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Lecture Notes
Chapter 11: Intercultural Communication in Business, Health Care, and
Educational Settings
LEARNING OBJECTIVES
1. Discuss how dimensions of the cultural context affect organizations across cultures
2. Compare managerial styles of Japanese, Germans, Mexicans, and Chinese
3. Compare the different beliefs, values, and behaviors associated with health and health care across
cultures
4. Identify and discuss learning style differences across cultures
CHAPTER OVERVIEW
Coordinating and managing people from different cultures within business, health care, and educational
settings represents one of the greatest challenges in the new millennium. Few managers, health care
providers, or teachers will survive and function effectively without an understanding of the subtleties
and complexities of interacting with others in a multicultural and multinational environment. Given the
dramatic cultural transformation in today’s marketplace, health care settings, and classrooms, the
relevance of intercultural communication competence cannot be overstated. To function effectively,
business leaders, health care providers, and teachers must possess the skills to interact with people who
are different from themselves.
CHAPTER OUTLINE
I. Intercultural Management
1. Successful cross-cultural management depends on the ability of managers to communicate
effectively. Communication is especially important during the initial stages of a business
relationship. Depending on the culture, the process of building trust among business partners
may take days, weeks, or even months. Many American managers prefer to “get down to
business” without spending much time getting to know their business partners. In fact, many
American managers view such relationship building as a waste of valuable time. However, this is
not the case in many cultures. Perceptions of time and timing are important considerations in
cross-cultural business exchanges. American managers should allow the pace of negotiations to
develop on their own and should not to impose artificial deadlines for the sake of efficiency.
Most of what students have been exposed to in this textbook can be applied to their role in
organizational settings across cultures.
a. First, consider the cultural context of an organization. Organizational culture often
parallels country culture. Hence, if values differ significantly across cultures, then the
management practices of those cultures are also likely to differ.
b. In addition to assessing an organization’s cultural context, it is important to assess its
environmental context—that is, its perspective on the environment, including such
issues as information load, privacy, and the company’s overall orientation to nature.
Assumptions about privacy are also important to take into account.
c. The perceptual context of the individual, learned through enculturation, often
manifests in the organization. Understanding how the organization processes
information is crucial to establishing and maintaining effective communication
d. An organization’s emphasis on group membership is clearly something that U.S.
managers should know about their foreign counterparts. As mentioned in Chapter 6, all
people of all cultures belong to groups.
e. Understanding the verbal and nonverbal codes of the foreign counterparts is an
essential part of a successful business venture. Although it is true that most of your
foreign business partners will speak some English, knowledge and use of their language
demonstrates your willingness to meet them halfway and will be much appreciated.
II. Management Practices across Cultures
1. The top 10 countries with which the United States trades, in terms of both imports and exports,
are (in order) China, Canada, Mexico, Japan, Germany, South Korea, the United Kingdom,
France, Taiwan, and India. In 2015, U.S. trade with these countries accounted for nearly $3
trillion (i.e., $3,000,000,000,000).
a. Japanese organizations are essentially social organizations, of which two key features
are lifetime employment (shushin koyo) and seniority grading (nenko joretsu). Based on
these principles, the Japanese company is seen as a custodian of employee security and
welfare. The lifetime employment system is based on a psychological contract between
the employees and the company about the employees’ lifetime dedication to the
company in exchange for lifetime job security from the organization. Japanese
organizations also practice a seniority-based wage and promotion arrangement
whereby employees are promoted and compensated based on the number of years
they have served the organization. The system rewards older and longer-serving
employees. Conversely, employees who change their employers are penalized. But then
there is the phenomenon of the Japanese salaryman, of which many articles, films, and
even YouTube videos have been produced. He stays on the job for an average of 13
hours, not leaving the office until after 11:00 p.m. in order to make the final train home.
He does this 6 days a week, averaging nearly 80 hours of work and only 35 hours of
sleep a week. Many consider the salaryman the core of Japan’s economy, where they
are expected to put the company first, even before family. They work brutal hours,
often followed by marathon drinking sessions with colleagues and clients. Japan is
witnessing a record number of deaths due to overworking, termed karoshi, which
translates literally as overwork death in Japanese. It manifests as sudden death due to
heart attack, stroke, stress, and a starvation diet. White notes that this phenomenon is
associated with salaryman but is now afflicting younger Japanese and female
employees.
b. A unique feature of Germany’s economic structure is a state-regulated apprentice
system through which young German adults learn a specialized skill, for which they
receive a state diploma. Learning is both on the job and theoretical. The curriculum is
determined by the government, an employers’ association, and German trade unions.
During their apprenticeship, students are supervised by local chambers of commerce.
This system leads to a remarkably well-trained workforce. About 70% of German
workers have been through this system. Technical knowledge and engineering skills are
highly valued in Germany. They maintain that German employees are continuously
challenged with new procedures, tools, and techniques. German managers are known
to be specialists for which a technical background is more typical than a formal
education. German foremen, supervisors, and managers typically have professional
rather than academic degrees. Hence, quality of skill and amount of experience are the
most important promotional considerations in German firms.
c. Mexicans are unusually group oriented. They are exceptionally concerned about any
behavior that would upset the harmony of their household, church, or workplace.
American managers working in Mexico should not reward individuals within work
groups. Generally, Mexican workers do not wish to call attention to themselves for
outperforming coworkers and may be ashamed and embarrassed if recognized above
others. In Mexico, individual effort and self-starting are met with suspicion. Even
arriving early to work requires an explanation to coworkers, because they will think that
person is trying to get ahead by showing off. For a worker to leave his or her
workstation to talk to the supervisor about mundane, work-related issues is disquieting
to others in the group, unless the employee has explained his or her need to
communicate with the supervisor beforehand. The Mexican worker’s attitude toward
the boss is virtually never confrontational. Mexican workers value harmony above all
else. A manager expressing favoritism to an individual Mexican worker will upset the
harmony and shatter the team spirit.
d. China’s Confucian heritage affects how Chinese will approach their business
relationships. In Confucian-based societies, great emphasis is placed on harmonious
relationships and knowing one’s proper place in the social hierarchy. All relationships
are seen as unequal, and one’s ethics are directed toward observing these inequalities.
Contrary to the United States, where business is business and not to be taken
personally, the Chinese will go to great lengths to establish trust and a social bond in
their international business relationships. When doing business in China, you can expect
your Chinese counterpart to invite you to informal gatherings and to discuss topics
unrelated to the business at hand, such as politics, the arts, information about your
family, etc. The Chinese want to see you as a member of the business family—that is,
the group.
III. Culture, Intercultural Communication, and Health Care
1. People from diverse cultural backgrounds face different health issues and carry vastly different
assumptions about their health. To be sure, different cultural groups have different beliefs,
values, and behaviors associated with their health and health care. These different belief and
value systems translate into diverse theories and practices about the causes and treatments of
illness.
2. People from different cultures generally attribute illness to one of four causes: (a) factors within
the individual, such as bad eating and exercise habits; (b) factors within the natural
environment, such as air and water pollution; (c) societal factors, such as intergroup conflict,
poor health care facilities, etc.; or (d) supernatural factors, including religious beliefs, fate, and
indigenous beliefs. These attributions for health and illness reflect the particular culture’s
general value orientations.
3. Persons in Western cultures such as the United States, which are often individualistic, generally
believe that the origins of illness are rooted in the individual patient. The responsibility for one’s
health generally, though not exclusively, rests with the individual. So ill health is often
considered to be the result of the individual’s bad habits, such as poor diet, lack of exercise,
damaging lifestyle choices, poor personal hygiene, alcoholism, drug abuse, or other deviant
behavior. Thus, from this perspective, one should feel guilty when faced with ill health.
4. In many non-Western cultures, illness is often attributed to societal and/or supernatural
conditions. Societal attributions are based on intergroup or interpersonal conflict within the
culture. Here, one of the most common causes of illness is thought to be witchcraft.
IV. Health Communication
1. The Centers for Disease Control and the National Cancer Institute define health communication
as “the study and use of communication strategies to inform and influence individual decisions
that enhance health.” The study of health communication covers a vast arrays of topics, far too
many to address in this chapter. But one area in particular that has direct relevance for
intercultural communication is patient–provider communication. The focus here is on the face-
to-face interaction between the patient and his or her individual health care provider, which
includes physicians, nurses, psychiatrists, psychologists, and counselors, among others.
2. Historically, the relationship between the provider and patient in medical contexts has been
asymmetrical. Because of their advanced education and experience, providers (e.g., physicians)
hold more power than patients and are responsible for managing the interaction with patients,
while the patients are generally passive. This approach, which was dominant throughout the
20th century, is called paternalism. In contrast, an approach labeled consumerism or mutual
participation has been the popular model in the 21st century, where the patient sets the agenda
and shares responsibility for decision making. In this model, the provider accommodates patient
requests for information and services.
3. The degree to which paternalism and consumerism are practiced across cultures has been the
focus of a number of studies. Theoretically, we would expect that in large–power-distance and
collectivistic cultures, a paternalistic approach might continue to dominate provider–patient
communication. But several studies have shown that this is not the case. Across most cultures
patients prefer to participate in such decision making. Of course, while these patients indicate
that they would like to participate in such decision making, we do not know for sure if they
actually do.
V. Intercultural Communication and Educational Settings
1. One type of relationship that exists in every culture is the student–teacher relationship. And in
all cultures, students learn and teachers teach. Students can learn by seeing, hearing, reflecting,
experiencing, reasoning, memorizing, and even intuiting. Teachers can teach by lecturing,
demonstrating, discussing, questioning, and applying principles. But how students go about
learning and teachers go about teaching may vary considerably across cultures.
a. According to the Institute of International Education, in the 2014–2015 academic year,
there were nearly 1 million (i.e., 974,926) international students attending U.S. colleges
and universities, which was the highest growth rate in 35 years. The United States hosts
more of the world’s 4.5 million international students than any other country. Students
from China represent the largest percentage of international students in the United
States,
b. Just over 300,000 U.S. college students studied abroad for academic credit during the
2013–2014 academic year, which is an increase of 5.2% over the previous year. U.S.
student participation in study-abroad programs has nearly tripled in the past 20 years.
2. One area of research in education that has received a substantial amount of attention is the
subject of learning styles. Proponents of the learning style approach (e.g., educators,
psychologists, sociologists, counselors) maintain that individuals have their own personal
learning style—that is, their own unique way of gathering, storing, and retrieving information to
solve problems. Many now believe that while learning is a universal feature among humans,
specific information-processing abilities (i.e., learning styles) are acquired via culture and the
socialization process. If we know and understand how people learn, we can then adapt our
teaching methods to accommodate them.
3. One theory of learning styles is called experiential learning theory (ELT), developed by David
Kolb. Although not accepted by all learning theory scholars, Kolb’s ELT model has received a
substantial amount of attention in education and psychology and has been applied extensively
in cross-cultural and intercultural research.
a. Kolb’s central thesis is that learning occurs when knowledge is gained via the
transformation of experience. In other words, we learn when we take our experiences
and transform or convert them into knowledge. He argues that knowledge, and hence
learning, results from (1) grasping experience and (2) transforming experience.
b. According to Kolb, grasping experience means to seize or take hold of it. This includes
concrete experience (CE) and abstract conceptualization (AC). In explaining CE, Kolb
argues that in grasping experience, some people take in new information directly via
tangible and empirical methods; that is, they need to see, hear, smell, touch, or taste it.
For them, experience needs to be real or factual. Others tend to take in new information
via symbolic means (i.e., AC). These people think, analyze, and plan abstractly. In
transforming experience, some people tend to observe others who are involved in the
experience and reflect on it (i.e., reflective observation, or RO). Then, there are those
who approach experience and actively participate in it (i.e., active experimentation, or
AE). one’s choice of grasping experience (i.e., CE or AC) and one’s choice of
transforming experience (i.e., AE or RO) define that person’s preferred learning style, of
which there are four: diverging, assimilating, converging, and accommodating.
4. In the past 30 years, the topic of teacher immediacy has received a great deal of attention in the
communication literature. The concept of immediacy stems from the work of psychologist
Albert Mehrabian and refers to those verbal and nonverbal behaviors that reduce the
physiological and psychological distance between interactants. Researchers in communication
have extended the concept of immediacy to the classroom and, specifically, teacher immediacy.
Here, teacher immediacy refers to the verbal and nonverbal communication expressed by
teachers that reduces the physiological and psychological distance between teachers and
students. Perceptions of teacher immediacy vary considerably across cultures.
5. So we know that students across cultures have different learning styles, and we know that
teachers across cultures have different teaching styles. Hence, in an intercultural classroom,
students and teachers prefer to learn and teach differently. In recognizing the differences in
learning and teaching styles, here are some recommendations that may be helpful for teachers
in an intercultural classroom.
1. Motivate learning.
2. Balance concrete and conceptual information.
3. Balance structured and unstructured activities.
4. Make liberal use of visuals.
5. Don’t just lecture.
6. Allow students to cooperate on some assignments.
