 0.89 1,560 -1.63a Reverse discrimination (I) 771 3.74 0.81 786 3.76 0.84 1,555 -0.96a Organizational functioning a Commitment 773 3.19 0.84 805 3.11 0.85 1,576 1.88 Downloaded from https://academic.oup.com/milmed/article/164/3/202/4832122 by guest on 30 September 2021 Work-group effectiveness 795 3.95 0.93 836 4.03 0.95 1,629 -1.72a Job satisfaction 793 3.91 0.81 827 3.75 0.85 1,618 3.88 b Race and gender discrimination Discrimination, minorities and women 785 3.61 0.96 827 3.20 1.05 1,610 8.17 b Reverse discrimination (II) 795 3.37 0.96 828 3.49 1.01 1,621 -2.45c Racial/gender separatism 794 4.36 0.77 829 4.36 0.72 1,621 o.oo- Overall equal opportunity climate 795 3.33 1.01 836 2.90 1.11 1,629 8.17 b Higher mean scores indicate a more favorable perception of the MEOCS factor. aNot significant. bp < 0.0001. cp< 0.05.

TABLEV MEANS ANDSD VALUES BElWEEN MAJORI1Y ANDMINORI1Y PERSONNEL ON 12 MEOCS FACTORS

Majority Minority Factor n Mean SD n Mean SD dJ t Behavioral perceptions Sexual harassment/discrimination 722 3.88 0.85 859 3.64 0.98 1,577 5.15 a Different command behaviors 713 4.42 0.64 847 3.68 0.96 1,558 17.56a Positive equal opportunity behaviors 708 4.07 0.73 851 3.42 0.83 1,557 16.25a Racist/sexist behaviors 712 4.11 0.79 850 3.80 0.88 1,560 7.26 a Reverse discrimination (I) 702 3.71 0.86 855 3.80 0.79 1,555 -2.15b Organizational functioning Commitment 717 3.24 0.89 861 3.07 0.80 1,576 3.99° Work-group effectiveness 735 4.01 0.93 896 3.97 0.94 1,629 0.86 C Job satisfaction 735 3.90 0.79 883 3.76 0.86 1,616 3.38 d Race and gender discrimination Discrimination, minorities and women 726 3.94 0.77 887 2.96 1.00 1,611 21.67 a Reverse discrimination (II) 730 3.14 0.98 892 3.66 0.93 1,620 -10.93a Racial/gender separatism 731 4.45 0.68 891 4.28 0.79 1,620 4.59 a Overall equal opportunity climate 732 3.45 1.04 900 2.83 1.03 1,630 12.04a Higher mean scores indicate a more favorable perception of the MEOCS factor. ap < 0.0001. bp < 0.05. -Not significant. dp < 0.001. tion, discrimination against minorities and women, and the minorities and women, racial and gender separatism, and the overall equal opportunity climate. Civilian personnel had more overall equal opportunity climate. Minority personnel reported favorable perceptions ofreverse discrimination (II). Differences more favorable perceptions ofreverse discrimination (I) and re­ of perceptions for the remaining 6 factors did not achieve sig­ verse discrimination (II). There was no significant difference in nificance. the groups' perception ofwork-group effectiveness. When majority and minority personnel were compared, there Figure 1 displays the disparity indexes for the studied cul­ were significant differences on 11 of the 12 factors. Majority tural groups. The disparity index estimates the potential for personnel reported more favorable perceptions ofsexualharass­ organizational conflict based on perceptions that differ between mentand discrimination, different command behaviors, positive cultural groups. The higherthe index, the greaterthe discrep­ equalopportunity behaviors, racist and sexistbehaviors, orga­ ancyin perceptions. Sociological research indicates that these nizational commitment, job satisfaction, discrimination against perceptual discrepancies may lead to conflict. 14 The reported

Military Medicine, Vol. 164, March 1999 Measuring Cultural Climate in a Uniformed Services Medical Center 207

II Males vs. Females • Majority vs. Minority ~ Military vs. Civilian Downloaded from https://academic.oup.com/milmed/article/164/3/202/4832122 by guest on 30 September 2021

o 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9

(Low) (Mod. Low) (Med) (Mod. High) (High) (Very High) (Extreme)

Figure. Disparity index. disparity indexes (low, medium, high) are based on values con­ In studying the differences between gender groups, males tained in the DEOMI database. As can be seen, the disparity generally helda more positive perception ofthe culturalclimate index for the majority/minority comparison (0.39) placed it in in terms of sexualharassment and discrimination against mi­ the medium category. A disparity index of medium or high is norities and women, perceived that there was more reverse considered significant enough to warrant analysis of specific discrimination practiced at the medical center, and heldstron­ perceptual differences. 14 gerbeliefs that the racesshouldremain separate. Theindication that males perceived a higher incidence oftraditional overt rac­ Discussion ist and sexistbehaviors mayimply that males are more aware of this behavior becausetheyare more likely to engage in it in the The purpose of this study was to determine the perceived presence of other males rather than females. Additionally, as cultural climate within the medical center. The evidence pro­ might be expected, males tended to believe that they were the vided by these analyses suggests that the medical center per­ victims ofreverse discrimination.There wasno statistically sig­ sonnel generally perceived that, compared with the 000 as a nificant difference between males and females in their percep­ whole, the medical center's cultural climate rated above-aver­ tions oforganizational functioning. age. Themedical centerpersonnel and the 000 personnel were Military and civilian personnel reported similar perceptions of divided in their perceptions of the MEOCS factors, with each the culturalclimate in 6 ofthe 12MEOCS factors; however, the group scoring significantly higher on 6 of the 12 factors . Al­ reported differences were significant (p < 0.0001). Military per­ though the medical center personnel, in general, had lower sonnelgenerally scored higherin all three sections: behavioral scoreson the factors that make up the behavioral perceptions perceptions, organizational functioning, and attitude.Thecivil­ section, higher scoreson the work-group effectiveness andjob­ ian personnel mean scalescore (2.90) on the overall equalop­ satisfaction factors indicate that the medical center personnel portunity climate scaleplaced them below the medical center's had more favorable perceptions of organizational functioning mean score. Thismayindicate that although civilian personnel than did the comparison 000 sample. mayhavescored manyofthe factors related to culturalclimate Medical center personnel also had more favorable attitudes above-average, their global perception of equal opportunity at regarding reverse discrimination (ll) and racial and gender sep­ the medical center was less than favorable. However, caution aratism, but they had less favorable attitudes regarding dis­ shouldbeexercised ininterpreting this scorebecauseitis based crimination and the overall equal opportunity climate. Addi­ ononly two questions. Futurestudiesmight focus onthisaspect tional information regarding the demographic composition of of equal opportunity to determine if these results are a true the 000 respondents is needed to perform additionalanalyses reflection ofthe medical centerclimate or a statisticalanomaly. ofthese differences. Unfortunately, this is beyond the scope of Majority personnel had significantly more favorable percep­ this study. tions of every factor except reverse discrimination (less favor-

Military Medicine, Vol. 164, March 1999 208 Measuring Cultural Climate in a Uniformed Services Medical Center able) and work-group effectiveness (no difference). This finding Furthermore, studies should be conducted on the differing is consistentwith the comparison between males and females, perceptions between military and civilian personnel in a military suggesting againthat majority personnel are sensitive toreverse organization. As the work force is restructured to place more discrimination. civilians in traditional military leadership roles, care must be Thenegative perception that majority personnel heldregard­ taken toaccept, incorporate, and empower the diverse talents of ing reverse discrimination is interestingin that it clearly illus­ thesenewleaders. Additional research,coupled withthis study, trates a sense of self-interest by the majority group that was will assist organizations in developing programs that will en­ common throughout the results of this study. In almost every courage the assimilation ofdiverse personnel into a united cor­ case, an unfavorable perception regarding discrimination was porate culture. held by the groupbeingdiscussed. Forexample, minorities felt The findings ofthis study indicatethat there are differences morestrongly that there was discrimination againstminorities, among the perceptions of different cultural groups within the and women had a strongerperception ofthe existence ofsexual medical center. These perceptions may be enhanced through harassment. the implementation oforganizational policies and programs that Downloaded from https://academic.oup.com/milmed/article/164/3/202/4832122 by guest on 30 September 2021 The disparityindexof0.39 indicatesthat the perceptual dis­ encourage the acceptance ofdiversity. Managed appropriately, crepancies between majority and minority personnel may be cultural diversity may become the medical center's greatest severe enoughto createorganizational conflict. Additional anal­ strength.Theresults ofthis study can alsoapplyto hospitalsin yses should be performed to determine the differences in the the civilian sector. Like military medical care facilities, civilian perceptions ofmajority and minority personnel. health care facilities employ a highly diverse population. Be­ In summary, the evidence provided by these analyses indi­ cause ofthis diversity, it would be logical to assume that there cated that large, systematic differences existin the perceptions would be similardifferences in the perceptions of the cultural ofthe medical centerculturalclimate between (1) medical center climate between those different cultural groups, specifically be­ and DoD personnel, and (2) the following cultural groups: (a) tween majority and minority personnel, malesand females, and maleand female personnel, (b) military and civilian personnel, management and employees. and (c) majority and minority personnel. Our findings are consistent with previous research in that there weredifferences in the perceptions ofthe cultural climate References between different cultural groups. Specifically, the findings of 1. Johnston WE, Packer A:Workforce 2000: Work and Workers for the Twenty-First this studyparallel thoseofBrown et ale and Bowers in that there Century. Indianapolis, IN, Hudson Institute, 1987. were statistically significant differences in the perceptions ofthe 2. Sabatino F: Culture shock: are U.S. hospitals ready? Hospitals 1993 May: 23-6. cultural climate between majority and minority personnel. 5,8 3. Epting LA, Clover S, Boyd S: Managing diversity. Health Care Supervisor 1994; The finding of statistically significant differences between gen­ 12(4): 73-83. der groups is consistentwith those ofSpicherand Rely."? The 4. Gardenswartz L, RoweA: Recognizing the power of diversity. Physician Executive 1993; 19(6): 64-7. finding of perceptual differences between military and civilian 5. Brown DK, Nordlie PC, Thomas JA: Changes in Black and White Perceptions of personnel have not previously been reported in the literature. the Army's Race Relations/Equal Opportunity Programs: 1972 to 1974. Technical Thelow responserate (350/0) is ofconcernbecauseit callsthe report TR-77-B3. Alexandria, VA,US Army Research Institute for the Behavioral generalizability ofthe studyintoquestion. However, it shouldbe and Social Sciences, 1977. noted that one-time, mass-distribution surveys often yield re­ 6. Spicher CR: Equal Opportunity and Treatment Perceptions of United States Air Force Military Men and Women. MaxwellAir Force Base, AL,Air Command and sponse rates in the 30°A> range. 15 Nevertheless, further efforts Staff College, 1980. shouldbe madeto increasethe responserate. Furthermore, the 7. Soldiers Report IV. Washington, DC, Department of the Army, Directorate of results of the current study should be interpreted with some Human Resources Development, 1986. skepticism. 8. Bowers DG: Navy Manpower: Values, Practices, and Human Resources Require­ ments. Ann Arbor, MI,University of Michigan, Institute for Social Research, 1975. 9. Rely PJ: Sexual harassment in the Navy. Thesis. Monterey, CA, Naval Postgrad­ Conclusions and Recommendations uate School, 1980. 10. Landis D, Dansby M, Faley RH:The Military Equal Opportunity Climate Survey: At a minimum, the findings ofthe current study provide the an example of surveying in organizations. In Improving Organizational Surveys. Edited by Rosenfeld P. 1993. medical center administration with a broad overview of its or­ 11. Dansby MR, Landis D: Measuring equal opportunity climate in the military ganizational climate and maybe used to identify specific areas environment. International Journal of Intercultural Relations 1991; 15: 489­ that warrant additional study.Studiessuch as ours can provide 505. the leadership with a baseline of our current state with the 12. Short W: The United States Air Force Organizational Assessment Package. Max­ purposeofdeveloping programs that embrace culturaldiversity. well Air Force Base, AL, Leadership and Management Development Center, Air University, 1985. Future research should focus on differences among more 13. Hiett R, McBride R, Fiman B, Thomas J, O'Mara F, Sevilla E: The Racial Attitudes narrowly defmed cultural groups, such as minority civilian and Perceptions Survey (RAPS). AR technical paper 338 ADA 064263. Alexan­ males, minority civilian females, minority military males, and dria, VA, US Army Research Institute for the Behavioral and Social Sciences, minority military females. This will provide additional insight 1978. 14. MEOCS Results from the Medical Center. Defense Equal Opportunity Manage­ into the factors that contributeto each subgroup'sperceptions ment Institute, 1995. and will supplymorespecific information withwhichto develop 15. Dillman DA:Mail,Telephone Surveys: The Total Design Method. NewYork, John proactive policies and programs. Wiley & Sons, 1978.

MilitaryMedicine, Vol. 164, March 1999