Preparing Veterinary Students with the Interactive Skills to Effectively Work with Clients and Staff
R. L. Russell
From the College of Veterinary Medicine
Kansas State University
Manhattan, KS 66506.
Because students are so engrossed in learning the technical aspects of veterinary medicine, they tend to overlook the importance of developing people skills. Students perceive interpersonal skills to be the soft side of management and do not recognize the critical nature of these skills in working with clients and staff.
Practitioners, on the other hand, feel just the opposite. They understand the need for new associates to have good people skills since compensation is directly linked to client satisfaction. A recent study validates their concerns (1). More than 200 practitioners throughout North American were asked, "What are you looking for when you hire a new graduate?" Their answers were almost universally similar to this, "New graduates are well prepared with technical skills, but frequently are deficient in communication and interpersonal skills."
A study of 615 senior U.S. executives by the Gallup Organization discovered the most critical factor in business today is service quality. In spite of the increased awareness and talk about good customer service, it appears that business is getting worse instead of better. Customers in every service-oriented business are becoming highly sophisticated and are demanding a higher standard of service than ever before.
The demand for superior client service directly impacts veterinary education and future jobs for new graduates. Most of the complaints registered against veterinarians to state medical examining boards are closely related to poor communication and interpersonal skills. Many malpractice complaints could be avoided if practitioners were better equipped with interactive skills. In our highly litigious society, professionals must be better prepared to cope with these challenges. Therefore, educators need to be constantly searching for more effective ways to teach interactive skills to students during their formal education.
Since the release of the Pew National Veterinary Education Program Report, there has been an increased awareness of the necessity of shifting the emphasis in veterinary education from the accumulation of information to the behaviors and attitudes necessary for success as a veterinarian (2). One of the vital shifts required, regardless of the student's career path, is the ability to effectively work and communicate with people. The gap between veterinary education and better understanding of human behavior and values can be narrowed significantly by utilization of organizational psychological instruments and computer technology.
One approach which has been frequently utilized and reported in veterinary medicine is the Myers-Briggs Type Indicator (MBTI) (3-4). Many veterinary medical faculty members have been exposed to this instrument (5).
We have effectively utilized another Marston-based instrument in the Hill's National Center for Veterinary Practice Management at Kansas State University for teaching practice management. The "Managing for Success"(c) profiles and computerized reports (6) have been valuable aids in teaching students interpersonal skills, communications, team building, and client service.
Behavior describes how people do things while values tell us why they do what they do. Values can be measured utilizing the "Personal Interest and Values"(c) instrument (7). Both measurements are valuable in understanding how and why people behave as they do, however the focus of this paper will be limited to the behavioral measurement.
In 1928, Dr. William Moulton Marston, published The Emotions of Normal People (8). His theories are currently used by more than 50 companies as the basis for examining patterns of behavior. The individuals most directly responsible for translating Marston's work into measurement devices were Hendrickson and Geier of the Division of Health Ecology, University of Minnesota. The "Managing for Success Style Analysis"(c), while based primarily on Marston's book, also uses the works of Carl Gustave Jung.
Jung makes the assumption that there are three pairs of functions that are expressed differently in each person: extroversion-introversion; perception-intuition; and thinking-feeling. Jung's work forms the basis of the Myers-Briggs Type Indicator diagnostic tools. These functions are utilized and are in complete harmony with Marston's work.
Isabel Briggs Myers and her mother Katharine Cook Briggs, developed the Myers-Briggs Type Indicator test (MBTI) which places another pair of functions, judging-perceiving, into the equation. The Myers-Briggs profile places people into 16 different types.
These Marston-based instruments are widely used by business, education, and government including several Equal Employment Occupational Commission agencies. They have been administered to over 30 million people worldwide. They are valued by many professionals because their validity is reproducible. The instrument we utilize was compared against 5 popular psychological instruments and found to compare favoraby to each in terms of accuracy and reliability (9). In addition to being accurate and valid, the profiles are cost-effective and easy to perform and interpret.
There is no right, wrong, or best style. The profile only describes how one does things (behavior). A knowledge of behavioral styles assists in understanding an individual and how he or she relates to others. This knowledge can be an asset to help blend style on the job or in the home, if needed. The 4 primary emotions as Marston viewed them are (8):
- D Dominance How people respond to problems or challenges
- I Influence How people influence others to their point of view
- S Steadiness How people respond to the pace of the environment
- C Compliance How people respond to rules and procedures set by others
These are commonly referred to as DISC behavioral styles. People are a combination of these 4 styles although one or two styles usually predominate. Behavioral research suggests that the most effective people are those who understand themselves and those around them. This understanding of personal strengths and weaknesses, coupled with the ability to identify and understand the strengths and weaknesses of others, allows one to develop strategies to meet the demands of the environment (10). By appreciating and understanding human differences, veterinarians can increase their effectiveness in working with clients and staff. This same knowledge is important in preventing communication blocks between doctor and clients. When gaps exist in this relationship, misunderstandings frequently arise leading to dissatisfaction, client complaints, and possible legal action.
The predominant characteristics of the DISC behaviors are:
D Dominance--Work Behavioral Tendencies
- High ego strength; high self-confidence
- Desire change; can make decision on very few facts
- Fear being taken advantage of
- Need direct answers
I Influencing--Work Behavioral Tendencies
- People oriented; persuasive; often have great ideas
- Disorganized (may not notice change)
- Fear loss of social approval
- Optimistic; can make decisions on whether it sounds good
S Steadiness--Work Behavioral Tendencies
- Loyal; team person; good listener; patient
- Family oriented
- Fear loss of security
- Slow to change; base decision on their trust in you
C Compliance--Work Behavioral Tendencies
- Accurately base decisions on information pros and cons
- Fear criticism of the job
- Need many explanations; slow to change; need reasons
Three hundred sixty-three students completed a 24-question "Style Analysis Instrument" (11). These data were used to generate a report that assessed dominance, influence, steadiness, and compliance (DISC). Each report described a student's general characteristics; value to the organization; check-list for communicating; perceptions; natural and adapted style; areas for improvement; and an action plan (6). The action plan is very important because students can select their own objectives and develop a plan of action to modify, blend, or change behavior to increase their personal effectiveness. The computerized style analysis is considered by others to be more sophisticated than reports generated from instruments that produce two dimensional analysis (12).
Figure 1. Comparison of veterinary students and the general population (male and female). N = number of people in each study with a breakdown of the numbers and percentage in each DISC quadrant.
In addition to the reports, 2 style analysis graphs were created for each student. Graph I is the response or adapted graph and plots the student's responses to his/her environment. It is the behavior a person feels they need to exhibit in order to survive and succeed in their job. Graph II is the basic or natural style graph. We primarily use Graph II in teaching because it more nearly represents the student. This graph identifies the student under pressure or when he/she is totally at ease (13).
In a fifty-minute class students learned the basic skills of how to interpret the graphs. This understanding allowed students to see the differences and similarities between co-workers and clients. Armed with this knowledge, we believe they will be better prepared to work with practice associates and clients.
Figure 1 compares male and female veterinary students and the general population. The basic style (natural) graph very nearly approximates the general population. The 363 male and female students profiled at Kansas State University were almost identical in behavioral profile to 1941 males and females in the general population. These data refute the myth that veterinarians are different from the general population. It indicates that the behavior measurements of veterinary students at Kansas State University are very similar to the behavior measurements of the general population.
Analysis of Styles
Marston said, "All people exhibit all four behavioral factors in varying degrees of intensity." The danger with most behavioral profiles is the tendency to forget the complexity of human behavior. The computerized profile takes these differences into account by generating a very sophisticated report utilizing 384 different graphs (14). Keep in mind there is no right or wrong, best or worst styles. Each behavioral style brings strengths and weaknesses to the situation which is important in putting together all four styles needed to form successful practice teams.
Conclusions and Application
Utilizing these computerized reports can simplify the teaching of interpersonal skills important to success in a practice. The reports and corresponding graphs are effective tools to compliment training in client service, team building, time management, and mentoring. Some organizations utilize these profiles for employee selection because they are helpful in matching behavior with specific job requirements. Regardless of a person's style, it does not preclude them from adapting to any job; however, certain positions naturally fit certain behavioral styles. For example, a person with the "I" being predominant, is more naturally suited for sales or reception work, while a person with a predominance of "C would more naturally feel more comfortable in jobs requiring detail and perfectionism. Utilizing this knowledge, a dental staffing firm in Atlanta, GA has been able to reduce the turnover of dental assistants from 40% to 10% in two years.
Since human behavior is quite predictable, a knowledge of behavioral styles will help new graduates more effectively interact with employers, clients and the practice staff. It also is helpful in teaching leadership skills because the computer report gives insights into communication, motivation, and keys to managing others. The inability to communicate effectively with others often causes a breakdown in relationships. This may become a major cause of client and employee dissatisfaction.
When students understand their strengths and weaknesses and how their behaviors communicate that style to others, they can blend or adjust their style to become more effective in working with others (15). For example, in relating with a high "D", use specifics, be brief, and get to the point quickly. Stick to business and don't ramble or waste their time. Don't direct or give orders to a high "D." Recognize that these people are self-starters, place high value on time, and may challenge the status quo. These people are innovative, action oriented, and impatient for results, which often causes them to be perceived as being "nervy" or "pushy."
In working with a high "I," leave time for relating and socializing. Ask for their opinions and don't talk down to them. Be careful not to over-control the conversation and don't emphasize facts and figures. "I" people are usually creative problem solvers, motivate others towards a goal, and are articulate.
In relating with a high "S," show sincere interest in them as a person. Patiently draw out their personal goals and don't be domineering or demanding. It is important not to threaten with position or power. Present your case softly without being vague. These people take criticism of their work as a personal affront. They are dependable and loyal team workers, good listeners, patient, and empathetic.
Approach the high "C" person in a straight-forward, direct way. Don't be disorganized, messy, or rush the decision-making process. They tend to be perfectionists, conscientious, and steady. They have high standards, but may criticize others, especially if they are not prepared.
Research suggests that the most effective people are those who understand the most about themselves and others. Measurement of DISC behaviors provides a universal language of observable human behavior (13). Understanding human behavior is essential in developing confidence and trust. Teaching these principles to students makes it possible for them to blend their style and increase their interactive competencies.
Computerized behavioral instruments have been effective teaching and learning tools at Kansas State University.
References and Endnotes
1. Personal interviews of more than 200 veterinary practitioners by Ray L. Russell, Director of The Hill's National Center for Veterinary Practice Management at Kansas State University, 1991-1994.
2. Pritchard WR: Future Directions for Veterinary Medicine. Durham, NC: Pew National Veterinary Education Program, Duke University, 1988.
3. Robinson DC: Application of psychological type in veterinary medicine: a comprehensive analysis of participant data from the center for creative leadership. Jour Vet Med Educ 17:23-27, 1990.
4. Banks WJ: Learning and teaching styles: an important component of the veterinary medical education debate. Jour Vet Med Educ 19:138-145, 1992.
5. Dimuzio J: Developing problem-solving skills utilizing the Myers-Briggs Type Indicator in veterinary education. Jour Vet Med Educ 20:19-23-1993.
6. Managing for Success, Employee-Manager Version(c). Scottsdale, AZ: TTI Software, Ltd., 1991.
7. Personal Interest and Values(c). Scottsdale, AZ: TTI Performance Systems, Ltd., Values Research Associates, 1991.
8. Marston WM: Emotions of Normal People. New York: Harcourt Brace Co., 1928.
9. Style Analysis: Origin--Accuracy--Validity(c). Scottsdale, AZ: Values Research Associates, 1992.
10. Lapointe JR, Bonnstetter BJ, Young KD, Slaats M, Bonnstetter D: Sports Psych. Mason City, IA: SportsPsych Inc., 1987.
11. Style Analysis Part I. Scottsdale, AS: TTI, Ltd., 1986.
12. Kaplan S, Kaplan BE: The Kaplan Report: A Study of the Validity of the Personal Profile System. Minneapolis, MN: Performax International Systems, Inc., 1983.
13. Bonnstetter BJ, Suiter JI, Wildrick RJ: The Universal Language of DISC. Scottsdale, AZ: TTI, Ltd., 1993, pp. 105-107.
15. Alessandra T, O'Connor JO, Alessandra J: People Smart. LaJolla, CA: Keynote Publishing Co., 1992, p. 7.