The construct validity of Emotional intelligence (EI) measurement among medical staffs of an emergency room in Taiwan

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1 The construct validity of Emotional intelligence (EI) measurement among medical staffs of an emergency room in Taiwan Chia-Pang Shih, Kuang-Hung Hsu*, Department of Business Administration, Collage of Management, Chang Gung University, No.259, Wen-Hwa 1 st Rd, Kwei-Shan, Tao-Yuan, Taiwan 333, *jane@mail.cgu.edu.tw Abstract Emotional intelligence (EI) has its roots in the concept of social intelligence and has been an emerging topic for psychological, educational and management in recent years. However, the validity of EI measurement is still imperfectly certified and is awaited for investigation. Medical staffs in emergency room encountered tremendous pressure from handling life-threatening diseases/injuries under a stressful condition. The interaction between an emergency medical staff and patients requires a mature personality for maintaining good quality of care. EI as defined by previous studies is a measurement of parts for such maturity of one s personality. The main purpose of this study is to offer the measurement of EI among physicians and nurses in a medical center as well as a process of validation on this tool. An EI measurement instrument developed specifically from Chinese populations was adopted for this study. The Mini Marker questionnaire for measuring personality was also used for comparison with EI. The study has collected 181 samples from an emergence room of a medical center in north Taiwan including 77 physicians and 104 nurses. A significant correlation was found between EI and openness to experience among physicians (r=0.24) and nurses (r=0.25). There were consistent findings with previous documents on positive association between EI with emotional stabilities and EI with conscientiousness. Age was significantly associated with EI items in force choice among physicians (r=0.26). The particular EI measurement on this unique population in emergency room is deemed as novel in the field of human resource management. We found some common characteristics and other inconsistent distinctiveness with this high self-autonomic professional staffs as opposed to others. The maturity as surrogated by age was found positively correlated with EI in physicians but not as favorable in nurses. Meanwhile, the openness and emotional stability were allied well with EI score in both physicians and nurses. The study provides grounds for empirical validating of EI in highly professional personnel with which paves the way for extensive applications of this tool in the future. Keyword: Emotional intelligence, EI measurement, medical staffs INTRODUCTION Since researchers have introduced the construct of emotional intelligence (EI) into the scientific community (Salovey & Mayer, 1990), EI has been an issue for studies and applications in areas of psychology, education, and management recently (Law, Wong et al. 2004). A growing number of studies was found to examine the relationship between EI and human activities and behaviors (Extremera and Fernandez-Berrocal 2005) such as social interaction (Lopes, Brackett et al. 2004), resistance to stress (Mikolajczak, Luminet et al. 2006), academic achievement (Gil-Olarte Marquez, Palomera Martin et al. 2006), job performance, and leadership (Spector 2005). A report further elaborated the importance of EI as opposed to the well known IQ, which received more attentions ever in the past (McEnrue and Groves 2006).

2 Nevertheless, the meaning of EI has not been adequately defined and has gathered discussion for decades. The controversial arguments placed not only in the measurement but in the nature of EI (Spector 2005). Therefore, several conceptualizations of EI were proposed during the last decade. Mayer, Salovey and Caruso (2000) gave a comprehensive review of this topic and proposed three distinct concepts of EI. The first was deemed as a zeitgeist of current culture. The second notion of EI was shown as a component of personality. The third conception of EI was viewed as the ability model (Hemmati, Mills et al. 2004). In addition, the second one was called as mixed or trait models of which integrated a wide range of personality measurements into the term of EI (Freudenthaler and Neubauer 2005). Furthermore, the third one as also named ability of information processing models was divided into four dimensions, including perception of emotion, emotional facilitation of thought, understanding emotions, and managing emotions (Mayer and Salovey 1997). Even though emotional measurement theory has been established for several decades (Hemmati, Mills et al. 2004), debates were exited in the measurement of EI (Spector 2005). Although researchers have developed a number of instruments for measuring EI, poor internal reliability and unstable factorial validity were found in many of them and distinction from well-established personality factors was not noticeable (Luebbers, Downey et al. 2007). One of the EI measures was based on ability of information processing models in which included the Multifactor Emotional Intelligence Scale (MEIS;(Mayer, Caruso et al. 1999) and the Mayer-Salovey-Caruso Emotional Intelligence Test (Mayer, Salovey et al. 2003). In contrary, the Emotional Quotient Inventory (Bar-On 1997) was developed according to mixed or trait models, which characterized more dimensions of personality traits. EI measurements developed from the populations with western culture may not be well fitted to the measures in population with oriental backgrounds. Major limitations were found while applying the MSCEIT to populations with different cultures (Wong, Wong et al. 2007). Therefore, a particular research group has established EI Scale specific for oriental populations (Law, Wong et al. 2004; Wong, Law et al. 2004). The applications of EI were frequently appeared in personnel training of industries with multimillion dollar scale (Kunnantt 2004; McEnrue and Groves 2006). Human resource development (HRD) professionals had to take seriously accounts on the differentiation of items with added value from others. As EI were growingly used in evaluation for personnel training and career development in various industries, the validation of EI measurement is so important that it can not be overlooked to avoid redundancy with other existed instruments (McEnrue and Groves 2006). The construct validity was usually applied to express this meaning. Take MSCEIT as an example, researchers have demonstrated a positive correlation with IQ and a slightly association with personality traits. Te score is distinct from other measurements such as cognitive, conative, and physical phenomena (Mayer, Salovey et al. 2003). From the current stands, the measurement can be improved by examining associations between EI and job performance, hence to add information for future management implications. The main purpose of this study is to offer the measurement of EI among physicians and nurses in department of emergency of a medical center as well as validation on this tool. Medical staffs in emergency room encountered tremendous pressure from handling life-threatening diseases/injuries under a stressful condition. A stability of emotional status is highly demanded for coping and maintaining normal practice, therefore EI becomes an important measure for multidimensional applications. This study addresses issues in validation of WEIS and applications on highly demanded professionals, physicians and nurses in emergency room.

3 MATERIALS AND METHODS Participants and Demographic Variables During January, 2005, 181 samples from the emergency room of a medical center in north Taiwan were collected including 77 physicians (Mean±SD of age is 32.3±5.7 years with range of years) and 104 nurses (Mean±SD of age is 27.7±4.4 years with range of years). There were 11 females (14%) in physicians group and no males in nurses among study samples. Since EI were found different among gender (Amelang and Steinmayr 2006) and age (Luebbers et al. 2007), this study surveyed personality and EI score together with demographic data. Personality Personality traits were collected from questionnaire, which was developed by Saucier (1994) based on the big five model and rated with 9-point Likert scales (Sacucier 1994). The big five model has become a well-accepted personality measurement by psychologists in studies of industries and business for years (Barrick and Mount 1991; Robbins 1997). The five dimensions of personality traits are included as 1) openness to experience; 2) neuroticism; 3) extraversion; 4) agreeableness and conscientiousness. This questionnaire contains 40 items of which subjects were able to finish within 15 minutes. Emotional Intelligence The measurement of WEIS follows the definition of EI, which is a set of abilities, includes 40 forced choice items. There are four dimensions as EI constructed: 1) self emotional appraisal (SEA); 2) other s emotional appraisal (OEA); 3) regulation of emotion (ROE); and 4) use of emotion (UOE). The WEIS is constructed by two parts: part A (EIA) contains 20 ability pairs of which respondents are asked to choose one for best explaining their own strengths; Part B (EIB) contains 20 scenarios of which respondents are asked to choose one for best reflecting their likelihood of reacting to each scenario (Wong et al. 2007). RESULTS Descriptive statistics of EI and its sub-dimensions

4 The mean score of EI was (SD=4.02). There is no statistically significant difference of EI between physicians (26.01±4.52) and nurses (26.74±3.60). However, EIA of physicians (14.02±3.63) are significant lower than EIA of nurses (14.68±2.83) (p-value=0.002). EIB of physicians (12.87±2.02) are significant higher than EIB of nurses (12.05±2.02) (p-value=0.008). Descriptive statistics are shown in Table 1. WEIA is constructed from four dimensions of EI ability, including SEA, OEA, ROE and UOE. SEA score of physicians is significantly lower than that of nurses (p <0.001). However, ROE score of physicians is significantly higher than that of nurses (p =0.01). Furthermore, in part A section of WEIS, SEA and OEA score of physicians are both lower than those in nurses (p = and p=0.01). SEA score of physicians is lower than that of nurses significantly (p =0.01) in part B section of WEIS as the same as result observed in part A. ROE score of physicians are higher than that of nurses in part B (p <0.001) (Table 2). Correlation analysis of EI and age In correlation analysis, total EI is not significantly associated with age (r=0.21). However, age is positively associated with the part B of WEIS (r=0.21), ROE (r=0.25), and ROE in part B of WEIS (r=0.32). In contrast, age is negatively correlated with OEA in part A (r=-0.16) at the statistical level of significance. Furthermore, the differences among physicians and nurses are presented. Although age is significantly and positively associated with EI in part B and ROE in part B of physicians (r=0.26), but not as the same in nurses. There is positive correlation between age and SEA in part A (r=0.22), but not in physicians. Correlation analysis of EI and sub-dimensions SEA score in part B of physicians and UOE score in part B of nurses have shown statistically nonsignificant correlation with total EI (r=0.17 and r=0.12). The scores of other dimensions showed significant association with EI (r=0.30 to 0.73). However, there is no correlation between EI scores of part A and of part B, the intra-correlation (correlation coefficient) is as low as In addition, the analyses of sub-dimensions have shown different pattern of correlation between physicians and nurses. SEA score is significantly correlated with UOE score in physicians (r=0.46) but not as significant as observed in nurses. EI score in part B, SEA, ROE and SEA in part A were significantly correlated to UOE in part A among physicians but not in nurses (r=0.31, 0.50, 0.31 and 0.48) (Table 3). EI and Big Five personality Total EI score was significantly associated with big five personality traits including openness to experience, conscientiousness, and neuroticism, with correlation coefficient were 0.23, 0.39 and 0.31, respectively. EI score in part A have significant correlation

5 with personality traits of conscientiousness and neuroticism (r=0.32 and r=0.26, respectively). With regards to EI in part B, conscientiousness, neuroticism, and openness to experience were significantly associated (r=0.32, 0.26, 0.25, respectively). Besides, SEA was significantly correlated to openness to experience, conscientiousness, and agreeableness (r=0.17, 0.29 and 0.18, respectively). OEA only had significant correlation with conscientiousness (r=0.20). ROE and total EI were significantly associated with personality traits of openness to experience, conscientiousness, and neuroticism with correlation coefficient of 0.18, 0.25 and 0.41, respectively. UOE was only observed in the correlation with conscientiousness (r=0.15). There were some discrepancy observations between physicians and nurses in terms of this study. The correlation between EI in part A was significantly associated with openness to experience among physicians (r=0.30) but not as of nurses. On the other hand, the correlation between EI in part B was associated with openness to experience among nurses (r=0.39) but not as of physicians. There were also some correlation coefficient were observed to be relatively high as above 0.40 in this study, for example, the correlation coefficient between SEA of part A and conscientiousness among physicians (r=0.44), ROE and neuroticism among nurses (r=0.40), and ROE of part A and neuroticism among nurses (r=0.41) (Table 4). Table 1: Descriptive statistics analysis and two sample t test of EI variables mean ± sd t value p-value EI ± 4.02 physician ± nurse ± 3.60 EIA ± 3.28 physician ± nurse ± 2.83 EIB ± 2.05 physician ± nurse ± 2.02 Note: EIA-EI in part A; EIB-EI in part B

6 Table 2: Descriptive statistics analysis and two sample t test of sun-dimensions of EI variables mean ± sd t value p-value SEA 7.17 ± 1.55 physician 6.58 ± <.0001 nurse 7.60 ± 1.42 OEA 6.51 ± 1.77 physician 6.32 ± nurse 6.65 ± 1.67 ROE 6.58 ± 2.06 physician 7.03 ± nurse 6.25 ± 2.16 UOE 6.16 ± 1.59 physician 6.06 ± nurse 6.23 ± 1.54 SEAA 3.77 ± 1.19 physician 3.41 ± nurse 4.03 ± 1.01 OEAA 3.16 ± 1.36 physician 2.84 ± nurse 3.40 ± 1.21 ROEA 3.52 ± 1.44 physician 3.41 ± nurse 3.60 ± 1.47 UOEA 3.56 ± 1.20 physician 3.46 ± nurse 3.63 ± 1.17 SEAB 3.39 ± 1.04 physician 3.16 ± nurse 3.56 ± 1.09 OEAB 3.34 ± 1.02 physician 3.48 ± nurse 3.25 ± 0.93 ROEB 3.06 ± 1.15 physician 3.62 ± <.0001 nurse 2.64 ± 1.13 UOEB 2.59 ± 0.95 physician 2.59 ± nurse 2.59 ± 0.95 Note: SEA-self emotional appraisal ;OEA-other s emotional appraisal ;ROE- regulation of emotion ; UOE-use of emotion; SEAA-self emotional appraisal in part A;OEAA-other s emotional appraisal in part A;ROEA- regulation of emotion in part A; UOEA-use of emotion in part A; SEAB-self emotional appraisal in part B;OEAB-other s emotional appraisal in part B;ROEB- regulation of emotion in part B; UOEB-use of emotion in part B.

7 Table 3: Correlation analysis of EI and sub-dimensions Variables EI EIA EIB SEA OEA ROE UOE SEAA OEAA ROEA UOEA SEAB OEAB ROEB UOEB EIA 0.86** 1 Physician 0.90** Nurses 0.83** EIB 0.58** Physician 0.62** 0.22 Nurses 0.62** 0.07 SEA 0.67** 0.59** 0.37** 1 Physician 0.73** 0.66** 0.43** Nurses 0.64** 0.45** 0.50** OEA 0.49** 0.42** 0.30** 0.18* 1 Physician 0.57** 0.50** 0.38** 0.22 Nurses 0.40** 0.31** 0.27** 0.09 ROE 0.63** 0.55** 0.36** 0.22** Physician 0.68** 0.65** 0.36** 0.31** 0.16 Nurses 0.68** 0.63** 0.32** 0.31** UOE 0.51** 0.43** 0.31** 0.23** Physician 0.65** 0.56** 0.45** 0.46** * Nurses 0.36** 0.30** 0.22* SEAA 0.65** 0.79** ** ** 0.28** 1 Physician 0.73** 0.82** ** ** 0.49** Nurses 0.57** 0.73** ** ** 0.06 OEAA 0.39** 0.49** * 0.82** * 1 Physician 0.42** 0.55** ** * Nurses 0.33** 0.37** ** ROEA 0.64** 0.71** ** ** ** Physician 0.66** 0.71** ** ** 0.25* 0.50** 0.17 Nurses 0.63** 0.74** ** ** ** -0.05

8 (continued) UOEA 0.49** 0.53** ** * 0.80** 0.32** * 1 Physician 0.60** 0.58** 0.31** 0.50** ** 0.82** 0.48** Nurses 0.38** 0.48** ** SEAB 0.25** ** 0.64** Physician ** 0.52** Nurses 0.30** ** 0.71** OEAB 0.34** ** ** Physician 0.39** ** ** Nurses 0.30** ** ** * ROEB 0.33** ** ** ** Physician 0.35** ** ** ** Nurses 0.47** 0.23* 0.51** ** * ** UOEB 0.23** ** ** Physician 0.34** ** ** 0.23* Nurses ** ** AGE ** ** * ** Physician * * 0.13 Nurses * Note: SEA-self emotional appraisal ;OEA-other s emotional appraisal ;ROE- regulation of emotion ; UOE-use of emotion; SEAA-self emotional appraisal in part A;OEAA-other s emotional appraisal in part A;ROEA- regulation of emotion in part A; UOEA-use of emotion in part A; SEAB-self emotional appraisal in part B;OEAB-other s emotional appraisal in part B;ROEBregulation of emotion in part B; UOEB-use of emotion in part B. * p-value<0.05 ** p-value<0.01

9 Table 4: Correlation analysis of EI and Big Five personality Variables Openness Conscientiousness Extraversion Agreeableness Neuroticism EI 0.23** 0.39** ** Physician 0.24* 0.40** ** Nurses 0.25** 0.39** ** EIA ** ** Physician 0.30** 0.41** ** Nurses ** ** EIB 0.25** 0.25** ** Physician Nurses 0.39** 0.31** * SEA 0.17* 0.29** * 0.14 Physician 0.30* 0.38** * Nurses ** ** 0.24* OEA ** Physician * Nurses ROE 0.18* 0.25** ** Physician * ** Nurses 0.20* 0.23* ** UOE * Physician Nurses SEAA ** * Physician 0.31** 0.44** ** Nurses OEAA Physician * Nurses ROEA ** ** Physician ** Nurses * ** UOEA * Physician 0.24* Nurses SEAB * 0.15* 0.04 Physician Nurses 0.25* 0.20* 0.20* 0.26** 0.15 OEAB * Physician Nurses ROEB 0.23** 0.19* ** Physician * Nurses 0.24* *

10 (continued) UOEB * Physician * Nurses AGE ** ** 0.24** Physician * 0.15 Nurses ** ** 0.17 Note: SEA-self emotional appraisal ;OEA-other s emotional appraisal ;ROE- regulation of emotion ; UOE-use of emotion; SEAA-self emotional appraisal in part A;OEAA-other s emotional appraisal in part A;ROEA- regulation of emotion in part A; UOEA-use of emotion in part A; SEAB-self emotional appraisal in part B;OEAB-other s emotional appraisal in part B;ROEBregulation of emotion in part B; UOEB-use of emotion in part B. * p-value<0.05 ** p-value<0.01 DISCUSSION This study describes the construct validity of WEIS among medical staffs of an emergency room in north Taiwan. We survey medical staffs EI by using WEIS instrument, which was based on ability model and personality by Mini-Marker with Big Five model. The WEIS was developed by Wong, Law and Wong (2004) to solve the problems occurred from culture discrepancy while using other EI scales developed from western culture. Wong et al. found that it was possible to develop scenario and ability-paired items to measure EI by a forced choice format with parts A and B appeared in WEIS. Wong et al. also pointed out that the choices of the 40 newly developed items were identified as comparable to social desirability ratings and relevant to meaning of EI, which was apparently distinctive from personality and mental intelligence (Wong, Law et al. 2004). In this study, we provided analyses on intra-consistency of WEIS. The results have demonstrated that ability-paired items were not as relevant as expected to the scenario items (r=0.09, p=0.24). Correlation between ROE in part A and in part B was significant (r=0.24) but discrepancy appeared in different professional groups. A significant correlation observed in nurses (r=0.36) but not as significant as in physicians. Dimensions of SEA, OEA, and UOE had low correlation with part A and part B, which convergence was beyond acceptance. Although Wong et al. did not estimate the correlation coefficient between scenario EI items and ability-paired EI items since these two parts were developed by different study groups. In stead, they measured the correlation for ability pair EI items and WLEIS (Wong and Law 2002) and scenario EI items and WLEIS. The results showed acceptable convergent validity with significant correlation of 0.41 and 0.37, respectively (Wong, Law et al. 2004). This study failed to demonstrate the same results as at least one part for sure that study populations were different. Besides, some researchers have found that EI score was different among age groups (Luebbers, Downey et al. 2007) but it was not supported by this study as well. Arguments raised while examining the purpose of utilizing EI as a measurement of emotional-related behavior instead of measuring emotional knowledge (Freudenthaler and Neubauer 2005). WEIS was granted as a better instrument for measuring emotional-related behaviors than the way MSCEIT provided. In this sense, WEIS is more accurately measuring what respondents would do while MSCEIT was

11 primarily a knowledge based measuring of what one should do (Wong et al. 2007). Further evidence was provided by a study group, who believed that self-estimates of interpersonal abilities might be partly biased by a favorable self-description (Freudenthaler and Neubauer 2005). Follow this argument; part A of WEIS is a measure of one should do rather than one would do. In contrary, part B of scenario EI items are more likely to be one would do, a closely related part for EI performance. As regard to the association between EI and personality, there were consistency observations with previous documents while difference existed in some points. The observation of significant correlation between personality traits of neuroticism, extraversion, agreeableness, and conscientiousness with measures of EI was concordant with previous findings (Saklofske, Austin et al. 2003; Wong, Law et al. 2004; Extremera and Fernandez-Berrocal 2005; Amelang and Steinmayr 2006; Wong, Foo et al. 2007; Wong, Wong et al. 2007). Some researchers found no significant correlation between EI and agreeableness, which were consistent with this study (Fukunishi, Wise et al. 2001; Freudenthaler and Neubauer 2005). Extraversion was discriminated from agreeableness in correlation with EI due to the nature of its measurement of social skill in this analysis. The observations of high correlation between many EI dimensions and personality traits in this study than those in previous studies were believed due to the divergence of study populations Medical staffs with high education level and professionalism belonged to a specific occupational group skewed to populations tested by original studies (Wong, Law et al. 2004; Wong, Foo et al. 2007; Wong, Wong et al. 2007). The EI was found distinct between physicians and nurses in this study population. Physicians tended to get lower scores of EI in items of part A but higher scores in items of part B as opposed to nurses. Physicians might have better self-awareness in their EI performance than nurses did. However, nurses had better ability in self emotion appraisal than physicians. One of the explanations may be due to gender difference, that females were more sensitive to emotional perception than males (Amelang and Steinmayr 2006; Brackett, Rivers et al. 2006; Luebbers, Downey et al. 2007). The difference of professional characteristics between physicians and nurses could be a factor affecting the results while advanced studies are required. The differences between physicians and nurses on association of EI and personality were worthwhile to notice as well. The findings suggested that physicians were likely to adapt their emotion to environment. Again, the issues of gender difference and professional distinction are awaited for investigations. Limitations occurred in this study. Firstly, the study was confined by the gender distribution in physicians and nurses because all nurses were female and most physicians were male. The effects of gender and professionalism were undifferentiated. Secondly, a slightly different measurement was made for shortening the length of questionnaire. Forced-choice items EI was implemented for measuring score of medical staffs rather than WLEIS, an evaluation of convergent validation was not possible in such circumstance. Thirdly, the different culture impact from societies of Hong Kong and Taiwan was noticeable in such studies. Therefore, suitableness of using WEIS in medical staffs with different cultural impact is still a puzzle to be solved. CONCLUSIONS The particular EI measurement on this unique population in emergency room is deemed as novel in the field of human resource management. We found some common characteristics and other inconsistent distinctiveness with this high self-autonomic professional staffs as opposed to others. The maturity as surrogated by age was found positively correlated with EI in physicians but not as favorable in nurses. The study provides grounds for empirical validating of EI in highly professional personnel with which paves the way for extensive applications of this tool in the future.

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