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understand the relationship between supervisor and subordinate and the implicit and explicit expectations of this relationship?
clarify my manager’s performance expectations of me and the broader expectations of managers to obtain the best performance from each individual?
identify why some staff fall below expectations and determine the appropriate approaches to manage these issues?
develop skills in using frameworks to guide my behaviour and actions in holding staff to account?
adopt leadership styles that will be most effective in holding others to account?
Introduction
In contemporary healthcare services, managers are required to create environments in which competing forces place significant demands on the system as well as individuals to contribute to productivity. Each employee is held accountable and responsible for their part in contributing to this productivity.
Often, people feel that being held to account is something negative that usually happens to them when things go wrong, rather than something they can utilise to ensure success (Smith, 2014). Holding to account can be difficult if the perceptions of the supervisor and subordinate are at odds. It could reasonably be expected that a nurse manager would be aware of their supervisor’s expectations and hold a shared perspective on performance accountabilities; however, this is not always the case. We cannot assume that people share the same understanding of what they are accountable for or the standards expected of them. Accountabilities need to be made explicit and clear.
use the basic principles of communication theory to improve my communication?
understand communication as a process in a health services context?
identify the barriers to effective communication, particularly in health services?
develop skills to improve the use of communication in team-based health services settings?
adapt to evolving communication practices, including electronic communication?
Introduction
Critical to successful engagement with any organisation is a strong basic understanding of the important elements affecting good communication. There are many dimensions to the study of communication, both generally and in health service settings, in the 21st century. This chapter considers the foundational concepts, with references that will help students to discover more about communication in organisational, social and cultural settings.
Many believe that even the defi nition of communication is worth questioning. As a notion it is so discursive and diverse that any defi nition other than the most simple becomes so complex as to cease being useful (Newman, 1960).
Communication, knowledge and learning are all inextricably linked. Not all our daily communication is merely functional. Increasingly, communication contains significant amounts of information, some of it important and some of it not so important. The information transmitted has become so great in volume that there is a need for better information science to absorb what is important for now, store what is important for later and discard or archive what is not important at all.
Like health, education is both an end and a means. It is one of the basic human rights and a developmental goal in its own right. But, education also contributes to the realisation of other important developmental goals (UNESCO, 2002c). The functions and tasks generally ascribed to education include the following:
1. Promotion of economic growth and development. Investment in the physical capital stock is not sufficient for economic development. Investment in ‘human capital’ is also required.
2. Modernisation of attitudes and mentalities in society.
3. Contribution to important developmental goals such as increased life expectancy, improved health and reduced fertility. Education of mothers, in particular, makes important contributions to better health of children and reductions in fertility. These are among the important noneconomic benefits of education. These relationships have been discussed in Chapters 5 and 6 on population and health.
4. Political socialisation, promotion of a sense of civic responsibility, contributing to national integration and national political consciousness in developing countries.
5. Reduction of social and gender inequality and increasing social mobility.
6. Contribution to personal growth, development and emancipation.
In the context of the framework of proximate, intermediate and ultimate causality, these relationships are summarised in Figure 7.1
Immediately after the Second World War, expectations concerning the role of education in development were high. Expansion and improvement of education were generally considered as essential to development. Governments in developing countries were prepared to invest heavily in education. Families saw education as the main way to improve their children’s chances in life. International organisations were eager to provide financial and technical support for the construction of new educational systems.
The differences in income levels, which characterise the present-dayinternational economic order, are not self-evident. In the past these differences used to be much smaller. Around 1500 by far the greater part of world population made its living in agriculture. Although some countries were richer than others, most people in most countries lived close to subsistence levels. The distribution of world income by region was therefore relatively equal (Bairoch, 1980; Cipolla, 1981: 220; Clark, 2007; Maddison2001). In contrast, in the year 2012, the average income per capita in the thirty-five richest countries was no less than 35 times that in the thirty-five poorest countries in PPP dollars (seeTable 1.1, p. 16).
How did the present diversity of levels of economic development and welfare in the world economy come about? In order to examine possible answers to this question, this chapter will offer a rough outline of the history of European expansion and the development of the international economic order associated with it.
In the framework of proximate and ultimate causality, this chapter focuses on the ultimate factors influencing growth and development, namely the role of the international economic and political order.
International economic order
Instead of presenting a formal definition of the slippery concept of international economic order, Box 2.1 identifies some of its important characteristics (Goldin and Reinert, 2012; Lewis, 1978b; Maddison, 1985, 1989; Streeten, 1984).
Economic breakthrough and external expansion from Western Europe
Since the middle of the fifteenth century, Western Europe has experienced a dual process of internal economic growth and external economic and political expansion. This process of development is unique in two respects. First, in a limited part of the world the age-old vicious circle of struggle for survival at near-subsistence level was broken. Second, the European expansion led to the formation of a world economy in which all countries and regions in the world are interrelated in networks of interdependence. Both statements are in need of clarification and qualification.
As long as people work with their bare hands, their daily production will remain low. This sets a limit to the attainable level of economic welfare in a traditional agriculture-based economy. Higher standards of living can only be realised if production per worker increases. One of the principal ways to raise labour productivity is by providing workers with tools, implements and machines – in other words through capital accumulation.
Some sectors offer better opportunities for capital accumulation and productivity increases than others. Therefore, economic development and capital accumulation are linked to structural change. Since the mid eighteenth century, capital accumulation and accelerated growth have been intimately associated with the emergence of the industrial sector, i.e. with industrialisation. This chapter focuses on structural change and the relationships between agriculture and industry in the course of economic development. It provides a setting for the discussion of industrialisation in Chapter 9 and agricultural development in Chapter 10.
Structural change is not limited to industrialisation. It also refers to other changes in the structure of the economy. One of the interesting questions raised in this chapter is whether manufacturing will continue to play the leading role it has played in the past two-and-a-half centuries. Services seem to be becoming more important over time. But manufacturing will continue to be one of the important engines of growth in developing countries in the years to come.
The aim of this book is to provide a general introduction to the dynamics of socio-economic development and to the study of the problems of developing countries. The book was written for students of universities and other institutions of higher education from a variety of disciplines, who encounter the problems of developing countries in their studies and who are in need of a general introduction to this field. It is also intended for people pursuing a professional career in developing countries and international organisations, for policy makers and for readers with a general interest in development. The text can be read as an introduction by students with no prior knowledge of development. It also can be used at an advanced level as a handbook of development, providing a comprehensive overview of past and present theoretical and empirical debates and controversies in the field of development studies. The book provides non-economists with a non-technical introduction to economic perspectives on development, while introducing economists to a broader socio-economic view of development.
The central issue in development, as approached in this book, lies in low levels of per capita income and low standards of living among the mass of the population in the so-called developing countries. The key elements in the book are trends in productive capacity, per capita income, changes in standards of living and poverty, and the factors that affect economic development or economic stagnation in the long term. The core of development is thus defined in economic terms. However, the explanatory factors are not limited to economic ones. Historical, institutional, cultural, demographic, political, social and ecological factors are all of great importance for the analysis of economic development. They will receive ample attention in the book.