Michelle M. Fleig-Palmer’s research while affiliated with South Dakota State University and other places

An emerging area of trust research considers trust in multiple trustees, largely examining how trust in multiple trustee aggregates additively. Few studies have considered potential non-additive ways an individual trustor might weigh trust in each of the multiple trustees, depending on the situation-context, specifically what is needed from the trustees to address the risk. We conducted an experimental vignette study to test aspects of the Perceived Influence Model of Trust. This model predicts different trust effects depending on how a trustor weighs trust in each trustee, described as additive, compensatory, and compulsory trust effects. The vignette focused on workplace conflict because of its ubiquity and the importance of trust for resolution. Participants imagined themselves as an employee (trustor) deciding whether to risk disclosure of a conflict with a co-worker to two supervisors (trustees) before the supervisors conduct a performance evaluation of the employee to determine if they receive a promotion. The study contained a manipulation of the task requirements – what is needed from the trustees to achieve the trustor’s desired end. The trustworthiness cues of the two trustees were also manipulated to indicate high or low trustworthiness. ANCOVA analyses supported a three-way interaction effect, demonstrating the importance of the trustees’ task requirements in determining how trust in one trustee changes the effects of trust in another trustee on the trusting outcome. These results provide initial support for the Perceived Influence Model of Trust and provide a foundation for researchers seeking an enhanced understanding of multi-trustee trust in situations involving conflict.

Prior research investigating situations involving one trustor and multiple trustees often examines how a trustor’s trust in one party affects their amount of trust in another party. This paper fills a gap by predicting the effects of trust. The Perceived Influence (PI) Model of Trust is an individual-level model focused on the perceptions of a trustor. It builds upon the Mayer et al. (1995) model by integrating insights from literature on task interdependence and expanding to two trustees. The PI model describes and explains three possibilities for how a trustor’s trust in two trustees may combine to form a sense of aggregate multi-trustee trust via: (1) additive effects, such that the trustor’s trust in each of the trustees has independent effects on the aggregate; (2) compulsory effects, such that increasing the amount of trust in one trustee increases the effect of trust in the other trustee; and (3) compensatory effects, such that increasing trust in one trustee decreases the effect of trust in the other trustee. We propose that the theoretical mechanism explaining which of these three possibilities takes place is the trustor’s perceived influence of the trustees, which is tightly linked to perceptions of task requirements necessary to attenuate the trustor’s risk. The PI model begins to fill an important gap in the literature pertaining to pervasive, but rarely considered, multi-trustee situations, and proposes the importance of trustor perceptions of trustee influence and task requirements for future models of trust.

Although the federal government's Meaningful Use electronic health record (EHR) implementation program resulted in some successes, there have been many challenges. The purpose of this study was to obtain detailed empirical data to better understand physicians' and nurses' experiences with EHRs. We conducted in-depth interviews with 30 physicians and nurses from two large health systems that were focused on attaining Stage 3 Meaningful Use criteria. Thematic framework analysis identified themes related to perceived benefits and challenges with EHR use. Participants appreciated benefits such as real-time patient data and easier access to information. Challenges included lack of interoperability across units, and this seemed to underlie many other noted challenges such as increased workload, insufficient training, and the perceived need for workarounds. Two key findings included mixed messages about trust in the EHR's information and its interference with interpersonal relationships. Results suggest that conservation of resources theory may be a useful strategy for understanding behaviors that enhance or undermine effective EHR use. Implications for policy and practice are discussed.

Background: In health care organizations, trust is critical for effective workplace relationships that ensure patient-centered outcomes. Although research has focused on trust in the relationship between patients and clinicians, less is known about what influences workers to trust their managers. An understanding is needed of the specific behaviors that influence health care workers' evaluations of their managers' trustworthiness. Mentoring research focuses on the developmental assistance that a more experienced worker provides to a less experienced worker. Building upon Kram's (1988) seminal research on mentoring functions, we argue that health care managers can build trust by providing informational (career-related) and interpersonal (psychosocial) support. Purpose: The aim of the study was to investigate the influence of health care managers' informational and interpersonal mentoring behaviors on workers' perceptions of their managers' trustworthiness and the mediating role of trustworthiness on trust in the managers. Methodology/approach: Surveys were completed during work hours by 315 health care workers at an acute care hospital and associated clinics in the Midwest. Findings: Results showed that managers' mentoring behaviors influenced worker perceptions of their managers' trustworthiness, in terms of ability, integrity, and benevolence. Ability partially mediated the relationship between informational mentoring and trust in managers, whereas integrity and benevolence partially mediated the relationship between interpersonal mentoring and trust in managers. Practice implications: Health care managers can actively build trust through mentoring behaviors that inspire positive assessments of managers' ability, integrity, and benevolence.

While many agree that interpersonal and institutional trust are key ingredients for social order, the differences between the two and how they influence one another remain unclear. We define trust as the willingness to be vulnerable to another party, and focus our discussion on situations where the trustor (trusting party) is an individual member of the public and the trustee (party being trusted) is an institution or one of its members. We review the literature on trust and related concepts that address the potential relationships between interpersonal trust and institutional trust, focusing on two illustrative contexts: the political arena and health care. For each context, we examine extant research to provide definitions of institutions and note how these definitions have implications for defining institutional trust in each context. Second, we examine how characteristics of the trustor (individual-level characteristics) may affect the relationship between interpersonal and institutional trust. For example, a trustor’s gender, race and ethnicity, and familiarity with the institutional trustee may frame his/her interactions with, and subsequently their trust in, the institution. Being cognizant of these factors will improve understanding of the cases where a relationship between interpersonal and institutional trust exists. We conclude by highlighting how these arguments can inform future research.

Jones and Stout (2015) have recommended that industrial and organizational (I-O) researchers and practitioners take a more nuanced perspective with respect to nepotism and cronyism—recast as social connection preference (SCP)—when relevant I-O decisions (e.g., hiring) are made on the basis of kin or affiliation considerations. Jones and Stout's (2015) arguments have challenged the reflexive view that SCP is always negative and thus the prudent approach is to restrict and, if possible, prohibit it. They call for further research to flesh out our understanding of SCP in organizations, and we suggest that one way to do that is to explicitly incorporate trust theory, that is, the components of trustworthiness, which represent antecedents of trust.

To be financially viable in today’s healthcare industry, health care providers must balance quality patient care with effective management of the business aspects of their practices. While clinical training has kept pace with medical advancements, less attention has been given to business and practice management training. Health care providers need business training to be good stewards of health care resources. The purpose of this study was to understand health care providers’ perspectives regarding the content and the timing of business-related education so that business professors assist health care providers in their stewardship efforts. Health care providers — physicians, dentists, pharmacists, nurse practitioners, and optometrists — in a Midwestern state were sampled via a mailing. Surveys and informed consent forms were mailed to health care providers listed in Hoover’s database as currently practicing in various sized communities, i.e., rural, micropolitan, and urban. Of the 273 respondents, at least 80% of the currently practicing health care providers indicated that additional business knowledge would be helpful overall and with cost containment. Across health care professions, accounting, finance, management/human resources, and computer information systems were seen as most beneficial although size of practice influenced preferred business subject. To successfully manage a practice, business knowledge is critical for health care providers. Business- related education for health care providers must be tailored to the profession with consideration for the type and size of the practice. Creative methods, for incorporating business-related subjects into clinical education are discussed. These include adapting case studies and interprofessional education at the graduate/post-graduate level. The survey results can guide business professors in making curricular and continuing education decisions regarding practice management training for health care providers.

Health care organizations (HCOs) invest in knowledge transfer to promote improved patient outcomes; however, these investments prove costly when health care workers with enhanced knowledge and skills leave to seek better employment opportunities. The aim of this study was to examine the impact of interpersonal mentoring on affective organizational commitment and the potential moderating effect of affective commitment in the knowledge transfer-retention relationship. One hundred fifty-three clinicians working at a Midwestern acute care hospital and associated clinics were surveyed at their worksite. Clinicians who received more interpersonal mentoring were also more likely to have stronger affective commitment. In addition, affective commitment moderated the relationship between knowledge transfer and turnover intentions, that is, when affective commitment was low, clinicians with higher levels of knowledge transfer indicated higher turnover intentions. However, clinicians with high levels of affective commitment and knowledge transfer reported lower turnover intentions. HCOs must simultaneously invest in knowledge transfer while implementing strategies that assist in retaining knowledgeable workers. Interpersonal mentoring appears to play an important role in the retention of valued clinicians through its influence on affective commitment. HCOs must facilitate cultures that show top management support for mentoring through practices such as educational programs, flexible scheduling, and reward systems.