When Voice Matters: A Multilevel Review of the Impact of Voice in Organizations

The conventional wisdom is that voice leads to desirable outcomes for organizations. However, this is most certainly an oversimplification. Of the over 1,000 studies examining the impact of voice in organizations, the implications of voice vary by the level of the organization (individual, group, organization) as well as the outcome of interest (e.g., group harmony vs. job satisfaction). In this article, we draw from the diverse literatures examining the impact of voice to integrate the theoretical frameworks and empirical results for voice outcomes across organizational levels. To do so, we start with a discussion of the definition and development of voice as a construct, beginning with Hirschman’s seminal work on voice/exit/loyalty. We then review the theoretical frameworks within each level that explain the effect of voice on outcomes, highlight the role of mediating or moderating mechanisms, and discuss directions for future research. Finally, we emphasize emerging trends in the study of voice and suggest areas in which the various literatures may benefit from borrowing across fields and levels of interest to produce a more comprehensive, theoretically grounded, and cohesive body of work.</jats:p

The Empirical Foundations of Telemedicine Interventions in Primary Care

Introduction: This article presents the scientific evidence for the merits of telemedicine interventions in primary care. Although there is no uniform and consistent definition of primary care, most agree that it occupies a central role in the healthcare system as first contact for patients seeking care, as well as gatekeeper and coordinator of care. It enables and supports patient-centered care, the medical home, managed care, accountable care, and population health. Increasing concerns about sustainability and the anticipated shortages of primary care physicians have sparked interest in exploring the potential of telemedicine in addressing many of the challenges facing primary care in the United States and the world. Materials and Methods: The findings are based on a systematic review of scientific studies published from 2005 through 2015. The initial search yielded 2,308 articles, with 86 meeting the inclusion criteria. Evidence is organized and evaluated according to feasibility/acceptance, intermediate outcomes, health outcomes, and cost. Results: The majority of studies support the feasibility/acceptance of telemedicine for use in primary care, although it varies significantly by demographic variables, such as gender, age, and socioeconomic status, and telemedicine has often been found more acceptable by patients than healthcare providers. Outcomes data are limited but overall suggest that telemedicine interventions are generally at least as effective as traditional care. Cost analyses vary, but telemedicine in primary care is increasingly demonstrated to be cost-effective. Conclusions: Telemedicine has significant potential to address many of the challenges facing primary care in today's healthcare environment. Challenges still remain in validating its impact on clinical outcomes with scientific rigor, as well as in standardizing methods to assess cost, but patient and provider acceptance is increasingly making telemedicine a viable and integral component of primary care around the world.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140293/1/tmj.2016.0045.pd

Followership, Leadership and Social Influence

Traditional research in leadership has largely relegated followers to the role of passive recipients or, at best, moderators of leader influence and behaviors. However, recent work in the area of followership has begun shifting this focus and emphasizing the possibility that followers actively have an influence over leaders, in particular leader behavior. This paper revisits traditional areas of the leadership literature and builds on the emerging followership literature to reintroduce followers as part of the social context of leaders. In an attempt to build theoretical rationales for how followers influence leader behavior we draw on the social influence (e.g., Social Impact Theory, Latane, 1981) and the power literature to suggest individual (e.g., strength and immediacy of followers) and group level (e.g., number of followers and unity of the group) characteristics that influence leader behaviors as a function of a leader's informational and effect dependence on followers

The Empirical Evidence for the Telemedicine Intervention in Diabetes Management

Objective: The research presented here assesses the scientific evidence for the telemedicine intervention in the management of diabetes (telediabetes), gestational diabetes, and diabetic retinopathy. The impetus derives from the confluence of high prevalence of these diseases, increasing incidence, and rising costs, while telemedicine promises to ameliorate, if not prevent, type 2 diabetes and its complications. Materials and Methods: A purposeful review of the literature identified relevant publications from January 2005 to December 2013. These were culled to retain only credible research articles for detailed review and analysis. The search yielded approximately 17,000 articles with no date constraints. Of these, 770 appeared to be research articles within our time frame. A review of the abstracts yielded 73 articles that met the criteria for inclusion in the final analysis. Evidence is organized by research findings regarding feasibility/acceptance, intermediate outcomes (e.g., use of service, and screening compliance), and health outcomes (control of glycemic level, lipids, body weight, and physical activity.) Results: Definitions of telediabetes varied from study to study vis-à-vis diabetes subtype, setting, technology, staffing, duration, frequency, and target population. Outcome measures also varied. Despite these vagaries, sufficient evidence was obtained from a wide variety of research studies, consistently pointing to positive effects of telemonitoring and telescreening in terms of glycemic control, reduced body weight, and increased physical exercise. The major contributions point to telemedicine's potential for changing behaviors important to diabetes control and prevention, especially type 2 and gestational diabetes. Similarly, screening and monitoring for retinopathy can detect symptoms early that may be controlled or treated. Conclusions: Overall, there is strong and consistent evidence of improved glycemic control among persons with type 2 and gestational diabetes as well as effective screening and monitoring of diabetic retinopathy.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140288/1/tmj.2015.0029.pd

When the tables are turned: The effects of the 2016 US Presidential election on in-group favoritism and out-group hostility

The outcome of the 2016 U.S. Presidential election was a big surprise to many, as the majority of polls had predicted the opposite outcome. In this two-stage cross-sectional study, we focus on how Democrats and Republicans reacted to this electoral surprise and how these reactions might have influenced the way they allocated resources to each other in small groups. We find that, before the election, Republicans showed greater in-group favoritism than Democrats, who treated others equally, regardless of their political affiliation. We then show that Democrats experienced the election outcome as an ego shock and, in the week following the election, reported significantly higher levels of negative emotions and lower levels of self-esteem than Republicans. These reactions then predicted how individuals' decided to allocate resources to others: after the election, Republicans no longer showed in-group favoritism, while Democrats showed out-group derogation. We find these decisions when the tables were turned can be partially explained by differences in participants' state self-esteem

Speaking truth to power: The effect of candid feedback on how individuals with power allocate resources

Subordinates are often seen as impotent, able to react to but not affect how powerholders treat them. Instead, we conceptualize subordinate feedback as an important trigger of powerholders’ behavioral self -regulation , and explore subordinates’ reciprocal influence on how powerholders allocate resources to them over time. In two experiments using a multi-party, multi-round dictator game paradigm, we find that when subordinates provided candid feedback about whether they found prior allocations to be fair or unfair, powerholders regulated how self-interested their allocations were over time. However, when subordinates provided compliant feedback about powerholders’ prior allocation decisions (offered consistently positive feedback, regardless of the powerholders’ prior allocation), those powerholders made increasingly self-interested allocations over time. In addition, we show that guilt partially mediates this relationship: powerholders feel more guilty after receiving negative feedback about an allocation, subsequently leading to a less self-interested allocation, while they feel less guilty after receiving positive feedback about an allocation, subsequently taking more for themselves. Our findings integrate the literature on upward feedback with theory about moral self-regulation to support the idea that subordinates are an important source of influence over those who hold power over them

Head above the parapet: How minority subordinates influence group outcomes and the consequences they face

Research on power often treats the recipients of powerholders’ decisions (i.e., subordinates) as an undifferentiated group, overlooking how their responses to powerholders’ decisions might vary and how those responses might affect powerholders’ later decisions. In this paper, we examine the role of lone dissenting subordinates (individuals whose feedback differs from that expressed by other group members) in shaping powerholders’ allocation decisions, and explore the consequences those subordinates face for their dissent. In three experimental studies, we show that even as a lone voice, the feedback of a dissenting subordinate influences powerholders’ decisions. Powerholders make more self-interested allocations when a lone subordinate provides consistently positive feedback, even when others provide mostly negative feedback. However, powerholders regulate their allocations when a lone subordinate provides candid feedback that points out the self-interested nature of their allocations, even when others provide consistently positive feedback. We further show that lone dissenting subordinates’ influence is stronger when they share a salient group membership with the powerholder (e.g., their school or political affiliation). Finally, we find that powerholders reward lone subordinates who provide them with positive feedback, but only punish lone candid subordinates if they do not share a salient group membership with them. Overall, our results suggest that subordinates who risk putting their head above the parapet can improve outcomes for their group members, and can avoid being punished for doing so, as long as they share a salient group membership with the powerholder

Seeing the "forest" or the "trees" of organizational justice: Effects of temporal perspective on employee concerns about unfair treatment at work

What events do employees recall or anticipate when they think of past or future unfair treatment at work? We propose that an employee’s temporal perspective can change the salience of different types of injustice through its effect on cognitions about employment. Study 1 used a survey in which employee temporal focus was measured as an individual difference. Whereas greater levels of future focus related positively to concerns about distributive injustice, greater levels of present focus related positively to concerns about interactional injustice. In Study 2, an experimental design focused employee attention on timeframes that differed in temporal orientation and temporal distance. Whereas distributive injustice was more salient when future (versus past) orientation was induced, interactional injustice was more salient when past orientation was induced and at less temporal distance. Study 3 showed that the mechanism underlying the effect of employee temporal perspective is abstract versus concrete cognitions about employment

A Strategic Vision for Telemedicine and Medical Informatics in Space Flight

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63255/1/15305620050503924.pd