Healthcare Quarterly

Healthcare Quarterly 6(1) September 2002 : 36-41.doi:10.12927/hcq.2002.16653
Features

Emotional Intelligence - How Well Do We Know Ourselves and How We Relate to Others?

Moriah Shamian-Ellen and Peggy Leatt

Abstract

How do we characterize an ideal or effective leader? Is it someone who has vision? A person who can make decisions quickly? Someone who speaks with authority? A person who can persuade others to work towards the mission of an organization? Someone who can be trusted and has integrity? These are some of the ways we have tried to illustrate what we mean when we describe members of our society who are successful. But are these characteristics the most appropriate? The purpose of this article is to explore the concept of emotional intelligence (EI) - our ability to manage ourselves and our relationships effectively - and its relevance for the performance of leaders and managers who make up the essential decision-makers in Canada's healthcare systems.

Over the last decade, EI has generated increasing interest among managers, leaders and researchers in many different types of organizations, including healthcare (see, for example, Cherniss 2000). Daniel Goleman's 1995 book Emotional Intelligence: Why It Can Matter More than IQ was published in 33 languages and is available in more than 50 countries. EI's growing popularity is demonstrated by the fact that Amazon.com has more than 70 titles related to EI.

EI has become popular because it seems to raise new ideas about why some individuals appear more successful than others. We are very familiar with the Intellectual Quotient (IQ) measure of intelligence that has been accepted (not without some criticisms and limitations) as an important determinant of life and work-related success. Goleman (1998c) claims that IQ measures threshold capabilities: that is, an individual needs a certain level of cognitive abilities to enter a profession or the workforce. However, supporters of EI claim that once individuals have proven themselves intellectually, there must be something more than IQ that differentiates the high-performing leaders from those who are less successful.

The components of EI are a synthesis of a broad range of findings from interviews, observations and surveys of managers, leaders and decision-makers in a wide variety of organizations. EI is not new, but it builds upon on an extensive history of research and theory about thoughts, feelings and abilities that until recently were thought to be disparate and unrelated ideas.

Recent research to identify effective leadership was conducted by Hay/McBerr consultants drawing from a random sample of 3,871 executives selected from a database of 20,000 executives from around the world (Goleman 2000). The research found six leadership styles, each evolving from different components of emotional intelligence:

  • Coercive leaders - demanding immediate compliance.
  • Authoritative leaders - mobilizing people towards a vision.
  • Affiliatative leaders - creating emotional bonds and harmony.
  • Democratic leaders - building consensus through participation.
  • Pace-setting leaders - expecting excellence and self-direction.
  • Coaching leaders - developing people for the future.

These styles appeared to have a direct impact on the characteristics of the workplace and how people are able to function in it, and subsequently on the financial performance of the organization. The research also indicated that leaders who are most successful are able to switch leadership styles as the situation demands. The more types of leadership styles a person is able to master, the more successful the person will be. In other words, successful executives were able to modify their styles according to their perceptions of what was most appropriate.

Why Are We Talking about Leadership in Healthcare Now?

Healthcare in Canada, as well as in the rest of the world, is at a stage of unprecedented change. Since the early 1990s every province has been implementing major reforms in order to reduce or maintain costs while at the same time maintain quality. Healthcare in Canada is a complex system that has experienced broad strategic management strategies over the past decade, such as restructuring, regionalization, downsizing of personnel, reduced bed capacity and decreased funding. At a different, more interpersonal level, health professionals are burnt-out, feel undervalued and unrewarded, have lost trust in their employers and governments, and appear extremely dissatisfied. Health services workers appear more reluctant to change, not open to creativity, and resistant to innovation (Cherniss 1995).

What Is the Evidence for Change?

To lead at times of major reform requires different skills and competencies than at times of predictable and stable circumstances - yet we have little understanding of what these are. In the past, it was always conventional wisdom that as long as you were "smart" you would be successful. For decades, the relationship between cognitive effects, measured by IQ and similar tests, and success has been the focus of research and theoretical discussions.

Since the mid-1980s there has been an explosion of literature on the relationships between emotions and on-the-job performance, various organizational characteristics, and individual and organizational success. During the 1980s, however, research conducted on emotions and their effect on work concentrated on one or a small cluster of emotions. It was not until 1990 (Salovey and Mayer) that emotion-based research was brought together into the comprehensive framework called emotional intelligence.

Disciplines that have been interested in the science and research of EI include neurology, management, leadership and various branches of psychology - developmental, educational, clinical, social and industrial (Cherniss 2000; Cherniss and Goleman 2001). "One main reason for this penetration seems to be that the concept of EI offers a language and framework capable of integrating a wide range of research findings" (Cherniss and Goleman 2001).

Until recently, emotions were expected to be left at the door before an employee entered work. The view was that emotions were "the antithesis of rationality" and therefore they could not contribute to success (Ashforth and Humphrey, 1995). Emotions were then recognized as having a positive effect on motivation and group dynamics (Ashforth and Humphrey 1995; Gardner 1983). Reuven Bar-On developed the first measure of a plethora of emotions and coined the term Emotional Quotient or EQ (Bar-On 2000). Peter Salovey and John Mayer published a landmark article that first coined the term EI and the definition that is now widely used: "A form of social intelligence that involves the ability to monitor one's own and others' feelings and emotions, to discriminate among them, and to use this information to guide one's thinking and action" (Salovey and Mayer 1990).

From the mid-1990s until 2001, growing interest in EI occurred and in-depth research in the field was initiated. Daniel Goleman, a Harvard-trained psychologist, first popularized EI with the release of his book Emotional Intelligence in 1995. Goleman worked with David McClelland, known for his research on the relationships between cognitive tests of intelligence such as SATs and individuals' success in life (Cherniss 2000).

Figure 1: Goleman's Framework of Emotional Intelligence
  Self
Personal Competence
Other
Social Competence
Recognition Self-Awareness
Emotional self-awareness
Accurate self-assessment
Self-confidence
Social Awareness
Empathy
Service orientation
Organizational awareness
Regulation Self-Management
Self-control
Trustworthiness
Conscientiousness
Adaptability
Achievement drive
Initiative
Relationship Management
Developing others
Influence
Communication
Conflict management
Leadership
Change catalyst
Building bonds
Teamwork & collaboration
Source: Cherniss and Goleman 2001.

Goleman's framework has become the most predominant because of its comprehensive nature. Goleman differentiates between personal and social competency clusters and emotional intelligence and emotional competence (Figure 1). Personal competencies relate to how we manage ourselves and our emotions, while the social competencies describe how we manage others and handle relationships. Goleman also differentiates between "recognition" - being aware of one's and other people's emotions - and "regulation" - responding to these emotions.

David McClelland was one of the first researchers to identify the idea of a competency as a means of differentiating top performers from average performers (McClelland 1973). Emotional Competency (EC) is "a learned capability based on emotional intelligence that results in outstanding performance at work" (Goleman 1998a). By reviewing data from over 30 different organizations and executives in various professions, McClelland (1998) displayed that there is a wide range of EI competencies that top performers possessed while average performers did not.

To be proficient in a competency such as empathy or service orientation demands an underlying expertise in an emotional intelligence, in this case, social awareness. ECs are the social and personal skills that an individual needs to be successful in the working world (Cherniss 2000). It is important to note that EI and ECs can be learned, and that although one may have mastered one or all four aspects of EI, it does not mean that person will automatically have the associated EC. Having mastered one of the EI areas just means that one has the potential to become proficient in a related EC (Goleman 2000).

The current model proposed by Goleman is based on statistical analyses conducted by Richard Boyatzis (Boyatzis, Goleman and Rhee 2000). In this study, the Emotional Competence Inventory (ECI 360), a tool that assesses the ECs an individual possesses, was given to almost 600 corporate managers, engineers, professionals and social work students. The ratings individuals gave themselves were compared to those made of them by their colleagues. The key clusters and related competencies emerged from these analyses. The following few sections illustrate the ECs related to the four EIs.

Personal Competence

Self-Awareness

The first personal competency, self-awareness, entails knowing oneself. This includes knowing one's own preferences, intuitions and resources (Goleman 1998a). Three competencies emerge out of self-awareness, the first one being emotional self-awareness. This includes recognizing one's emotions and their possible effects on performance. It requires individuals to understand the connections between what they feel and how they act. The second competency, accurate self-assessment, requires individuals to be aware of their strengths and limitations while willing to be reflective and learn from their experience and accept feedback from others. The third competency in this cluster, self-confidence, is when individuals have a strong sense of their worth and competencies. Individuals with this competency are not afraid to speak up and are decisive. Boyatzis (1982) demonstrated that supervisors, managers and executives with a high degree of self-confidence are among the star performers, as opposed to the average performers.

Self-Management

The second cluster of competencies falls under the category of self-management. Overall, this cluster of six competencies embodies managing one's impulses, internal states and resources. The first competency, emotional self-control, is the absence of disruptive and distressful feelings. Individuals with this competency can handle stressful situations and will not lash out at hostile individuals (Cherniss and Goleman 2001). The competency of trustworthiness entails having standards of honesty and integrity. This includes letting others know what one stands for and acting in congruence with those values. Trust is a crucial competency to have in today's healthcare environment. With constant restructuring and change occurring, employees complain of unpredictability and need to be able to trust their leaders (Baumann et al. 2001). Conscientiousness follows on the heals of trustworthiness by having individuals take responsibility for their own performance. This embodies being careful and meticulous with responsibilities.

Adaptability is a fundamental competency in today's economy of constant change and government intervention. Adaptability is the flexibility to deal with change, the readiness to let go of old ideas and learn new information (Cherniss and Goleman 2001). The more adaptable one is to change, the better one will perform, especially in the Canadian healthcare system. Achievement orientation was conceived as the necessary competency for entrepreneurs to succeed in McClelland's (1985) work. This competency is defined as a constant striving to meet or exceed standards of excellence (Cherniss and Goleman 2001). Individuals in this group will take more risks, challenge their employees and support creative ideas. The last competency in this cluster is initiative: the willingness and readiness to act on opportunities (Cherniss and Goleman 2001). Individuals in this category are proactive rather than reactive and seek out the chance to make a difference. One would assume that initiative is crucial in healthcare not only as a method of treating patients, but also with respect to trying new standards of care and treatment plans. In today's competitive environment, initiative is a quintessential skill in every industry to guarantee success.

Social Competence

Social Awareness

The third cluster of competencies requires an awareness of others' feelings, concerns and needs. There are three major competencies underlying this intelligence, the first one being empathy. An empathetic leader can read employees' non-verbal cues and understand their concerns. Empathy is a critical skill for success in any industry. Physicians who are empathetic with their patients are sued less and are more successful than their less sensitive counterparts (Levinson et al. 1997). Reynolds and Scott (2000) claim that the current research suggests a direct relationship between high levels of nurses' empathy to beneficial client outcomes. Organizational awareness is the ability to read an organization, its politics and where it is heading, and to understand the power relationships. This has a considerable effect on behind-the-scenes networking and influencing individuals or whole organizations. Service orientation is recognizing and meeting customers' and employees' needs. This is crucial for healthcare because healthcare professionals need to listen to their patients and clients, and CEOs need to listen to their employees to determine what will create a better working environment.

Relationship Management

This last emotional intelligence is the skill a leader has to induce the appropriate or desired response from others. The first competency, developing others, requires empathy to sense an individual's development needs while at the same time encouraging and helping the individual and to actually develop these needs. Leaders that utilize the coaching leadership style require this competency because they "help employees identify their unique strengths and weaknesses and tie them to their personal career aspirations" (Goleman 2000). Furthermore, a leader who develops others gives the employees the confidence to act autonomously and take initiative. The second competency in this cluster is influence: the ability to persuade others through effective strategies (Cherniss and Goleman 2001).

The competency of communication is very significant in ensuring that employees feel valued. This involves not only listening to others, but also sending clear messages. Leaders adept at this competency foster environments with open communication and are receptive to employees' concerns and new ideas (Goleman 1998b). Conflict management supports communication because it involves negotiating and solving disputes. It also includes spotting problems or troublesome situations before they occur and dealing with the problem appropriately. One needs to be a good communicator and empathize with others so people will listen properly.

Visionary leadership and the competency of influence are usually symbiotic. Visionary leadership embodies inspiring others to work towards common goals. Leading by example and guiding the performance of others are necessary actions associated with this competency. The new economy has created the necessity for the competency of change catalyst. Leaders must initiate and manage change, and they "must be able to recognize the need for change, remove barriers, challenge the status quo, and enlist others in the pursuit of new initiatives" (Cherniss and Goleman 2001).

Building bonds is an indispensable and strategic skill that is supported by the network and resource dependency theories because an organization needs to build these bonds to ensure it has the necessary resources for survival (Pfeffer and Salancik 1978). Creating and nurturing relationships with employees, other leaders and key stakeholders is essential. Building these bonds during competitive times determines who will succeed in each field.

The final competency in this cluster is that of collaboration and teamwork. This is vitally important as the culture in healthcare moves to more team-based problem solving (Shortell et al. 1994). A leader needs to be able to collaborate with colleagues and work effectively with them. Establishing synergy in a group and working with others towards a common goal are indispensable actions that are needed to succeed (Urch-Druskatt and Wolff 2001).

In summary, EI is not a new concept; it is a synthesized framework of disparate amounts of research over the past few decades (Cherniss 2000). The framework itself is fairly new and is in the theory development phase. It is important to note that it is not necessary for a leader to have all the ECs discussed above in order to be a successful leader. The theory is that one can package the competencies differently and get varied results, and different clusters are necessary in dissimilar situations (Goleman 2000). "Emotional competencies seem to operate more powerfully in synergistic groupings" (Cherniss and Goleman 2001). There is evidence to suggest that one needs a "critical mass" of the competencies to have exceptional performance (Boyatzis et al., 2000). EI has been proven to positively affect not only an individual's success, but also an organization's success (Cooper and Sawaf 1997). "When it comes to improving organizational effectiveness, management scholars and practitioners are beginning to emphasize the importance of a manager's emotional intelligence" (Sosik and Megerian 1999). Furthermore, "emotionally intelligent leadership is key to creating a working climate that nurtures employees and encourages them to give their best" (Cherniss and Goleman 2001).

Are You Ready for the Challenge?

There is increasing recognition that understanding ourselves is essential if we are to be able to respond to the complex work demands of professional life as healthcare managers and policy-makers. As has been stated previously, IQ is not enough. The research reported here suggests that it is possible for emotional intelligence to be learned as long as there is a willingness to learn. As a first step, individuals must be prepared to be honest with themselves in order to understand their own level of emotional intelligence. We challenge you to take the "test" shown in Figure 2. Rate yourself in terms of where you currently are in each of the dimensions and components of EI. Be honest with yourself! Reflect on your results, and then take the test again - this time indicating where you would like to be on each of the dimensions. Now assess the gap and set yourself some realistic goals for moving to your preferred level of emotional intelligence.

Figure 2: What Makes a Leader?

The Components of Emotional Intelligence at Work

Self-Awareness
Ability to understand and recognize moods, emotions and drives as well as their effects on others
_______ Self-confidence
_______ Accurate self-assessment
_______ Emotional self-awareness

Self-Management
Ability to control or redirect disruptive impulses and moods - able to suspend judgment - to think before acting
_______ Trustworthiness
_______ Self-control
_______ Conscientiousness
_______ Ability to adapt
_______ Strong drive to achieve
_______ Initiative

Social Awareness
Ability to understand the emotional make-up of people, and skill in treating people according to their emotional reactions
_______ Empathy
_______ Organizational awareness
_______ Service to clients and customers

Social Skill
Proficiency in managing relationships and building networks, and an ability to find common ground and build rapport
_______ Expertise in developing others
_______ Influence
_______ Ability to communicate effectively
_______ Conflict management
_______ Leadership
_______ Effectiveness in leading change
_______ Building bonds
_______ Expertise in building and leading teams

TASK: Rate yourself on each of the components and the sub-components of this Emotional Intelligence scale. Give yourself a high, medium or low rating according to how well you feel you meet the criteria for emotional intelligence.
Source: Adapted from Cherniss and Goleman 2001.

In conclusion, emotional intelligence and emotional competencies may have the potential to offer healthcare executives important tools in dealing with the complex situations they face. The current tools and styles are not resulting in a satisfied workforce. Leaders in the private industry have already been applying EI to their daily practices for years. The time has come for the healthcare industry to examine the possible beneficial impact EI can have on our industry.

About the Author(s)

Moriah Shamian-Ellen, MBA, is a PhD student in the Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto.

Peggy Leatt, PhD, is Professor Department of Health Policy and Administration in the School of Public Health at the University of North Carolina at Chapel Hill. She is also Editor in Chief of Hospital Quarterly and HealthcarePapers.

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