well i work in periodicals department looks like i can help
http://www3.pak.org/gupshup/smilies/tongue.gif
what are u looking for …articles most likely … alright i have done research under the databases that our library provides… i got more than 50 articles that might be helpful …u wont be able to access it from any other pc besides on campus… so in pakistan forget it
http://www3.pak.org/gupshup/smilies/hehe.gif
hmcq…dont delete it..let the poor girl take them
here are few
1
The end of managed care
JAMA; Chicago; May 23/May 30, 2001; James C Robinson;
Source (subtitle):
The Journal of the American Medical Association
Volume:
285
Issue:
20
Start Page:
2622-2628
ISSN:
00987484
Subject Terms:
Managed care
Social conditions & trends
Health care industry
Abstract:
After a turbulent decade of trial and error, the managed care experiment can be
characterized as an economic success but a political failure. The strategy of giving with
one hand while taking away with the other, of offering comprehensive benefits while
restricting access through utilization review, has infuriated everyone involved.
Full Text:
Copyright American Medical Association May 23/May 30, 2001
[Headnote]
Managed care embodies an effort by employers, the insurance industry, and some elements of the
medical profession to establish priorities and decide who gets what from the health care system. After a
turbulent decade of trial and error, that experiment can be characterized as an economic success but a
political failure. The strategy of giving with one hand while taking away with the other, of offering
comprehensive benefits while restricting access through utilization review, has infuriated everyone involved.
The protagonists of managed care now are in full retreat, broadening physician panels, removing
restrictions, and reverting to fee-for-service payment. Governmental entities are avoiding politically volatile
initiatives to balance limited resources and unlimited expectations. By default, if not by design, the
consumer is emerging as the locus of priority setting in health care. The shift to consumerism is driven by
a widespread skepticism of governmental, corporate, and professional dominance; unprecedented
economic prosperity that reduces social tolerance for interference with individual autonomy; and the
Internet technology revolution, which broadens access to information and facilitates the mass
customization of insurance and delivery.
JAMA. 2001;285:2622-2628 www.jama.com
THE UNITED STATES FACES AN ACcelerating demand for medical services due to new
quality-- enhancing but cost-increasing drugs and devices, an ever-broadening social definition of
health, and an ever more informed and assertive consumer. Despite unprecedented prosperity, the
nation lacks the economic resources to finance all services that would provide some benefit to some
patient. The setting of social priorities and balancing of competing claims is imperative. The
fundamental question concerns where and by whom these difficult decisions will be made. Five
candidates present themselves: government, employers, insurers, physicians, and consumers. Each
has serious limitations as arbitrator of who should get what, yet of necessity one must be assigned
the role.
Most industrialized nations rely on public sector institutions to allocate scarce resources through a
combination of capacity limits and price controls, but the United States appears no closer to
embracing this approach today than in the past. The indelible political lesson of the past decade has
been that initiatives to control health care costs lose votes, while initiatives that increase costs,
through expansions of coverage, benefits, and access, win votes. During the same decade,
employers, insurers, and some physician organizations developed managed care as a private sector
alternative to governmental regulation. The managed care system has achieved considerable
economic success but has proven itself a cultural and political failure, unleashing a reaction against
narrow physician panels, “gatekeeping,” utilization review, and capitation. Employers, insurers, and
physician organizations now are renouncing managed care functions and seeking new missions as
entities that inform, structure, and support consumer choice.
This article examines the retreat of employers, insurers, and physicians and the emergence of the
consumer as the central decision maker in US health care. A consumer-centered health care system
will have incomplete information on quality, inadequate spreading of insurance risk, and insufficient
financial subsidies for the poor. Some observers thus argue that the resurgence of health care
inflation, coupled with an economic recession, will bring the public and the private sectors back into
the central role they now abandon. But the transition to health care consumerism builds on deeper
social trends, including the widespread distrust of big government and big business, the increasing
diversity in health-related attitudes and preferences, and the emergence of Internet technology as a
source of information, entropy, and accelerating change.
RETREAT OF THE CARE MANAGERS Employers
Employers entered into the financing of health benefits by historical accident and remained to
purchase employee loyalty with pretax dollars! When confronted with the explosion in insurance
premiums, they shifted their contracts and herded their employees into managed care. This strategy
achieved short-term gains, with an unprecedented slowdown in cost inflation during the 1990s,2 but
has caused deep damage to the workplace social compact. Although economists maintain that
employer contributions to health insurance would have been added to wages and salaries,3
employees view insurance contributions as a supplement to, rather than a substitute for, cash
compensation. The advantages produced by managed care, in the form of lower medical inflation,
were perceived as accruing to employers, while the disadvantages, in the form of restricted access,
accrued to employees. Employers now purchase ever less employee satisfaction at an ever-growing
price and face a threatening wave of litigation if corporate benefit programs, as well as the insurance
firms that administer them, are judged liable for the adverse health consequences of cost-- cutting
initiatives.
A tight labor market promotes caution and impedes initiative among corporate health benefit
managers, but the trend in attitudes is clear. Employers are retreating from managed care constraints
while simultaneously restricting coverage and benefits. Enrollment is shifting from tightly managed
health maintenance organization (HMO) products to lightly managed alternatives, and even HMOs
are relaxing gatekeeper, utilization review, and other hallmark functions under pressure from their
customers. Employees are being asked to pay a greater share of the health insurance premium, with
the consequent rise in the number of individuals who are offered but decline employment-based
coverage.4 The increase in co-payments and benefit exclusions was muffled by the imperative to
retain employees, but many firms are waiting for a loosening of labor market conditions to increase
cost-sharing and reduce benefits.
More important than any shortterm restructuring of premiums or copayments is the change from a
paternalistic corporate culture to one that defines itself as supporting rather than restricting employee
choice. This shift has been most visible in the evolution from defined benefit to defined contribution
pension plans, where most private corporations now contribute a specified monthly sum to
tax-favored retirement accounts that are controlled by individual employees rather than by the firm.5
The advent of Internet technology has accelerated a move toward the contracting of human
resources functions to other companies, consistent with the business mantra to focus on core
competencies and outsource everything else. Investment analysts and human resource managers
now are abuzz with discussions on how and when, rather than whether, to apply similar principles to
health insurance benefits.6-8 While many employers remain committed to funding health insurance,
as they remain committed to funding pensions, the trend is to offer information, options, and partial
financial support, but to otherwise get out of the decision-making position in health care.
Insurers
The managed care industry is the confluence of several distinct sectors, including commercial
indemnity carriers, prepaid group practices, and the BlueCross/BlueShield plans. Years of mergers
and acquisitions have churned these once distinct entities into large and diversified conglomerates
that offer multiple products across multiple states to multiple customer segments.9 Some embraced
the role of managing care, accepting a predefined capitation budget for a predefined enrollee
population and establishing criteria for allocating resources and evaluating medical necessity. Plans
that could not develop physician networks, negotiate prices, and review utilization either sold out or
lost market share to those that could. For a moment it seemed that insurer-based managed care was
the US route to establishing priorities and balancing trade-- offs in health care.
The market success of managed care, measured most commonly through the rising enrollment in
HMO products, ultimately proved to be its undoing. Once the consumer and physician backlash
against managed care began, it quickly swirled into an unstoppable political tornado, reaching its
peak perhaps in the recent presidential campaign, during which one candidate accused his opponent
of herding elderly persons into private HMOs while the other countered that his opponent was
herding them into public HMOs. The fundamental flaw of managed care, in retrospect, was that it
sought to navigate the tensions between limited resources and unlimited expectations without
explaining exactly how it was so doing. Enrollees were offered comprehensive benefit coverage with
only minimal co-payments, which they interpreted as a promise of unrestrained access to all relevant
services. Managed care proposed to control costs behind the scenes, through volume price
discounts from physicians, gatekeeper restraints on specialty consultations, drug formularies, prior
authorization of tests and admissions, and retrospective denial of payment for unnecessary services.’
Consumers experienced managed care’s cost-control strategy in the form of barriers to access,
administrative complexity, and the well-articulated frustration of their caregivers. Controlling health
care costs behind the scenes is difficult even in the most propitious circumstances; it became volatile
in the context of reports of excessive profits, bureaucratic hassle, and exorbitant executive earnings.
Proponents of managed care may win some of the legislative and judicial battles, but clearly they
have lost the war. The largest firms in the health insurance industry, and especially the
investor-owned corporations, have lost the will to fight against US popular culture and political
institutions. Investment analysts are downgrading stocks of firms that persist with narrow networks
and capitation, while promoting stocks of those that offer the broadest panels with the least
utilization review.11-13 They note that the core function of an insurance firm is to predict cost trends
and establish premiums accordingly, not to accept the prices offered by purchasers and seek to hold
expenditures beneath those limits. In the short run, health plans are outrunning costs by raising
premiums. In the long run, they are hoping to redefine themselves as entities that structure and
support choices for individuals, offering information on coverage and quality, Web-enabled decision
support tools, and actuarially fair prices for each choice." Heretofore, managed care organizations
rarely have managed care but mostly have managed costs. Henceforth, they will not even manage
costs but only analyze, explain, and pass those costs on to the consumer.
Physicians
Historically, physicians and hospitals have served as social agents for the increase in health care
expenditures, adding capacity, technology, and services in pursuit of higher incomes and better
clinical outcomes. During the past decade, a variety of medical groups, hospital systems, and
physician-- hospital entities emerged with a goal of managing the cost as well as the quality of care.
15,16 They have combined primary, specialty, hospital, and ancillary services; have been paid
through global or professional services capitation; and have been delegated authority for managed
care functions, such as credentialing, utilization review, and claims processing. Many have
interpreted themselves as the natural locus for clinical and financial responsibility, in marked contrast
with governmental, employer, or insurance entities.
Some physician and hospital organizations have gained prominent positions in their local
communities, but many others have foundered under the difficulties inherent in governing complex
organizations and managing capitation payment. Attempts to expand patient volume through price
cutting pulled revenues below costs; the conversion of self-employed physicians into salaried
employees undermined productivity; the amalgamation of primary, specialty, and institutional
physicians stimulated factionalism; the mix of professional, administrative, and community cultures
enfeebled governance. The once rising tide of integrated health care now is ebbing; as medical
groups retrench, the physician practice management firms are declaring bankruptcy, and physician–
hospital organizations are breaking into their component pieces. 17,18 Physician organizations
are retreating from global capitation to partial capitation, case rates, or fee-for-service; are
renouncing or losing authority for utilization review and claims processing; and are quietly
abandoning the rhetoric of disintermediating the health insurance plans.19
No one can predict the future organizational and payment structures for physicians and hospitals, but
it appears probable that the structures will lie on some point intermediate between vertical integration
and global capitation, on the one hand, and solo practice and fee-for-service, on the other. The key
point for current purposes is that most physicians and hospitals no longer aspire to the dual role of
agent for society and for the individual patient, for managing costs as well as quality. Physicians
want to be on the side of their patients, advocating for more resources and better quality, rather than
taking on the social responsibility for comparing costs and benefits in a complex and volatile
environment.
POLITICAL RISK AVERSION
Enthusiasm in political circles for disciplining the health care system has waxed and waned over the
years, but now is at nadir. Control over health care costs requires I or more of 3 equally unattractive
initiatives. Elected politicians and their administrative appointees must impose limits on the
professional, institutional, and technological capacity of the delivery system, limits on the prices paid
to physicians, hospitals, and pharmaceutical manufacturers, or limits on which specific services
physicians can offer to which specific patients. Each of these strategies requires saying no to socially
influential interests.
The first strategy would require explicit reductions in how many medical specialists are trained, how
many inpatient facilities are authorized, and how many clinical devices are diffused into the
community. A sustained underfunding of operating expenses could achieve this goal over time, albeit
in a very unattractive manner, but no meaningful short-term victories against costs are to be
expected, and the political backlash against a deteriorating infrastructure likely would reverse the
process.
The second public sector approach to cost control, a direct attack on physician fees, hospital
payments, and drug prices, could achieve short-term political support if the targeted groups first
were demonized through media exposes, fraud investigations, and liberal use of the presidential bully
pulpit. But the economic beneficiaries of cost-control initiatives are quiescent while the opponents
are passionate in their own defense. Physicians will argue that quality of care is threatened and that
the best and brightest young people are avoiding the profession; hospitals will argue that jobs and
community institutions are at stake; drug and device manufacturers will argue that the pace of
innovation is slackening.
The third strategy, setting priorities and queuing for particular patients and services, is a relatively
common practice in some nations and has been subject to experiments in the United States.20,22
But without a doubt, this is the least attractive strategy for politicians and regulators facing voters
who want to have their cake and eat it too, who consider as their birthright the unlimited access to
services without payment of the requisite taxes.
The risk-averse governmental strategy now is bipartisan and beyond real debate. When budgetary
surpluses are available, the public sector expands coverage, benefits, research subsidies, physician
payments, and patients’ rights. When budgetary deficits loom, the public sector defends itself by
cutting payments to physicians; the voting public is reassured that no sacrifices on its part will be
necessary. In neither the fat nor the lean years does the government place itself at the center of a
discussion over which services are appropriate for which patients, what constitutes adequate quality
at what price, and who should get less so that others can get more.
CONSUMERISM
The health care system is becoming increasingly consumer driven, not by design but by default.
Some group must decide who gets what from a limited pool of economic resources. The United
States has experimented with professional, governmental, and, most recently, corporate mechanisms
for allocating resources and apparently found none to its liking. The proximate cause of the shift to
consumerism is the widespread backlash against managed care’s instruments of cost control,
including integrated delivery systems, capitation, and utilization review. This backlash, however, is
merely the tip of an iceberg of hostility toward any entity that would substitute its own priorities for
those of the individual citizen. The new culture of health care consumerism is the volatile confluence
of 3 central features of US society: a deeply rooted political culture, an extended period of
economic prosperity, and the phenomenal growth of Internet technology.
POLITICAL CULTURE
The uproar over managed care will not be mollified by half-hearted compromises over specialty
access and dispute resolution. It builds on long-standing traditions of individual autonomy and
skepticism with respect to professional, governmental, and corporate dominance in health care.
Historical resistance to professional authority, quieted during the middle decades of the last century,
reemerged during the 1960s as part of the wider questioning of the role of institutions. Its
manifestations include the women’s health movement, the surge of complementary medicine, the
application of antitrust law to medicine, the doctrine of informed consent, the explosion of
malpractice litigation, and the erosion of the traditional physician-patient relationship.22-25 The
contemporary flood of health-related information from the Internet, direct-to-- consumer
pharmaceutical advertising, and the proliferation of patient support groups is hastening the
displacement of the physician as the principal source of decision-making authority in health care.
Employees place a high value on employment-based health insurance and protest every effort by
employers to cut coverage or benefits. The inexorable trend in the contemporary economy,
however, is toward a more transient and less paternalistic employment relationship. Firms are
interested in structuring compensation packages to reward performance and strengthen incentives,
as evidenced most graphically in the replacement of traditional pension programs with
employer-subsidized but employee-managed individual retirement accounts. The culture of business
today is one of focusing on core competencies while exiting from peripheral activities, such as
defining benefit packages, physician networks, and appropriate care. For the past decade
employers have outsourced health care cost control to the managed care industry, and they felt
lucky that these contractual agents stood between them and their angry employees. Now, as the
insurers decline the role of buffering employers from employees, firms are looking for a new
approach. Some seek to use their leverage to identify the best physicians and practices but are loath
to force employees to act in their own best interest. Rather, the trend is toward providing data,
decision-support tools, and financial subsidies that permit employees to make better choices for
themselves.
Popular attitudes toward governmental control over health care have moved in tandem with attitudes
concerning the governmental role more broadly, but the resistance toward public sector dominance
has never lain far beneath the surface. Subsidy programs, such as Medicare, enjoy universal
popularity but only as long as the administrative agencies refrain from visible incursions into and
restrictions of individual choices. The politically viable range of cost-control measures available to
public programs has been limited to cutbacks in payments to physicians rather than limits on the
demand for clinical services. The failure of former President Clinton’s Health Security Act, despite
polls suggesting wide support for extension of insurance coverage, provides eloquent testimony to
the liabilities of any proposal that may be characterized as a governmental takeover of individual
decisionmaking authority.26 Politicians of both parties have learned the lesson well and now restrict
themselves to always-- popular promises to extend coverage, enrich benefits, and ensure access.
None even whispers that public resources are limited, that budget surpluses cannot be spent twice,
and that costs cannot be controlled indefinitely by cutting payments to physicians, hospitals, and drug
manufacturers.
ECONOMIC PROSPERITY
Economic prosperity provides the personal incomes and governmental budget surpluses to support
more and better health care. But good times heighten rather than attenuate the strains between the
demand and supply for services due to their effect on expectations and the social definition of health
and health care. United States citizens increasingly believe they have a right to unrestricted access to
ever more convenient, personalized, and high-- quality services. Needless to say, the benefits of the
economic expansion have been unevenly distributed and many citizens feel thankful for those health
care services they can obtain. The recent economic downturn will have little immediate impact on the
wave of legislation, regulation, and litigation that attack every cost-reducing instrument in the
managed care toolkit.
Business cycle fluctuations will not reverse the overall trend toward an ever more demanding and
impatient patient population. Whereas once health care and health insurance were understood as
activities related to acute injuries and illnesses, they have expanded to include preventive and mental
health services, long-term care, complementary medicine, and, more broadly, the ability to maintain
psychological, social, spiritual, and sexual performance far into the golden years. The revolution of
rising expectations, coupled with the elastic definition of health, accentuates the sentiment that health
care is a matter of satisfying diverse individual preferences rather than providing a one-size-fits-all
solution to collective needs. Information, decision support, and subsidies are welcomed; channeling,
prior authorizations, and retrospective denials are not.
THE INTERNET REVOLUTION
Internet technology enhances and amplifies the cultural changes unleashed by prosperity,
individualism, and rising social expectations. Each of the 4 key Internet health sectors, including
content, commerce, connectivity, and care, accelerates the move away from managed care and
toward a health care system based on individual choice. The core of the Internet is the rapid,
costless, and increasingly universal dissemination of text, graphic, and audio content on a scale
heretofore inconceivable. Despite the economic problems facing the content-oriented “e-- health”
companies, actual use of the Internet continues to grow at an exponential rate, with health and health
care being among the most common subjects searched. The most radical feature of the Internet
medium, however, is the opportunity it provides for users to interact with information distributors
and with each other, thereby opening new channels of peer communication and community. Use of
the Internet is particularly intense for individuals newly diagnosed with serious ailments and for those
experiencing chronic disease." Patients increasingly arrive in their physicians offices armed with
printouts, citations, etiological theories, referral requests, and suggested interventions. Most
important, the Internet stokes the culture of individual choice, the sentiment that each person is
responsible for managing his or her own health, relying on physicians as a valuable, but by no
means unique, source of information and advice.
As insurance benefit packages incorporate more consumer cost sharing while offering partial
coverage of a broader range of physicians, the individual patient will take on an ever more important
role as direct purchaser of health care services. The rise of consumer as purchaser will be
accelerated by any shift among employers toward "defined contribution"programs and of Medicare
toward a choice framework modeled on the Federal Employees Health Benefits Program (as
advocated by President Bushy). The Internet commerce sector packages information with products
in a way usually not available in the offline sector, including rich search and comparison shopping
prior to purchase and extended information on use, servicing, and related products after purchase.
The connectivity sector spawned by the Internet, including electronic links between employers,
insurance plans, pharmacies, hospitals, and, eventually, physician offices, will enable consumers to
track the administrative and clinical dimensions of their care in a manner that could not be done
previously. Consumers will be able to check administrative matters, such as eligibility, benefits,
coinsurance limits; search for and switch among plans and physicians; read up on others’ evaluations
of quality; and make their own contribution to quality monitoring by reporting experiences with
individual physicians, hospitals, and health plans.
CHALLENGES OF HEALTH CARE CONSUMERISM
The enhanced role for consumers not only offers numerous benefits, but also presents severe
potential difficulties to the health care system. An ideal system presumably would allocate
decision-making rights and responsibilities among government, employers, insurers, and physicians,
as well as consumers, with the latter entrusted with those decisions for which they are adequately
informed and supported. But the headlong retreat of the public and private sectors from the
thankless job of controlling costs is delegating to the consumer a very broad array of tasks for which
many are not prepared. The rising informational, cultural, financial, and political challenges are by
no means limited to consumerism and plague both managed care and highly regulated health
systems. Nevertheless, they will contribute new forms of dissatisfaction and ultimately instigate new
forms of social backlash.
Four problems will plague a consumer-driven health care system. First, despite the widespread
dissemination of information, consumers will face significant obstacles in understanding the quality
and even the true price of health insurance and health care services. Variations in utilization, cost,
and outcomes challenge the analytic capabilities of governmental, corporate, insurer, and physician
organizations and are daunting for even the most sophisticated and Internet-enabled consumer.
Second, consumers vary enormously in their financial, cognitive, and cultural preparedness to
navigate the complex health care system. The new paradigm fits most comfortably the educated,
assertive, and prosperous and least comfortably the impoverished, meek, and poorly educated.
Third, the consumer era will complicate the pooling of insurance risk between consistently healthy
citizens and those who are chronically ill. Risk-adjusted subsidies by government and employers can
foster risk-spreading, but the requisite actuarial methods are only embryonic. Finally, the emerging
era will make transparent and render difficult the redistribution of income from rich to poor that
otherwise results from the collective purchasing and administration of health insurance. The
proliferation of insurance products and physician networks likely will accentuate the contemporary
allocation of care based on ability to pay, partially mitigated through tax exemptions and refundable
tax credits.
COMMENT
Managed care embodies an effort by employers, insurers, and some physician organizations to
establish priorities, balance competing goals, and decide who should get what from the US health
care system. After a turbulent decade of trial and error, that experiment can be characterized as a
partial economic success and total political failure. The strategy of giving with one hand while taking
away with the other, of offering consumers 'comprehensive benefits while restricting access through
utilization review, obfuscates the workings of the system, undermines trust between patients and
physicians, and has infuriated everyone involved.
The protagonists of the managed care system now are in full retreat, broadening panels, removing
restrictions, reverting to fee-for-service, and generally getting out from between consumers and the
services they want to consume. The retreat from managed care promotes access but also removes
the brakes on health care cost inflation. The individual consumer and patient is the last candidate for
the difficult but necessary role of balancing resources and expectations. Lest the prediction of a
consumer-driven future seem unrealistic, it is worth reviewing briefly the roles desired by physicians,
insurers, employers, and government in the brave new world after managed care.
The natural role of the physician is as the agent of the patient, offering information, advice, service,
and support. Physicians want to advocate for more social resources to be devoted to health care,
not for a balancing of their individual patients’ needs with the other economic priorities of the nation.
Bedside cost-benefit analysis does not come easily to the individual physician any more than
population-based care based on incomplete clinical and actuarial data comes easily to the physician
organization. After the contemporary period of retrenchment has passed, medical groups are likely
to reemerge as mechanisms that permit physicians to share administrative services, on-call
responsibilities, information technology, and disease management initiatives. But it is unlikely that
they will again shoulder the burden of financial responsibility for populations of restive, assertive, and
choice-oriented consumers.
The natural role of the insurer is to pool risks, predict cost trends, and set premiums accordingly.
Insurers lack the clinical skills and the ethical authority to distinguish the experimental from the
accepted therapy, the appropriate from the inappropriate procedure, the qualified from the
unqualified physician, or the patient who is truly ill from the worried well. Health insurers cannot
control the major epidemiological, technological, and cultural sources of health care utilization any
more than property and casualty insurers can control the major causes of fire, theft, and collision.
Health plans will continue to play significant roles as entities that design, price, and market insurance
products that consumers are willing to buy. But never again will they succumb to the bait-and-switch
gambit used by government and employers, who exhorted them to control health care costs and then
vilified them for using the marketplace mechanisms that were at their disposal. After a decade of
confusion, insurers finally have identified their true customer, the individual consumer. Though
subsidized by governmental programs and employment fringe benefits, the consumer is the ultimate
locus of price-sensitive and quality-conscious choice. Insurers want to stop frustrating and start
facilitating those choices.
The natural role of the employer is to manufacture automobiles, distribute newspapers, and sell
coffee. Their central role in the financing and design of the health care system developed through a
combination of historical accidents, tax loopholes, and the paternalism of a passing era of lifetime
employment. No one today would design a health insurance system that places industrialists,
entrepreneurs, and convenience store owners in charge of adjudicating health benefits on behalf of
employees. Most large and many small employers will continue to subsidize health insurance for their
employees.
Group insurance offers administrative efficiencies, risk-spreading opportunities, and volume
discounts on a scale never to be matched by individual patients shopping alone in the complex health
care market. But employers will no longer seek to control the costs of fringe benefits by herding
employees into health plans they disdain, to physicians they distrust, or to procedures they dislike.
Information and incentives will replace paternalism and control as the primary instruments of
corporate health benefits policy.
The natural role for the government in a democracy is to do what the people want rather than what
the people could, would, or should want. Casual empiricism and harsh political reality suggest that
the people of this nation want the government to finance care for the poor, underwrite research and
training, limit fraud and abuse, facilitate standards for quality measurement, ensure technology
compatibility, and protect data confidentiality, but otherwise not dictate who gets what and from
whom. The American people want to direct their own health care, with clinical advice from their
physicians, financial subsidy from employers and public programs, information from the Internet and
offline sources, and the support of their families and friends. Public health insurance initiatives will
expand to the extent private initiatives contract, but the likelihood of a national, uniform,
one-size-fits-all program becomes more remote with each passing year. The centralization of finance
and authority would concentrate on Washington, DC, all the tensions between limited resources and
unlimited expectations that today are diffused among multiple targets. While predictions in politics
are as risky as in economics, the public sector strategy appears similar to its private sector
counterpart, supporting and subsidizing rather than controlling and channeling the idiosyncratic
choices of individual citizens.
The natural role for the consumer in a market economy is to make informed, price-sensitive choices
based on personal preferences and subject to individual budgetary constraints. This paradigm is
poorly matched to the special features of health care. Individual patients often lack the information
and willpower to shop effectively across the array of physicians and procedures. Differences in
health and wealth require insurance mechanisms that spread actuarial risk across the population and
foster cross-subsidies from rich to poor. A purely consumer-driven health care system would be
grossly inefficient as well as grotesquely inequitable. Government, employers, insurers, and
physicians will continue to influence health care decision making to a much greater extent that they
do in most other economic sectors. But the attempt by public and private sector entities to allocate
limited resources has proven itself incompatible with US cultural proclivities and institutional
structures. The consumer era in health care is emerging due to the rejection of governmental,
corporate, and professional dominance rather than due to a judicious evaluation of the alternative.
British Prime Minister Winston Churchill once remarked that Americans could be counted on to do
the right thing, after having exhausted the alternatives. If the right thing for health care is defined as an
approach without potential problems of equity, efficiency, and clinical quality, then consumerism
fails the test. Of course, all other candidates for setting priorities and managing care, including
government, employers, insurers, and physicians, also fail the test. But if the right thing is defined as
the approach most compatible with the nation’s social culture and political institutions, the candidate
that remains standing after other contestants are vanquished, then consumerism is not only the likely
but indeed the right thing for US health care.
Funding/Support: This research was supported by the California Health Care Foundation, Oakland.
[Reference]
REFERENCES
[Reference]
- Starr P. The Social Transformation of American Medicine. New York, NY: Basic Books; 1983.
- Levit J, Cowan C, Lazenby H, et al. Health spending in 1998: signals of change. Health Aff (Millwood).
1999;19:124-138.
- Pauly MV. Health Benefits at Work. Ann Arbor: University of Michigan Press; 1997.
- Thorpe KE, Florence CS. Why are workers uninsured? employer-sponsored health insurance in 1997.
Health Aff (Millwood). 1999;18:213-218.
- 401 kafe.com. The evolution of the 401(k): plan’s creator looks back at 20 years of changes. CBS
Market Watch. November 20, 2000. Available at: http://www.cbsmarketwatch.com. Verified April 20, 2001.
- Marhula DC, Shannon EG. Defined Contribution Defined: Health Insurance in the Next Century.
Minneapolis, Minn: US Bancorp Piper Jaffray Equity Research; June 2000.
- Sherlock D. Next Steps for Managed Care: Pulse Analysis 2001 (January):1-8. Gwynedd, Pa: Sherlock
Co; 2001.
- Clulow MD, Frisch A, Phillippe JE. The Future of E-Health. New York, NY: UBS Warburg Global Equity
Research; August 2000.
- Robinson JC. The future of managed care organization. Health Aff (Millwood). 1999;18:7-24.
- Zelman WA, Berenson RA. The Managed Care
[Reference]
Blues and How to Cure Them. Washington, DC: Georgetown University Press; 1998.
11. Marsh LC, Feinstein AT, Raskin JR. Managed Care Industry Guidebook. New York, NY: Lehman
Brothers; October 1999.
12. Boorady C, Pyle N, Seguritan F. Healthcare Services: Managed Care. New York, NY: Goldman Sachs
Global Equity Research; October 2000.
13. Harris GE, Ripperger MJ, Horn HGS. Managed Care Industry. New York, NY: Warburg Dillon Read (UBS
Warburg); December 1999.
14. Marhula DC, Shannon EG, Bozivich JC. Unitedhealth Group Incorporated. Minneapolis, Minn: US Bancorp
Piper Jaffray Equity Research; September 2000.
15. Robinson JC. The Corporate Practice of Medicine: Competition and Innovation in Health Care.
Berkeley: University of California Press; 1999.
16. Shortell SM, Gillies RR, Anderson DA. The new world of managed care: creating organized delivery
systems. Health Aff (Millwood). 1994; 13:46-64.
17. Burns LR, Cacciamani J, Clement J, Aquino W. The fall of the house of AHERF: the Allegheny
bankruptcy. Health Aff (Millwood). 2000;19:7-41.
18. Robinson JC. Crisis and opportunity for physician organization in California. Health Aff (Millwood). In
press.
19. Robinson JC, Casalino LP. Re-evaluation of capitation contracting in New York and California. Health
Aff(Millwood). In press.
20. Hadorn DC. Setting health care priorities in Oregon. JAMA. 1991;265:2218-2225.
21. Aaron H, Schwartz WB. Rationing health care: the choice before us. Science. 1990;247:418-422.
22. Freidson E. Professional Dominance: The Social Structure of Medical Care. New York, NY: Atherton
Press; 1970.
23. Illich I. Medical Nemesis. New York, NY: Bantam Press; 1976.
24. Boston Women’s Health Book Collective. Our Bodies, Our Selves. New York, NY: Simon and Schuster;
1976.
25. Havighurst CC. Health Care Choices: Private Contracts as Instruments of Health Reform. Washington,
DC: AEI Press; 1995.
26. Skocpol T. The rise and resounding demise of the Clinton plan. Health Aff (Millwood). 1995;14:66-85.
27. Cain M, Mittman R, Sarasohn-Kahn J, Wayne JC. Health E-People: The Online Consumer Experience.
Oakland, Calif: California Healthcare Foundation; 2000.
28. Bush GW. Ensuring access to health care: the Bush plan. JAMA. 2000;284:2108-2109.
[Author note]
Author Affiliation: School of Public Health, University of California, Berkeley.
Corresponding Author and Reprints: James C. Robinson, PhD, School of Public Health, University of
California, Berkeley, CA 94720-7360 (e-mail: [email protected]).
============================================
2
Employee spirituality in the workplace: A cross-cultural view for the
management of spiritual employees
Journal of Management Education; Thousand Oaks; Oct 2000; Jeffrey S Lewis; Gary D Geroy;
Volume:
24
Issue:
5
Start Page:
682-694
ISSN:
10525629
Subject Terms:
Work environment
Employees
Spirituality
Cross cultural studies
Management
Business education
Curricula
Abstract:
The workplace is evolving to reflect the diversity within society. Reflected within society
are numerous spiritual beliefs and practices that are ingrained in the cultures. The
cultural mix reflects not only ethnic diversity but also a diversity of spiritual beliefs and
behaviors that influence workplace roles.
Full Text:
Copyright Sage Publications, Inc. Oct 2000
The United States’ workplace is evolving to reflect the diversity within its society. Reflected within
the society are numerous spiritual beliefs and practices that are ingrained in the cultures. Employees
have always brought their spiritual beliefs to work but most have been required to suppress any
spiritual expression. Recent trends including the valuing of diversity; a tolerance for spiritual beliefs;
an integration of Asian, Central American, and South American immigrants causing a more culturally
diverse workforce; and the introduction of political correctness have influenced increased spiritual
expression on the job. The cultural mix reflects not only ethnic diversity but also a diversity of
beliefs and behaviors that influence workplace roles. Employees have started manifesting spiritual
beliefs and practices at work, which has contributed to a more diverse workplace.
The Management ChallengeIncreasing Workplace Diversity
As a result of the recent debate surrounding the articulation of spiritual practices in the work
environment, managers face a real challenge (Hopkins, 1997; Mitroff & Denton, 1999). Are
managers to give license to a holistic personal expression, or are boundaries to be erected that result
in a “spirit-free” zone? Many workers desire opportunities for spiritual expression in the workplace
but are hesitant because of fears of offending peers and management (Mitroff &. Denton, 1999).
The challenge has recently become greater as a result of the incorporation of integrated workgroups
that have increased employee interaction. Immigrants working in the United States are frequently
reporting that their American employers do not understand or respect their spiritual beliefs or
religious practices (Blank & Slipp, 1994). Another aspect of the challenge is related to a cultural
norm that makes discussion of religion or spirituality, like politics and sex, taboo in the workplace.
In summary, managers face a challenge as a result of a freer expression of spirituality in the
workplace (Mitroff & Denton, 1999).
Increased diversity gives rise to the same issues caused by commonly accepted diversity issues
such as race, ethnicity, gender, sexual orientation, and generational differences. Because of issue
similarity, spirituality in the workplace can be treated as a cross-cultural issue. Although much is
written about the management of employee diversity, most of the literature does not embrace the
concept of defining spirituality as a diversity issue. Current diversity management textbooks
identify diversity categories such as:
Work between men and women (Blank & Slipp, 1994; Carr-Ruffino, 1996; Gentile, 1994;
Hopkins, 1997; Kossek & Lobel, 1996)
Characteristics of African American employees (Blank & Slipp, 1994; CarrRuffino, 1996; Hopkins,
1997; Kossek & Lobel, 1996)
Characteristics of Asian employees (Blank & Slipp, 1994; Carr-Ruffino,1996; Harris & Moran,
1996; Hopkins, 1997; Kossek & Lobel, 1996)
Characteristics of Hispanic/Latino employees (Blank & Slipp, 1994; Carr-Ruffino, 1996; Harris &
Moran, 1996; Hopkins, 1997; Kossek & Lobel, 1996)
Issues surrounding sexual orientation and/or homosexual employees (Arredondo, 1996; Blank &
Slipp, 1994; Carr-Ruffino, 1996; Hopkins, 1997; Kossek & Lobel, 1996)
Issues surrounding physically challenged employees (Arredondo, 1996; Blank & Slipp, 1994;
Carr-Ruffino, 1996; Hopkins, 1997; Kossek & Lobel, 1996)
Issues surrounding obese employees (Carr-Ruffino, 1996)
AIDS in the workplace (Gentile, 1994)
Issues surrounding age differences between employees (Arredondo, 1996; Blank & Slipp, 1994;
Gentile, 1994; Hopkins, 1997)
Employees with families and/or working families (Arredondo, 1996; Gentile, 1994; Kossek &
Lobel, 1996)
After examining a number of textbooks, only one author identifies spirituality as a major diversity
category (Hopkins, 1997). Authors frequently discuss the fact that specific ethnicities have unique
spiritual or religious beliefs, but an examination of how the spirituality may manifest in the workplace
seems to be avoided.
As illustrated in the previous list of diversity categories, the issues associated with the management
of diversity have expanded. We have recently seen the issues of sexual orientation, obesity, and
working parents emerge as workplace diversity categories. It is possible that employee spirituality
will become the next commonly accepted diversity issue. We acknowledge that a deep theoretical
discussion is needed before spirituality is embraced by the academic community as a top-level
diversity issue on par with gender, race, and sexual orientation. As the discussion proceeds, some
management educators may choose to treat employee spirituality as a cross-cultural issue. We
suggest that the complexities of management of diversity within the integrated constructs are not
dissimilar to managing cross-cultural differences. This article provides an introductory framework
for those educators to incorporate the management of employee spirituality into the curriculum.
PREPARING MANAGERS
The issue of employee spirituality presents instances of incongruent value systems that must be
integrated by managers into a performance gestalt. To prepare managers to effectively manage a
diverse workforce, managers in training should be made aware of the challenges they will certainly
face as they interact with their employees. Three discussion points have been provided for your
consideration as a management educator. We believe that the use of these discussion points,
models, and themes will prepare better managers.
Spirituality Defined
Although we recognize that spirituality can and should be more broadly defined, we chose to use the
following definition. Spirituality is the inner experience of the individual when he or she senses a
beyond, especially as evidenced by the effect of this experience on his or her behavior when he or
she actively attempts to harmonize his or her life with the beyond (Clark, 1958). Some spiritual
beliefs and practices are founded in religion and others are unconnected to any religious doctrine or
organization. A discussion regarding the similarities and differences between the constructs of
spirituality and religion is occurring in many disciplines including management, counseling,
philosophy, and psychiatry (Burke, Hackney, Hudson, & Miranti, 1999; Mitroff & Denton, 1999;
Nicholls, 1996). Regardless of making a distinction between spirituality and religion, the discussion
of this article encompasses both spirituality and religion and focuses on the manifestation of spiritual
or religious beliefs and practices in the workplace. Some employees practice a spirituality or religion
that is devoid of interaction with a higher spiritual being or interaction with other spiritual beings. In
contrast, most religions and spiritual practices are framed by the influence of belief in spiritual entities
or beings. The entity may be a higher spiritual power known as God or the Great Spirit. Spiritual
entities also encompass good and evil spirits; some examples include the Christian belief in angels
and demons or the Hmong’ belief in ancestral spirits and dabs (Fadiman, 1997). Some employees
believe that spirits or ghosts inhabit the buildings where they work. At an extreme, some may believe
that evil spirits possess their managers and coworkers. The primary issue emerging is related to the
manifestation of spiritual beliefs in the workplace. An employee may be very spiritual or very
religious but have no outward expressions in the workplace. Others may have no spiritual or
religious beliefs or practices but are active in manifesting a strong antispiritual or antireligious agenda
in the workplace. Because of the broad continuum of spiritual beliefs and practices, managers must
be able to answer the question, How should managers deal with employees who practice or
manifest any spiritual or religious behaviors in the workplace?
Discussion Point 1
DEMOGRAPHIC INFORMATION
The initial step in introducing mangers to the issues of spirituality in the workplace involves
communicating the basic demographic data related to the American society. A poll released by the
Gallup News Service found that 9 out of 10 Americans claim to engage in prayer, and 3 out of 4
Americans say they pray on a daily basis (Poloma & Gallup, 1991). Prayer is commonly defined as
a communication process with God or a spiritual being. In addition, in 1998, the Pew Research
Center reported research findings that stated, “71% of Americans say that they never doubt the
existence of God,” which was up 11 % from the same poll taken in 1987 (Pew Research, 1998). A
third information source states that 94% of Americans believe in God or a Universal Spirit (The
Gallup Report, 1987). A basic normal distribution curve can be used to represent the degree of
spiritual belief within our society (see Figure 1). Most Americans have a medium or moderate level
of spiritual belief and practice. Smaller populations exist of people who have no spiritual beliefs or a
high level of spiritual belief. In addition to the normal distribution curve, we have also included a
challenge curve that will be discussed later (represented by the dotted line).
CONTINUUM EXPLANATION
Figure 1 contains four primary components: level of spiritual belief, occurrences within the
workforce, place within the dominant culture, and the level of managerial challenge. The use of a
normal curve to illustrate cultural constructs is supported by other cross-cultural researchers
(Trompenaars & Hampden-Turner, 1998).
The level of spiritual belief (bottom x-axis) illustrates the continuum of beliefs that is represented in
the typical American workplace. The none-low category identifies those employees who do not
believe in a spiritual realm or who have a low level of belief that has no associated practices. As
illustrated in Figure 1, the none-low group is relatively rare within the workforce. This group
corresponds to a minority position within the dominant American culture (top x-axis). Examples of
philosophies or cultures associated with a none-low level of belief are atheism and agnosticism.
Enlarge 200%
Enlarge 400%
Figure 1:
The medium level of belief identifies the dominant culture present within the workforce. As stated
earlier, approximately 71% of adults have some level of spiritual belief that is acted upon to some
degree (Pew Research, 1998). Examples of philosophies or cultures associated with a medium level
of spiritual belief are Catholicism, Islam, Judaism, Evangelical Christianity, Protestant Christianity,
and moderate New Agers. This group represents the majority group within the culture.
Medium-level employees are common within the workforce.
The third group on the continuum is identified as having a high level of spiritual belief. The group can
be considered as being a minority when compared with the norm or dominant culture. Examples of
philosophies or cultures associated with a high level of spiritual beliefs are Hmong immigrants, Native
Americans, religious zealots, and the hyperspiritual. There are also many individuals unconnected
with any philosophy or culture who would classify themselves as being highly spiritual. Examples
include, but are not limited to, psychics, persons having near-death experiences, persons who share
“out-of body” experiences, or persons who place significant attention to their own spiritual growth.
Continuum Discussion Table
In an attempt to expose management students to the continuum of spiritual beliefs and practices,
Table 1 can be used in discussions of workplace diversity and cross-cultural management. The
table builds on the spiritual belief continuum and provides examples of characteristics, philosophies
and cultures, and possible workplace effects. It is important to note that the examples are not
intended to stereotype any person or group. There are degrees of diversity within any culture,
belief, or philosophy.
EXPLANATION OF THE CHALLENGE CURVE
In addition to the normal curve representing the levels of spiritual belief, Figure 1 also illustrates a
challenge curve. The second curve illustrates the degree of challenge managers may face based on
employee spiritual belief. The curve begins in the none-low spiritual belief group indicating a
mid-high level of challenge. The challenge decreases for managers as they manage employees within
the dominant middle-level group. As managers interact with employees from the high level of
spiritual belief, the challenge curve spikes into the high-challenge area. The challenge is a result of
cross-cultural management issues including intraorganizational communication and the occurrences
of manifested behaviors that fall outside the behaviors associated with the dominant culture. The
following discussion point elaborates on the cross-cultural management challenges.
Discussion Point 2
The primary challenge that managers will face is the result of interactions between the three cultural
groups: none-low, medium, and high (see Figure 2). As employees from different cultural groups
interact in the course of the workday, cultural incidents will occur (Sorb, 1990). Cultural incidents
will also arise from the diverse beliefs and practices represented within each of the cultural groups.
The interaction that takes place is similar to cross-cultural interactions in which expatriates venture
into a foreign territory. The natives of the territory (i.e., employees from the dominant spiritual culture
with a medium level of spiritual belief) are challenged to interact with people from a different spiritual
culture. Likewise, the expatriates encounter difficulties as a result of experiencing life in a place that
is controlled by a culture unlike their own. These challenges can be clearly illustrated using Sorti’s
model of cross-cultural interaction (see Figure 3).
Enlarge 200%
Enlarge 400%
TABLE 1
Sorti’s model can be used to help managers respond correctly when cultural incidents occur.
Managers must be trained to expect incidents that will cause reactions among employees and
reactions within themselves. The training should also encompass communication skills, negotiating
skills, and interpersonal skills.
Cultural Incidents
There are two primary types of incidents that are associated with Sorti’s model, Type I incidents and
Type II incidents. Type I incidents are those interactions in which actions taken by the dominant
culture cause the minority cultures to have an adverse reaction. Type II incidents are those
interactions in which actions taken by the minority culture cause the dominant culture to have an
adverse reaction. It is also possible that minority cultures will interact, which may also result in a
conflict. We have added a third type of incident, Type III, to encompass the interaction between
minority groups. Examples of the incidents are found in Table 2.
Enlarge 200%
Enlarge 400%
Figure 2:
Managing Cross- Cultural Incidences
According to Sorti ( 1990), the first step in managing cross-cultural incidences is to avoid the
choice to withdraw. Withdrawal or avoidance is always the easiest choice to make but is rarely the
choice with the best results. Once the actions and reactions occur, the parties must become aware
of the incident. It is possible that the perpetrator of the incident has no awareness of the resulting
reaction. Managers must develop a climate of open communications within their organizations so
their employees have the skills to discuss and resolve the incidences that arise. It is common for
organizations that are composed of distinct cultural groups to also need significant levels of
understanding and knowledge (Sorti, 1990). For example, a manufacturing company may have a
dominant group of middle-level employees and a strong group of high-level employees such as
Hmong immigrants. It is inevitable that numerous cultural incidents will occur until a significant level
of understanding is developed between the two groups. The understanding will develop through
cultural education, communication training, and experience.
Two cases are suggested for educators to facilitate course discussions. Both are found in Hopkins’s
(1997) book Ethical Dimensions of Diversity. The first case is titled “Religious Warfare at Jones
Consulting.” This case examines conflicts arising from differences in employee spiritual beliefs and
practices in the workplace. The second case is titled "Joe Foster’s Rules:’ This case involves a
situation where an employee makes a significant decision on the basis of a religious belief that greatly
affects a subordinate employee. Both cases help facilitate discussion of manifested behaviors based
in employee spirituality.
Enlarge 200%
Enlarge 400%
Figure 3:
Discussion Point 3
MANAGER SELF-AWARENESS
In addition to having the ability to mediate and oversee interactions among employees, managers
need to have an adequate level of self- awareness. Managers will experience an increased level of
effectiveness as they identify and understand their own beliefs and biases toward spirituality.
Management educators can facilitate an impactive discussion using Neal’s ( 1997) Guidelines for
Teaching From a Spiritual Perspective adapted to Guidelines for Managing From a Spiritual
Perspective. Neal’s guidelines were intended to help management educators incorporate spirituality
into the curriculum. Upon further reflection, discussion, and experience, we believe that Neal’s
guidelines can be expounded and used as a model for managers in spiritually diverse organizations.
The following five points are the adapted Guidelines for Managing From a Spiritual Perspective
(Neal, 1997).
Enlarge 200%
Enlarge 400%
TABLE 2
-
Know thyself - Where do you personally fit in the continuum? does the Continuum model
represent your beliefs? How have your spiritual beliefs changed in the past few years? Do you see
yourself changing in the future?
-
Act with authenticity and congruency - Managers should not be chameleon-like. You should
make your spiritual beliefs known in an appropriate way to be fair to your coworkers and
subordinates. Others have a right to know your perspective and biases.
-
Respect and honor the beliefs of others - Respect and honor begin with an awareness and
understanding of where coworkers and subordinates fit on the continmuum. If cultural instances
occur, managers should take the initiative to “seek first to understand, then be understood” (Covey,
1989). In addition, managers must be able to honor even without understanding because ther will
asways be beliefs and behaviors that will not be understood (Sorti, 1990).
-
Be as trusting as you can be - Managers should give their coworkers and employees the benefit
of the doubt. Spiritual beliefs and practices are not intended to reduce organizational effectiveness
and efficiency, although they may at times. Some managers may view spiritual beliefs as optional,
but to some employees, spiritual belief is as deeply grained as ethnicity.
-
Maintain a spiritual practice - If you have spiritual beliefs, use the experience of interacting with
others from different spiritual cultures to grow professionally and personally. If you are antispiritual,
interacting with people who have spiritual beliefs can facilitate interpersonal communication growth,
increase tolerance, and can solidify or challenge your beliefs about spirituality.
Implications for Managemant Educators
In summary, management educators have the opportunity to incorporate a discussion of employee
spirituality into the management curriculum. We believe there are six possible entry points to initiate
the spirituality issue: cross-cultural management, workplace diversity, leadership, team
management, organizational culture, and human resource development. Our suggestion involves
using the topic of employee spirituality to enrich the discussion of diversity at multiple levels. As we
have incorporated the discussion points and models into our undergraduate- and graduate-level
classes, the discussion has been lively and the students have appreciated the exposure to the spiritual
facet of diversity. Our students have recognized that spirituality does contribute to diversity and
have appreciated the opportunity to discuss the associated challenges. Many students have been
appreciative of the new management tools and strategies they have received resulting from the
discussion. There have also been students who do not believe there should be any expression of
spirituality in the workplace. The multiplicity of views related to spirituality always ensures a lively
and productive discussion.
The main crux of this discussion returns to the question we presented earlier. How should managers
deal with employees who manifest spiritual or religious behaviors in the workplace? As with many
issues, the decision will be based on the culture and leadership values of the specific organization.
Regardless of the specific situation, few would disagree with the notion that the workplace is
becoming more diverse and managers must be prepared to interact with a wide continuum of diverse
people. Because of this, we strongly encourage management educators to enable their students with
the tools necessary to manage within the spiritual continuum.
[Footnote]
Note
[Footnote]
- References to the Hmong culture are made throughout the article to provide an example of a group of
highly spiritual people. Other examples could be used, but the challenges of interacting with the strong
spiritual beliefs and manifested practices associated with the Hmong are well documented in current
literature (Cart-Ruffino, 1996; Fadiman, 1997). Fadiman’s (1997) book The Spirit Catches You and You
Fall Down, provides and excellent example of the cross-cultural challenges associated with a spiritually
active culture.
[Reference]
References
[Reference]
Arredondo, P ( 1996). Successful diversity management initiatives: A blue print for planning and
implementation. Thousand Oaks, CA: Sage.
Blank, R., & Slipp, S. (1994). Voices of diversity. New York: Amacom.
Burke, M. T., Hackney, H., Hudson, P., & Miranti, J. ( 1999). Spirituality, religion, and CACREP curriculum
standards. Journal of Counseling and Development, 77(3), 251-257. Cart-Ruffino, N. (1996). Managing
diversity: People skills for a multicultural workplace.
Cincinnati, OH: Thompson Executive Press.
Clark, W. H. (1958). The psychology of religion. New York: Macmillan.
Covey, S. R. (1989). The seven habits of highly effective people. New York: Simon & Schuster. Fadiman, A.
(1997). The spirit catches you and you fall down. New York: Noonday.
Gallup Organization. (1987). The Gallup Report No. 259. April. Princeton, Nl: Gallup Organization.
Gentile, M. C. ( 1994). Differences that work (Harvard business review book). Boston, MA Harris, P. R., &
Moran, R. T. (1996). Managing cultural differences, leadership strategies for a new world of business (4th
ed.). Houston, TX: Gulf Publishing.
[Reference]
Hopkins, W. E. (1997). Ethical dimensions of diversity. Thousand Oaks, CA: Sage.
Kossek, E. E., & Lobel, 5. A. (1996). Managing diversity, HR strategies for transforming the workforce.
Cambridge, MA: Blackwell.
Mitroff, I. L, & Denton, E. A. (1999, summer). A study of spirituality in the workplace. Sloan Management
Review, 40(4), 83-92.
Neal, J. ( 1997). Spirituality in management education: A guide to resources. Journal ofManagement
Education, 21(1), 121-139.
Nicholls, W. ( 1996). Saints and fanatics: The problematic connection between religion and spirituality.
Judaism, 45(4), 446-458.
Pew Research. (1998). Individualism still strong Pew values update: American social beliefs 1997-1987
[Online]. Available: http:l/www.people-press.org/valuetop.htm
Poloma, M. M., 8c Gallup, G., Jr. (1991). Varieties of prayer Dallas, TX: Trinity. Sorti, C. (1990). The art of
crossing cultures. Yarmouth, MA: Intercultural Press. Trompenaars, F, & Hampden-Turner, C. (1998).
Riding the waves of culture: Understanding
cultural diversity in global business. New York: McGraw-Hill.
[Author note]
Jeffrey S. Lewis
Gary D. Geroy
Colorado State University
[Author note]
Authors’ Note: Address correspondence to Jeffrey S. Lewis, Colorado State University, College of Business,
Fort Collins, CO 80523; phone: (970) 490-5585; fax: (970) 472-6295; e-mail: [email protected].
============================================
3Action research, the state and legitimation in Brunei Darussalam
Asia - Pacific Journal of Teacher Education; Abingdon; Jul 2000; John R Minnis;
Volume:
28
Issue:
2
Start Page:
179-190
ISSN:
1359866X
Subject Terms:
Teacher education
Education policy
Professional development
Geographic Names:
Brunei
Abstract:
The introduction of postgraduate programs at the Institute of Education, Universiti
Brunei Darussalam indicates that educational research will play a central role in teacher
education. Minnis argues that rather than improve educational practice as envisioned by
constructivists, action research may be used by the state to legitimize existing
education policies.
Full Text:
Copyright Carfax Publishing Company Jul 2000
[Headnote]
ABSTRACT The introduction of postgraduate programmes at the Institute of Education, Universiti Brunei
Darussalam indicates that educational research will play a central role in teacher education. While there is
widespread agreement on the appropriateness of action research, little consideration has been given to the
degree to which it is compatible with cultural and political expectations of the teacher’s role. This paper
argues that rather than improve educational practice as envisioned by constructivists, action research may
be used by the state to legitimize existing educational policies. Since schools are a major socialization
agency in this small, Malay-Islamic state, it will be difficult for teachers to modify their traditional teaching
and problem-solving strategies, let alone question educational policies. The paper suggests that when
interpreted within a broader political framework, action research is likely to be appropriated by the state to
delimit research and legitimize existing policies and social arrangements of the school, thereby
strengthening the status quo.
Introduction
Teacher training has been a high priority of the Brunei State ever since independence from Britain in
1984 when educational expansion became an integral dimension of Brunei’s development thrust
(Cheong & Nuttman, 1995). The Institute of Education housed in the Universiti Brunei Darussalam,
the country’s only university, offers programmes at certificate, degree and postgraduate levels, thus
providing students with different routes into primary and secondary teaching.
Since independence, substantial investments in education have continued unabated with the result
that enrolment has been all but universalized at the primary level, while secondary and tertiary ratios
continue to steadily increase (Seventh National Development Plan 1996-2000, 1996, pp.
147-150). Recently, postgraduate programmes leading to the M.Ed. have been established. The
newly formed Centre for Applied Research in Education signals a shift toward research grounded in
classroom management, administrative and pedagogical processes that privileges practice over
theory.
In particular, `action research’ has found favour with teacher educators across disciplines and
specialty areas. It features significantly in the taught courses, schoolbased projects and practicums
leading to the M.Ed. in Educational Management. (External Examiner’s Report, 1998). Despite
ready acceptance of action research as a methodological tool, there has been little formal debate on
its relative merits within the context of Brunei culture/values. This constitutes a puzzling oversight
given recent concerns expressed in the literature vis-a-vis the knowledge transfer process.
Various writers (Crossley, 1992; Crossley & Vulliamy, 1997; Ilon, 1997) have drawn attention to
the increasing number of educators involved in consultancies in the developing world without training
in cross-cultural education or relevant experience of the local culture. Leach (1994) has questioned
the role expatriates play in the knowledge transfer process, arguing that the administrative culture of
host institutions often conflicts with projects designed on Western concepts of organization and
management. In her judgement, `the transfer of knowledge has to be seen as a culture-bound
process that will likely be unsuccessful if the values implicit in the expertise being offered are
incompatible with those prevailing in the receiving culture’ (p. 229).
Focusing on classroom practices in developing countries, Thomas (1997) has called for a
culture-sensitive' pedagogy wherein the day-to-day behaviour patterns at home and in the school are integrated with curricula and teaching methods to develop a pedagogy that is culturally grounded and therefore more relevant to students' understanding. Other analysts argue that Western education constructs need to be filtered’ through the local culture if they are to be successfully adapted. This
point is underscored in O’Donogue’s (1994) critique of the manner in which reflective practice' was imposed on teacher education programmes in Papua New Guinea with disastrous results. In a similar vein, Phillips (1997) writes of the hazards involved in policy borrowing’ from one country to
another. He warns of the danger inherent in `borrowing strategy without borrowing either the tactics
or the contextual changes needed to make a strategy effective’ (p. 289).
Further to the concerns expressed by Phillips, there are politically and culturally imposed
expectations about teachers’ work in Brunei that must be taken into account in the `borrowing’
process. Teacher educators, many of whom are expatriates, may be indifferent toward or know
nothing about such expectations. The important feature of these limits or constraints is that they are
not likely to be explicitly stated, but rather, implicitly understood by school personnel as part of a
broader cultural understanding of the purpose of education.
For example, many expatriate academics are unaware of the fact that, as a MalayIslamic monarchy,
Brunei culture and history suggests that all social institutions are very clearly directed at reinforcing
the dominant values and beliefs of the wider culture in which they are embedded (Blunt, 1988;
Brown, 1970, 1976). In the monarchical system, which has been in place for over 500 years, power
is concentrated in the hands of the Sultan, members of his family, close advisors and confidants. This
in itself is not hard to discern. However, political consensus is constructed and enforced by dominant
groups who, in turn, control or have the capacity to control all socializing institutions, such as the
media and the schools. For the most part, all social institutions in Brunei, except perhaps the more
private sphere of family and kin, come under the control of powerful actors in the socio-political
system. Moreover, Brunei’s small size and relatively insignificant geo-strategic position in Southeast
Asia allows the state to minimize the ability of alternative world views to gain an audience or
establish legitimacy (Dao, 1996).
Within this stable and highly constrained political environment, it is not likely that action research or
academic inquiry in general can be allowed to seriously question deeply ingrained hegemonic
structures, beliefs and values. It is plausible, then, to think of action research in a different way, not
as a politically neutral device that inevitably leads to an improvement in educational practice, but
rather as a state-sanctioned means by which existing educational policy can be legitimized. Within
Brunei’s patrimonial system of decision-making, high priority is placed on ensuring that education
policy and practices are geared to serving Malay-Islamic values. This is why it is near impossible for
any teacher, all of whom are civil servants, to question educational policy and practice in the way a
teacher might in a more politically open society. Further, as studies on Brunei culture indicate, the
character waits and personal dispositions of the Brunei Malays do not mesh well with those
associated with Western versions of the `action researcher’ (Mulder, 1996; King, 1994).
Against this background, the paper argues that the intent and meaning of action research is
essentially incompatible with Brunei’s authoritarian and hegemonic values. This does not necessarily
mean that action research is without value as a teaching strategy. However, given heavy teaching
loads emanating from the pressure to produce more teachers, teacher educators will need to balance
the amount of time, energy and follow-up spent on action research with its probable acceptance and
ultimate utility in the Brunei classroom. Opening up a discussion around educational research in the
context of Brunei culture and political values is the first purpose of the paper. The second purpose is
to deepen our understanding of how research in authoritarian states can be appropriated by state
actors to serve legitimation needs.
Action Research: limits and capabilities
Action research is part of a constructivist approach to teaching and learning. In this approach,
teachers and students are thought of as a community of learners in the process of constructing
knowledge and bringing about change. The teacher is depicted as a facilitator of learning rather than
a dispenser of knowledge. Teacher education programmes based on constructivist principles tend to
emphasize teaching for understanding (Tatto, 1997, p. 219).
Further, teachers are encouraged to see their pupils as makers of meaning; research and reflection
are necessary precursors to changing traditional conceptions of the teaching role, the learning role,
subject matter and pedagogy (Canella & ReifF, 1994). Action research is thought to contribute to
teacher autonomy, research acumen and the ability of the teacher to solve pedagogical and
organizational problems. Researchable problems are grounded in the empirical/practical
circumstances of the school or classroom, which are then investigated in order to generate evidence
on which action can be taken. In this manner, the teacher’s role can thus be transformed into
something more than a mere transmitter of knowledge. `Practice’ becomes privileged over theory.
The idea that practice, as depicted in the technical-rational view of teaching, consists merely of a
melange of skills to be applied to the solution of problems inherent in practice is rejected by action
researchers (Gilroy, 1993).
Armed with new insights and strategies gained from research and reflection, the teacher can then
concentrate on solving classroom-related problems. For most advocates, action research has
multiple goals, many that go far beyond the confines of the classroom (Altrichter et al., 1993; Atweh
et al., 1998; Elliott, 1991; Hollingsworth, 1997; Noffke & Stevenson, 1995). Certain analysts take
a more radical stance, interpreting action research as a democratic, participatory process wherein
the goal is to unmask sources of inequality and oppression. It is thought that the teacher has a moral
duty to promote understanding of the causes and consequences of inequality and to encourage
broad-based participation in determining the education agenda. The radical perspective links the
teacher to larger political processes outside the school (e.g. Elliott, 1991; Kemmis, 1990).
In summary, action researchers lament the gap between traditional research and classroom practice,
judging the application of knowledge acquired through the social sciences, psychology and
philosophy to educational problems as inadequate, if not alien, inappropriate and subversive. If it is
to be efficacious and authentic, educational knowledge must consist, it is argued, not primarily in the
application of general principles derived from the disciplines to educational problems, but in the
generation and explication of tacit knowledge, particularly the know-how' which is the peculiar property of the practitioner who engages particular problems. It is the view of the action research tradition that educational knowledge, as opposed to knowledge about education, has its genesis within the working life of the professional who is on the spot’, as it were.
However, implicit in much of the action research discourse is a rationalist and utilitarian ethos
requiring an affirmation in the form of what works best for the teacher is therefore good'. In other words, the affirmation of effectiveness must rest on appropriate research findings. Action research is seen as an efficient and economical way to achieve this. A contradiction immediately arises. On the one hand, action research is touted as a teacher's best friend, as liberator, as the road to newfound professionalism. It is the antithesis of what every action researcher despises-the technical-rational or banking’ approach to education-which depicts the teacher as a mere transmitter of a
pre-established facts and theories. And yet, for both action researchers and technical-rationalists,
practice' is depicted in basically the same manner-as that element that comes between input’ and
output', as a set of techniques, the core technology’ for managing throughput'. Neither perspective views education or the teacher's role as a particularly complex, dynamic or unpredictable process of ongoing construction. Because action research privileges practice over theory, it cannot help but reflect a utilitarian view of knowledge. If this interpretation is accurate, then does it not follow that action’ taken by the teacher can at best provide technical solutions to
classroom problems? Even if such changes are made and can be linked to efficiency gains in
student learning or achievement, can such gains be reasonably expected to alter the larger
production process?
Further, there are signs that the shift to market-based models of education have eroded the
professional status of teachers (Taylor et al., 1997). Teaching is now seen more as an occupation
than a profession and teachers’ freedom and autonomy has been curtailed. Given this development,
a gap exists between the vision of the constructivists and the dominant neo-classical, market-driven
view of education. This gap has been globally recognized by some as a crisis in teacher education
accompanied by calls for reform, but there appears to have been little change over the past three
decades in the way teachers are educated.
In a review of 310 studies of teacher education since 1980 in the United States, Anderson (1997)
finds few changes in the structure of teacher education. The predominant orientation continues to be
the technical-rational approach reinforcing transmission learning models. Anderson concludes, `over
the last 15 years there have been few innovations in teaching and learning’ (p. 214). Tatto (1997)
reports that there has been little progress in applying constructivist approaches to teacher education
in the United States. Tatto examined 53 empirical studies of teacher education and found that only
14 incorporated elements of constructivist theory, and only three reported programme experiences
that were deliberately planned as constructivist. The rest followed more conventional conceptions of
teacher education.
The emphasis on the role of markets in education (Taylor et al., 1997; Marginson, 1993) continues
to dominate educational policy and practice, imposing a rational, output-oriented, plan-based and
management-led view of schooling. `Managing for results’ best encapsulates the essence of such
trends in education in many Western countries (Vandenberghe, 1999). The potential of
constructivism as a guiding philosophy in Western education appears to be inhibited by these trends.
If so, and if constructivist principles have proven to be ineffective elsewhere, it is even more puzzling
why Brunei educators are so keen on implanting such constructs in Brunei. Given Brunei’s stated aim
of diversifying the economy, the more important need is to bring about a closer correspondence
between the education sector and the skill/knowledge requirements of the workplace (Minnis,
1997). This entails significant reforms in pedagogy, curriculum and corresponding modifications in
workplace training policies. And yet action research carried out in the schools ignores these issues,
concentrating instead on trival administrative and management problems.
Paradoxically, action research carried out by M.Ed. candidates suggests that researchers construe
educational practice very much like a production process (External Examiners Report, 1998).
Studies are narrowly conceived, concentrating mainly on classroom order and school efficiency
issues. In line with government policy, all researchers must gain permission from the Ministry of
Education before entering any school. Perhaps the bureaucratic penchant for order and authority
explains the preponderance of studies on classroom order and management, while issues pertaining
to gender, equity, and educational policy are ignored. The responsibilities of school administrators
are stressed and depicted in very traditional terms with an emphasis on leadership style. Issues such
as organizational and pedagogical effectiveness that lies at the heart of much constructivist discourse
in the West is nowhere to be found in Brunei action research. It appears that in Brunei educational
policies and practices are taken as given by action researchers.
The upshot of this narrowly focused approach to research is that when teachers are allowed so little
responsibility beyond clearly defined boundaries, formal exhortations to autonomy and participation
only serve to mystify the whole educational process. If allowed to continue in Brunei, action research
may have the effect of condemning both teacher educators and postgraduate students to a myopic,
particularistic view of knowledge that is nothing more than the sum total of personal accounts of
particular settings. Hoyle’s (1994) comments underscore the dangers inherent in privileging practice
over theory:
If teachers criticize the theory to which they have been exposed as irrelevant to practice, they are
denying themselves one of the traditional characteristics of a profession. If teaching is no more than
an experience-based skill with a limited set of precepts, the occupation is indistinguishable from the
crafts of, say, plumbing or motor mechanics. (p. 6094)
In their haste to make researchers out of teachers, teacher educators have failed to consider not only
Brunei culture, but sociological and political theory which encourages reflection on the interactive
relationship between schools, culture and the polity. The embeddedness of schooling within wider
social dynamics and power relationships means that context is relational, dynamic and interactive
such that schools and schooling are influenced by, but also influence and support, the cultural and
political structures of the society in which they are embedded.
Finally, and very briefly, we have some reservations about the value of action research vis-a-vis
educational policy. What is missing from the action research literature is any recognition that the
culture and politics of a school have a role to play in understanding not only why certain problems
exist, but in communicating the knowledge' gained from such research to significant others’. This
raises an equally important question of whether lessons from one school can ever be applied, more
or less straightforwardly, to another. There is an analogous debate in the literature on organizational
management, and the conclusion there is that corporate organizations are so radically different in
their culture, politics and strategic position that recipes for success cannot simply be transferred from
one organization to another (Kay, 1997).
Research for Action or Action Research for Legitimizing the State?
It is interesting that many of the action research projects undertaken by M.Ed. candidates closely
conform to the definition of legitimatory research put forward by Keeves (1994, p. 3370), i.e. `a
process involving the compilation of new knowledge that will strengthen social institutions and
validate institutionalized knowledge’. Keeves (1994) cites a number of defining features of
legitimatory research applied to education that serve to strengthen existing power relations in society:
(a) the problem to be investigated arises from existing policies and practices within an educational
organization;
(b) the major aim of the research is to maintain the existing structure of an educational organization,
and the continuance of its existing policies and;
(c) legitimatory research is generally conducted by people with competence in research who are
employed by the educational organization, so that the organization maintains control over the
investigation and the dissemination of results;
(d) the focus of the research is on the operation of the organization, on the activities of the people
within it, or on the characteristics of those who seek entry into the organization;
(e) the release of the findings of the research is controlled by senior administrators to occur at a time
to optimize the impact that the findings may have on the legitimization of a particular position, policy
or practice;
(f) frequently, legitimatory research is conducted under the guise of an evaluation study, since the
need for evaluation is widely acknowledged on the grounds of accountability, yet what is being
sought is information to sustain the program or policy in its existing form. (p. 3368)
In Brunei, the selection of research topics, where and under what conditions the research is
conducted and the dissemination of results is closely monitored by the Ministry of Education. Thus
Keeves’ description is an apt characterization of what actually happens in Brunei. The choice of
topics and method of inquiry is restricted to research on `safe’ subjects. Quantitative rather than
qualitative methods and cross-sectional rather than longitudinal designs are preferred. The need to
maintain strict control of research and the flow of knowledge is further reflected in the state’s
stringent censorship laws and vigorous attempts to curtail the movement and activities of foreign
reporters and journalists (see Behar, 1999).
State surveillance and control of the production and dissemination of knowledge is in keeping with
Brunei’s patrimonial and autocratic decision-making processes (Gunn, 1993). As the purveyors of
educational research, Ministry of Education officials in Brunei must be cognizant of any form of
knowledge production if for no other reason than, as civil servants, they are obligated by virtue of
their patrimonial ties to the governing elite to contain and minimize any threat new information
presents to the political status quo (Braighlinn, 1992).
In the wake of oil wealth and the creation of a welfare state, the tasks of the Brunei government
have become more specialized, complex and elaborate. As a result, the relations between the
monarch and his subjects tend to be filtered through a huge network of bureaucrats (Bill &
Springborg, 1994, p. 152). Social research, which is judged to be more politically sensitive than
scientific or technical research, is closely monitored by an army of government bureaucrats and must
be seen to support or confirm prevailing policies and ideologies. Because the schools are critical
agencies of socialization, the state is very sensitive about research on any facet of education, but is
particularly touchy about investigations in the areas of policy, funding, educational processes and
outcomes. While there is ample anecdotal evidence indicating that schools are not run very
effectively and that student achievement is lower than it should be, research is not encouraged, for
example, on how school effectiveness may be negatively affected by poor policy-making or lack of
adequate funding. Instead, there is encouragement of research on what teachers might do to curb
vandalism or absenteeism, or how administrators might improve their ability to enforce school rules.
But research that questions larger issues of policy or policy-making is taboo since it may undermine
the validity and thus the legitimacy of such policy.
Teaching and Teacher Education in the Render Economy
Public indifference to education is not unique to Brunei but seems to be characteristic of render
economies. In these economies based on oil rents, there is no nexus between production and income
distribution since revenues accrue directly to the state not through any production process but from
oil taxes that come from outside the country (Gunn, 1993, p. 114; Noreng, 1997). Local
consumption patterns become geared to the use of imported commodities. The implication for
education is that there are no strong links between the proceeds of production, effort and incentive.
The cradle-tograve welfare state based on oil rents owes little, if anything, to the productivity of its
citizens (Amuzegar, 1999). This is why student motivation is so problematic and why teachers find it
easier to follow prescribed ways of teaching and assessment.
The gap between the economy and education is nowhere more starkly drawn than in the
technical-vocational area. Despite the priority placed on technical-vocational education, many
graduates chose not to work in commercial or industrial enterprises. Out of a total of 4838
graduates since 1985, only 1372 are presently working in private and public jobs for which they
have been trained. Each year, Brunei produces on average a total of 400 graduates in various
technical-vocational fields, but only 35% have permanent jobs (Othman & Clark, 1998, p. 1). A
Brunei public servant is reported to have said, `without the active participation of locally trained
citizens, the nation will not be able to realize its vision to become a service, trade or tourism hub in
the regions’ (p. 1 ) .
Indifferent public attitudes toward work and education are derived from the `render mentality’ and
are passed on from one affluent generation to the next. Over time, this results in a break in the
work-reward causation-where reward or wealth is not related to work and risk-taking (Beblawi,
1987; Colclough, 1995; Gunn, 1993). From a teaching-learning perspective, there can be little
external motivation to learn. Education and training privileges form over content. This means that
learners are rewarded for formal compliance with modest performance requirements rather than for
demonstrating operational mastery of skills/knowledge deemed economically and socially useful. In
such a milieu, teachers can hardly be expected to embrace such notions as action research and
reflective practice unless there is some very good reason to do so (Minnis, 1997).
Because teaching and learning are essentially devalued in this environment, education policy and
teachers’ work are heavily oriented toward the effective socialization of youth into Malay-Islamic
values. For example, Yong (1998) found that students admitted to teacher education programmes at
the Universiti are not amongst the most qualified or talented. In an earlier study, Yong (1995)
discovered that teacher trainees are overwhelmingly motivated by materialistic concerns. Yong
argued that until such time as remuneration for teachers improved, the number of talented students
entering teaching and the subsequent quality of teaching would remain low. But it is questionable,
given the low status of education and learning, that higher remuneration will result in better teaching.
More highly qualified students are admitted to the Faculties of Science, Management and Social
Science. Graduates of these more prestigious faculties will be employed in the public sector
providing employment that pays higher salaries and guarantees better benefits than teaching.
It is clear that the Brunei state desires its most intellectually able students to become public sector
managers and bureaucrats, and its least able students to become teachers. Thus the state, through its
capacity to socially engineer the selection and training of teachers, appears to have implemented
policies that effectively place the least academically qualified and motivated people in schools.
Such policies fly in the face of attempts to `professionalize’ pre-service teachers and can only
frustrate attempts by teacher educators to turn them into action researchers.
Gender Concerns
In addition to the issues raised above, an unavoidable cultural factor that impacts the training of
teachers is the way in which the society is divided along gender lines. Over 80% of the Brunei
teaching force consists of females, not because females make better teachers than males, but
because teaching, and other occupations like nursing, have been designated by the state as a
legitimate female' occupations. Gender distinctions are quite marked in Brunei as one might expect in any Islamic country. While there is some gender border crossing’, from an early age, starting in
the home and reinforced in the schools and religious institutions, females are expected to conform
and obey those in authority, most of whom are male.
Male-female relationships are personal and particularistic, morally and ethically bounded by
Malay-Islamic values indicative of clearly defined gender roles. Therefore, social acceptance of
these roles sets upper limits on the extent to which young female pre-service teachers, for example,
could be expected to successfully engage in selfreflection or critical inquiry without violating gender
distinctions, social expectations and principles of group solidarity and cohesion. In Brunei, females
have long since learned that discretion is the better part of valour.
Furthermore, ethnographic evidence confirms that Brunei has remained a highly collectivist culture
where conforming to the group is more valued than demonstrating personal initiative or ambition
(King, 1994). Despite high levels of affluence and consumption, social roles are still defined in kin
terms; one’s place in society is based on an elaborate ranking system. Political, economic, ritual and
other kinds of obligations are superimposed on each other in a single idiom. This strengthens all of
them: one cannot ignore one’s kin of obligations, for instance, without imperilling their relationships.
The price of such strengthening is that all spheres of life become rigid, and innovation, technical or
otherwise, is rendered that much harder (Maxwell, 1996; Mulder, 1996).
Relevant to the potential and possibilities of action research is the degree to which Brunei
pre-service teachers will be willing to break with these cultural expectations and commit themselves
to a process of interrogating their own values and examining discrepancies between these values and
educational practice. The rigid Brunei ranking system, unaltered for centuries, is a powerful
underlying factor. It consists of a vertical dimension, reflecting varying degrees of inferiority and
superiority and of power distance (the tendency to acquiesce to one’s socially defined superior). In
one of the few studies of its kind in Brunei, Blunt (1988) found that Brunei workers typically do not
question those in authority and, in fact, prefer to keep a certain distance between one’s self and
one’s superior. They eschew leadership roles and prefer not to take initiative unless directed by a
superior to do so.
Therefore, to assume that through action research and/or reflection a Brunei female teacher can be
transformed into an active maker of meaning' (see Butler, 1992, 1996; Hendry, 1996), a political
actor’ (Reid et al., 1998) or `change agent’ (Anderson et al., 1994; Cannella & Reiff, 1994) is to
defy gender distinctions and role expectations.
Given this cultural profile, female teachers may be more inclined to demonstrate a strong personal
need to find their rightful place in the school organization, rather than question the basic
presuppositions of their role. They will likely accept the school organization in a manner that not
only conforms to their `gendered’ place in society, but also brings with it respect, status and a sense
of oneness with the larger social structure (Minnis, 1999). Thus the adoption of a formalistic,
teacher-led style of instruction is quite in keeping with traditional Malay-Islamic pedagogical
traditions.
Education or Indoctrination?
Advocates of action research in Brunei also appear to be unaware of the powerful indoctrinating
effect of Islamic education on young Bruneians which is taught not only in the official school
curriculum but also in special religious schools. Students are exposed to extensive religious
instruction from primary school and beyond, including mandatory instruction at the undergraduate
level in the Universiti.
The upshot of such powerful and sustained socialization is that obedience and deference becomes
habit-forming; that is, obedience becomes `natural’, part and parcel of everyday life. Thus to
re-socialize the pre-service teacher, for example, into thinking that they have the freedom to explore,
initiate and do research may be interpreted by them as an attack on their integrity. How might our
ideal-typical teacher respond to an increase in freedom? Initial reaction might range from outright
hostility to passive acceptance. If the protective shield of authority is taken away, the result may not
be ready acceptance of new ideas or a desire to engage in risk-taking behaviour. Instead, the result
may be confusion or, worse yet, inertia, in which case the teacher may keep on behaving as if she
were strictly controlled (see Steutel, 1991).
Teacher educators in Brunei, especially expatriates, have not examined the possible long-term
psychological impact of indoctrination on their students. Of course from the Muslim perspective,
students are not being indoctrinated, but simply taught how to be good Muslims. However, if one
accepts the dual proposition that state hegemony and preservation of Malay-Islamic ideology are
contingent on the effective socialization of youth through the schooling process, then the classroom
teacher has little choice but to conform accordingly. To maintain the system in its present form would
seem essential to state stability and hegemonic control. This is why traditional pedagogy buttressed
by countless hours of formal religious instruction works against reflective inquiry. The present
educational system, in which instruction is oriented toward public examinations, is very efficient at
leading students to correct answers and approved ways of learning leading to the passing of tests.
Unlike the Western-trained teacher, Brunei teachers are not correspondingly concerned that
students arrive at answers on the basis of critically assessing alternative answers or theories
(Ducharme, 1994). Regardless of the cultural context, extensive religious training, emphasizing rote
and memorization, is hardly conducive to reflective thinking. Thus teacher educators in Brunei should
not deny the possibility that if beliefs are held non-evidentially, that is, held without regard to
evidence relevant to its rational assessment, and held in such a way that it is impervious to negative
or contrary evidence, then the belief is an indoctrinated one (Steutel, 1991). This is the essence of
religious training. The pre-service teacher is therefore ill prepared to accommodate constructivist
teaching principles in a way that challenges their preconceptions and understandings of knowledge,
schooling and teaching.
Conclusion
Presently, the problem facing advocates of action research in Brunei is that there is little political
space in which to experiment, innovate, or to otherwise engage in a serious examination of the larger
social and political system. In such a controlled climate, it is improbable that educational researchers
will venture into the utopian, critical and evaluative forms of educational discourse characteristic of
educational research in more open societies. It will be very difficult for action research to take root
in Brunei soil. Those who continue to promote action research must keep in mind that cultural and
socio-political imperatives are of fundamental significance in determining approaches to education in
Islamic nations. It is the cultural-religious and political setting that keeps policies in place and
provides resistance to the implantation of ideas from other systems.
We close this essay with reference to the views of educational philosopher Paddy Walsh (1992). He
interprets philosophy and critical theory as examples of utopian discourse and suggests that such
discourses locate education within a framework of ideal scenarios which can further one's quest for coherence' (p. 143). Walsh maintains that if educational researchers are not allowed to explore the utopian and evaluative forms of discourse, then they will have failed to evaluate education from the
broadest possible perspective’ (p. 143). Utopian discourse that focuses squarely on the ends of
education ought to be disembedded from the immediate practical context of education in order to
present an overall perspective on matters of value and notions of the `good society’.
Unfortunately for educational researchers in Brunei, the state has already defined what the good society' should look like. This is why it makes little sense to regard action research as sufficient to meet the requirements of change for the better in education, for there can be no conception of the
better’ without utopian and evaluative discourse.
[Reference]
REFERENCES
[Reference]
ALTRICHTER, H., POSCH, P. & SOMEKH, B. (1993) Teachers Investigate their Work (London, Routledge).
AMUZEGAR, J. (1999) Managing the Oil Wealth: OPEC’s windfalls and pitfalls (London, Tauris).
ANDERSON, G., HERB, K. & NIHLEN, A. (1994) Studying your Own School: an educator’s guide to qualitative
practitioner research (London, Corwin).
ANDERSON, L. (1997) Teacher preparation for post-modern schools: the necessary integration of training
and education, in: W.C. CuMMINGS & N.G. MCGINN (Eds) International Handbook of Education and
Development: preparing schools, students and nations for the twenty-first century (Oxford, Pergamon
Press).
[Reference]
ATWEH, B., KEMMIS, S. BL WEEKS, P. (1998) Action Research in Practice: partnerships for social justice in
education (London, Routledge).
BEBLAWI, H. (1987) The render state in the Arab world, in: H. BEBL,wi & E. GIACOMO (Eds) The Render
State (London, Croom Helm).
BEHAR, R. (1999) The fairy tale’s over for the kingdom of Brunei, Fortune, February, pp. 53-62.
BILL., J.A. & SPRINGBORG, R. (1994) Politics in the Middle East, 4th edn (New York, Harper Collins).
BLUNT, P. (1988) Cultural consequences for organization change in a southeast Asian state: Brunei,
Academy of Management Executive, 1, pp. 235-240.
BRAIGHLINN, G. (1992) Ideological Innovation under Monarchy: aspects of legitimation activity in
contemporary Brunei (Amsterdam, VU University Press).
BROWN, D. (1970) Brunei: the structure and history of a Borneoan Malay sultanate, Brunei Museum
Journal, 2, pp. 120-134.
[Reference]
BROWN, D. (1976) PYr’nciples of Social Structure: Southeast Asia (London, Duckworth).
BUTLER, J. (1992) Teacher professional development: an Australian case study, Journal of Education for
Teaching, 18, pp. 221-238.
BUTLER, J. (1996) Professional development: practice as text, reflection in process, and self as locus,
Australian Journal of Education, 40, pp. 265-283.
CANNELLA, G.S. & Rare, J. (1994) Preparing teachers for cultural diversity: constructivist orientations,
Actions in Teacher Education, 16, pp. 37-45.
CHEONG, D. & NUTTMAN, C. (1995) Education policy: a global or local agenda? Reflections on Brunei
Darussalam, paper presented to the 5th SEAMO International Conference on Educational Challenges in the
World Community of the 21st Century, Manila, December.
COLCLOUGH, C. (1995) Brunei: development problems of a resource rich state, Euro-Asian Business Retv,
4, pp. 29-32.
CROSSLEY, M. (1992) Teacher education in Papua New Guinea: a comment on comparative and
international observations, Journal of Education for Teaching, 18, pp. 23-28.
CROSSLEY, M. & VULLIAMY, G. (1997) Qualitative Educational Research in Developing Countries (New York,
Garland).
[Reference]
DAO, M.Q. (1996) Brunei: an economy in transition, Journal of Contemporary Asia, 26, pp. 505-511.
DUCHARME, E.R. (1994) Characteristics of teacher educators, in: T. HUSEN & T.N. POSTLETHWAITE (Eds)
The International Encyclopedia of Education, 2nd edn, Vol. 6 (Oxford, Pergamon Press).
ELLIOTT, J. (1991) Action Research for Educational Change (Milton Keynes, Open University Press).
EXTERNAL EXAMINERS REPORT (1998) Sultan Hassanal Bolkiah Institute of Education, Universiti Brunei
Darussalam.
GILROY, P. (1993) Reflections on Schon: an epistemological critique and a practical alternative, in: P.
GILROY & M. SMITH (Eds) International Analyses of Teacher Education (Oxfordshire, Carfax).
GUNN, G.C. (1993) Rentier capitalism in Negara Brunei Darussalam, in: K. HEWISON, R. ROBISON & G.
RODAN (Eds) Southeast Asia in the 1990s: authoritarianism, democracy and capitalism (St. Leonards, Allen
& Unwin).
HENDRY, D. (1996). Constructivism and educational practice, Australian Journal of Education, 40, pp. 9-45.
[Reference]
HOLLINGSWORTH, S. (1997) International Action Research: a casebook for educational reform (London,
Falmer Press).
HOYLE, E. (1994) Teachers as professionals, in: T. HUSSEN & T.N. POSTLETHWAITE (Eds) The International
Encyclopedia of Education, 2nd edn, Vol. 6 (Oxford, Pergamon Press).
ILON, L. (1997) Confronting the bully: regional education trends in the global economy, Compare, 27, pp.
53-166.
KAY, J. ( 1997) The Business of Economics: competition, the stakeholder economy, business strategy
(Oxford, Oxford University Press).
[Reference]
KEEVES, J.P. (1994) Legitimacy in educational research, in: T. HUSEN & T.N. POSTLETHWAITE (Eds) The
International Encyclopedia of Education, 2nd edn, Vol. 6 (Oxord, Pergamon Press).
KEMMIS, S. (1990) The Curriculum Corporation: observations and implications (Melbourne, Australian
Curriculum Studies Association).
KING, T.L. (1994) What is Brunei society? Reflections on a conceptual and ethnographic issue, South East
Asia Research, 2, pp. 176-198.
LEACH, F. (1994) Expatriates as agents of cross-cultural transmission, Compare, 24, pp. 217-231.
MARGINSON, S. (1993) Education and Public Policy in Australia (Cambridge, Cambridge University Press).
[Reference]
MAXWELL, A.R. ( 1996). The place of the Kadayan in traditional Brunei society, East Asia Research, 4, pp.
157-196.
MINNIS, J.R. (1997) Economic diversification in Brunei: the need for closer correspondence between
education and the economy, Education Journal, 2, pp. 117-136.
MINNIS, J.R. (in press) Is reflective practice compatible with Malay-Islamic values? Some thoughts on
teacher education in Brunei Darussalam, Australian Journal of Education.
MULDER, N. (1996) The common cultural construction of social life in inner, littoral South East Asia, South
East Asia Research, 4, pp. 41-61.
NOFFKE, S.E. & STEVENSON, R.B. (Eds) ( 1995) Educational Action Research: becoming practically critical
(New York, Teachers College Press).
NORENG, O. (1997) Oil and Islam: social and economic issues (New York, Wiley).
O’DONOGUE, T.A. (1994) Transnational knowledge transfer and the need to take cognizance of contextual
realities: a Papua New Guinea case study, Educational Review, 46, pp. 73-88.
OTHMAN, M.N. & CLARK, C. (1998) Wastage in local skills, Borneo Bulletin, September, p. 1.
PHILLIPS, D. (1997) Policy borrowing in education, in: W.C. CUMMINGS & N.F. MCGIN (Eds) International
Handbook of Education and Development: preparing schools, students and nations for the twenty-first
century (Oxford, Pergamon Press).
REID, A., MCCALLUM, F. & DOBBINS, R. (1998) Teachers as political actors, Asia Pacific Journal of Teacher
Education, 26, pp. 247-259.
SEVENTH NATIONAL DEVELOPMENT PLAN 1996-2000 (1996) Ministry of Law, Brunei Government Printing
Office.
STEUTEL, J. (1991) Discipline, internalization and freedom: a conceptual analysis, in: B. SPIECKER & R.
STRAUGHAN (Eds) Freedom and Indoctrination in Education: international perspectives (London, Cassell).
[Reference]
TATTO, M.T. (1997) Limits and constraints to effective teacher education, in: W.C. CUMMINGS & N.F.
MCGINN (Eds) International Handbook of Education and Development: preparing schools, students and
nations for the twenty-first century (Oxford, Pergamon Press).
TAYLOR, S., RISZI, F., LiNGARD, B. & HENRY, M. (1997) Educational Policy and the Politics of Change
(London, Routledge).
THOMAS, E. (1997) Developing a culture-sensitive pedagogy: tackling a problem of melding `global
culture’ with existing cultural contexts, International Journal of Educational Development, 17, pp. 13-26.
[Reference]
VANDENBERGHE, V. (1999) Economics of education: the need to go beyond human capital theory and
production-function analysis, Educational Studies, 25, pp. 129-143.
WALSH, P. (1992) Discourses of the reflective educator, Journal of Philosophy of Education, 26,
pp.139-152.
YONG, B. (1995) Teacher trainees’ motives for entering into a teaching career in Brunei Darussalam,
Teaching & Teacher Education, 11, pp. 275-280.
YONG, B. (1998) Teaching as a career as perceived by Form V students in Brunei Darussalam, Journal of
Applied Research in Education, 2, pp. 19-34.
[Author note]
JOHN R. MINNIS, Universiti Brunei Darussalam
[Author note]
Correspondence: John Minnis, Box 4414, The Pas, Manitoba R9A 1R2, Canada.
man those articles are long…lol…well i am hoping that u will get them before hmcq deletes them or admin …
http://www3.pak.org/gupshup/smilies/smile.gif
i hope these helped… if u need more info… pm me i will give u my email address and lets see how do u do on your thesis…
http://www3.pak.org/gupshup/smilies/smile.gif
interesting topic in btw..
http://www3.pak.org/gupshup/smilies/smile.gif