Case study 4: The effect of culture on relationships

Culture intro image

Rao and Stevenson (2014) explored levels of wellbeing in Black and Minority Ethnic (BME) populations in England and observed that BME staff face disproportionate rates of racist verbal and physical attacks, bullying and harassment. This section explores the influence of culture on organisational structures, teams, policies and procedures. It offers an understanding of how culture can influence the interpretation of a practitioners’ performance and professional skills, interpretations that may then lead team members to perceive an individual practitioner's performance as poor or unsatisfactory when it does not comply with the prevailing organisational culture. 

Key learning outcomes for this section are to:

  1. explore the influence of culture on an individual practitioner's personal and professional skills, in particular, how their learning of team working skills in one culture may influence their relationship with their new team
  2. demonstrate how interventions that work successfully in one culture may be deemed inappropriate or unsuccessful in another culture
  3. offer an example of an intervention that members of a team could consider applying when supporting the transition of a new team member from one culture to another.

Seminal work that has informed this section is based on cultural studies by researchers like Hofstede. He sees that cultures are made manifest in the way people interact with each other, and that, whilst all cultures face similar problems, they seek different solutions to those problems.  It is these solutions, he says, that define their culture. 

Similarly, whilst organisations and professions exist in the wider background of prevailing culture, they are shaped by the function they perform, and the solutions they find to the challenges they face.  This leads to ‘cultures-within-cultures’ – aptly termed micro-cultures.  

Social research also suggests that culture is a dynamic process, which continues to evolve over time usually in response to economic and social drivers. Healthcare systems and health professionals, existing as micro-cultures within the wider social culture, also evolve over time, as they respond to the changes taking place in the wider culture. Looking through a cultural lens at the NHS, we can see, for example, how the evolution of specialities in the medical and nursing profession has taken place in response to the demands for change in the wider social culture.