effective communication in an organization case study

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Case Studies in Organizational Communication Ethical Perspectives and Practices

• Steve May - The University of North Carolina at Chapel Hill, USA
• Description

See what’s new to this edition by selecting the Features tab on this page. Should you need additional information or have questions regarding the HEOA information provided for this title, including what is new to this edition, please email [email protected] . Please include your name, contact information, and the name of the title for which you would like more information. For information on the HEOA, please go to http://ed.gov/policy/highered/leg/hea08/index.html .

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The course including ethical decision-making has to be reshuffled for now, but in the future I will definitely use the book as a source for supporting material.

Excellent supplement to text I'm using. Offers in depth case studies and addresses evaluation using critical thinking.

Is there any instructor material available?

This book provides an effective way to engage students into theory. The cases presented can also be further analysed using a plethora of approaches, which makes it a useful teaching tool.

This book will be particularly helpful for students who have an interest in communication. I will also use it to supplement my lectures with examples in class. The book is very well laid out, engaging in its detail with signposting to further material for those students who wish to read more.

Matched with course design- practical and applied pedagogy for studying ethical issues and communication in everyday life.

NEW TO THIS EDITION

• The Second Edition includes expanded coverage of the recent economic meltdown, globalization, new technologies, and corporate social responsibility.
• Eighteen new case studies on current workplace issues include companies such as BP, Google, Toyota, Gap, Wyeth, and Enron.

KEY FEATURES

• Emerging issues in the workplace, explored in several case studies, include work/family balance, sexual harassment, outsourcing, personal privacy, bribery, new technologies, social networking, corporate social responsibility, and other issues.
• International case studies examine the ethical behavior of non-American organizations, providing a more thorough understanding of ethics in a global business environment.
• The consistent case study structure allows instructors and students greater opportunity to compare and contrast cases on comparable terms.

Sample Materials & Chapters

Case Study 1

Case Study 3

For instructors

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Effective Communication in the Workplace

Source: https://pixabay.com/vectors/social-media-connections-networking-3846597/ is in the Public Domain at Pixabay.com. Retrieved 07.05.2022.

Effective workplace communication helps maintain the quality of working relationships and positively affects employees' well-being. This article discusses the benefits of practicing effective communication in the workplace and provides strategies for workers and organizational leaders to improve communication effectiveness.

Workplace Communication Matters

Effective workplace communication benefits employees' job satisfaction, organizational productivity, and customer service (Adu-Oppong & Agyin-Birikorang, 2014). We summarized Bosworth's (2016) and Adu-Oppong and Agyin-Birikorang's (2014) works below related to the benefits of practicing effective communication in the workplace.

• Reduces work-related conflicts
• Enhances interpersonal relationships
• Increases workers' performance and supervisors' expectations
• Increases workforce productivity through constructive feedback
• Increases employee engagement and job satisfaction
• Builds organizational loyalty and trust
• Reduces employees' turnover rate
• Facilitates the proper utilization of resources
• Uncovers new employees' talents

Strategies to Improve Communication Effectiveness

Effective communication is a two-way process that requires both sender and receiver efforts. We summarized research works and guidelines for good communication in the workplace proposed by Cheney (2011), Keyton (2011), Tourish (2010), and Lunenburg (2010).

Sender's strategies for communication planning

• Clearly define the idea of your message before sharing it.
• Identify the purpose of the message (obtain information, initiate action, or change another person's attitude)
• Be aware of the physical and emotional environment in which you communicate your message. Consider the tone you want to use, the configuration of the space, and the context.
• Consult with others when you do not feel confident or comfortable communicating your message.
• Be mindful of the primary content of the message.
• Follow-up previous communications to verify the information.
• Communicate on time, avoid postponing hard conversations, and be consistent.
• Be aware that your actions support your messages and be coherent in your verbal and behavioral communication style.
• Be a good listener, even when you are the primary sender.

Receiver's strategies during a conversation

• Show interest and attitude to listen.
• Listen more than talk.
• Pay attention to the talker and the message, avoiding distractions.
• Be patient and allow the talker time to transmit the message.
• Be respectful and avoid interrupting a talker.
• Hold your temper. An angry person takes the wrong meaning from words
• Go easy on argument and criticism.
• Engage in the conversation by asking questions. This attitude helps develop key points and keep a fluid conversation.

Effective communication practices are essential for any successful team and organization. Organizational communication helps to disseminate important information to employees and builds relationships of trust and commitment.

Key points to improve communication in the workplace

• Set clear goals and expectations
• Ask clarifying questions
• Schedule regular one-on-one meetings
• Praise in public, criticize in private
• Assume positive intent
• Repeat important messages
• Raise your words, not your voice
• Hold town hall meetings and cross-functional check-ins.

Adu-Oppong, A. A., & Agyin-Birikorang, E. (2014). Communication in the Workplace: Guidelines for improving effectiveness.  Global journal of commerce & management perspective ,  3 (5), 208–213.

Bosworth, P. (2021, May 19). The power of good communication in the workplace . Leadership Choice. Retrieved May 18, 2022.

Cheney, G. (2011). Organizational communication in an age of globalization: Issues, reflections, practices . Waveland Press.

Keyton, J. (2011). Communication and organizational culture: A key to understanding work experience . Sage.

Tourish, D. (2010). Auditing organizational communication: A handbook of research, theory, and practice . Routledge

Lunenburg, F. C. (2010). Communication: The process, barriers, and improving effectiveness.  Schooling ,  1 (1), 1-10.

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Please note you do not have access to teaching notes, managing internal communication: an organizational case study.

Corporate Communications: An International Journal

ISSN : 1356-3289

Article publication date: 1 September 2005

The primary objective of this article is to explore what senior managers think they should be doing to improve communication in their organization, what they actually do in communication terms, and the high work load which senior managers undertake.

Design/methodology/approach

This understanding is advanced by using the results of a communication audit which was conducted in a major European health‐care organization (HCO) undergoing significant internal re‐organization. A communication audit can be defined as: “a comprehensive and thorough study of communication philosophy, concepts, structure, flow and practice within an organisation”. It assists managers by “providing an objective picture of what is happening compared with what senior executives think (or have been told) is happening”.

First, senior managers who over‐work are even less likely to have the time for reflection, followed by behaviour change. Second, the absence of adequate upward communication may blind managers to the full nature of their problems, which in turn guides the search for solutions.

Research limitations/implications

Clearly there is a need to examine other types of organizations to establish the universality of the communication issues and problems that were found in a large HCO in Europe, using both quantitative and qualitative methodologies.

Practical implications

The data suggest that attempting to cover up communication weaknesses by managers working even longer hours only has the effect of further disempowering people, and so accentuating rather than alleviating the underlying difficulty.

Originality/value

The article has value to fellow academics and managers in practice and contributes to the debate on upward communication and the workload of managers.

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Robson, P.J.A. and Tourish, D. (2005), "Managing internal communication: an organizational case study", Corporate Communications: An International Journal , Vol. 10 No. 3, pp. 213-222. https://doi.org/10.1108/13563280510614474

Emerald Group Publishing Limited

Copyright © 2005, Emerald Group Publishing Limited

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5 Internal Communication Case Studies and Best Practices To Follow

Alex Cleary

Apr 6, 2022

Internal Communications

From employee engagement to workplace culture to change management, businesses often face similar challenges to each other even if those businesses are radically different. While the specifics of these challenges may differ, how other businesses solve these challenges can give you new insights into addressing your own.

We’re always interested in how our customers use ContactMonkey to solve their internal communications challenges, which is why we publish customer case studies. Learn how other businesses solve their communication challenges and get inspiration on ways you can improve your business by using an internal communications tool .

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What is an Internal Communication Case Study?

An internal communication case study examines how a company addressed a specific problem facing their organization, or achieved a specific goal. Communication is crucial for every business, and communication challenges can manifest in all kinds of situations.

An effective internal communication case study will clearly outline the problem, solution, and result of the business’ efforts to reach their goal. An internal communication case study should also outline best practices that were developed in this process, and how those best practices serve the business going forward.

Why are internal communication case studies important?

A good internal communication case study should not only explain the circumstances around a specific business’ problems and solution. It should also help others develop new ways to approach their own internal communication challenges , and shed light on common communication pitfalls that face a majority of businesses.

Whenever you’re facing a particular communication problem at your workplace, we recommend searching out a relevant internal communication case study about businesses facing similar issues. Even though the particulars may be different, it’s always important to see how internal communications problems are solved .

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5 Best Internal Communications Case Studies

We put together this list of our favourite ContactMonkey case studies that best demonstrate the many problems our internal communications software can be used to solve. If you want to learn more about any of these customers and see other case studies, check out our Customers page .

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1. Mettler Toledo Saves Days on their Internal Communications with ContactMonkey

When Kate Kraley began as Mettler Toledo’s Marketing Communications Specialist, she wanted to use internal communications to increase engagement and improve communication with employees.

But Mettler Toledo —a global manufacturer of precision instruments for various industries—had a confusing and ineffective array of internal communications channels . Here’s how Kate took charge of internal communications at Mettler Toledo with ContactMonkey.

Kate came to an internal communications department tasked with reaching employees through a number of channels. Email was the main focus of their approach, but this encompassed many forms of communication based on email like employee newsletters, eNews, and quarterly email updates.

Kate wanted to improve the quality of their internal communications. She used a variety of tools to create their newsletters, including using Mailchimp and online HTML template builder. But because Mailchimp is not for internal communications , Kate and her team found themselves spending over 8 hours a week building their internal communications:

“We faced challenges with Mailchimp. Since we had to leave Outlook to use Mailchimp, we found it was double the work to maintain distribution lists in both Outlook and Mailchimp. The HTML builder in Mailchimp was also difficult to use as it didn’t work well with older versions of Outlook, compromising the layout.”

Kate also needed a way to determine whether Mettler Toledo employees were actually reading her internal communications. She used Mailchimp to track open rate, but wanted more in-depth measures of engagement. That’s when she switched to ContactMonkey.

Kate found ContactMonkey via the IABC Hub in 2018, and began testing it out. ContactMonkey’s all-in-one internal communications software removed the need to switch from tool to tool. Using our email template builder , Kate now builds visually stunning email newsletters and templates without having to navigate away from Outlook:

She also now has access to her own analytics dashboard . Kate analyzes numerous email metrics like open rate, click-through rate, read time, opens by device and location, and more to see which communications are driving the most engagement. With this new centralized approach, Kate knew she had found the right solution:

“Once I started using ContactMonkey, I realized I was able to save 4 hours of work a week, which translated to 25 days saved per year! ContactMonkey has helped us understand what employees are interested in!”

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2. BASF Manages Their Remote Workforce with ContactMonkey

Mark Kaplan is the Global Communications Manager at BASF’s Agricultural Group —a department of the German chemical company BASF SE. Because BASF has offices and production sites around the world, Mark coordinates with other internal communicators across the company to drive employee engagement.

With the success of any business comes new challenges, and BASF isn’t any different. While Mark knew he had to keep others informed of the latest news from the BASF Agricultural Group, he was aware employees would be receiving news from other parts of the company as well.

With many different departments sending their own internal communications, Mark faced a difficult task: keeping employees engaged while being careful not to overwhelm them with countless emails and updates.

“We try to be very strategic with what we’re sending out because people are already getting a lot.”

Not only did Mark have to find a solution that made his email communications more engaging, but he also had to prove the value of whatever solution he chose to management. How could Mark show that he was increasing employee engagement while avoiding tuning out from oversaturation?

Mark began using ContactMonkey to create better internal communications for BASF employees. Using our drag-and-drop email template builder, he designs emails that maximized communication and minimized distractions, keeping information to just what his recipients needed to know.

Mark uses ContactMonkey’s email template library to save time on his email design process. He also uses the easy drag-and-drop format of the email template builder to add multimedia into his email communications to save space and increase their effectiveness:

Mark uses the email analytics provided by ContactMonkey to determine the best times to send internal emails . Not only does email analytics help Mark increase engagement on his employee emails, but he now has hard data he can show management to prove the value of his internal communications.

“ContactMonkey has been great in that I can download a report, attach it to an email, and send it to our top leadership and say, ‘Oh, wow. 88% of the organization opened this in the last 24 hours, I think we should do more of this.’ It’s that little extra credibility.”

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3. Alnylam Drives Remote Employee Engagement Using ContactMonkey

Employee engagement is crucial for ongoing productivity and growth, and Alnylam’s Brendon Pires wanted to leverage their internal communications to increase engagement.

Brendon is an internal communications specialist at Alnylam —the world’s leading RNAi therapeutics company—and is tasked with keeping their 2000+ employees engaged and informed. But Brendon’s existing internal communications process was leading to issues all over the place.

Like many companies, Alnylam shifted to remote work when the COVID-19 pandemic hit. Brendon knew that employees would be relying on his emails to stay up-to-date on the latest company news and announcements, but their existing internal communications tool wasn’t up to the task:

• Scheduled emails were prevented from being sent out.
• Email design was a chore with a difficult-to-use email builder.
• Intranet traffic was down and Brendon’s emails weren’t driving traffic to it.
• Email tracking was limited as many internal emails were being flagged by their tracking software’s firewall.

“We were having consistent issues and it had been going on for like a couple of months. It was one issue after the other, between emails not sending because they were getting caught in our firewall, and then tracking not being consistent. So at the end of the day it was kind of like that’s really important, you know? Obviously if I can’t send that email that’s a problem. So that’s what really drove us to look at other solutions like ContactMonkey”

Brendon and Alnylam use Outlook for their employee emails, so he began looking for alternatives to his current software. That’s when Brendon found ContactMonkey.

Right away Brendon had a much easier time creating internal emails using our email template builder. He can create stellar internal emails and email templates that drive more engagement.

Brendon also uses ContactMonkey’s embedded star ratings to let Alnylam employees rate the emails they’re receiving. This helps Brendon and his team zero-in on their most engaging email content. He also uses our email analytics to measure engagement via open rate and click-through rate. He maximizes his results on these metrics by using ContactMonkey’s scheduled email sending:

Using ContactMonkey, Brendon was able to increase email engagement and drive traffic to Alnylam’s internal intranet . He now sends emails without worry of encountering sending errors that can hinder engagement—like Outlook not rendering HTML emails .

“ContactMonkey is really easy to use and allows me to create really nice content. There’s enough customization so we can do what we really want and have some creative freedom.”

4. Travel Counsellors Ltd. Stays Connected with Remote Employees Using ContactMonkey

In an economy deeply impacted by COVID-19, countless companies had to adapt to new challenges. As Community Manager at Travel Counsellors , Dave Purcell experienced firsthand the effects on morale and engagement his over 1,900 partners experienced as result of the quarantine and resulting societal changes.

Dave wanted to regularly check-in on Travel Counsellors franchisees’ wellbeing, and measure their engagement over time. But Dave’s current method of checking-in on an audience of over 1,900 was not up to the task.

Using their existing email software, Dave encountered all sorts of problems when trying to gauge wellness and drive email engagement. He and his team were unable to create personalized internal communications , as they were told it just wasn’t possible with their existing “solution”. They also experienced numerous tracking issues, as they were receiving tracking numbers that didn’t make any sense.

“The stats we had previously were unusable and that’s the easiest way I can put it. I was getting 200% open rates, which was just impossible.”

Realizing that email tracking and personalization were must-have features for him and his team, Dave sought a new email software that could deliver what he was looking for.

With the aim of sending personalized emails and tracking wellness in his organization, Dave was immediately impressed by ContactMonkey. “I stumbled across ContactMonkey, and everything just screamed: ‘This is the right platform for us’. It’s pretty fantastic.”

Dave uses ContactMonkey’s merge tags to create personalized subject lines and body copy based on the recipient:

He also began using emoji reactions on his weekly employee newsletters , using them as a pulse check survey for his audience.

“Mindset and wellbeing have always been a big part of what we do. It’s even more so now. Our franchisees craved that personal interaction. ‘Welcome to a Brand New Week’ checks in with them on a Monday, sees how they’re feeling with emoji reactions. And we do the same on a Friday.”

In addition to customization and surveys, Dave uses our email template builder’s custom employer branding options to save time on creating his email newsletters. All of this is driven by email analytics that help Dave and his team determine which content is generating the greatest engagement.

“Our commercial team is looking at what people are engaging with in terms of link clicks and what they’re not engaging with and changing our tactic depending on that. We also send an update from our CEO and we can now track this more accurately. We’re getting a 90% open rate within two days.”

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5. Exemplis Boosts Internal Communications Engagement with ContactMonkey

When Corey Kachigan arrived at Exemplis as Engagement and Communications Lead, she knew she had her work cut out for her. Exemplis—the largest volume manufacturer of office seating in North America—was experiencing rapid growth but did not have any sort of internal communications strategy . Corey knew if she wanted to properly manage Exemplis’ ongoing growth, she’d need to make internal communications an indispensable part of the business.

Before Corey arrived, Exemplis’ existing internal communications consisted only of random announcements and update emails. They had no defined approach for sending internal communications, which lead to emails that can cause employees to tune out.

“Our receptionist would email: ‘Hey, whoever left their coffee mug in the sink, please clean it and take it back to your desk.’ And it’s like, okay, that just went to 200 people.”

Corey and her team knew they had to harness their email resources better, and wanted a way to measure what employees actually wanted to see.

“We need some metrics to gauge whether this is working or not. We’re rolling out all these things, but we can’t tell if employees are even clicking these emails. Our team is inundated with hundreds of emails a day. How do we know they are reading these and how do we know they find it valuable? We have no idea.”

They also wanted to use emails to align their ever-growing employee base with Exemplis’ core values and vision. Using Mailchimp—an external marketing email tool—resulted in more problems than solutions. Corey experienced issues with importing and tracking emails within Outlook. She realized that Mailchimp is not for internal communications , and set out to find a new solution to power her employee emails.

So Corey began searching for a new email software for internal communications. Creating a definite approach to internal communications was just one priority of hers; she also wanted to prove the value of internal communications to management using hard data.

What first stood out to Corey about ContactMonkey was the crisp layout and that it worked with Exemplis’ existing Outlook system. ContactMonkey uses your company’s existing email services, and this meant Corey would no longer encounter internal email problems caused by an external tool like Mailchimp.

Corey now uses email metrics and employee feedback to inform her internal communications approach. She features pulse surveys on her internal emails, and uses the results in combination with email metrics to pinpoint what Exemplis employees want to see.

With ContactMonkey’s email analytics, Corey can point to real engagement data to back up her internal communications objectives.

“The thing I love about ContactMonkey is that it allows us to communicate more consistently with our team, but also be able to have the data to back it up. When we used to send out newsletters, we didn’t really have a way to see who did or didn’t open it, who clicked what and they couldn’t interact with the communication besides reply to me, which was super cumbersome.”

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Achieve Your Internal Communications Goals with ContactMonkey

Although internal communications is a common aspect of all businesses, everyone approaches it differently. Finding out the best email practices that work for your employees is a crucial step in the quest for increased engagement.

Read even one internal communication case study and you’ll see how ContactMonkey stands out among other internal communications tools. You can create, send, and track internal emails, and collect employee feedback and email metrics to develop innovative internal communication tactics . Whether you’re a seasoned internal communicator or new to the field, ContactMonkey can turn your internal communications into a powerful driver of productivity and growth at your organization.

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Want to see ContactMonkey in action? Book a free demo to see how our internal communications software can transform your employee emails:

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Importance Of Effective Communication In An Organization 2024

Effective communication is vital in all forms of life and of course even more vitally across all businesses and industries. If you don't run a tight ship then you can fall foul of confusion in the ranks.

Apple and Microsoft became highly successful companies not just because they had a great product to sell that people wanted or required, but also because their employees were all pulling in the same direction. This goal-oriented outlook came by way of effective communication from the top down, but also across with leaders of teams making sure that everyone knew what they had to do, and when it needed to be done by.

If open communication be it written or oral within a workplace is encouraged, a more cohesive and effective team will emerge, and this will show up on the bottom line. Good communication within a team also tends to build trust and boost employee morale. When managers communicate effectively, employees feel that they are well informed of the company’s direction and vision, there is no misunderstanding, and they will feel more secure within their role. 

Importance of Effective Communication in An Organization 

1. it boosts growth .

Effective communication is important when it comes to developing a better company culture and the growth and plays a pivotal role in driving growth and success in any setting, be it within a business, a team, or even personal relationships. When individuals are able to communicate their thoughts, ideas, and goals clearly and concisely, it leads to increased understanding, collaboration, and productivity. By fostering open dialogue, active listening, and clear messaging, effective communication paves the way for growth, innovation, and success.

2. It increases innovation

Effective communication plays a vital role in fostering innovation within an organization and can be achieved via idea sharing and collaboration, active listening and feedback, cross-functional communication, and transparent and inclusive communication.

On the subject of idea sharing and collaboration, when individuals feel comfortable expressing their thoughts and opinions, it creates a fertile ground for innovation.

With regards to active listening and feedback, when individuals actively listen to others' ideas and provide constructive feedback, it promotes a culture of mutual respect and encourages the free exchange of ideas. Constructive feedback helps refine and strengthen innovative concepts, leading to improved outcomes.

On the subject of cross-functional communication, effective communication facilitates collaboration across departments, teams, and disciplines, enabling the cross-pollination of ideas. By breaking down silos and encouraging interdisciplinary communication, organizations can leverage diverse skill sets and knowledge, resulting in fresh insights and breakthrough innovations.

Last but not least, transparent and inclusive communication can facilitate collaboration across departments, teams, and disciplines, enabling the cross-pollination of ideas. By breaking down silos and encouraging interdisciplinary communication, organizations can leverage diverse skill sets and knowledge, resulting in fresh insights and breakthrough innovations.

3. It improves productivity

Effective communication has a significant impact on productivity in the workplace. When communication is clear and concise, employees have a better understanding of their roles, responsibilities, and objectives. Clear communication eliminates confusion and ambiguity, enabling employees to prioritize their tasks and work efficiently towards specific goals. The end result of all that? You got it. Improved productivity.

4. It increases efficiency

Effective communication plays a key role in increasing efficiency within an organization. There are several ways in which it contributes to improved efficiency. Experts maintain that it can come via clear instructions and expectations, more streamlined processes, timely information sharing, regular feedback and performance evaluation, effective collaboration and teamwork, and better utilization of technology. By eliminating misunderstandings, facilitating quick decision-making, promoting teamwork, and leveraging technology, efficient communication optimizes workflows and resource utilization, leading to improved overall efficiency within the organization

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5. It increases loyalty

Effective communication plays a crucial role in fostering employee loyalty within an organization. When employees feel that their voices are heard, opinions are valued, and information is transparently shared, they develop a sense of trust and belonging. Open and honest communication from leaders and managers helps establish a culture of transparency and integrity, creating an environment where employees feel comfortable expressing their concerns, ideas, and feedback. By actively listening to their employees, leaders can address their needs and provide support, which in turn boosts morale and loyalty.

6. It increases employee engagement

Effective communication plays a vital role in increasing employee engagement within an organization and there are several ways to make employees more involved. These can be open and transparent communication, two-way communication, recognition and feedback, making sure that levels of expectation are clearly set out, empowerment and autonomy is provided to all levels of employees, and teams are regularly communicated to and encouraged to collaborate on tasks. Effective communication that is open, transparent, two-way, and focused on recognition, feedback, clarity, empowerment, growth, and collaboration contributes to increased employee engagement.

7. It resolves problems

Effective communication serves as a powerful tool in resolving work problems and conflicts. When faced with challenges or disagreements, open and honest communication allows individuals to express their concerns, perspectives, and emotions in an early and respectful manner. By actively listening to each other, seeking to understand different viewpoints, and engaging in constructive dialogue, parties involved can find common ground and work towards a mutually beneficial resolution. Clear communication helps clarify misunderstandings, addresses underlying issues, and prevents conflicts from escalating further.

8. It enhances skills

Effective communication plays a significant role in enhancing skills in various areas. There are many ways that it can contribute to skills development and those include; greater clarity and articulation, an increase in active listening, greater incidences of nonverbal communication, better empathy and rapport-building, advanced conflict resolution and negotiation, and more effective written communication. Overall, effective communication enhances various skills, including clarity and articulation, active listening, nonverbal communication, empathy, conflict resolution, negotiation, presentation, and written communication. By consciously practicing and refining these skills, individuals can become more effective communicators, leading to improved personal and professional growth.

Conclusion 

Communication is key in business, and those organizations that have been able to master this crucial art of open and honest channels of communication between leaders and employees, and vice versa, will be best placed to reap all of the benefits. With open, honest and effective communication organizations will be able to mitigate conflict, increase employee engagement, improved productivity, a healthy workplace culture, boosted employee satisfaction, and increased innovation. 

Can being a great communicator be taught? You bet it can! Anyone can be a great communicator with training and practice and as an added bonus, it can make you a better leaders. The best communicators and leaders spend time developing, practicing and incorporating feedback into their communication efforts. These skills can be honed by doing a leadership management and teams course , and/or a leadership and organizational development course from a leading online university that offers MBA and BBA programs. 

Download our brand new free report on how you can acquire the most important skills for becoming a more successful communicator and effective leader.

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Common types of communication in the workplace

Experts maintain that there are four common types of communication in the workplace, namely verbal, nonverbal, written, and visual. Verbal, or oral communication among employees and managers plays an important part because at its core it means using speech to share information with other people. 

Verbal communication: Verbal communication involves the use of spoken words, tone of voice, and effective listening. It helps in resolving misunderstandings by providing clarity and immediate feedback. Through face-to-face conversations, phone calls, or video conferences, individuals can express their thoughts, ask questions, and seek clarification in real-time, ensuring clear understanding and reducing the chances of misinterpretation.

Nonverbal communication: Nonverbal cues such as body language, facial expressions, and gestures convey important information in workplace interactions. Paying attention to nonverbal cues helps individuals understand emotions, attitudes, and intentions, which can aid in resolving communication problems. For example, observing signs of frustration or confusion allows others to respond appropriately and offer support or clarification.

Written communication: Written communication, including emails, memos, reports, and documentation, provides a clear and permanent record of information. It helps overcome communication problems by ensuring that details are accurately conveyed, allowing individuals to refer back to messages for reference or clarification. Written communication also provides time for thoughtful reflection and revision, reducing the likelihood of misunderstandings caused by hasty or impulsive responses.

Visual communication: Visual aids such as charts, graphs, diagrams, and presentations can enhance understanding and overcome communication barriers. Visual communication simplifies complex information, making it easier to grasp and remember. Visuals can be especially useful when dealing with diverse audiences or when language barriers exist, as they transcend linguistic differences and convey information in a universally understandable manner.

How to develop communication skills as a manager

Having effective management communication and an effective communication strategy can help improve many aspects of a business. There are many ways you can improve management communication in the workplace, as every company is different. Some of the best practice tips on how managers can develop and improve their management communication skills are, work on writing skills, create an open channel for communication, listen and be receptive, involve your team and be transparent, and have a primary channel of communication. 

How to develop communication skills between managers and employees at work

It goes without saying that that the importance of communication between managers and employees is one of the most important factors of any successful business. Clear and effective communication helps ensure everyone is on the same page regarding objectives, direction, and expectations. It means everyone knows where they stand. Experts maintain that there are six ways to improve communication between managers and employees and those are, meet weekly, have regular 1-2-1s, keep employees in the loop, have an open door policy with managers, take advantage of tools that improve communication, and ask for and give feedback.

How to improve communication skills of employees working remotely

There is an expression that goes, "out of sight, out of mind." When managers are dealing with employees that are not in an office environment daily, communication levels and frequency of communication can slip. But this need not be the case. Fortunately, there are examples you can look to for inspiration and guidance as you adapt to the dynamics of managing remote working teams. Good communication skills means saying good morning either on a video or via a message in Teams, engaging in casual chit chat, and trying to meet offline when possible. Be proactive with communication and don't just wait for planned meetings, and respect time differences.  

Challenges of communication training for employees

Communication is a vital skill for any trainer, whether delivering online or in-person sessions, facilitating group activities, or providing feedback. However, lack of communication and communication challenges and barriers can arise in any training scenario, affecting the quality of learning outcomes and the satisfaction of the participants. But all hope is not lost. There are ways to address these issues and ensure effective communication with training stakeholders. Identify the audience, choose the right mode of training that suits attendees, use clear and concise language, handle difficult situations, and finally evaluate and improve by using surveys, tests, observations, or feedback forms, to measure the effectiveness and impact of your communication on your audience's learning outcomes and satisfaction.

Should you invest in a leadership and communication training course for your staff?

In short, the answer is yes. The right leadership and communication development program can improve productivity, employee retention, engagement levels, corporate culture, and internal hiring. More and more studies are showing that effective communication and communication-related skills amongst employees contribute to some of an organization’s most important KPIs, including profitability, productivity, and client engagement. Whilst on the subject of leadership training, it has been proven that leadership development boosts employee engagement, increases the organization's ability to deal with gaps in the talent pipeline, and reduces the headaches and costs associated with turnover. 

What are the best communication training programs?

People learn in different ways and in accordance with their own timeframes. This is why organizations should take these things and more into account before settling on training programs that are right for your organization. Although we're biased, at Nexford, we have a broad range of online courses for you to take, whether you're interested in entrepreneurship, AI, leadership, data analytics and much more.

Mark is a college graduate with Honours in Copywriting. He is the Content Marketing Manager at Nexford, creating engaging, thought-provoking, and action-oriented content.

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The role of communication transparency and organizational trust in publics' perceptions, attitudes and social distancing behaviour: A case study of the COVID‐19 outbreak

Yeunjae lee.

1 Department of Strategic Communication, School of Communication, University of Miami, Coral Gables FL, USA

Jo‐Yun Queenie Li

Associated data.

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Integrating social cognitive theory and public relations literature, this study examines the effectiveness of organizations' transparent communication in building public trust and encouraging health‐protection behaviours (i.e. social distancing) during a pandemic, that is, the COVID‐19 outbreak. Three aspects of transparent communication are investigated, namely information substantiality, accountability and participation. Results of an online survey of American citizens show that during the early stage of COVID‐19, information substantiality by state governments and health institutes (e.g., the Centers for Disease Control and Prevention) increases publics' trust, which positively influences their perceived risks, behavioural control and subjective norms. The participation of health institutes, rather than state governments, significantly increases public trust, whereas accountability has no effects. Individuals' perceptions and attitudes towards social distancing predict their social distancing behaviour during the outbreak. Theoretical and practical implications are discussed.

1. INTRODUCTION

The 2020 pandemic caused by the coronavirus (COVID‐19) is an unprecedented global crisis. As of April 28, 2020, the number of confirmed COVID‐19 cases in the United States reached 1,000,000, with a death toll nearing 60,000 as the number continues to rise (Almasy et al.,  2020 ). The speed and scale of the outbreak have disrupted American society and economy substantially. To slow the speed of the virus and protect public health, Americans have been asked to practice social distancing (or physical distancing), that is, maintaining distance (approximately six feet) between oneself and other people, outside of their home at all times and to not leave their home except to obtain essential needs, such as medical care or groceries (Pew Research Center,  2020 ). Social distancing helps limit contact with infected people and contaminated surfaces; thus, maintaining social distance is one of the best strategies for avoiding exposure to the virus and slowing its spread locally and across the country and the world (Centers for Disease Control and Prevention (CDC), 2020 ). Anyone can get and spread COVID‐19 before knowing that they are sick; hence, government organizations (e.g., the CDC) have continuously emphasized the importance of staying away from others as much as possible despite the absence of symptoms.

However, practising social distancing is difficult. Being with others and human connection are fundamental human needs and natural inclinations (DiDonato,  2020 ). Social distancing is thus challenging, because it goes against cultural norms of communication and feels impersonal and awkward, as it is not what people have been trained to do with people they like (McArthur,  2020 ). Social distancing is especially difficult when it is an abrupt, unexpected and dramatic shift from substantial face‐to‐face time to very little, which is what people are experiencing during the COVID‐19 outbreak (DiDonato,  2020 ). However, to slow the spread of the virus and protect individuals, their family, community and the world, practising social distancing is necessary. Given that individuals' intention to follow government instructions is determined largely by the contextual environment (Jung et al.,  2013 ) and public behaviours are affected by government actions during a public health crisis (Reynolds & Quinn,  2008 ), communicative efforts by organizations responsible for addressing a crisis and implementing policies (e.g., the government and health institutes) during a pandemic are crucial. An important question is, how can publics be encouraged and persuaded effectively to practice social distancing, which is essential but difficult?

Public relations scholars emphasize the importance of strategic communication during a public health crisis for organizations to build quality relationships with publics and influence their behaviours in a way that is desired by the organizations (e.g. Guidry et al.,  2017 ; Yang,  2018 ). Particularly, as publics increasingly expect transparency and accountability from organizations (Adams & Evans,  2004 ), transparency is regarded as a key element in contemporary strategic communication (Albu & Wehmeier,  2014 ) to foster public confidence and trust in organizations, such as the government (Fairbanks et al.,  2007 ; Kim,  2018 ). The importance of transparency is also emphasized by health/risk communication researchers in increasing trust in institutions (e.g. Freimuth et al.,  2014 ; Quinn et al.,  2013 ; Vaughan & Tinker,  2009 ), which will ultimately change publics' health‐related behaviours (e.g. Meredith et al.,  2007 ). Trust in the government and in the health information it communicates can positively impact publics' health‐related outcomes during a pandemic (Quinn et al.,  2013 ). In the context of a public health crisis, while most public relations studies focus on the effects of communication on publics' issue‐related activeness (e.g. Kang et al.,  2018 ; Yang,  2018 ), health communication literature provides a thorough explanation of publics' health‐related behavioural motivations and outcomes (e.g. Chon & Park,  2019 ). However, few studies integrate the literature to examine publics' health‐related behaviours during a crisis, which are influenced by the strategic communication efforts of organizations.

Thus, by integrating the health communication and public relations perspective, this study aims to examine the effectiveness of transparent communication by the government and health institutes during a public health crisis in increasing public trust and influencing perceptions, attitudes and social distancing behaviour. Furthermore, to understand how organizations' communication efforts influence the complicated nature of publics' behavioural motivations during a crisis, this study draws on social cognitive theory to explain individual health behaviours. Specifically, using the theory of planned behaviour (TPB) and the health belief model, this study attempts to provide an integrative model that can predict publics' social distancing behaviour during the COVID‐19 outbreak based on their perceived risks, norms, behavioural control and attitudes towards social distancing. Focusing on the state government and public health institutions (e.g. the CDC) as two major public health crisis‐related information sources for publics during the early stage of the COVID‐19 pandemic, this study also compares the role of transparent communication in affecting publics' behaviours.

2. LITERATURE REVIEW

2.1. the role of communication during a public health crisis.

Effective communication from the government and public health officials is essential during times of public danger, such as health emergencies, to strengthen publics' resilience (Vardavas et al.,  2020 ), ensure trust in organizations and facilitate the adoption of behaviours necessary to reduce risks (Quinn et al.,  2013 ). The literature highlights the importance of communication during a pandemic, particularly in affecting publics' behaviours (e.g. being vaccinated; e.g. Bish et al.,  2011 ; Poland,  2010 ). For example, during the H1N1 outbreak, clear communication and trust in government authorities lessened publics' uncertainty about the pandemic, thereby leading to preventive measures (Rubin et al.,  2009 ). In communicating with publics during a crisis, what matters is not only “what” is communicated (e.g. message content) but also “who” is conveying the information and “how” it is communicated (Larson & Heymann,  2010 ). During a pandemic, the “who” is in charge of communication (e.g. the government and health officials) should pay attention to not just “what” is communicated (i.e. communication content) but also “how” it is delivered (Quinn et al.,  2013 ).

Focusing on the COVID‐19 pandemic in the United States, this study examines the role of two major organizations that have become focal points in the national public health crisis response, namely health institutions (e.g. the CDC) and the state government . Health institutions, such as the CDC, which is a federal agency under the Department of Health and Human Services, serve as national standards for public health preparedness planning within the United States. Communication from such public health agencies is crucial during a pandemic, because public health officials are often considered as the most truthful spokespersons during such challenging times (Quinn et al.,  2013 ). Publics also tend to demonstrate high levels of trust in health agencies, such as the CDC (Kowitt et al.,  2017 ) and thus are likely to follow their guidelines, as crucial information sources, during uncertain times. Furthermore, during a public health crisis, though the federal government is often expected to slow the speed of virus entry into the country, state/local governments mainly implement courses of action, including public health interventions (French & Raymond,  2009 ). During the COVID‐19 pandemic, as the federal government leads the national response to the outbreak, state and local government officials have taken decisive action (e.g. stay‐at‐home orders), standing on the front lines to control the spread of COVID‐19. Such declarations vary considerably by state (NCSL,  2020 ). Therefore, publics' perceptions, attitudes and social distancing behaviour are likely highly affected by government orders in the state where they reside.

Transparent communication from organizations is suggested as a normative communication model by public relations scholars as it helps organizations effectively manage a crisis (Kim,  2018 ), increase public trust and build healthy and long‐term relationships with publics (Men & Bowen,  2016 ). Specifically, transparent government communication is emphasized during a pandemic health crisis (Fairbanks et al.,  2007 ; Huang,  2004 ; Yang et al.,  2015 ) to build trust by providing publics with a basic understanding of the crisis and guidance for appropriate courses of action to reduce harm (Reynolds & W. seeger,  2005 ). Transparent communication from health institutions is likewise important. Publics judge the communication efforts of such institutions during public health emergencies in terms of honesty and trustworthiness (Meredith et al.,  2007 ), which influence their perceived quality of communication and compliance with recommended actions (Quinn et al.,  2013 ). Thus, the current study focuses on the role of communication transparency and trust, as important organizational antecedents, in influencing publics' attitudes and social distancing behaviour during the COVID‐19 outbreak. Transparent communication and organizational trust are discussed in the succeeding sections.

2.1.1. Transparent communication

Transparent communication is a multifaceted concept. In the political context, Cotterrell ( 1999 ) defined transparency as “the availability of information on matters of public concern, the ability of citizens to participate in political decisions, and the accountability of government to public opinion or legal processes” (p. 414). In public relations, the notion of transparency is advocated as an ethical and normative communication practice (e.g. Avery & Graham,  2013 ; Men & Bowen,  2016 ). The current study adopts the definition of transparent communication proposed by public relations scholars (e.g. Men,  2014 ), including three key components, namely information substantiality, participation and accountability.

First, the basic component of transparency is information substantiality . Organizational transparency is typically understood as information disclosure (Yang et al.,  2015 ). As a basic human right (i.e. “the right to know”), transparency is often associated with the idea of information completeness or comprehensiveness (Grimmelikhuijsen et al.,  2013 ). Government transparency, including open administrative procedures and government hearings, is viewed as a key element in democracies (Beaumont,  1999 ; Finel & Lord,  1999 ). In an organizational setting, the importance of openness in the disclosure of information is also emphasized as part of corporate social responsibility (Sykes, 2002 ). Second, transparent communication ensures the participation of other parties. The provision or disclosure of information does not constitute transparency (Rawlins,  2008 ). To achieve transparency, audiences' capacities for processing information are crucial; thus, audiences should be involved to address the interests of both sides (Heald,  2006 ). In other words, the mutual understanding of a message and information is a necessary component of transparent communication (Albu & Wehmeier,  2014 ). Therefore, in terms of transparency, organizations are responsible for ensuring that a party who is interested in an organization's actions and decisions can actively participate in acquiring, creating and providing information (Cotterrell,  2000 ). Finally, the idea of transparency includes accountability , which refers to the objective and balanced reporting of an organization's activities and policies that hold the organization accountable (Rawlins,  2008 ). Accountability also represents organizations' acceptance of responsibility and the alleviation of problems, which is a core strategy for effective crisis communication (Grunig & Hunt,  1984 ). Accountability, as a form of democratic decision‐making transparency, is relevant in making the decision‐making process visible to ascertain publics' understanding and assess outcomes (Grimmelikhuijsen et al.,  2013 ).

2.1.2. Organizational trust

Honest and transparent communication is vital in building and maintaining trust‐based relationships (Goodman,  2002 ). From the perspective of public relations, organizational trust is defined as “one party's level of confidence in and willingness to open oneself to the other party” (Hon & Grunig,  1999 , p. 3). Organizational trust includes three dimensions, that is, integrity (the belief that an organization performs fairly and justly and considers publics' expectations), dependability (the belief that an organization will deliver what it promises) and competence (the belief that an organization can fulfil its promises; Hon & Grunig,  1999 ). Trust, as the outcome of effective communication, such as mutuality, transparency and openness, during a crisis, is the primary focus of public relations research (Auger,  2014 ; Yang et al.,  2015 ; Yang & Lim,  2009 ).

In the public health context, trust in government agencies, which reflects individuals' overall evaluation of the performance of political authorities and institutions (Miller & Listhaug,  1990 ), has been suggested as a major predictor that advances organizations' agendas, implements policies effectively (Kowitt et al.,  2017 ) and affects relationships between citizens and political entities in general (e.g. Hon & Grunig,  1999 ). Most important, trust in the government influences publics' health‐related behaviours, such as being vaccinated, during a pandemic (Poland,  2010 ; Quinn et al.,  2013 ). Trust in health institutions also fosters publics' health‐related behaviours (Meredith et al.,  2007 ). For these reasons, the growing body of literature suggests that organizations (i.e. the government and health institutions) should incorporate strategic communication efforts with considerable transparency to increase publics' level of trust (Huang,  2004 ).

Transparency is an important tool for organizations to demonstrate trustworthiness and manage organizational reputation (Goodman,  2002 ). Specifically, information availability (Fombrun & Rindova,  2000 ) and accountability (Vaughan & Tinker,  2009 ) breed trust. In an organizational setting, scholars also empirically demonstrated that transparent communication influences internal publics' trust level (Lee & Li,  2019 ). Open, responsive and transparent communication have been suggested as key elements in fostering public trust in the government (Fairbanks et al.,  2007 ; Kim,  2018 ), which indicates democratic governance (Grimmelikhuijsen et al.,  2013 ) by creating a culture of openness and increasing the confidence of citizens in the government's abilities (Beaumont,  1999 ). The role of technology (e.g. social media) was particularly emphasized to increase publics' trust level (Appleby‐Arnold et al.,  2019 ). The close link between communication and trust during a pandemic is also well‐demonstrated (Freimuth et al.,  2014 ; Shore,  2003 ). During the H1N1 pandemic, officials' openness about evolving information increased publics' perceived quality of communication and trust in government actions (Quinn et al.,  2013 ). According to Kang et al. ( 2018 ), in the MERS context, mutuality and openness, which are similar to the key attributes of government transparent communication, can reduce the level of public distrust against the government. Communication transparency from public health officials during a pandemic also plays an important role in increasing public trust (Vaughan & Tinker,  2009 ). Therefore, this study expects that transparent communication, information substantiality, accountability and participation will increase public trust in an organization, thereby leading us to propose the following hypotheses:

Transparent organizational communication, namely (a) information substantiality, (b) accountability and (c) participation, during a pandemic, will increase public trust in an organization.

2.2. Organizational trust and social cognitive factors

Organizational trust during a pandemic is key (Funk,  2020 ) in encouraging publics to comply with recommended preventive measures, such as social distancing. To understand the motivational routes of individuals for engaging in social distancing behaviour during the COVID‐19 pandemic based on their trust in organizations, this study draws on a social cognitive framework, which identifies key factors that predict individuals' decision‐making process. Such key factors include trust in the government, risk perception of the pandemic, attitudes, subjective norms and perceived behavioural control over the acceptance of preventive measures (e.g. Leppin & Aro,  2009 ; Prati et al.,  2011 ). Social cognitive theory offers essential premises for linking these variables to behavioural intention and actual behaviours (Bandura,  1986 ).

Moreover, the impact of these variables can be explained by several health behavioural change models, such as TPB and the health belief model. These models indicate that cognitive and social factors are the central determinants of recommended‐behaviour adoption (Fishbein & Ajzen,  1980 ; Rosenstock,  1974 ). According to these models, in the case of a pandemic, risk perceptions refer to perceived vulnerability and severity judgment of a pandemic (Ibuka et al.,  2010 ). Meanwhile, attitude is defined as one's belief about whether engaging in precautionary actions can generate positive outcomes. Finally, subjective norms refer to one's perception of whether his/her important referents agree with practising precautionary actions. The social acceptability and endorsement of behaviour play an important role in a person's decision‐making process (Ajzen,  1991 ). Perceived behavioural control is defined as one's perception of the ease of performing precautionary actions.

The health behaviour model postulates that individuals systematically process available information and carefully consider the outcomes of their actions (e.g. social distancing) based on these perception variables. Given that organizational trust plays an important role in shaping publics' perceptions of and attitudes towards a pandemic and related preventive guidelines (Poland,  2010 ; Quinn et al.,  2013 ), this study hypothesizes trust as a precursor of individual social cognitive variables. Thus, the specific links between organizational trust and social cognitive factors are discussed in the following sections.

2.2.1. Organizational trust and risk perceptions

In pandemic management, organizational trust (e.g. government trust) has been shown to broaden individuals' health knowledge about a pandemic and increase their awareness of risk situations (Quinn et al.,  2013 ). The trust and confidence model suggests that trust in the government plays an important role in pandemic management, as it influences individuals' evaluation of risks and thus can indirectly affect the acceptance of preventive measures (Siegrist et al.,  2003 ). However, a lack of trust in the government generates scepticism regarding public health warnings (Vaughan & Tinker,  2009 ). Such doubt may influence publics to underestimate the vulnerability and severity of a disease (Blair et al.,  2017 ). Similarly, institutional trust serves as the foundation of how pandemic outbreak communication is heard, interpreted and responded to and can reinforce perceived threats of a disease (Slovic,  2000 ). Thus, we expect that trust in organizations during the COVID‐19 pandemic, including the state government and health institutions, positively influences publics' risk perceptions of a pandemic. The following hypothesis is thus proposed:

Publics' trust in an organization will increase their perceived risks of a pandemic.

2.2.2. Organizational trust and attitudes

Given the high uncertainty and extreme impact of a pandemic, the pandemic and risk communication literature suggest that trust in the government is an essential element of public cooperation towards government action (Houston & Harding,  2013 ). Institutional trust has been identified as one of the most important variables for predicting publics' attitudes and preferences towards preventive measures in pandemic management (SteelFisher et al.,  2010 ; Taylor‐Clark et al.,  2005 ). Public health research indicates that trust in the government enhances individuals' confidence in institutions, thereby increasing perceived legitimacy of government action as well as the expected outcomes of such action (Vaughan et al.,  2012 ). The trusting relationship between an institution and its publics enables positive expectations that negative outcomes will not occur if the publics comply with institutional guidelines (Pavlou & Fygenson,  2006 ). In addition, such a relationship creates an impression that an institution will prioritize its publics' interests (Hosmer,  1995 ). These optimistic expectations that build on trust create positive perceptions of the outcomes of institutional actions, thereby generating positive attitudes towards related policies (Pavlou,  2003 ). Thus, we expect that trust in organizations (i.e. health institutions and the government) may influence publics' attitudes towards pandemic preventive measures, which is social distancing in this study. Thus, we propose the following hypothesis:

Publics' trust in an organization will influence their attitudes towards social distancing.

2.2.3. Organizational trust and subjective norms

Most research that integrates institutional trust and normative beliefs examine the two variables separately with no interactions (e.g. Hsieh,  2015 ). However, research on social capital suggests that trusting relationships with the government may establish social capital, which is a social norm that can “facilitate coordination and cooperation for mutual benefit” (Putnam,  1995 ). Trust in government reputation, image and actions can thus establish a mutual and healthy relationship between institutions and publics, thereby creating a social norm of government action acceptance (Chuang et al.,  2015 ). Specifically, scholars indicated that individuals' perceptions of the reference groups' behaviours or interpersonal agreements can be determined by subjective culture variables, the approaches people use to interpret the social environment (Triandis,  1980 ). In an organizational context, essential elements of organizational trust, such as fairness and integrity, reflect the perceptions of subjective culture variables; these perceptions will then affect the formation of social pressure or subjective norms (Ellis & Shockley‐Zalabak,  2001 ; Fu & Lee,  2005 ). Namely, higher levels of organizational trust can reflect publics' positive values of being treated with fairness and integrity by the organization. These perceptions decrease the likelihood that people attempt to behave differently or increase the likelihood that people comply with others in the social environment (Fu & Lee,  2005 ), as such trusting relationships leads to less rupturing behaviour among publics (Chang,  2007 ). Particularly in the pandemic context, organizational trust can help facilitate effective interaction and communication between the government and the publics and thus allow greater health information flow (Jung et al.,  2013 ), which serves as an important resource that mobilizes a community and establishes social pressure regarding the precautionary measure adoption (Lee & Kam,  2015 ). Based on this line of reasoning, in the context of this study, organizational trust is expected to enhance the public's perceived social pressure to practice social distancing behaviour (i.e. subjective norms). The following hypothesis is thus posed:

Publics' trust in an organization will increase their perceived norms regarding social distancing.

2.2.4. Organizational trust and perceived behavioural control

Trust in an institution can be a resource to help publics cope with social uncertainty and unexpected contingencies (Gefen,  2002 ), thereby resulting in considerable control over certain behaviours (Pavlou & Fygenson,  2006 ). Moreover, trust in an institution can indicate support for its actions, which may motivate individuals to overcome barriers to engage in a behaviour or cooperate as an expression of support (Hsu et al.,  2007 ). Thus, the positive impact of organizational trust on publics' perceived behavioural control during the COVID‐19 pandemic is expected, and the following hypothesis is proposed:

Publics' trust in an organization will increase their perceived behavioural control over social distancing.

2.3. Social norms, cognitive perceptions and preventive measures

In addition to considering all social cognitive factors as parallel variables that can predict behavioural intentions, this study investigates the role of subjective norms in shaping one's risk perceptions, attitudes and perceived behavioural control over a behaviour. Although the majority of research on TPB considers the three main variables, namely attitudes, subjective norms and perceived behavioural control, as exogenous factors that lead to behavioural intentions, scholars suggest that subjective norms may exert an impact on attitudes and perceived behavioural control (Quintal et al.,  2010 ). According to TPB, one's attitudes and perceived control towards a behaviour are both considered to be personal factors because such attitudinal perceptions are internally generated on the basis of the person's evaluations of the potential outcomes or competence to complete the behaviour. In contrast, one's subjective norms are viewed as a social factor as they depend on people who surround the person and one's perceived social pressure to perform the behaviour (Bandura,  1986 ). Scholars argued that an individual's attitudes or perceived behavioural control can be contingent on his/her perceived subjective norms (Oliver & Bearden,  1985 ; Park,  2000 ). Norm beliefs about a behaviour in the social environment serve as facilitators or barriers in individuals' decision‐making processes (Bagozzi et al.,  2004 ; Han et al.,  2010 ). The literature in social psychology has also long acknowledged that the attributes of the social environment and social pressure play critical roles in shaping one's attitudes (Eagly & Chaiken,  1993 ). Accordingly, individuals' perceptions of others' expectations or/and behaviours are found to directly influence the formation of attitudes and behaviour control perceptions because subjective norms are outcomes of social normative pressures (Park,  2000 ).

Moreover, social norms are constructed within informal personal networks, which facilitates the delivery of risk information (Kasperson et al.,  1988 ). According to the social amplification of risk framework, the diffusion power of information delivered within a social network could influence the magnitude of risk perception of a specific issue (Kasperson et al.,  1988 ; Renn,  2011 ). Although earlier studies of TPB placed subjective norms as an exogenous construct leading to intentions and behaviour, many studies have attempted to identify the causal relationship between subjective norms and other variables (e.g. Al‐Swidi et al.,  2014 ). While it might be argued that perceptions that are internally created such as risk or attitudes can influence normative beliefs, scholars suggested that it is more likely characteristics of the social environment will affect characteristics of the person (Eagly & Chaiken,  1993 ; Ryan,  1982 ). This is particularly relevant in this study's context. The novelty and ambiguity of COVID‐19 have resulted in larger‐scale uncertainty in society compared with other pandemics in the past (Altschuler,  2020 ). In uncertain situations, such as the present, in which effective preventive measures are unclear, individuals may likely use others' behaviours as evidence or justification to decide to also adopt the same behaviour (Cialdini et al.,  2006 ; Kim et al.,  2015 ). Thus, we expect the impacts of norms on social cognitive variables, proposing the following hypotheses:

Publics' perceived norms will increase their (a) perceived risks of a pandemic, (b) positive attitudes and (c) perceived behavioural control over social distancing.

In the social cognitive approach, the primary models of health behavioural change, such as the health belief model, TPB and protection motivation theory, identify factors that can predict the outcome variables of behavioural intention and actual behaviours (Schwarzer,  2001 ). These theoretical frameworks share several common factors, such as risk perceptions, attitudes, social norms and perceived behavioural control. Based on previous studies on health communication, this study assumes that such factors can predict publics' adoption of social distancing during the pandemic. Thus, the following hypotheses are proposed.

Publics' (a) risk perceptions of a pandemic, (b) attitudes, (c) perceived norms and (d) perceived behavioural control over social distancing will increase their likelihood of adopting such behaviour.

The conceptual model is presented in Figure  1 .

Conceptual model

3.1. Participants

An online survey was conducted with participants in the United States for 1 week in early April 2020 after the social distancing guideline for COVID‐19 was presented by the CDC on April 4 (CDC,  2020 ) and the stay‐at‐home order was implemented in all 50 states (Mervosh et al.,  2020 ). Participants were recruited through Amazon Mechanical Turk (MTurk). The Mturk user population represents the demographic distribution in the United States (e.g. Casler et al.,  2013 ; Mason & Suri,  2012 ) and tends to be more diverse than the population drawn from traditional survey research (Buhrmester et al.,  2016 ). Therefore, Mturk samples for social scientific research is an appropriate participant recruitment pool for numerous studies, including communications research (e.g. Krishna,  2018 ). To obtain a nationally representative sample of the US population in terms of age, gender and race/ethnicity, stratified random sampling was used. The participants were compensated for $1 for participating in the 15‐min survey. After removing invalid responses (e.g. who are not qualified for the survey, who spent less than 4 min or more than 1.5 hr in a survey, who failed attention check questions), among the initial 823 survey participants, this study retained a final sample of 502.

Of the final sample of 502 participants (mean age = 36.6, SD  = 11.4), 50% of them were male ( n  = 251). A majority of them were Caucasian ( n  = 365, 73%) and held bachelor's or postgraduate degrees ( n  = 408, 81.3%). 75.4% of the participants ( n  = 378) had more than $40,000 of household income, and 77.1% of them ( n  = 387) were currently employed full‐time. In terms of political affiliation, 43.8% of the respondents ( n  = 220) identified themselves as liberal, while 32.7% ( n  = 164) of them were conservative Table  1 summarizes the demographic information of these participants.

Participant Profiles ( N  = 502)

According to the most recent U.S. census data (the United States Census Bureau, 2019), the U.S. population consisted of 49.2% male and 50.8% female. The median age was 38.2. A majority were Caucasians (60.2%), followed by Hispanic/Latino (18.5%), African Americans (13.1%) and Asian/Asian Americans (6.4%) and others (1.7%).

3.2. M easures

All measurement items were adopted from previous literature. A 5‐point Likert scale from strongly disagree (=1) to strongly agree (=5) was used for the items.

For transparent communication and organizational trust, participants were asked to answer each item twice for two organizations, health institutions (e.g. CDC) and state government, respectively. Transparent communication was measured with 10 items (health institutes: α  = 0.864, state government: α  = 0.893) adopted from Men ( 2014 ). It includes three components, information substantiality (four items, health institutes: α  = 0.773, state government: α  = 0.788), accountability (four items, health institutes: α  = 0.722, state government: α  = 0.760) and participation (three items, health institutes: α  = 0.763, state government: α  = 0.743). To measure organizational trust, six items (health institutes: α  = 0.858, state government: α  = 0.858) were adopted from Hon and Grunig ( 1999 ). Publics' perceived risks of a pandemic were measured with four items ( α  = 0.812) of perceived severity and four items of perceived susceptibility ( α  = 0.822) (Jang & Park,  2018 ). Norm was measured with three items ( α  = 0.745) from Chung and Lapinski's ( 2019 ) study. To measure individuals' perceived behavioural control, five items ( α  = 0.735) were used from Cho and Lee ( 2015 ) and Krishna ( 2018 ). Individuals' attitudes towards social distancing were measured with six revised items ( α  = 0.923) adapted from Krishna ( 2018 ). In terms of social distancing behaviour, three items ( α  = 0.749) were used. A list of measurement items is presented in Table  2 .

Measurement items

3.3. Data analysis

First, the reliabilities for all measurement items were evaluated through Cronbach's a. All variable measures achieved satisfactory scale reliability: Cronbach's alpha coefficients ranged from 0.72 to 0.94, surpassing the acceptable threshold of 0.70. To test the hypotheses, the researchers used a two‐step process of structural equation modelling ( SEM ) using Mplus program. The measurement model was firstly evaluated, followed by testing the structural model. Hu and Bentler's ( 1999 ) joint‐fit criteria was used to assess the model fit: “CFI ≥ 0.95 and SRMR ≤ 0.10” or “RMSEA ≤ 0.06 and SRMR ≤ 0.10.” is considered as a good model fit. The hypothesized model was tested twice for each organization, health institutes (Model 1) and state/local government (Model 2).

4.1. Preliminary data analysis

Table  3 reports descriptive statistics and correlations among the variables. During the time when the data were collected, participants as a whole, in general, were highly engaged in social distancing behaviour ( M  = 4.21), while their positive attitude towards social distancing was moderate ( M  = 3.36). Participants also had a moderately high level of perceived risk, norm and behavioural control ( M s > 3.8). In terms of perceived transparent communication efforts by two organizations and trust level, publics are more likely to trust health institutes ( M  = 3.82) than state government ( M  = 3.57), t (501) = 6.79, p  < .001. Moreover, publics tend to believe that compared to the state government, health institutes provide more substantial information about the outbreak ( t (501) = 6.19, p  < .001) and be more accountable for the crisis ( t (501) = 3.40, p  = .001). No significant difference was found for participation between the two organizations ( t (501) = 0.672, p  = .502).

Descriptive statistics and correlations among the study variables

4.2. Testing socio‐demographic variables

A series of t tests, ANOVA and regression analysis was conducted to examine the effects of demographic variables on the main variables used in the current study. Individuals' age, gender, education level and political identification were found to have significant impacts and were thus controlled in the following SEM analysis. Specifically, the results of t tests showed that female participants reported higher levels of perceived risk ( t (500) = −2.95, p  = .003), attitude ( t (500) = −3.69, p  < .001) and social distancing behaviour ( t (500) = −3.57 , p  < .001) than male participants. The results of regression analysis indicated that liberal participants reported high levels of trust towards health institutions ( β  = 0.157, p  < .001), perceived risks ( β  = 0.223, p  < .001), norm ( β  = 0.181, p  < .001), attitude ( β  = 0.167, p  < .001) and social distancing behaviour ( β  = 0.159, p  < .001). Age was also significantly and positively related to the participants' perceive risk ( β  = 0.126, p  = .011), attitude ( β  = 0.132, p  = .005), norm ( β  = 0.146, p  = .003) and behaviour ( β  = 0.138, p  = .005) and negatively related to behavioural control ( β  = −0.106, p  = .035). Education level was negatively associated with norm ( β  = −0.137, p  = .002), attitude ( β  = −0.247, p  < .001) and social distancing behaviour ( β  = −0.170, p  < .001), while positively associated with behavioural control ( β  = 0.122, p  = .008). Individuals' race/ethnicity and income level did not have any significant associations with the key variables.

4.3. Hypotheses testing

The CFA results showed that the measurement models fit the data well: Model 1: χ 2 (781) = 1738.974, RMSEA = 0.049 [.046, 0.053], CFI = 0.949, TLI = 0.940, SRMR = 0.041; Model 2: χ 2 (781) = 1657.746, RMSEA = 0.047 [0.044, 0.050], CFI = 0.959, TLI = 0.950, SRMR = 0.043. Therefore, the researchers evaluate the structural models. Two models reached satisfactory data fit: Model 1: χ 2 (800) = 1,860.850, RMSEA = 0.051 [.048, 0.054], CFI = 0.930, TLI = 0.920, SRMR = 0.053; Model 2: χ 2 (800) = 1787.222, RMSEA = 0.050 [.047, 0.053], CFI = 0.938, TLI = 0.931, SRMR = 0.054. The coefficient paths are thus interpreted (see Figure  2 ).

Results of the hypothesized model

In H1, a positive effect of transparent communication on publics' trust level with an organization was expected. The results revealed that for health institutes (Model 1), information substantiality (0.950, p  < .001) and participation (0.280, p  = .007) were positively related to trust, while accountability (−0.217, p  = .191) was not significantly related to trust. For state government (Model 2), information substantiality (0.516, p  < .001) was positively related to trust, whereas accountability (0.173, p  = .589) and participation (0.274, p  = .546) were not significantly associated with trust. These results support H1a, do not support H1b and partially support H1c.

H2 examined the effect of trust on publics' perceived risk of a pandemic. The effect was positive and significant in both models (Model 1: 0.291, p  < .001; Model 2: 0.114, p  = .022), which supports H2. In H3, whether publics' trust level increased their attitude towards social distancing was investigated. The results showed that trust did not significantly affect publics' attitude in both models (Model 1: −0.061, p  = .282; Model 2: 0.103, p  = .090), which does not support H3. H4 investigated how public trust is related to individuals' perceived norm. The association was also positive and significant (Model 1: 0.530, p  < .001; Model 2: 0.204, p  < .001), and thus, H4 is supported. In H5, we expected a positive effect of publics' trust on their perceived behavioural control. The paths were positive in both models (Model 1: 0.300, p  < .001; Model 2: 0.331, p  < .001). H5 is supported.

H6 examined how publics' norm increases perceived risks, attitude and perceived behavioural control, respectively. Norm was significantly and positively related to perceived risks in both models (Model 1: 0.651, p  < .001; Model 2: 0.712, p  < .001). It also significantly increased publics' attitude towards social distancing (Model 1: 0.515, p  < .001; Model 2: 0.553, p  < .001) and perceived behavioural control (Model 1: 0.458, p  < .001; Model 2: 0.562, p  < .001). H5a, H5b and H5c are thus all supported.

In H7, this study expected publics' perceived risks, attitude, norm and perceived behavioural control towards social distancing all positively influence their social distancing behaviour during the pandemic. As expected, perceived risks (Model 1: 0.163, p  = .034; Model 2: 0.160, p  = .025), attitude (Model 1: 0.264, p  < .001; Model 2: 0.261, p  < .001), norm (Model 1: 0.578, p  < .001; Model 2: 0.595, p  < .001) and perceived behavioural control (Model 1: 0.164, p  = .004; Model 2: 0.135, p  = .014) all positively and significantly predicted social distancing behaviour in both models. H7 is thus supported.

5. DISCUSSION

An increasing number of studies discuss the effective crisis/risk communication strategies during the COVID‐19 in diverse settings (e.g. Clark‐Ginsberg & Petrun Sayers,  2020 ; Petridou & Zahariadis,  2021 ; Subert,  2020 ). This study particularly examines the role of organizations' transparent communication and trust levels in influencing American publics' perceptions, attitudes and social distancing behaviour during the COVID‐19 pandemic. The results of the online survey indicated that information substantiality significantly increased publics' trust in the state government and health institutes during the pandemic. Participation enhanced publics' trust in health institutes, whereas accountability demonstrated no effect on trust for both organizations. Organizational trust played an important role in increasing publics' perceived risks, norms and behavioural control, which ultimately fostered their social distancing behaviour. This study provided important theoretical and practical implications.

First, the current study advanced public relations and strategic communication scholarship by understanding publics' health‐related behaviours during a global pandemic. Previous studies have long demonstrated the overall effectiveness of communication transparency, such as openness or mutuality, in increasing public trust (e.g. Yang,  2018 ). However, distinct transparent communication elements may play different roles during a public health crisis. One of the key findings of this study was that information substantiality was positively and strongly related to publics' trust in organizations, whereas publics' evaluation of accountability and participation did not consistently lead to trust. During uncertain times, such as a public health crisis, publics have intrinsic needs to know what is going on and what should be done. This study revealed that in the context of the COVID‐19 pandemic, the state government and health agencies, as truthful information sources for the outbreak, were responsible for providing substantial information that is truthful, timely and relevant to satisfy publics' needs. As noted by numerous public relations and crisis communication studies, releasing information is crucial for building public trust during a crisis (e.g. Chang,  2020 ; Huang,  2004 ), which was also demonstrated empirically in the current study.

Moreover, participation, which is similar to the concept of listening and mutuality, has been considered as a normative and ethical communication model in the literature (e.g. Kang et al.,  2018 ). Our results indicated that the idea of participation, as a core element of transparency, was effective in establishing public trust in health institutions during a public health crisis. However, state governments' participative efforts were not significantly related to publics' level of trust. The risk communication literature suggests that publics will trust the government when the government sends empathetic and caring messages and demonstrates competence and expertise in their promises and actions (Reynolds & Quinn,  2008 ). The literature likewise posits that publics may expect reassurance and directional leadership from the government during a pandemic to feel relieved and take immediate specific steps to avoid health risks rather than speaking up on an issue to the government. In other words, not all publics may want to participate in the decision‐making process. Some may want to merely follow directions provided by authorities during an uncertain period. In addition, public participation occasionally delays organizations' decision‐making process (Godschalk et al.,  2003 ), thereby preventing organizations from providing information quickly and timely. Therefore, whether or not publics perceived opportunities to express their opinions or for the state government to listen to them did not necessarily increase trust during a pandemic.

Furthermore, accountability was not a key element for enhancing publics' trust during a pandemic. Generally, though the notion of accountability based on reporting balanced information, that is, positive and negative information, and admitting mistakes helps organizations establish quality relationships with publics, our findings suggested that this situation was not always the case during a pandemic. One possible explanation was that publics may not consider these organizations responsible for the pandemic, unlike other types of organizational crises. When publics perceive a pandemic as uncontrollable and view government organizations and health institutes as victims (Coombs,  2007 ), they will not necessarily expect these organizations to acknowledge their mistakes, which is not related to how much they trust these organizations to address the crisis. In summary, the findings of the current study suggested an effective communication model in the public health crisis context, that is, the COVID‐19 outbreak, based on the public relations literature by analysing the distinct roles of information substantiality, participation and accountability in building organizational trust with publics.

Second, this study demonstrated the theoretical applicability and practical utility of health behaviour theory via the social cognitive approach in the public health crisis context. As expected in the theory, original TPB components (i.e. attitudes, subjective norms and perceived behavioural control) and an additional component (i.e. perceived risks) contributed to people's decisions on social distancing. One interesting finding was that, among the four predictors, subjective norms were the strongest determinants of social distancing behaviours. Moreover, as shown in Table  4 , subjective norms, among other factors, played a significant mediating role in the relationship between trust and social distancing behaviour. In the public health crisis management literature, individual factors, such as risk perceptions or self‐efficacy, were hypothesized to exert more impact on the adoption of preventive measures than social factors in a national cultural environment that emphasizes individualism (Cho & Lee,  2015 ). However, our findings highlighted the significant predictive power of social factors in terms of social distancing behaviour. As we noted above, such a pattern may be explained by the novel and uncertain situations created by COVID‐19 in the United States. The ambiguity and uncertainty of the crisis situation may encourage publics to use other people as references to decide whether or not to follow the same behaviour (e.g. Kim et al.,  2015 ). Moreover, in addition to the direct impact of subjective norms on behaviours, our findings showed that individuals' cognitive behaviours (i.e. perceived risks, attitudes and perceived behavioural control) also depended on how their important referents, such as family and friends, viewed the adoption of social distancing (see Table  4 for the results of direct and indirect effects). The findings once again highlighted the importance of social environments and social pressures in decision‐making in uncertain and ambiguous situations.

Results of direct and indirect effects of organizational trust on social cognitive factors in SEM model

Another contribution of this study was to expand key theoretical frameworks in health communication by integrating public relations research to understand public behaviours during a pandemic. The findings suggested that organizational trust significantly increased publics' perceived risks, norms and perceived behavioural control during an outbreak. However, trust in both organizations did not significantly affect publics' attitudes towards social distancing. Although we expected trust in government organizations to enable publics to understand the benefits of social distancing practices, this insignificant result may be explained by the American individualistic culture. Although publics trust organizations to address the public health crisis, they may not agree with social distancing practices, as such preventive measures may violate their beliefs about personal freedom and independence (Davis et al.,  2015 ). Therefore, such individual‐first thinking may discredit preventive measures that prioritize community benefits but constrain individual freedom (Davis et al.,  2015 ). As shown in Table  4 , however, it was found that normative beliefs acted as a significant mediator that increased the effect of organizational trust on publics' agreement towards social distancing practices. Such social reinforcement may help publics move beyond the individualistic frame of thinking and believe in the benefits of social distancing, thereby aligning with their trust in organizations. However, this assumption warrants further investigation by exploring the role of Americans' individualistic values in shaping social distancing behaviour. This finding suggested that, to understand publics' conflicting viewpoints and complicated motivations to engage in social distancing, examining the effectiveness of government‐ or health institution‐initiated efforts in reinforcing publics' favourable attitudes towards social distancing may be a worthy direction for future communications research.

In summary, by testing an integrative model of publics' health behaviours during a pandemic and incorporating organizational‐, social‐ and individual‐level antecedents, this study provided a satisfactory foundation for future interdisciplinary research on public relations and health communication, particularly in the context of a public health crisis.

The current study also provided important practical implications for managing a pandemic through strategic communication. Organizations' transparency is expected more than ever through direct inputs on issues that affect publics. Based on the tested model, organizations responsible for public health crises (i.e. the state government and health institutes) should provide relevant, accurate and timely information to help publics (re)build trust, which can enhance individuals' perceived risks and community norms and ultimately lead to desired behaviours, such as social distancing in this case. Health institutions, such as the CDC, should also provide opportunities for publics to participate in obtaining and creating information related to the crisis. This situation would create the impression that organizations prioritize publics' interests, which will encourage them to build trust and develop positive perceptions of the guidelines or actions of an institution. Meanwhile, state governments need to consult with public health and crisis communication experts and collaborate closely with health institutions to identify situations accurately, which will help them communicate the benefits of social distancing to publics clearly and effectively. Moreover, promotion programmes may consider perceived risks, attitudes, norms and perceived behavioural control related to social distancing. Given that social norms were the strongest predictors in this study, generating positive social pressure for individuals to follow social distancing instructions will likely be considerably effective in enhancing their recommended cognitive behaviour, thereby increasing the likelihood of practising social distancing. Thus, proposing programmes and messages that can help establish general prosocial distancing norms is essential.

6. LIMITATIONS AND FUTURE STUDIES

This study has several limitations that should be addressed. First, this study was based on cross‐sectional survey data collected in early April during the early stage of the stay‐at‐home order and lockdown. After the implementation of state‐led orders, public opinions on social distancing changed and became polarized with the occurrence of anti‐social distancing rallies across the nation (Corse & Calvert,  2020 ). In addition, the data were collected during the early stage of COVID‐19, which limited our choice of organizations (e.g. health institutes, local government) in this study. For example, although the CDC generally holds a communication leadership role in public health emergencies, its credibility may have been diminished as a result of its acquiescence to the administration's demands (Sun & Achenbach,  2020 ). A longitudinal design is thus needed for future studies to understand the dynamics of public responses to government communication and social distancing. Second, publics tend to use presidential communications as a crucial information source (Brenan,  2020 ). The significant impact of the word of the president, the White House, and the federal government was not examined in this study. Thus, future studies should investigate how transparent communication from the president and the federal government affects public perceptions and behaviours during a public health crisis. Third, though participation did not increase government trust, the notion of mutuality was a significant predictor of government trust in the South Korean context in a previous study (Kang et al.,  2018 ). This finding suggested possible cultural differences in terms of strategic communication effects. Given the nature of the COVID‐19 global pandemic, future research should explore and compare the effectiveness of communication in a global setting to enrich the understanding of strategic public health crisis communication. Finally, to delimit the scope of the study, our model included transparent communication and organizational trust as the key antecedents of individuals' social cognitive factors. Other variables in relation to individuals' risk perception (e.g. uncertainty, knowledge level) or communication through technology such as social media (Silver & Andrey,  2019 ; Zhao et al.,  2019 ) could also be examined as mediating or moderating factors in future studies.

CONFLICT OF INTEREST

The author declares that there is no conflict of interest.

Lee Y, Li J‐YQ. The role of communication transparency and organizational trust in publics' perceptions, attitudes and social distancing behaviour: A case study of the COVID‐19 outbreak . J Contingencies and Crisis Management . 2021; 29 :368–384. 10.1111/1468-5973.12354 [ CrossRef ] [ Google Scholar ]

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The Impact Of Effective Communication On Organizational Performance

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Ambo University , Fikre Fikadu Fufa

Communication for development is a broad cognitive field of enormous international, national and regional interest attracting attention as a special field of study by students and researchers across disciplines. All those involved in the analysis and application of communication for development - or what can broadly be termed ―development communication‖ - would probably agree that in essence development communication is the sharing of knowledge aimed at reaching a consensus for action that takes into account the interests, needs and capacities of all concerned. It is thus a social process. Communication media are important tools in achieving this process but their use is not an aim in itself—interpersonal communication too must play a fundamental role.

International Journal of Advance Research in Computer Science and Management Studies [IJARCSMS] ijarcsms.com

Dr. S H I N E David

Manju Singh

Benson James Lyimo

The main objective of this study was to assess the effective communication in attaining organizational goals; this study has been conducted for three main specific objectives. The first one was to investigate the influence of effective communication on employee performance objective in attaining organizational goals. The second objective was assess the effectiveness of staff objectives on attaining organization goals and lastly was to find out relation between change management objective and attainment of organizational goal, in Iringa regional commissioner office, Tanzania The study adopted both research methods, qualitative and quantitative approaches. Both were used so as to help the researcher to complement the weakness of each, therefore provide an extended room for triangulation of both instruments for data collection and approaches. Respondents were obtained by using Non-probability sampling. The sample comprised of 50 respondents. Data was collected through questionnaires, both open ended questionnaires and open ended questionnaires. The quantitative data was analyzed with the help of Microsoft Excel 2010 and Statistical Package for Social Science (SPSS) software program version 22 and were summarized in tables of frequencies, percentages, correlations, regression and charts. Study findings unveiled that effective communication creates mutual understanding between management and workers which helps in attainment of organization’s goals also management need to communicate with employees regularly to get feedback and offer suggestions in other to prevent confusion about future job assignments; this will help improve workers performance and organizational productivity. Thus the study recommends organization to embraces timely feedback and proper, immediate communication. Staff appraisal should also be improved so as to inform on areas of improvement and identify training needs/gaps. Communication and feedback should include elements of reward, commendation, recognition and praise. These elements reinforce behavior which in turn motivates staff to greater individual and organizational performance.

antony waihenya

The study was based on the role of communication in enhancing organizational growth. The objectives of the study was to determine the most preferred communication means used at equity bank, to determine the importance of communication at equity bank, to find out factors affecting communication channels at equity bank and to determine challenges faced by equity bank in facilitating efficient communication mode. The study was limited to Equity Bank Eldoret branch only. The study adopted a case study as a research design. The researcher used questionnaires to collect data from a sample size of 40 respondents out of targeted population of 80 respondents. The researcher used a stratified sampling technique then followed by a simple random sampling to come up with the sample size. Data was then analyzed and presented using descriptive statistics including frequency tables, and percentages. From the findings the study established that communication has a greater importance in enhancing organizational growth it lead to better understanding in the bank, it improves efficiency, it also leads to effective coordination and avoid loses. However, the company’s greater challenges such as financial resources being insufficient, competition from other companies and poor management. To overcome all these challenges the company has to train its employees on communication skills and training of personnel should be put in place as part of the recommendation of the study. Finally the study suggested that further research should be conducted on the effects of multi directional communication on organizational development. Also study should be carried on the best communication type an organization can adopt to gain competitive advantage.

shewayirga assalf

Euro Asia International Journals

There are varying views about Organizational Communication. Contingency approach assumes that organizational communication effects can be explained only in the context of the constraints of different contingencies But most thinkers opine that through communication, everyone knows his /her role place, and task within the organization and the different parts of that organization are adequately coordinated. When communication stops, organized activity ceases to exist, individual, uncoordinated activity returns. Communication is effective when members of an organization share information with each other and all parties involved are relatively clear about what this information means. Communication is not an end in itself but a means to an end. Proper communication lays the foundation of a sound organizational culture, builds high employee morale to the extent that in some cases listening the actual problem of the employees itself can give them the impression that proper action will be taken. Management has to ensure that it leaves the impression that communication efforts guarantee results.

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Effective Communication Case Study Analysis

Introduction Johnson & Johnson is one of the world’s biggest health care companies.

In the early eighties, the company faced a challenging task of responding to public relation crises. These crises were grave to an extent that they could spell the company collapse were they not handled with utmost care and creativity. Public relation and effective communication play a pivotal role in handling crises not only in companies but also in other organisations. The Johnson & Johnson Tylenol crisis case presents the real impact of public relation and effective communication in solving and changing public perception. Public perception is very important in maintaining customer loyalty on product as well as marketing.

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Effectiveness of Communication Effective communication is very important in running an organisation (Fielding, 2005). It involves sending of relevant information to the required person without any problem. There are several benefits of effective communication. These benefits include good relationship and good understanding among others. In an organisation, communication is critical in many ways. For instance, effective communication is used to motivate employees, change the public perception concerning a given product.

In the case of Johnson and Johnson , effective communication made it possible to regain the tarnished image of the company, which resulted out of Tylenol product death. The company used effective communication to explain what happed and to convince the public that it was not their mistake. In addition, effective communication made the public convinced by the company’s concern, which was done through advertisements that were designed to warn the public not to use the product until the cause of death was determined. This strategy actually worked to the best interest of the company. Different Public Targeted by the Company The different public involved were internal and external.

Johnson & Johnson had an obligation of convincing both the internal and external audience regarding the situation of where its original product, extra-strength Tylenol, had been allegedly used as a weapon to kill three people. Internal and External Public The recognition of the role of employees as stakeholders, with hom to communicate corporate crises, should be emphasized in any company. It should be noted that this can cause enormous pressure and ambivalence for any affected company and its staff. In order to avoid rumors, false information and public statements made without proof, all external and internal public have to be communicated with. Companies should never underestimate the role of effective communication during crisis (Daniela, Radebaugh, and Sullivan, 2011). This is because companies which ignore the importance of employee normally bear substantial economic damage due to the lack of trust, low morale, and the eventual loss of dedicated workforce.

The changing landscape in people’s management has called for the initiation and implementation of effective communication strategies aimed at increasing the levels of organizational performance (Armstrong, 2007). The role of people as a key ingredient in the realization of organizational goals forms the main reason behind their valued importance. A dissection of literature on HRM and effective communication shows that several companies employ various perspectives to achieve higher levels of employee satisfaction. Employees’ satisfaction is very important, more so during crisis. Impact of the Communication The communication by the company clarified the allegation which was made without investigation. In addition, effective communication helped in regaining public trust on the use of the product.

Moreover, effective communication was used to market the company despite the crisis. How the Communication was Handled by the Company The company did a very good job and provided a benchmark on how to handle public relation crisis. However, the message could have been communicated effectively The types of key tools available to carry out the public relations function include: Media Relations The company management led by its chairman Burke appeared on TV and radio, and explained the crisis of newspapers. In addition, media was given freedom to access the company premises and investigate the situation on the ground. This media relation played a bigger role in coming out of the crisis.

Media is quite important is creating a positive or negative impression, and therefore, the company’s good mediaa relation helped it in creating a positive impression on the public (Lordan, 2003). Media Tours The company also gave media an opportunity to tour its production plants and investigate any information concerning the crisis. Re-launch The company organized for a new package and re-launch of the product. The re-launch made the product have a new look with improved security feature for safety. This was significantly designed not only to gain the public trust but also to reinforce the message that contamination could have been the cause of the product poisoning.

Sponsorships The company decided to invite the investigative news program 60 Minutes to film its management strategy sessions for the new launch. This enhanced the company’s image among the people. Among the other public relations tools are: Newsletters The company also could produce newsletters explaining their goals, values, and the other relevant information targeted to enhance its positive image to the publicSpecial Events The company could also organize tournaments, family retreat, and free medical camp for the community to enhance its public relation program. Speaking Engagements The company could also directly engage the public through debates and speaking engagement. This is important in hearing the first hand information on consumers’ expectation and perception. Employee Relations Community Relations and Philanthropy.

The company had an opportunity of involving in community projects as well as taking part in philanthropic activities. This is a powerful move to create a great public relation. The activities can be in the form of a corporate social responsibility. In conclusion, Johnsons & Johnson managed the crisis very well and offered a great lesson to other businesses insightful information of how to handle effective communication and public relation subject.

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1. WHAT IS TECHNICAL COMMUNICATION?

1.4 Case Study: The Cost of Poor Communication

No one knows exactly how much poor communication costs business, industry and government each year, but estimates suggest billions.  In fact, a recent estimate claims that the cost in the U.S. alone are close to $4 billion annually! [1] Poorly-worded or inefficient emails, careless reading or listening to instructions, documents that go unread due to poor design, hastily presenting inaccurate information, sloppy proofreading — all of these examples result in inevitable costs. The problem is that these costs aren’t usually included on the corporate balance sheet at the end of each year; if they are not properly or clearly defined, the problems remain unsolved.

You may have seen the Project Management Tree Cartoon before ( Figure 1.4.1 ); it has been used and adapted widely to illustrate the perils of poor communication during a project.

The waste caused by imprecisely worded regulations or instructions, confusing emails, long-winded memos, ambiguously written contracts, and other examples of poor communication is not as easily identified as the losses caused by a bridge collapse or a flood. But the losses are just as real—in reduced productivity, inefficiency, and lost business. In more personal terms, the losses are measured in wasted time, work, money, and ultimately, professional recognition. In extreme cases, losses can be measured in property damage, injuries, and even deaths.

The following “case studies” show how poor communications can have real world costs and consequences. For example, consider the “ Comma Quirk ” in the Rogers Contract that cost $2 million. [3]   A small error in spelling a company name cost £8.8 million. [4]   Examine Edward Tufte’s discussion of the failed PowerPoint presentation that attempted to prevent the Columbia Space Shuttle disaster. [5] The failure of project managers and engineers to communicate effectively resulted in the deadly Hyatt Regency walkway collapse. [6]   The case studies below offer a few more examples that might be less extreme, but much more common.

In small groups, examine each “case” and determine the following:

• Define the rhetorical situation : Who is communicating to whom about what, how, and why? What was the goal of the communication in each case?
• Identify the communication error (poor task or audience analysis? Use of inappropriate language or style? Poor organization or formatting of information? Other?)
• Explain what costs/losses were incurred by this problem.
• Identify possible solution s or strategies that would have prevented the problem, and what benefits would be derived from implementing solutions or preventing the problem.

Present your findings in a brief, informal presentation to the class.

Exercises adapted from T.M Georges’ Analytical Writing for Science and Technology. [7]

CASE 1: The promising chemist who buried his results

Bruce, a research chemist for a major petro-chemical company, wrote a dense report about some new compounds he had synthesized in the laboratory from oil-refining by-products. The bulk of the report consisted of tables listing their chemical and physical properties, diagrams of their molecular structure, chemical formulas and data from toxicity tests. Buried at the end of the report was a casual speculation that one of the compounds might be a particularly safe and effective insecticide.

Seven years later, the same oil company launched a major research program to find more effective but environmentally safe insecticides. After six months of research, someone uncovered Bruce’s report and his toxicity tests. A few hours of further testing confirmed that one of Bruce’s compounds was the safe, economical insecticide they had been looking for.

Bruce had since left the company, because he felt that the importance of his research was not being appreciated.

CASE 2: The rejected current regulator proposal

The Acme Electric Company worked day and night to develop a new current regulator designed to cut the electric power consumption in aluminum plants by 35%. They knew that, although the competition was fierce, their regulator could be produced more affordably, was more reliable, and worked more efficiently than the competitors’ products.

The owner, eager to capture the market, personally but somewhat hastily put together a 120-page proposal to the three major aluminum manufacturers, recommending that the new Acme regulators be installed at all company plants.

She devoted the first 87 pages of the proposal to the mathematical theory and engineering design behind his new regulator, and the next 32 to descriptions of the new assembly line she planned to set up to produce regulators quickly. Buried in an appendix were the test results that compared her regulator’s performance with present models, and a poorly drawn graph showed the potential cost savings over 3 years.

The proposals did not receive any response. Acme Electric didn’t get the contracts, despite having the best product. Six months later, the company filed for bankruptcy.

CASE 3: The instruction manual the scared customers away

As one of the first to enter the field of office automation, Sagatec Software, Inc. had built a reputation for designing high-quality and user-friendly database and accounting programs for business and industry. When they decided to enter the word-processing market, their engineers designed an effective, versatile, and powerful program that Sagatec felt sure would outperform any competitor.

To be sure that their new word-processing program was accurately documented, Sagatec asked the senior program designer to supervise writing the instruction manual. The result was a thorough, accurate and precise description of every detail of the program’s operation.

When Sagatec began marketing its new word processor, cries for help flooded in from office workers who were so confused by the massive manual that they couldn’t even find out how to get started. Then several business journals reviewed the program and judged it “too complicated” and “difficult to learn.” After an impressive start, sales of the new word processing program plummeted.

Sagatec eventually put out a new, clearly written training guide that led new users step by step through introductory exercises and told them how to find commands quickly. But the rewrite cost Sagatec $350,000, a year’s lead in the market, and its reputation for producing easy-to-use business software.

CASE 4: One garbled memo – 26 baffled phone calls

Joanne supervised 36 professionals in 6 city libraries. To cut the costs of unnecessary overtime, she issued this one-sentence memo to her staff:

After the 36 copies were sent out, Joanne’s office received 26 phone calls asking what the memo meant. What the 10 people who didn’t call about the memo thought is uncertain. It took a week to clarify the new policy.

CASE 5: Big science — Little rhetoric

The following excerpt is from Carl Sagan’s book, The Demon-Haunted World: Science as a Candle in the Dark, [8] itself both a plea for and an excellent example of clear scientific communication:

The Superconducting Supercollider (SSC) would have been the preeminent instrument on the planet for probing the fine structure of matter and the nature of the early Universe. Its price tag was $10 to $15 billion. It was cancelled by Congress in 1993 after about $2 billion had been spent — a worst of both worlds outcome. But this debate was not, I think, mainly about declining interest in the support of science. Few in Congress understood what modern high-energy accelerators are for. They are not for weapons. They have no practical applications. They are for something that is, worrisomely from the point of view of many, called “the theory of everything.” Explanations that involve entities called quarks, charm, flavor, color, etc., sound as if physicists are being cute. The whole thing has an aura, in the view of at least some Congresspeople I’ve talked to, of “nerds gone wild” — which I suppose is an uncharitable way of describing curiosity-based science. No one asked to pay for this had the foggiest idea of what a Higgs boson is. I’ve read some of the material intended to justify the SSC. At the very end, some of it wasn’t too bad, but there was nothing that really addressed what the project was about on a level accessible to bright but skeptical non-physicists. If physicists are asking for 10 or 15 billion dollars to build a machine that has no practical value, at the very least they should make an extremely serious effort, with dazzling graphics, metaphors, and capable use of the English language, to justify their proposal. More than financial mismanagement, budgetary constraints, and political incompetence, I think this is the key to the failure of the SSC.

CASE 6: The co-op student who mixed up genres

Chris was simultaneously enrolled in a university writing course and working as a co-op student at the Widget Manufacturing plant. As part of his co-op work experience, Chris shadowed his supervisor/mentor on a safety inspection of the plant, and was asked to write up the results of the inspection in a compliance memo . In the same week, Chris’s writing instructor assigned the class to write a narrative essay based on some personal experience. Chris, trying to be efficient, thought that the plant visit experience could provide the basis for his essay assignment as well.

He wrote the essay first, because he was used to writing essays and was pretty good at it. He had never even seen a compliance memo, much less written one, so was not as confident about that task. He began the essay like this:

On June 1, 2018, I conducted a safety audit of the Widget Manufacturing plant in New City. The purpose of the audit was to ensure that all processes and activities in the plant adhere to safety and handling rules and policies outlined in the Workplace Safety Handbook and relevant government regulations. I was escorted on a 3-hour tour of the facility by…

Chris finished the essay and submitted it to his writing instructor. He then revised the essay slightly, keeping the introduction the same, and submitted it to his co-op supervisor. He “aced” the essay, getting an A grade, but his supervisor told him that the report was unacceptable and would have to be rewritten – especially the beginning, which should have clearly indicated whether or not the plant was in compliance with safety regulations. Chris was aghast! He had never heard of putting the “conclusion” at the beginning . He missed the company softball game that Saturday so he could rewrite the report to the satisfaction of his supervisor.

• J. Bernoff, "Bad writing costs business billions," Daily Beast , Oct. 16, 2016 [Online]. Available:  https://www.thedailybeast.com/bad-writing-costs-businesses-billions?ref=scroll ↵
• J. Reiter, "The 'Project Cartoon' root cause," Medium, 2 July 2019. Available: https://medium.com/@thx2001r/the-project-cartoon-root-cause-5e82e404ec8a ↵
• G. Robertson, “Comma quirk irks Rogers,” Globe and Mail , Aug. 6, 2006 [Online]. Available: https://www.theglobeandmail.com/report-on-business/comma-quirk-irks-rogers/article1101686/ ↵
• “The £8.8m typo: How one mistake killed a family business,” (28 Jan. 2015). The Guardian [online]. Available: https://www.theguardian.com/law/shortcuts/2015/jan/28/typo-how-one-mistake-killed-a-family-business-taylor-and-sons ↵
• E. Tufte, The Cognitive Style of PowerPoint , 2001 [Online]. Available: https://www.inf.ed.ac.uk/teaching/courses/pi/2016_2017/phil/tufte-powerpoint.pdf ↵
• C. McFadden, "Understanding the tragic Hyatt Regency walkway collapse," Interesting Engineering , July 4, 2017 [Online]: https://interestingengineering.com/understanding-hyatt-regency-walkway-collapse ↵
• T.M. Goerges (1996), Analytical Writing for Science and Technology [Online], Available: https://www.scribd.com/document/96822930/Analytical-Writing ↵
• C. Sagan, The Demon-Haunted World: Science as a Candle in the Dark, New York, NY: Random House, 1995. ↵

Technical Writing Essentials Copyright © 2019 by Suzan Last is licensed under a Creative Commons Attribution 4.0 International License , except where otherwise noted.

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Effective Communication in Organizations: Case Study Presentation

Poor team building policies.

Poor implementation of team building policies in the workplace affects the morale of employees. As a result, the productivity of an organization is affected negatively. Maggie is one of the employees who possess weak communication skills. In an effort to overcome this problem, the following strategies have been proposed:

• Maggie should be paired with John so that he can help her to enhance her communications skills through team spirit.
• An open communication network in the workplace should be developed (Freeman 1999, p. 40) so that employees such as Maggie can be able to improve their communications skills.

Organizational policies

Employees in the organization cannot communicate directly with the company’s board of directors. Some of the employees are already intimidated when they have to talk to the the management, and Maggie is no exception. In order to overcome this problem, it has been proposed that:

• The company should adopt an open policy form of communication so that the top management and employees such as Maggie can be able to communicate with as little resistance as possible.

Deaf Employees

It has emerged that Maggie has a weak linguistic background. The proposed solutions to overcome this challenge include:

• Maggie should be paired with Lydia so that she can assist her to internalize information correctly. In the process, her language skills will improve.
• Maggie should be provided with linguistic materials so that after reading them, her language skills may improve.
• Maggie should also be paired with Bito as he can assist her to improve her language skills.

Poor upward and downward communication

Poor upward and downward communication was evident at the organization. This is affecting the productivity of some employees such as Maggie who find it hard to communicate with her fellow employees and her superior due to poor communication skills. In order to overcome this challenge, it was proposed that:

• Maggie should be assigned tasks that involve interacting with people frequently so that she can improve her language skills.
• Maggie should be provided with reading materials on how to improve communication skills.

Fielding, M. (2006). Effective communication in organisations: preparing messages that communicate (3rd ed.). Lansdowne, Cape Town: Juta Academic.

Freeman, R. M. (1999). Correctional organization and management: public policy challenges, behavior , and structure . Boston: Butterworth-Heinemann.

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Research: How Different Fields Are Using GenAI to Redefine Roles

• Maryam Alavi

Examples from customer support, management consulting, professional writing, legal analysis, and software and technology.

The interactive, conversational, analytical, and generative features of GenAI offer support for creativity, problem-solving, and processing and digestion of large bodies of information. Therefore, these features can act as cognitive resources for knowledge workers. Moreover, the capabilities of GenAI can mitigate various hindrances to effective performance that knowledge workers may encounter in their jobs, including time pressure, gaps in knowledge and skills, and negative feelings (such as boredom stemming from repetitive tasks or frustration arising from interactions with dissatisfied customers). Empirical research and field observations have already begun to reveal the value of GenAI capabilities and their potential for job crafting.

There is an expectation that implementing new and emerging Generative AI (GenAI) tools enhances the effectiveness and competitiveness of organizations. This belief is evidenced by current and planned investments in GenAI tools, especially by firms in knowledge-intensive industries such as finance, healthcare, and entertainment, among others. According to forecasts, enterprise spending on GenAI will increase by two-fold in 2024 and grow to $151.1 billion by 2027 .

• Maryam Alavi is the Elizabeth D. & Thomas M. Holder Chair & Professor of IT Management, Scheller College of Business, Georgia Institute of Technology .

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• Open access
• Published: 27 March 2024

Effectiveness of a standardized scenario in teaching the management of pediatric diabetic ketoacidosis (DKA) to residents: a simulation cross-sectional study

• Alice Monzani 1 ,
• Elena Corti 1 ,
• Antonio Scalogna 2 ,
• Silvia Savastio 1 ,
• Erica Pozzi 1 ,
• Pier Paolo Sainaghi 3 ,
• Francesco Della Corte 2 , 3 &
• Ivana Rabbone 1  

BMC Medical Education volume  24 , Article number:  345 ( 2024 ) Cite this article

Metrics details

Diabetic ketoacidosis (DKA) is a frequent manifestation at the onset of type 1 diabetes mellitus in children, possibly associated with a wide range of complications, often as a consequence of wrong or delayed treatment. Due to its complex and risky management, direct exposure to real situations alone is not sufficient to achieve adequate skills in pediatric DKA for residents. Simulation could be a valuable aid, allowing to practice a standardized scenario of a complex real-world situation. We aimed to test the effectiveness of a standardized scenario of pediatric DKA in teaching its recognition and treatment.

We develop a standardized scenario able to guide step-by-step the learners through the flowchart of DKA management and considering alternative evolutions in the case of possible deviations from guidelines. It was a real-life simulation with the use of a high-fidelity pediatric simulator. It was played by 78 pediatrics 20 and emergency medicine residents. At the end of the simulation, a validated questionnaire was administered to collect feedback from participants regarding the impact of the simulation on learning. All materials to reproduce the DKA scenario are provided.

Overall, the scenario was rated as realistic (mean score 4.37 ± 0.68, from 1 to 5) and relevant to professional training (4.72 ± 0.47), useful in increasing confidence in interpreting laboratory tests (3.97 ± 0.65), group organization and communication strategies (3.49 ± 0.94), and managing the treatment of DKA (3.46 ± 0.92).

Conclusions

The use of a standardized scenario of pediatric DKA may be a valid tool to reinforce theoretical knowledge in residents, both in pediatrics and in emergency medicine, and to directly and safely practice pediatric DKA management.

Peer Review reports

Diabetic ketoacidosis (DKA) is the most common emergency related to acute hyperglycemia in patients with type 1 diabetes mellitus (T1DM), being the leading cause of morbidity and mortality in these patients. It is characterized by a severe metabolic derangement, due to the lack of insulin and increased circulating counter-regulatory hormones, which progressively leads to acidosis and dehydration, eventually evolving to coma and death if not promptly and adequately treated [ 1 , 3 ].

The diagnosis of DKA is based on the presence of hyperglycemia (blood glucose > 11 mmol/L or 200 mg/dL), ketosis (serum β-hydroxybutyrate concentration > 3 mmol/L, or ketonuria ≥ 2+), and metabolic acidosis (pH < 7.30 or serum HCO3- < 18 mmol/L), accompanied by a varying degree of hypovolemia [ 2 , 3 , 4 ].

The frequency of DKA at T1DM onset varies approximately between 15% and 70% in Europe and North America. The risk of DKA in patients already diagnosed with T1DM ranges from 1 to 10% per patient per year [ 2 , 3 , 4 , 5 ].

Fluid and electrolyte administration and insulin therapy are the basic steps of DKA therapy. The goal is to correct acidosis, ketosis, and electrolyte imbalance, restore normal circulatory volume and blood sugar level, and avoid possible complications of DKA [ 2 , 3 , 4 ]. Indeed, DKA is associated with a wide range of complications, if not properly and timely managed. Among them, hypokalemia or other electrolyte changes, hypoglycemia, and more fearsome, cerebral edema, which in its severe form occurs in 0.3–0.9% of pediatric DKAs. Cerebral edema has a high mortality (21–24%) and permanent neurological morbidity (20–26%), being responsible for 70–80% of DKA deaths [ 2 , 3 , 4 ]. Management of young patients with DKA should occur in a hub center experienced in pediatric DKA or, if not possible, arrangements should be made to contact a physician experienced in DKA [ 3 , 4 , 6 ]. The first assessment of pediatric patients with DKA is frequently performed in the emergency department, where not only pediatricians but also emergency medicine physicians may be involved. The proper management of DKA is outlined by national and international recommendations [ 3 , 4 , 7 ]. Proper application of guidelines in emergency situations can be complicated and error-prone because they are highly time-dependent and due to the emotional burden and different management of pediatric DKA compared with adults [ 2 , 4 , 8 ]. Nonetheless, only strict adherence to DKA management guidelines can reduce deviations and errors, related to a worse clinical outcome [ 3 , 6 , 9 ].

For these reasons, simulation could be a valuable aid, allowing to practice a standardized scenario of a complex real-world situation, with the purpose of facilitating learning through immersion, reflection, feedback, and practice, without the risks that such a situation would entail in reality [ 8 , 10 , 11 ]. In this study, we tested the effectiveness of a standardized scenario of pediatric DKA that can be used to improve its recognition and treatment, according to current international guidelines [ 3 ].

A standardized simulation scenario was developed with the collaboration of pediatric diabetologists, pediatric simulation experts, and medical simulation technicians. The scenario was constructed based on real cases, reworked according to teaching needs, learning, and educational objectives (Appendix A ) (see Video, Additional file 2, which shows the setting of the scenario). All subjects provided written informed consent to participate to the simulation study and to the tape-recording of scenarios and their publication. The need for ethics approval was deemed unnecessary by the local Ethics Committee (Comitato Etico Territoriale Interaziendale AOU Maggiore della Carità di Novara) because the study has negligible risks involving only health care professionals for education purposes and not involving patients.

The simulations were performed by pediatrics and emergency medicine residents of University of Piemonte Orientale to evaluate its appropriateness and teaching effectiveness. All participants (both pediatrics and emergency medicine residents) attended a theoretical lesson about the principles of pediatric DKA management in the past 6 months. The simulation sessions occurred at the Interdepartmental Centre for Innovative Didactics and Simulation in Medicine and Health Professions of the University of Piemonte Orientale (SIMNOVA) from January to June 2022. The materials, environment, and personnel involved in the simulation are detailed in Appendix B . Before starting the simulation session, participants were divided into teams of 3 members. All teams attended the same introductory briefing in which they were shown the simulation environment, the high-fidelity simulator (SimJunior, Laerdal, Wappingers Falls, NY, USA), and the available equipment. Each team was given a few minutes to organize roles, then they were given the initial information regarding the patient and the simulation was started (the scenario is described in appendices C , D , and E ).

Participants were expected to collect the patient’s history, perform a physical examination, and request appropriate laboratory tests to make a diagnosis of DKA and initiate the appropriate treatment. Laboratory results, chest X-ray, ECG were provided upon participants’ request during the scenario, according to the performed actions. The examination results are shown in Figs.  1 – 11 .

Blood count and coagulation at T0

T0 biochemistry results

T0 Urine analysis

T0 blood gas analysis

T2 blood gas analysis

T4 blood gas analysis

T6 blood gas analysis

Chest X-ray

T0 brain CT

Cerebral edema brain CT

In the real world, the scenario would take 6 h, but in the simulation time transitions between one time point and the next one occurred once the team had performed the critical actions of that time or when they declared they would not perform any further action. Time transitions were announced by a microphone from the control room. If deviations from the protocol occurred, we provided minor scenarios evolving into complications: cerebral edema, hypoglycemia, hypokalemia (information regarding the various simulation times and deviation from the main scenario due to errors are described in Appendices E – I ).

At the end of the simulation, a validated scenario evaluation questionnaire was provided [ 12 ] (Appendix J ). The questionnaire was used to collect feedback from participants regarding the simulation. The questionnaire consisted of 13 statements that could be rated using a Likert scale (from 1: strongly disagree to 5: strongly agree), and three open-ended questions that allowed participants to give a freer evaluation of the scenario. In general, the questionnaire’s aims were to assess whether the scenario was realistic and useful for improving professional skills, the impact of the simulation on learning, the usefulness of debriefing, and how the scenario impacted certain skills.

Statistical analysis

The scores for each item of the questionnaire are expressed as mean and standard deviation (SD). Groups were compared using the Mann–Whitney U test. A p-value < 0.05 was considered statistically significant. All analyses were performed using SPSS version 21.0 (IBM, New York, NY, USA).

Briefing content

Mark is a 10-year-old boy, anamnestic weight 28 kg, who arrives at the emergency department accompanied by his mother. The mother reports that the child has had a cold in the previous few days and today has nasal congestion, vomiting, and is particularly tired. The mother also noticed that the child urinates a lot in the past few days. At first look, he appears tachypneic and dehydrated, with fuzziness. If requested by participants, other information can be provided as in Appendix C . Initial simulator settings and changes in vital parameters at different time points according to the actions performed by participants are reported in Appendix D .

The scenario was played by 78 pediatrics and 20 emergency medicine residents. At the end of the simulation, all participants filled the scenario evaluation questionnaire (Table  1 ).

Overall, the scenario was rated as realistic (mean score 4.37 ± 0.68, on a scale from 1 to 5) and relevant to professional training (mean score 4.72 ± 0.47), but less effective in teaching basic resuscitation techniques (mean score 3.27 ± 1.16). The debriefing, group discussion and facilitators’ activity were all rated positively (mean scores: 4.49 ± 0.74, 4.41 ± 0.67, and 4.34 ± 0.82, respectively).

The scenario appeared useful in increasing confidence in interpreting laboratory tests in cases of DKA (mean score 3.97 ± 0.65), group organization and communication strategies (mean score 3.49 ± 0.94), and managing the treatment of DKA (mean score 3.46 ± 0.92).

When comparing pediatrics residents and emergency medicine residents evaluations, pediatrics residents rated items number 3, 6, 7, 8, 12, and 13 significantly higher than emergency medicine residents.

When asked how this simulation would change the way they would work in the future, the most frequent responses were to pay more attention to guidelines, to have a flowchart to follow, and to pay more attention to the communication among colleagues and with nursing staff (in particular, the main problems were the lack of closed-loop communication, followed by generic and not individually addressed directives and instructions given by the team leader). (Fig.  12 , in the word cloud the size of the word is proportional to their frequency).

Cloud representation of the answers to the question: “Can you list/describe 1 or more ways this session will change how you do your job?”

When asked how the simulation could be improved, the main answers were: to set it up to give more time for clinical reasoning and to provide educational material on pediatric DKA in advance.

DKA is a frequent manifestation at the onset of T1DM in pediatric age, possibly associated with a wide range of complications, many of which may be iatrogenic in nature, as a consequence of wrong or delayed treatment. Thus, early diagnosis and proper treatment are strong predictors of positive outcomes, while deviations from guidelines are associated with a higher number of complications. As reported by Mendpara et al. [ 9 ] in the DKA management in a single center experience, at least one deviation from ISPAD 2018 guidelines was observed in 82.9% of cases and two or more errors were made in 40%, including: failure to administer the initial fluid bolus, expected in case of shock, in 5.7% of cases; excessive fluid administration in 11.4%; insufficient initial fluid administration in 35.7%; inadequate initial potassium supplementation in 18.6%; delayed response to falling serum potassium concentration (21.4%) and blood glucose (34.4%); erroneous insulin administration in 27.1%. The observed complications were hypokalemia (27.1%), hypoglycemia (35.7%), and cerebral edema (24.3%).

To possibly avoid such complications, teaching residents, who will be future clinicians directly involved in managing children with DKA, the proper management of pediatric DKA in a simulation setting seems to be a safe way to practice strict adherence to current international guidelines. In this regard, we develop a standardized scenario that aims to guide step-by-step the learners through the flowchart of DKA management and, at the same time, considers alternative evolutions in the case of possible deviations from guidelines.

We chose to test such a scenario not only with pediatrics residents, but also with emergency medicine residents, because not rarely the management of children with DKA occurs in emergency departments, and not only pediatricians but also emergency medicine physicians are involved in it. Due to its complex and risky management, direct exposure to real clinical situations alone is not sufficient to achieve adequate skills in pediatric DKA for residents, both in pediatrics and in emergency medicine. For these reasons, the use of simulation with the purpose of facilitating learning through immersion, reflection, feedback, and practice, without the risks of real-world experience, could prove useful.

Our study confirmed that this simulation scenario was on the whole positively judged in teaching the strict application of current guidelines on the management of pediatric DKA. It allowed participants to strengthen their confidence in interpreting laboratory data and setting rehydration and insulin therapy in the context of pediatric DKA. The simulation also allowed participants to develop non-technical skills (teamwork, leadership, communication, and clarity in assigning roles), and to understand the importance of accurate and effective communication among colleagues, with the nursing staff, and with parents in an emergency setting.

The main limitation of the described case scenario is its standardized structure, an intrinsic characteristic of simulation-based learning. Still, it can also be considered a point of strength, allowing the participants to become confident with the strict application of the algorithm, leaving variations to the case scenario (different severity and dehydration rates, patient weight and vitals…) to further steps of the teaching process.

The use of a standardized scenario of pediatric DKA may be a valid tool to go through all the steps of pediatric DKA management and thus can be effectively used to reinforce theoretical knowledge in residents and to directly and safely practice pediatric DKA management.

Data availability

All data generated or analysed during this study are included in this published article [and its supplementary information files].

Abbreviations

diabetic ketoacidosis

type 1 diabetes mellitus

International Society for Pediatric and Adolescent Diabetes

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Acknowledgements

The authors would thank the residents who took part in the simulations.

This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

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Division of Paediatrics, Department of Health Sciences, University of Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy

Alice Monzani, Elena Corti, Silvia Savastio, Erica Pozzi & Ivana Rabbone

SIMNOVA Interdepartmental Centre for Innovative Learning and Simulation in Medicine and Allied Health Professions, University of Piemonte Orientale, via Lanino 1, 28100, Novara, Italy

Antonio Scalogna & Francesco Della Corte

Department of Translational Medicine, University of Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy

Pier Paolo Sainaghi & Francesco Della Corte

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Contributions

AM, AS, and IR conceptualized the study. AM, EC, AS, SS, EP, and IR developed the scenario, performed the simulations and collected the data; AM, EC, AS, and IR analyzed and interpreted the data. AM, EC, PPS, FDC, and IR wrote the manuscript. All authors read and approved the final manuscript.

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Correspondence to Alice Monzani .

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Ethics approval and consent to participate.

All subjects provided written informed consent to participate to the simulation study and to the tape-recording of scenarios. The need for ethics approval was deemed unnecessary by the local Ethics Committee (Comitato Etico Territoriale Interaziendale AOU Maggiore della Carità di Novara) because the study has negligible risks involving only health care professionals for education purposes and not involving patients.

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All subjects provided written informed consent for publication of collected data and recorded scenarios.

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The authors declare no competing interests.

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Monzani, A., Corti, E., Scalogna, A. et al. Effectiveness of a standardized scenario in teaching the management of pediatric diabetic ketoacidosis (DKA) to residents: a simulation cross-sectional study. BMC Med Educ 24 , 345 (2024). https://doi.org/10.1186/s12909-024-05334-0

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Received : 17 October 2023

Accepted : 20 March 2024

Published : 27 March 2024

DOI : https://doi.org/10.1186/s12909-024-05334-0

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