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Effects of cultural shock on foreign health care professionals: An analysis of key factors

Rakesh Guru, Muhammad A Siddiqui, Zeeshan Ahmed, Adeel Ahmed Khan.

Abstract
This review is based upon the foreign health care professionals (FHCP) who go to various developed countries (United Kingdom, United States of America, Australia, Germany and France) from developing countries (India, Pakistan, Africa, Philippines etc) for work to have a better life style, good income, more opportunities, but experienced cultural shock with other types of problem. “Cultural shock” is the mixture of anxiety and feelings of confusion, excitement and insecurity and each person feels it differently. To explore this topic in depth, we divided the topic into separate themes to achieve maximum knowledge that followed by reflection, recommendations and conclusion. FHCP generally feel the unfamiliar environment when they visit to a completely different culture in a foreign country and feel certain problems (familial, professionals, technical etc.) along with cultural shock. Following these findings, we have identified three themes: The first theme will discuss about the cultural shock among FHCP and its impact. The second theme will be a focus on different issues of FHCP about their failure or struggle due to culture shock and third theme which is management challenges in order to establish appropriate culture in organization. For this review, we searched and selected various peer reviewed articles online using search engines and databases including Medline, Scopus, Cinahl and Cochrane and books from the University of Northampton library and peer reviewed journals including International Journal of Intercultural Relations, Human Resources for Health, British Medical Journal and Bulletin of The World Health Organization as well. This review will help to explore different aspects of FHCP such as adjustment with entirely different culture, lack of experience, different lifestyles, face problems being immigrants, and working in a completely different setup with certain rules and regulations.

Key words: Health care professionals, culture, cultural shock, effects of cultural shock


 
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REFERENCES
1. Tran D, Hall LM, Davis A, Landry MD, Burnett D, Berg K, Jaglal S. Identification of recruitment and retention strategies for rehabilitation professionals in Ontario, Canada: results from expert panels.BMC Health Services Research. 2008;8:249
[DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   

2. Suttari V, Brewster C. Expatriate Management practices and perceived relevance. Personnel Review. 2000;30(5):554-577
[
DOI via Crossref]   

3. Buchan J, Parkin T, Sochalski J. 2003. International nurse mobility: trends and policy implications. Geneva, World Health Organization WHOLIS database. http://whqlibdoc.who.int/hq/2003/WHO_EIP_OSD_2003.3.pdf [Accessed on 12/ 09/2011]


4. Blood GW, Ridenour JS, Thomas EA, Qualls CD, Hammer CS. Predicting job satisfaction among speech-language pathologists working in public schools. Language, Speech, and Hearing Services in School. 2002;33:282-290
[
DOI via Crossref]   

5. Von Zweck C. The occupational therapy workforce in Canada. Occupational Therapy Now. 2006;8:17-20


6. Iredale R. The migration of professionals: theories and typologies. International Migration Quarterly Review. 2001;39(5):7-27
[
DOI via Crossref]   

7. Vujicic M, Zurn P, Diallo K, Adams O, Mario R, Poz D. The role of wages in the migration of health care professionals from developing countries. Human Resources for Health. 2004;2:3-9
[
DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   

8. Adlung R, Carzaniga A. Health services under the general agreement on trade in services. Bulletin of the World Health Organisation. 2001;79(4):352-364
[
Pubmed]   

9. Chanda R. Trade in health services. Bulletin of the World Health Organization. 2002; 80(2):158–163
[
Pubmed]    [PMC Free Fulltext]   

10. World Health Organization: International migration and health personnel: a challenge for health systems in developing countries. Agenda item 12.11. Fifty-seventh World Health Assembly: Health Systems Including Primary Care. 2002;22 Geneva


11. Buchan J. Here to Stay? International Nurses in the UK. Queen Margrets University College, Edinburgh. 2002.


12. Department of Health: Code of practice for NHS employers involved in the international recruitment of healthcare professionals. London: Department of Health. 2001


13. Briggs J. The International Migration of Health Staff, International Health Division School of Tropical Medicine. Liverpool. 2000.


14. Bundred PE, Levitt CA. ‘Medical Migration: Who are the real losers?’ Lancet. 2000;356: 245–6
[
DOI via Crossref]   

15. Martineau T, Decker K, Bundred P. 2002. Briefing note on international migration of health professionals: Levelling the playing field for developing health systems, International Health Division School of Tropical Medicine, Liverpool. www.liv.ac.uk/lstm/hsrhome.html [Accessed at 05/09/2011]


16. Kangasniemi L, Winters A, Commander S. Is the medical brain drain beneficial? Evidence from overseas doctors in the UK. Social Science & Medicine.2007;65: 915–923
[
DOI via Crossref]   

17. Astor A, Akhtar T, Matallana MA, Muthuswamy M, Olowu FA, Tallo V. et al. Physician migration: views from professionals in Colombia, Nigeria, India, Pakistan and the Philippines. Social Science & Medicine. 2005;61, 2492–2500
[
DOI via Crossref]   

18. European Commission: Follow-up to the high level reflection process on patient mobility and healthcare developments in the European Union. COM 2004/301, 20 April. Brussels, Commission of the European Communities. 2004


19. Kohls LR. Survival Kit for Overseas Living, Maine: Intercultural Press, Inc. 1996.


20. Milikic BB, Janicijevic N. Cultural divergence and performance evolution system: A comparative study of three Serbian companies. Economic Annals. 2009;54(180):40-55
[
DOI via Crossref]   

21. Piet-Pelon NJ, Hornby B. Women guide to overseas living. 2ed edition. Intercultural Press. Yarmouth, Me. 1992


22. Walton S. Stress management training for overseas effectiveness. International Journal of Intercultural Relations.1990;14: 507-27
[
DOI via Crossref]   

23. Black JS. Personal dimensions and work role transitions. Management International Review. 1990. 30: 119-134


24. Harrison JK. Developing successful expatriate managers. Human Resource Planning. 1994;17:17-33


25. Solomon CM. Success abroad depends on more than job skills. Personal Journal.1994;4:51-59


26. Winkelman M. "Cultural Shock and Adaptation." Journal of Counseling & Development. 1994;73(2):121-126
[
DOI via Crossref]   

27. Wild R, Griggs K, Downing T. "A framework for e-learning as a tool for knowledge management". Industrial Management & Data Systems. 2000;102(7):371-80
[
DOI via Crossref]   

28. Foley M. What is cultural shock? http://workabroadtravel.suite101.com/article.cfm/what-is-culture-shock. [Accessed at 05/09/2011]


29. Pedersen P. The Five Stages of Culture Shock: Critical Incidents around the World. Westport, CT. pp. 12.Greenwood Press, 1995


30. Milstein T. Transformation abroad: Sojourning and the perceived enhancement of self efficacy. International Journal of Intercultural Relations.2005;29(2):217-238
[
DOI via Crossref]   

31. Anderson BA. Expatriate Selection: Good Management or Good Luck? International Journal of Human Resource Management. 2005;16(4):567-583
[
DOI via Crossref]   

32. Black JS, Gregersen HB. The right way to manage expatriates. Harvard Business Review. 1999;77: 52-63


33. Denison DR, Haaland S, Goelzer P. Corporate Culture and Organizational Effectiveness: Is Asia Different From the Rest of the World? Organizational Dynamics. 2004;33(1):98–109
[
DOI via Crossref]   

34. McCabe JA. An assignment for building an awareness of the intersection of health literacy and cultural competence skills. Journal of Medical Library Assoc.2006;94(4):458–461
[
Pubmed]    [PMC Free Fulltext]   

35. Callen BL, Lee JL. Ready for the world: Preparing nursing students for tomorrow. Journal of Professional Nursing. 2009;25(5): 292-298
[
DOI via Crossref]    [Pubmed]   

36. World Conference on Higher Education. The New Dynamics of Higher Education and Research for Societal Change and Development, COMMUNIQUE. 2009


37. Osland J, Bird A. Beyond Sophisticated Stereotyping: Cultural Sense making in Context. Academy of Management Executive. 2000;14(1):65-77


38. Iredale R. Luring Overseas Trained Doctors to Australia: Issues of Training, Regulating and Trading’’. International Migration. 2009;47(4):31-65
[
DOI via Crossref]   

39. Redfoot L, Houser AN. ‘‘We Shall Travel On’’: Quality of Care, Economic Development, and the International Migration of Long-Term Care Workers, AARP Public Policy Institute, Washington DC, 2005


40. Wickramasekara, P. Asian labor migration: Issues and challenges in an era of globalization, International Migration Papers 57. Geneva. 2002


41. Khadria B. Skilled labour migration from developing countries: Study of India, International Migration Papers No. 49. International Labor Office, Geneva. 2002


42. Bach S. International migration of health workers: labour and social issues. Geneva: Sectorial Activities Programme, International Labour Office;(WP 209).2003


43. Canales MK. Othering: toward an understanding of difference. Advances in Nursing Science.2000;22(4):16–31


44. Kline DS. Push and pull factors in international nurse migration. Journal of Nursing Scholarship.2003;35(2):107–111
[
DOI via Crossref]    [Pubmed]   

45. Stalker P. Migration trends and migration policy in Europe. InternationalMigration.2002;40(5):151–179


46. De Beiji R. Documenting discrimination against migrant workers in the labour market. Geneva, ILO. 2000


47. De Jong G, Madamba A. “A double disadvantage? Minority group, immigrant status and underemployment in the United States”, Social Science Quarterly, 2001;82:117-130
[
DOI via Crossref]   

48. Royal College of Nursing: 2003. ‘‘We Need Respect’’ Experiences of Internationally Recruited Nurses in the UK http://www.rcn.org.uk/downloads/international/irn_report_we_need_respect.pdf. [Accessed on 16/09/2011]


49. Organisation for Economic Co-operation and Development: International Migration of Physicians and Nurses: Causes, Consequences, and Health Policy Implications, 2002 OECD Paris


50. Magnusdottir H. Overcoming strangeness and communication barriers: a phenomenological study of becoming a foreign nurse. International Nursing Review. 2005;52:263–269
[
DOI via Crossref]    [Pubmed]   

51. Johnson, F., and Oldham, M: “International recruitment: Learning the hard way”, in Health Services Journal. 2001;111(5759):30


52. Black JS, Gregersen HB. Antecedents to cross-cultural adjustment for expatriates in Pacific Rim assignments. Human Relations. 1991;44(5):497-515
[
DOI via Crossref]   

53. Takeuchi et al. An examination of crossover and spillover effects of spousal and expatriate cross-cultural adjustment on expatriate outcomes. Journal of Applied Psychology. 2002;87: 655-666
[
DOI via Crossref]    [Pubmed]   

54. Taylor S, Lurie N. The role of culturally competent communication in reducing ethnic and racial healthcare disparities. Am J Managed Care. 2004;10:1-4


55. Weech-Maldonado R, Morales LS, Spritzer K, Elliot M, Hays RD. Racial and ethnic differences in parents’ assessments of pediatric care in Medicaid managed care. Health Serv Res. 2001;36(3):575-595
[
Pubmed]    [PMC Free Fulltext]   

56. Council on Graduate Medical Education: Physician Education for a Changing Health Care Environment. 13th report. 1999. Health Resources and Services Administration, US Department of Health and Human Services. http://www.cogme.gov/13.pdf. [Accessed on 10/09/ 2010]


57. Elderkin-Thompson V, Silver RC, Waitzkin H. When nurses double as interpreters: a study of Spanish-speaking patients in a US primary care setting. SocSciMed, 2001;52(9):1343-1358
[
DOI via Crossref]   

58. United States Agency for International Development: The Health Sector Human Resources Crisis in Africa: An issues paper Washington, DC: USAID Bureau for Africa, Office of Sustainable Development. 2001


59. Mutizwa-Mangiza D. The impact of health sector reform on public sector health worker motivation in Zimbabwe. Major Applied Research Working Paper. Partnerships for Health Reform.Bethesda: Abt Associates. 1998


60. Black JS, Gregersen HB, Mendanhall ME, Stroh L. Globalizing People through International Assignments(1999). 1st ed. Reading, MA: Addison-Wedley Publishing.


61. Deshpande SP, Viswesvaran C. Is cross-cultural training of expatriate managers effective: A Meta-analysis. International Journal of Intercultural Relations. 1992;16: 295-310
[
DOI via Crossref]   

62. Shamash J. Finders keepers. For description of local initiatives on induction of international Nurses. Nursing Times.2002;98(21


63. Alvesson M, Sveningsson S. Changing Organizational Culture, Cultural change work in progress;1998. Newyork. Routledge.


64. Brass DJ, Butterfield KD, Skaggs BC. Relationships and Unethical Behavior: A Social Network Perspective. Academy of Management Review. 1998;23(1):14-31


65. Chinn PL, Kramer MK. Theory and Nursing: Integrated Knowledge Development. 5th ed., St. Louis. 1999. Mosby.


66. Aroskar MA. 1998. Administrative Ethics: Perspectives on Patients and Community-Based Care.Journal of Issues in Nursing. http://www.nursingworld.org/ojin [Accessed on 14/09/2011].


67. Department of Health and Human Services. 2000. Report to Congress: The pharmacist workforce: A study of the supply and demand for pharmacists http://newsroom.hrsa.gov/releases/2000Releases/pharmacistshortage.htm [Accessed on 16/09/2011]


68. Smith P. Measuring up: Improving health system performance in OECD countries. OECD: Paris. 2002


69. Ferlie E, Shortell S. Improving the quality of health care in the UK and the USA: a framework for change. Millbank Q. 2001;79: 281-316
[
DOI via Crossref]    [Pubmed]   

70. Scott T, Mannon R, Davies HTO, Marshall MN. Implementing culture change in health care: Theory and practice. International Journal for Quality in Health Care. 2003;15(2): 111-118
[
DOI via Crossref]    [Pubmed]   

71. Davies HTO, Nutley SM, Mannion R. Organisational culture and quality of health care. Qual Health Care. 2000. 9:111-119
[
DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   

72. Harrison J, Nutley SM. Professions and management in the public sector: the experience of local government and the NHS in Britain. In: Leopold J, Glover I, Hughes M,(eds), Beyond Reason: The National Health Service and the Limits of Management. Aldershot: Avebury. 1996


73. Schneider Y. Advocacy: A Background Paper for the 1st National Summit of Mental Health Consumers and Survivors. Portland, Oregon.1999


74. Hagberg R, Heifetz J. Corporate culture/organizational culture: Understanding and assessment, telling the CEO his/her baby is ugly. http://www.hegnet.com/html/articles/understanding-Culture.html. [Accessed on 15/08/11].


75. Northouse PG. Leadership Theory and Practice, 4th ed. London;Sage publications, 2007, p. 3


76. Mariotti J. On management: The role of a leader. http://www.industryweek.com/columns/asp/columns.asp?ColumnId=409. [Accessed on 15/08/11].


77. Hewison A, Griffiths M. Leadership development in health care: A word of caution. Journal of Health Organisation and Management. 2004. 18(6):464-473
[
DOI via Crossref]   

78. Kotter JP. What leaders really do. Harvard Business Review. 2001;79(11):85-91(2001).


79. McConnell CR. The effective health care supervisor.5th edition. Gaithersburg,MD: Aspen Publishers. 2002.


80. Littrell RF. Desirable leadership behaviours of multi-cultural managers in China. Journal of Management Development. 2002;21:5-73
[
DOI via Crossref]   

81. Goleman D. What Makes a Leader? Harvard Business Review. 93-102(1998).
[
Pubmed]   

82. Wagner KV. Psychology. Leadership Theories. http://psychology.about.com/od/leadership/p/leadtheories.htm [Accessed on 15/05/2011]


83. Stone AG, Russell RF, Patterson K. Transformational versus servant leadership: A difference in leader focus. Leadership & Organization Development Journal. 2004;25(4):349-361
[
DOI via Crossref]   

84. Lowe KB, Kroeck KG, Sivasubramaniam N. Effectiveness correlates of transformational and transactional leadership: A meta-analytic review of the MLQ literature. Leadership Quarterly. 1996;7:385–425
[
DOI via Crossref]   

85. Bass B M. Transformational leadership: Industrial, military, and educational impact. Mahwah, NJ: Erlbaum. 1998.


86. Madhu B, Krishnan VR. Impact of transformational leadership and karma-yoga on organizational citizenship behaviour, Prestige Journal of management and research. 2005;9(1):120


87. Jackson D. The school improvement journey: perspectives on leadership. School Leadership & Management.2000;20(1):61–78
[
DOI via Crossref]    [Pubmed]   

88. Yukl G. An Evaluative Essay on Current Conceptions of Effective Leadership. European journal of work and organizational psychology.1999;8(1):33-48
[
DOI via Crossref]   

89. Podsakoff PM, MacKenzie SB, Morrman RH, Fetter R. Transformationalm leader behaviours and their effects on follower’s trust in leader, satisfaction, and organizational citizenship behaviors. Leadership Quarterly. 1990;1:107–142
[
DOI via Crossref]   

90. Ross SM, Offerman L R. Transformational Leaders: Measurement of personality attributes and work group performance. Personality and social Psychology Bulletin. 1997;23(10):1078-1086
[
DOI via Crossref]   

91. Fry L. Toward a theory of spiritual leadership. The Leadership Quarterly.2003;14: 693–727
[
DOI via Crossref]   

92. Saya F, Gbarayor M. The Case for Cultural Competence in Health Professions Education. American Journal of Pharmaceutical Education. 2006;70(6):1-6
[
Pubmed]   

93. National Centre for Cultural Competence: Conceptual Frameworks/Models, Guiding Values and Principles, Washington DC, Georgetown University Child Development Centre.2006


94. Beach MC, Price EG, Gary TL et al. Cultural competence: a systematic review of health care provider educational interventions. Med Care. 2005;43:356-73
[
DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   

95. Brower HH, Schoorman FD, Tan HH. A model of relational leadership: the integration of trust and leader–member exchange. Leadership Quarterly. 2000;11: 227– 250
[
DOI via Crossref]   

96. Uhl-Bien M, Maslyn JM. Reciprocity in manager-subordinate relationships: components, configurations, & outcomes. Journal of Management. 2003;29(4):511– 532
[
DOI via Crossref]   

97. Adler NJ. International Dimensions of Organizational Behavior. South-Western/Thomson Learning, Cincinnati, OH. 2002.


98. Chen YF, Tjosvold D. Cross-cultural leadership: Goal interdependence and leader–member relations in foreign ventures in China. Journal of International Management.2005; 11: 417-439
[
DOI via Crossref]   

99. Deresky H. International Management: managing across borders and cultures. 4th ed. New Jersey: Pearson Education Inc. 2003


100. Chew J. 2004. Managing MNC Expatriates through Crises: A challenge for International Human Resource Management. Research and Practice in Human Resource Management. 12(2): 1-30. http://rphrm.curtin.edu.au/2004/issue2/expats.html [Accessed on 05/08/10].


101. Demers J. Crossing the Cultural Divides. CMA Management. 2002;76(6):27-30


102. Sullivan P. Canada a prime destination as MDs flee South Africa. Canadian Medical Association Journal. 1999;160(11):1615-1616
[
PMC Free Fulltext]   

103. Pearce RJ. Towards understanding joint venture performance and survival: a bargaining and influence approach to transaction cost theory. Academy of Management Review. 1997;22:203– 235


104. Tung RL. Managing cross cultural and international diversity. Human Resource Management. 1993;32(4):461
[
DOI via Crossref]   

How to Cite this Article
Pubmed Style

Guru R, Siddiqui MA, Ahmed Z, Khan AA. Effects of cultural shock on foreign health care professionals: An analysis of key factors. J Environ Occup Sci. 2012; 1(1): 53-62. doi:10.5455/jeos.20120429110947



Web Style

Guru R, Siddiqui MA, Ahmed Z, Khan AA. Effects of cultural shock on foreign health care professionals: An analysis of key factors. www.scopemed.org/?mno=18976 [Access: November 24, 2014]. doi:10.5455/jeos.20120429110947



AMA (American Medical Association) Style

Guru R, Siddiqui MA, Ahmed Z, Khan AA. Effects of cultural shock on foreign health care professionals: An analysis of key factors. J Environ Occup Sci. 2012; 1(1): 53-62. doi:10.5455/jeos.20120429110947



Vancouver/ICMJE Style

Guru R, Siddiqui MA, Ahmed Z, Khan AA. Effects of cultural shock on foreign health care professionals: An analysis of key factors. J Environ Occup Sci. (2012), [cited November 24, 2014]; 1(1): 53-62. doi:10.5455/jeos.20120429110947



Harvard Style

Guru, R., Siddiqui, M. A., Ahmed, Z. & Khan, A. A. (2012) Effects of cultural shock on foreign health care professionals: An analysis of key factors. J Environ Occup Sci, 1 (1), 53-62. doi:10.5455/jeos.20120429110947



Turabian Style

Guru, Rakesh, Muhammad A Siddiqui, Zeeshan Ahmed, and Adeel Ahmed Khan. 2012. Effects of cultural shock on foreign health care professionals: An analysis of key factors. Journal of Environmental and Occupational Science, 1 (1), 53-62. doi:10.5455/jeos.20120429110947



Chicago Style

Guru, Rakesh, Muhammad A Siddiqui, Zeeshan Ahmed, and Adeel Ahmed Khan. "Effects of cultural shock on foreign health care professionals: An analysis of key factors." Journal of Environmental and Occupational Science 1 (2012), 53-62. doi:10.5455/jeos.20120429110947



MLA (The Modern Language Association) Style

Guru, Rakesh, Muhammad A Siddiqui, Zeeshan Ahmed, and Adeel Ahmed Khan. "Effects of cultural shock on foreign health care professionals: An analysis of key factors." Journal of Environmental and Occupational Science 1.1 (2012), 53-62. Print. doi:10.5455/jeos.20120429110947



APA (American Psychological Association) Style

Guru, R., Siddiqui, M. A., Ahmed, Z. & Khan, A. A. (2012) Effects of cultural shock on foreign health care professionals: An analysis of key factors. Journal of Environmental and Occupational Science, 1 (1), 53-62. doi:10.5455/jeos.20120429110947