\"What are your assumptions (implicit as well as explicit) about the most effective way to manage people?\" So began Douglas McGregor in this 1960 management classic. It was a seemingly simple question he asked, yet it led to a fundamental revolution in management. Today, with the rise of the global economy, the information revolution, and the growth of knowledge-driven work, McGregor's simple but provocative question continues to resonate-perhaps more powerfully than ever before. Heralded as one of the most important pieces of management literature ever written, a touchstone for scholars and a handbook for practitioners, The Human Side of Enterprise continues to receive the highest accolades nearly half a century after its initial publication. Influencing such major management gurus such as Peter Drucker and Warren Bennis, McGregor's revolutionary Theory Y-which contends that individuals are self-motivated and self-directed-and Theory X-in which employees must be commanded and controlled-has been widely taught in business schools, industrial relations schools, psychology departments, and professional development seminars for over four decades. In this special annotated edition of the worldwide management classic, Joel Cutcher-Gershenfeld, Senior Research Scientist in MIT's Sloan School of Management and Engineering Systems Division, shows us how today's leaders have successfully incorporated McGregor's methods into modern management styles and practices. The added quotes and commentary bring the content right into today's debates and business models. Now more than ever, the timeless wisdom of Douglas McGregor can light the path towards a management style that nurtures leadership capability, creates effective teams, ensures internal alignment, achieves high performance, and cultivates an authentic, value-driven workplace--lessons we all need to learn as we make our way in this brave new world of the 21st century.

The Human Side of Enterprise.

Purpose Empathy is a key element of patient– physician communication; it is relevant to and positively influences patients’ health. The authors systematically reviewed the literature to investigate changes in trainee empathy and reasons for those changes during medical school and residency. Method The authors conducted a systematic search of studies concerning trainee empathy published from January 1990 to January 2010, using manual methods and the PubMed, EMBASE, and PsycINFO databases. They independently reviewed and selected quantitative and qualitative studies for inclusion. Intervention studies, those that evaluated psychometric properties of self-assessment tools, and those with a sample size 30 were excluded. Results Eighteen studies met the inclusion criteria: 11 on medical students and 7 on residents. Three longitudinal and six cross-sectional studies of medical students demonstrated a significant decrease in empathy during medical school; one cross-sectional study found a tendency toward a decrease, and another suggested stable scores. The five longitudinal and two cross-sectional studies of residents showed a decrease in empathy during residency. The studies pointed to the clinical practice phase of training and the distress produced by aspects of the “hidden,” “formal,” and “informal” curricula as main reasons for empathy decline.

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Empathy decline and its reasons: a systematic review of studies with medical students and residents.

The aim of the present study was to examine further the role that self-identity plays in the theory of planned behaviour and, more specifically, to: (1) examine the combined effects of self-identity and social identity constructs on intention and behaviour, and (2) examine the effects of self-identity as a function of past experience of performing the behaviour. The study was concerned with the prediction of intention to engage in household recycling and reported recycling behaviour. A sample of 143 community residents participated in the study. It was prospective in design: measures of the predictors and intention were obtained at the first wave of data collection, whereas behaviour was assessed two weeks later. Selfidentity significantly predicted behavioural intention, a relationship that was not dependent on the extent to which the behaviour had been performed in the past. As expected, there was also evidence that the perceived norm of a behaviourally relevant reference group was related to behavioural intention, but only for participants who identified strongly with the group, whereas the relationship between perceived behavioural control (a personal factor) and intention was strongest for low identifiers.

The theory of planned behaviour: Self identity, social identity, and group norms

Thirty years of safety climate research: Reflections and future directions

In May 1999, 21 leaders and representatives from major medical education and professional organizations attended an invitational conference jointly sponsored by the Bayer Institute for Health Care Communication and the Fetzer INSTITUTE: The participants focused on delineating a coherent set of essential elements in physician-patient communication to: (1) facilitate the development, implementation, and evaluation of communication-oriented curricula in medical education and (2) inform the development of specific standards in this domain. Since the group included architects and representatives of five currently used models of doctor-patient communication, participants agreed that the goals might best be achieved through review and synthesis of the models. Presentations about the five models encompassed their research base, overarching views of the medical encounter, and current applications. All attendees participated in discussion of the models and common elements. Written proceedings generated during the conference were posted on an electronic listserv for review and comment by the entire group. A three-person writing committee synthesized suggestions, resolved questions, and posted a succession of drafts on a listserv. The current document was circulated to the entire group for final approval before it was submitted for publication. The group identified seven essential sets of communication tasks: (1) build the doctor-patient relationship; (2) open the discussion; (3) gather information; (4) understand the patient's perspective; (5) share information; (6) reach agreement on problems and plans; and (7) provide closure. These broadly supported elements provide a useful framework for communication-oriented curricula and standards.

Essential elements of communication in medical encounters: the Kalamazoo consensus statement.

Preface to the Third Edition. Introduction. Interpersonal Communcation: A Skill-based Model. Nonverbal Communication. Rewarding and Reinforcing. Questioning. Reflecting. Set Induction and Closure. Explanation. Listening. Self-disclosure. Influencing. Assertiveness. Group Interaction and Leadership. Concluding Comments. Bibliography. Subject Index. Author Index.

Social Skills in Interpersonal Communication

It is now widely accepted that effective interpersonal communication is at the heart of quality health care delivery but that current standards in medicine must be improved (Numann 1988; Cowan et al. 1992). One approach acknowledged by the General Medical Council (1991) devotes more attention during training to the theme of communication, and quite significant modifications of the undergraduate medical curriculum are presently taking place. This article documents the results of a postal survey of the 26 UK Schools of Medicine, designed to illuminate current practices and future plans in respect of communication skills training (CST). As such, it takes advantage of the present period of ongoing curricular innovation and change to extend and update earlier reviews (Whitehouse 1991; Frederikson & Bull 1992). A total of 19 responses was received. Following preliminary analysis, the four schools who had already implemented their new curriculum were selected for further in-depth investigation by means of telephone interviews. In addition to reporting frequencies and percentages for responses to questions, cross-tabulations were carried out to explore relationships between certain of the findings. Apart from some consistency in CST teaching methods adopted, the overall picture to emerge is one of considerable variability in such areas as course content, timing, duration and assessment. Foremost among the difficulties encountered in implementing CST appeared to be lack of adequate physical resources and suitably trained staff. Future plans were often sketchy and inchoate. Results are discussed and tentative recommendations for the further development of CST in the medical curriculum proffered.

A survey of communication skills training in UK Schools of Medicine: present practices and prospective proposals

Effective provider‐patient communication and the relationships that it supports are located at the centre of quality health‐care delivery. The patient‐centred approach is increasingly seen as an effective way to provide effective patient care, being more sensitive and responsive to the needs of the individual. Empathy has been identified as a core component of “patient‐centredness” but definitions often lack conceptual clarity. This paper proposes to clarify the definition of empathy keeping the discussion true to Rogers' original definitions of the concept whilst integrating the work of other writers. A major thrust is the development of an innovative conceptual model of empathy which has the potential to both integrate previous research findings and provide a framework for future research and training. The model is based in social psychological conceptions of attitude.

Empathy: towards a conceptual framework for health professionals

High standards of interpersonal communication are fundamental to effective health care delivery. Communication Skills Training for Health Professionals succeeds in providing the sound theoretical basis and practical approach needed to implement a higher standard of care through better communication. This is an essential part of the relationship between the health care provider and both the client and carer, and of course, between providers themselves. By giving an explanation of the underlying rationale for CST, together with the principles of training programme design, implementation, transfer and evaluation, the book becomes essential as a resource, applicable in any health care setting.The importance of skilful interpersonal communication to the provision of effective health-care is now widely recognized. In addition to the various other dimensions of expertise which health professionals draw upon, they must be able to interact successfully with colleagues and other health workers as well as patients and clients. It would seem, however, that standards of practice, in this respect, frequently fall short of public expectations and levels of professional acceptability. Interpersonal communication is consequently beginning to emerge from the 'hidden curriculum' to form an integral part of the training of, for instance, doctors, dentists, nurses, pharmacists, health visitors, physiotherapists, occupational therapists, speech therapists and dietitians. This handbook has been prepared to meet the need for information and advice by tutors faced with the task of contributing inputs in this area as part of either pre- or in-service education programmes.The book is essentially concerned with elaborating a structured and systematic instructional procedure for enhancing skilful face-to-face communication. It is organised in four parts. Part One contributes a firm conceptual base for the rest of the text by introducing and examining the notions of communication and communicative competence. The importance of effective interpersonal communication in the health professions is assessed and contrasting approaches to facilitating performance considered. An initial overview of CST is also given. Part Two is devoted to the content of training. Here a theoretical model of skilled communication is developed incorporating interpersonal, intrapersonal and situational determinants. A range of skills, commonly documented as being relevant to health-care personnel, are presented and analysed. These include nonverbal communication, questioning, listening, explaining, reinforcement and assertiveness. Furthermore the incorporation and integration of such skills within the strategic contexts of interviewing, counselling and influencing is discussed.The CST process encompassing preparation, training and evaluation stages is the subject of Part Three. Having established the aims and objectives of the training intervention, techniques are presented for isolating and identifying appropriate skills content. Sensitisation, practice and feedback phases of training per se are expounded and guidelines offered as to their implementation. This section is concluded by focusing upon methods of programme evaluation. The fourth and final part of the book brings a more integrative perspective to bear upon CST. A detailed exposition is given of the major considerations which the tutor must acknowledge in designing and implementing training and the influence of these, at different levels, on the instructional sequence formulated. Finally the impact of CST upon the communicative competence of professionals is discussed.It has been our intention to produce a book which is fundamentally practical in orientation, containing not only information and guidance but also material which trainers can directly apply in planning, teaching and evaluating programmes. Practical exercises are inserted throughout, together with suggestions as to how they may best be made use of. Material is also contained which can be utilised in analysing performance, identifying skills and presenting structured feedback to trainees. This can either be accepted in its present form or adapted to more fully meet particular requirements.In outlining CST procedures and techniques we have, however, avoided a 'cook-book' approach which merely describes a stereotypical sequence of steps to be reflexively followed on each and everv occasion. This is not how we see CST. Rather we have resolved to document the underlying rationale for this type of training and illuminate the theoretical, conceptual and empirical underpinnings of the various instructional mechanisms which contribute to it. Trainers who have a firm understanding of why they are doing what they are doing are infinitely better prepared to maximize the potential which CST has to offer with different groups in disparate settings.

David Dickson

Papers

Social Skills in Interpersonal Communication

A survey of communication skills training in UK Schools of Medicine: present practices and prospective proposals

Empathy: towards a conceptual framework for health professionals

Communication Skills Training for Health Professionals

Communication in Management