The need to vent and dissatisfactory self-service technology encounters

Reports of customer dissatisfaction with self-service technologies (SSTs) are becoming increasingly common. The SST context is characterised by customer participation in service production and delivery, independently of service personnel. With no opportunity for humanto- human interaction, feelings of customer irritation and frustration can have a tendency to build-up in dissatisfactory SST encounters. If SSTs do not perform as promised, customers can become angry and frustrated, and do not have the security or reassurance of human service personnel. With this in mind, it is argued that customers’ “need to vent” will be an important predictor of customers’ complaint behaviours (CCBs), i.e., voice, negative word of mouth, negative “word of mouse”, third party action, false loyalty and exit, in dissatisfactory SST encounters. The “need to vent” is defined as the need, when one has a problem, to seek relief by expressing one’s problem / “getting it off one’s chest”. This construct has been subject to little conceptual or empirical scrutiny, and to the researchers’ knowledge, has not been previously operationalised or measured. This paper begins to address this gap by presenting a conceptual model and hypotheses depicting the relationships between the need to vent and CCBs in the context of SSTs.

Exploring the relationship between customer loyalty to the service worker and customer citizenship behaviors to the service organization

This paper conceptualizes the positive relationship between customer loyalty to the service worker (personal loyalty) and customer citizenship behaviors to the service organization including: positive word of mouth; suggestions for improvements; customer participation in activities; benevolent acts of service facilitation; customer policing; customer flexibility; customer voice and displays of relationship affiliation.

Effective recruitment and retention strategies in community health programs

Issue addressed: 

Screen-time weight-loss intervention targeting children at home (SWITCH): a randomized controlled trial

BACKGROUND: Screen-based activities, such as watching television (TV), playing video games, and using computers, are common sedentary behaviors among young people and have been linked with increased energy intake and overweight. Previous home-based sedentary behaviour interventions have been limited by focusing primarily on the child, small sample sizes, and short follow-up periods. The SWITCH (Screen-Time Weight-loss Intervention Targeting Children at Home) study aimed to determine the effect of a home-based, family-delivered intervention to reduce screen-based sedentary behaviour on body composition, sedentary behaviour, physical activity, and diet over 24 weeks in overweight and obese children.

METHODS: A two-arm, parallel, randomized controlled trial was conducted. Children and their primary caregiver living in Auckland, New Zealand were recruited via schools, community centres, and word of mouth. The intervention, delivered over 20 weeks, consisted of a face-to-face meeting with the parent/caregiver and the child to deliver intervention content, which focused on training and educating them to use a wide range of strategies designed to reduce their child's screen time. Families were given Time Machine TV monitoring devices to assist with allocating screen time, activity packages to promote alternative activities, online support via a website, and monthly newsletters. Control participants were given the intervention material on completion of follow-up. The primary outcome was change in children's BMI z-score from baseline to 24 weeks.

RESULTS: Children (n = 251) aged 9-12 years and their primary caregiver were randomized to receive the SWITCH intervention (n = 127) or no intervention (controls; n = 124). There was no significant difference in change of zBMI between the intervention and control groups, although a favorable trend was observed (-0.016; 95% CI: -0.084, 0.051; p = 0.64). There were also no significant differences on secondary outcomes, except for a trend towards increased children's moderate intensity physical activity in the intervention group (24.3 min/d; 95% CI: -0.94, 49.51; p = 0.06).

CONCLUSIONS: A home-based, family-delivered intervention to reduce all leisure-time screen use had no significant effect on screen-time or on BMI at 24 weeks in overweight and obese children aged 9-12 years.

Deaf education and underlying structures of power in communication

This article argues that claims of diversity in communication in deaf education are empty rhetoric when underlying structures of power are unexamined and remain unchanged. The field of deafness provides a powerful example of the way in which competing interests can be played out under the guise of choice of communication methods. Historically, teachers of the deaf have been divided about whether deaf children should be educated through speech or sign. However, recognition of the legitimacy of native sign languages has caused a shift in the debate to the linguistic basis of this communication and the way in which language policy privileges one cultural group and its method of communication over another.

A model of superiors and subordinates' aggressive communication in the workplace

In the workplace, superiors and subordinates may engage in a spiral of aggressive communication and emotional reaction that can lead to negative attitudes and unproductive organisational outcomes and higher staff turnover. In the manuscript, we develop and propose a model of superiors' and subordinates' aggressive communication and emotional reactions. In our model we suggest that organisational context (culture) and individual personal characteristics (personality, trust, self-esteem) influence superiors' and subordinates' aggressive communication. We also suggest that individual emotional characteristics (positive/negative affect, emotional intelligence) influence the protagonists' emotional reactions. Finally, we propose that subordinates' emotional reactions and organisational culture influence their attitudes (organisational identity, perception of a masculine vs. feminine organisation) and their considered behaviours (performance, turnover). We conclude with a discussion of potential limitations, and implications for theory, research, and practice.

Environmental management system and electronic communication : Is it the need of the hour?

Implementation and certification of Environmental Management Systems (EMS) is a reality for many businesses. Communication with an organisation’s stakeholders is a required element of any EMS. In the last five years companies have steadily moved towards integrating their different management systems, such as quality, environmental, and occupational health and safety, in an attempt to reduce their costs and increase efficiency. Legislation requires extensive reporting in each of these areas, so compliance is another important driver. During this period, communication by digital technology, or electronic communication, has gained prominence and acceptance amongst all groups of people including businesses primarily as a means to disseminate crucial EMS information to geographically diverse employees in a cost effective and instantaneous manner. Some perspectives have emerged to suggest that change processes in organisations may be hindered or helped in various ways through the application of digital technology in EMS. There are, however, gaps in the literature that document the impact and effectiveness of electronic communication amongst EMS stakeholders. In this paper we will discuss employees as one of the major stakeholders and whether the move to electronic communication has been assisting or hindering transformations in awareness and understanding of issues amongst employees. We highlight opportunities and challenges presented by an increased use of electronic communication in light of the environmental and climate change debates, which underpin EMS.

In situ growth of Soletellina alba (Bivalvia: Psammobiidae) in response to detrital supply and mouth status in a seasonally-closed estuary

The supply of detritus is an important food source for many soft-sediment invertebrates, but its importance for their growth and condition is rarely, if ever, tested directly using manipulative field experiments. Therefore, we designed such a study to: (1) test the importance of fine particulate organic matter for the growth and condition of the infaunal bivalve Soletellina alba; (2) indirectly test the feeding mode of S. alba, which has been assumed to be a deposit feeder like other members of the same superfamily (Tellinoidea); (3) compare growth rates across two summers with contrasting patterns of estuary mouth opening/closing; and (4) compare the condition of individuals used in two field studies (i.e. present versus past) and a past laboratory study. Neither growth nor condition differed when organic content of the sediments was varied, which suggests that S. alba is either a suspension feeder or capable of switching modes of feeding. There was considerable interannual variation in growth with greater growth occurring during the summer with a longer period of mouth opening. This suggests that periods of mouth closure may reduce secondary production within seasonally-closed estuaries. Potential artefacts associated with laboratory trials were also identified, with laboratory bivalves exhibiting poorer condition than those used in two field trials. The present study provides no evidence that variable quantities and qualities of organic matter within the sediments influence the growth and condition of S. alba, but future studies should focus on food supplied via the water column when the estuary is open versus closed.

Clinical supervision and symmetrical communication : towards a critical practice of supervision

The central argument of the thesis is that the dominant modes of the supervision of teaching are in need of critique and reconstruction. From a critical perspective, supervision is viewed as a political and ideological process enacted through asymmetrical relations and structures of communication. It is underpinned by a discourse of technocratic rationality and control Clinical supervision, a currently popular model of teacher supervision, has (despite its emancipatory origins) been accommodated by the dominant ideology and is employed as a hegemonic mechanism of evaluation, control and even dismissal of teachers. However, historical analysis reveals that teachers have contested and resisted authoritarianism and centralized control in favour of developing more democratic and participatory forms of professional development. In these moves can be found a rationale for a reconstruction of the theory and practice of clinical supervision around the concepts of symmetrical communication and critical pedagogy. The researcher engaged in a self-reflective study with a group of supervisors and teachers in N.S.W. schools to explore the possibilities and limitations of a critical and counter-hegemonic practice of supervision. The outcomes, in the form of three case studies, are analysed in terms of a dialectic of reconstruction and maintenance of the status quo. The evidence reveals that some of the research participants sought to reconstruct their supervisory relationships in ways which challenged the bureaucratic structures of their workplace. Others, however, rejected the emancipatory possibilities and resolved to maintain their traditional hierarchical relationship.

A systematic scoping investigation of cross-cultural visual communication design

This research project provides a systematic and strcutured investigation into the issues associated with the emergent field of cross-cultural visual communication design. The results of the scoping research and the international cross-cultural design project offer clear guidance for designers through all stages of the communication process. 

Nursing educator perspectives of overseas qualified nurses' intercultural clinical communication: barriers, enablers and engagement strategies

AIMS AND OBJECTIVES: To understand the intercultural communication experiences and associated communication training needs of overseas qualified nurses in the Australian healthcare system from the unique perspectives of nurse educators teaching in accredited bridging programmes. BACKGROUND: Overseas qualified nurses are an integral part of the nursing workforce in migration destination countries. Communication training needs are more complex when there are cultural, ethnic and language differences between nurses, other health professionals and patients. DESIGN: A qualitative, exploratory research design using semi-structured interviews. METHODS: All (nine) organisations involved in conducting the Australian Health Practitioner Regulation Agency approved preregistration bridging programmes for overseas qualified nurses within the state of Victoria, Australia, were involved in the study. Participants were 12 nurse educators employed in these organisations. Thematic analysis was undertaken. RESULTS: Three macro themes emerged about the overseas qualified nurses' intercultural communication: (1) pre-existing barriers and enablers to intercultural communication, for example, nurses' reluctance to engage in communicative strategies that build rapport with patients, (2) transitional behaviours and impact on communication, including maintenance of perceived cultural hierarchies between health professionals and (3) development of communicative competence, including expanding one's repertoire of conversational gambits. CONCLUSIONS: The findings point to the domains and causes of communication challenges facing overseas qualified nurses in new healthcare settings as well as strategies that the nurse educators and nurses can adopt. Communication cannot be merely regarded as a skill that can be taught in a didactic programme. Comprehensive understanding is needed about the sociocultural dimensions of these nurses' orientation, which can impact on how they communicate in their new healthcare settings. RELEVANCE TO CLINICAL PRACTICE: The findings can act as triggers for discussion with overseas qualified nurses and other health professionals to raise awareness about the aspects of intercultural communication and to debate alternative viewpoints and explanations. They can also inform changes in the structure and content of the bridging programmes.

Visual communication design as a form of public pedagogy

This paper identifies visual communication design as a form of public pedagogy. Communication design practices aim to achieve the successful transmission of a message to a recipient in a visual mode. Understanding the theories and practices of visual communication design can assist in enhancing the reception of the communication, as these practices become a tool to increase the effectiveness of learning in a public space. To demonstrate this, I will use the example of museums as an informal place of public learning, and argue design, and in particular visual communication design strategies, are extremely important in the creation of successful learning. If participants are not engaged or entertained, their capacity for learning will diminish. Engagement depends on the representation of the information and the successful interpretation of that information by the visitor. Further, this paper will emphasize the vital role communication design plays in all forms of public pedagogy, not just within the museum context. However, non-designers create many public learning environments and although this paper argues the benefits of communication design to increasing the effectiveness of learning, it recognizes the narrow opportunities of applying this knowledge.

Challenges and opportunities of undertaking a video ethnographic study to understand medication communication

AIMS AND OBJECTIVES: To examine the challenges and opportunities of undertaking a video ethnographic study on medication communication among nurses, doctors, pharmacists and patients. BACKGROUND: Video ethnography has proved to be a dynamic and useful method to explore clinical communication activities. This approach involves filming actual behaviours and activities of clinicians to develop new knowledge and to stimulate reflections of clinicians on their behaviours and activities. However, there is limited information about the complex negotiations required to use video ethnography in actual clinical practice. DESIGN: Discursive paper. METHOD: A video ethnographic approach was used to gain better understanding of medication communication processes in two general medical wards of a metropolitan hospital in Melbourne, Australia. This paper presents the arduous and delicate process of gaining access into hospital wards to video-record actual clinical practice and the methodological and ethical issues associated with video-recording. CONCLUSIONS: Obtaining access to clinical settings and clinician consent are the first hurdles of conducting a video ethnographic study. Clinicians may still feel intimidated or self-conscious in being video recorded about their medication communication practices, which they could perceive as judgements being passed about their clinical competence. By thoughtful and strategic planning, video ethnography can provide in-depth understandings of medication communication in acute care hospital settings. Ethical issues of informed consent, patient safety and respect for the confidentiality of patients and clinicians need to be carefully addressed to build up and maintain trusting relationships between researchers and participants in the clinical environment. RELEVANCE TO CLINICAL PRACTICE: By prudently considering the complex ethical and methodological concerns of using video ethnography, this approach can help to reveal the unpredictability and messiness of clinical practice. The visual data generated can stimulate clinicians' reflexivity about their norms of practice and bring about improved communication about managing medications.

Core components of communication of clinical reasoning: a qualitative study with experienced Australian physiotherapists

Communication is an important area in health professional education curricula, however it has been dealt with as discrete skills that can be learned and taught separate to the underlying thinking. Communication of clinical reasoning is a phenomenon that has largely been ignored in the literature. This research sought to examine how experienced physiotherapists communicate their clinical reasoning and to identify the core processes of this communication. A hermeneutic phenomenological research study was conducted using multiple methods of text construction including repeated semi-structured interviews, observation and written exercises. Hermeneutic analysis of texts involved iterative reading and interpretation of texts with the development of themes and sub-themes. Communication of clinical reasoning was perceived to be complex, dynamic and largely automatic. A key finding was that articulating reasoning (particularly during research) does not completely represent actual reasoning processes but represents a (re)construction of the more complex, rapid and multi-layered processes that operate in practice. These communications are constructed in ways that are perceived as being most relevant to the audience, context and purpose of the communication. Five core components of communicating clinical reasoning were identified: active listening, framing and presenting the message, matching the co-communicator, metacognitive aspects of communication and clinical reasoning abilities. We propose that communication of clinical reasoning is both an inherent part of reasoning as well as an essential and complementary skill based on the contextual demands of the task and situation. In this way clinical reasoning and its communication are intertwined, providing evidence for the argument that they should be learned (and explicitly taught) in synergy and in context.

End of life clinician-family communication in ICU: a retrospective observational study - implications for nursing

Objective: The objective of this study was to identify practice issues that influence end of life communication and care of patients and families in the intensive care unit (ICU).

Design: This study used a retrospective observational approach utilising a medical record review. Setting: An Australian metropolitan mixed medical/surgical ICU. Subjects: There are two parts to this study. The first part related to all of the patients who died in the ICU in one calendar year, a total of 97. The second part of this study related to a random selection of 25% of these patients, a total of 24.

Results: This study showed that death in the ICU was often anticipated, and that whilst communication between family and medical personnel was evident in the medical record, the involvement or occurrence of communication between the nurse and the family was not recorded, and that nurses were included in only 25% of formal family meetings.

Conclusion: Whilst this study confirmed that death is often predicted for critically ill patients, and opportunities for communication with the family or next of kin assists to achieve consensus on end of life decisions, the involvement of nurses, as primary care-givers is not well represented in the medical record, thus undermining the importance of the nurses role in direct patient care that extends to the family in the ICU.