JOURNAL OF BUSINESS AND PSYCHOLOGY Vol. 15, No. 2, Winter 2000

PERSONALITY AND COMMUNICATION SKILLS AS PREDICTORS OF HOSPICE NURSE PERFORMANCE Ronald E. Riggio Claremont McKenna College

Shelby J. Taylor University of California, Riverside

ABSTRACT: Based on a detailed job analysis, job-related personality dimensions and communication skills were used as predictors of hospice nurse performance. In particular, it was predicted that communication/social competence and certain dimensions of empathy (empathic concern, perspective-taking) would be positively related to hospice nurse performance, and that another type of empathy, personal distress, and trait dogmatism would be negatively associated with performance. Ninety-two hospice nurses were administered the battery of tests, and “file drawer” assessments of their performance were obtained. Possession of communication/social competence and certain dimensions of empathy led to good prediction of job performance. Implications for personnel screening and selection are discussed.

The past ten years has seen a resurgence in interest in using personality measures to predict job performance. Meta-analytic reviews have suggested that measures of certain personality traits, such as conscientiousness, dependability, agreeableness, and extraversion, are reasonably good predictors of job performance in various occupational groups, including managerial personnel (Barrick & Mount, 1991; Hough, Eaton, Dunnette, Kamp, & McCloy, 1990). In fact, it has been suggested that many or all of the core “Big Five” personality factors (i.e., Extraversion, Agreeableness, Conscientiousness, Emotional Stability, Openness to ExPortions of this paper were presented at the Society for Industrial and Organizational Psychology (SIOP) conference in San Diego, CA, April, 1996. The authors would like to thank David Bruesehoff for his assistance. Address correspondence to Ronald E. Riggio, Kravis Leadership Institute, Department of Psychology, Claremont McKenna College, 850 Columbia Avenue, Claremont, CA 91711. 351

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perience; see Costa & McCrae, 1985) might be useful in predicting effective work performance (Barrick & Mount, 1993). While general personality constructs, such as those represented in the Big Five taxonomy, may indeed be predictive of performance in a variety of occupations, there is merit in exploring how other dimensions of personality, and how personality-related dimensions such as the possession of communication skills or social competence, predict job performance. Moreover, there is evidence that personality characteristics may be even better predictors of job performance if the personality characteristics assessed are derived from a thorough analysis of the requirements for the specific job or occupation (Robertson & Kinder, 1993; Tett, Jackson, & Rothstein, 1991). Thus, the present exploratory investigation was an attempt to identify the personality dimensions, and other individual difference characteristics, that would be predictive of job success for a specific occupation, that of hospice nurse.

CHARACTERISTICS ASSOCIATED WITH HOSPICE NURSE PERFORMANCE In many ways, the position of hospice nurse is similar to other nurses and health care providers. For example, hospice nurses need to have sound technical and general nursing skills, and must show concern for the well-being of their patients. However, there are many unique characteristics associated with hospice nurses. For example, while nurses and other hospital medical personnel focus primarily on helping patients to get well, hospice workers administer to the physical and psychological needs of the dying patient, and to the emotional and psychological needs of the patient’s family. For example, Petrosino (1985) found that dealing with family members’ emotional difficulties is one of the prime work-related challenges of hospice nurses. In fact, hospice workers spend much more time communicating with family members than do traditional nurses (Hull, 1991; Reisetter & Thomas, 1986). Other aspects of communication critical for hospice nurse effectiveness are assertiveness and the ability to coordinate efforts with the other members of the caregiving team. For instance, Amenta (1984) found that hospice nurses were more assertive and forthright than were traditional nurses. Lafer (1989) found that hospice workers’ “flexibility” to meet the changing needs of hospice patients and their families predicted successful work performance. Effective communication is considered to be so important to hospice nursing, that it is often included in operational definitions of quality hospice care (Brockopp, King, & Hamilton, 1991). As with all caregiving personnel, effective hospice nurses must have empathy for their patients and family members, and an appreciation of

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their needs and concerns. Thus, empathy is another personality construct theoretically linked to effective hospice worker performance. Yet, research on empathy indicates that there are different definitions of empathy (e.g., Hogan, 1969; Mehrabian & Epstein, 1972), and that the construct of empathy is multidimensional (Davis, 1983; Riggio, Tucker, & Coffaro, 1989). One popular model of empathy, Davis’ (1983) multidimensional conception of empathy, indicates that there are at least three distinct types of empathy: Perspective-Taking—the ability to cognitively identify with another and see his or her perspective; Empathic Concern—an understanding of and concern for the feelings of others; and Personal Distress—empathy associated with vicariously experiencing another’s emotional state. From Davis’ model, the first two types of empathy, Perspective-Taking and Empathic Concern, should be theoretically related to hospice nurse performance. However, the third type of empathy, Personal Distress, may actually be harmful to performance as a hospice nurse. Identifying too closely with the dying patient, vicariously experiencing the patient’s pain and anxiety, may impair hospice nurse performance, and lead to worker stress and job burnout. In fact, job-related stress is often mentioned as one of the prime challenges faced by hospice workers (Munley, 1985; Riordan & Saltzer, 1992). The present study is a report on the use of standardized measures of communication skill and relevant personality characteristics as predictors of hospice nurse performance. Specifically, we were interested in whether self-report measures of communication/social skills, dimensions of empathy, and other relevant personality dimensions were predictive of job performance of hospice nurses. It was anticipated that hospice nurse performance would be positively correlated with possession of communication skills, as measured by a self-report index of social/communication skills, and positively correlated with two types of empathy: PerspectiveTaking and Empathic Concern. It was also predicted that hospice nurse performance would be negatively correlated with a third type of empathy, Personal Distress, and negatively correlated with a measure of psychological “inflexibility”—a self-report scale of dogmatism. Moreover, it was anticipated that a combination of these various predictors would account for a substantial proportion of variance in performance via regression analysis, due to the relative independence of these predictors.

METHOD Participants Participants were 92 hospice nurses employed by the same Southern California-based hospice organization. Participation was voluntary, al-

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though participants had to have been employed for at least 30 days to be eligible. The 92 nurses represented 70 percent of the nurses employed by this hospice organization. Procedure This project was constrained in certain ways by the client organization. The organization was interested in using only self-report, personality-based instruments to predict job performance. The eventual goal was to determine if personality dimensions could be used in the screening and selection of hospice nurses. A job analysis for the position of hospice nurse was conducted. The job analysis included a thorough literature review of research on hospice nurses, a review of existing performance appraisal instruments for hospice nurses, with particular attention paid to performance dimensions that had clear links to personality traits (e.g., “is concerned about patients’ welfare”; “is responsive to patients and family members”). Interviews with subject matter experts (SMEs), including the assistant human resources manager who was responsible for developing job information for hospice nurses, incumbent hospice nurses and hospice nursing supervisors. The job analysis used a critical incidents approach, asking these SMEs about particular instances of exceptional and poor hospice nurse performance. From this analysis, the authors identified a number of personality and skill dimensions that were presumably associated with performance of hospice nurses. The experts were then presented with a list of these dimensions and asked to select the most important dimensions. Communication skills and empathy were the most often mentioned characteristics of hospice nurses, while experts mentioned that nurses who become “overinvolved” with patients—getting too emotionally involved—eventually “burn out” and leave the profession, and that persons who are too “rigid” do not make good hospice nurses. Using the information obtained from this job analysis, the authors attempted to choose predictor measures to represent these dimensions. An additional constraint was brevity, since the client organization did not want lengthy self-report measures. It was determined that the first author’s self-report measure of communication skill/competence, the Social Skills Inventory (SSI; Riggio, 1989) would be used to assess overall communication skill. In addition, Davis’ Interpersonal Reactivity Index (IRI: Davis, 1980), a multidimensional empathy scale, seemed to measure both the “positive” forms of empathy (subscales labeled “Perspective-Taking” and “Empathic Concern”), and the reported “emotional overinvolvement”—a concept consistent with the IRI subscale labeled “Personal Distress.” Finally, the authors selected Rokeach’s Dogmatism Scale (RDS; Rokeach, 1960), to measure hospice nurse “rigidness.”

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Predictors All participants were administered each of the following instruments, in groups, at one of seven different company locations. Participants were told that the purpose was to determine the characteristics of effective hospice nursing, and that their responses would be held in strict confidence and not affect their employment in any way. Participants were allowed one hour to complete the measures. All participants were able to complete the instruments within the specified time. The Social Skills Inventory is a 90-item, self-report measure of basic social/communication skills. While the SSI measures 6 basic dimensions of communication skill, corresponding to skills in sending, receiving, and regulating both verbal and nonverbal communication, the total score on the SSI is an indicator of possession of overall communication skill or communication/social competence (Riggio, 1986; Riggio, Messamer, & Throckmorton, 1991). The alpha coefficient for the total score on the SSI for this group of workers was .88. Research evidence suggests that the scale scores on the SSI correlate with communication skills ratings made by trained raters, and with behavioral measures of communication skill, such as abilities to encode and decode facial expressions of emotion (see Riggio, 1989, 1992, in press; Tucker & Riggio, 1988, for overviews). The Interpersonal Reactivity Index is a 28-item self-report measure that assesses four types of empathy, three of which are relevant for this study: Perspective-Taking, Empathic Concern, and Personal Distress. Coefficient alphas for the three IRI subscales were: .81 for PerspectiveTaking (7 items); .82 for Empathic Concern (7 items), and .67 for Personal Distress (7 items). Rokeach Dogmatism Scale is a 35-item self-report instrument that measures the tendency of persons to be closed-minded, authoritarian, rigid, and intolerant of understanding the feelings and motives of others. Alpha coefficient for the RDS was .95.

Assessments of Worker Performance An attempt was made to have each hospice nurse participant’s nursing supervisor evaluate performance. However, during the course of the project, and after the administration of the personality measures, some concern arose among the employees about the purposes of the project. As a result, all supervisors gave extremely positive evaluations of nearly all of the hospice nurses. With virtually no variance in the supervisors’ performance ratings, an alternative method of measuring performance was needed. Therefore, “file drawer” assessments of overall work performance were made. A detailed, one-page performance appraisal form was

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created based on the job analysis conducted for hospice nurses. This instrument consisted of ratings on 26 performance-related dimensions, ranging from ratings of “dependability” and “professional development” to ratings of “quality of paperwork” and “quality of interactions with patients and family members.” The Director of Human Resources and the second author, who both had extensive experience in evaluating performance records, reviewed each nurse’s personnel file and independently made evaluations on the performance appraisal instrument. Both raters were blind as to the personality scores of the nurses. An acceptable alpha coefficient for the 26 items (α = .75) was obtained, so an average of all items was obtained for each rater. The zero order correlation between the mean ratings for the two raters was r = .66. An average of the two ratings was then used for the final assessment of hospice nurse performance.

RESULTS Table 1 presents the zero order correlations among the various predictor variables and between the predictor variables and the composite rating of hospice nurse performance. As anticipated, there were some significant correlations among the predictor variables. Specifically, scores on communication skill/competence (SSI total score) were positively correlated with scores on the “positive” dimensions of empathy (Perspective-Taking and Empathic Concern), and negatively correlated Table 1 Zero Order Correlations and Regression Equation of Predictor Variables and an Index of Hospice Nurse Performance (n = 92)

Performance SSI-Total IRI-PT IRI-EC IRI-PD

SSI-Tot IRI-PD RDS

SSI-Total

IRI-PT

IRI-EC

IRI-PD

RDS

.28** —

.12 .29** —

.08 .24* .38** —

−.24* −.23* −.03 −.05 —

−.08 −.21* −.13 −.08 .28**

Mult. R

Rsq

F

Sig F

Rsq Ch

.284 .337 .347

.081 .114 .121

7.90 5.70 4.02

.006 .005 .010

.081 .033 .007

Performance = .28 SSI-Tot + (−.19) IRI-PD + (−.09) RDS. Multiple R = .35 Rsq = .12 Adj. Rsq = .09 * p < .05; **p < .01.

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with Personal Distress and Dogmatism. However, these correlations were not large, and indicate that these predictors are still somewhat independent. In looking at the relationships between the predictors and performance, the only significant zero order correlations were between total score on the SSI and the IRI Personal Distress scale, such that greater possession of social/communication skills and less personal distress were associated with effective hospice nurse performance. Correlations between the other two IRI scales, Perspective-Taking and Empathic Concern, and between the Rokeach Dogmatism Scale and rated performance were in the predicted directions, but did not reach statistical significance. A stepwise regression analysis was conducted regressing the overall performance rating on the various predictor variables. Results of the regression analysis indicated that a combination of total score on the SSI, and reversed scores on the IRI Personal Distress scale and the Rokeach Dogmatism Scale led to significant prediction of hospice nurse performance, accounting for about 9 percent of the variance in rated performance (see Table 1).

DISCUSSION The results of this study indicate that possession of communication skills and certain personality dimensions do indeed predict performance of hospice nurses. Specifically, it was found that a global, self-report index of social/communication skills was positively associated with file drawer assessments of hospice nurse performance, while high levels of “personal distress” and dogmatism, were inversely related to hospice nurse performance. In combination, these three predictors accounted for a reasonable amount of variance in rated hospice nurse performance. While these findings are interesting, the implications of this line of research are potentially more important. First, these results suggest that lack of communication skill, and certain personality dimensions, such as the tendency to “over-identify” with another’s emotional distress and psychological “inflexibility,” as represented respectively by the personal distress and dogmatism scales, may impair performance of hospice nurses. This has relevance for the screening and selection of nurses for hospice work (and perhaps for nursing work in general). Another implication of this research involves the use of selected selfreport, individual difference measures of personality and communication skill—instruments that have been used primarily as research tools—for personnel evaluation and screening. These particular instruments were selected based on a job analysis that indicated that ability to communi-

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cate, and certain “types” of empathy (i.e., empathic concern, perspectivetaking) seemed to be related to success as a hospice worker. However, hospice workers and supervisors who were interviewed as part of the job analysis emphasized that hospice nurses who became “overinvolved” with their patients—vicariously experiencing the negative emotions of their patients—seemed to be less effective caregivers. Thus, the results of this job analysis seemed to fit well with both the first author’s work in measuring communication competence, and with Davis’ (1980, 1983) work on multidimensional empathy. As a result, some rather non-conventional personality measures were selected for use as predictors of hospice nurse performance. While the correlations between these personality measures and rated performance were significant in many cases, it is conceivable that the measure of personal distress empathy would be a stronger predictor of hospice worker burnout and subsequent rates of absenteeism and turnover. Unfortunately, we were not allowed to conduct follow-up studies with these hospice workers. As suggested by meta-analyses of personality predictors of job performance (i.e., Robertson & Kinder, 1993; Tett, Jackson, & Rothstein, 1991), prediction of job performance may be enhanced when predictors are chosen based on job analyses for the specific positions being assessed. Moreover, identifying specific measures of individual differences that have good measurement properties, but may be underutilized in personnel evaluation, has merit. Recent research has suggested that the Big Five dimensions of personality is a useful framework for personality predictors of job performance in many occupations (Barrick & Mount, 1991). Yet, there are limitations to such a global approach (see Hough & Schneider, 1996). It may be that using psychometrically sound measures of specific personality and skill dimensions, “tailored” to fit specific job categories, will, under certain circumstances, have advantages over using global personality instruments.

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