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Measuring Cultural Climate in a Uniformed Services Medical Center

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Measuring Cultural Climate in a Uniformed Services Medical Center 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
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