Hierarchical Culture Research Articles

Active learning of medical students in Taiwan: a realist evaluation

BackgroundActive learning is defined as any instructional method that engages students in the learning process. Cultural differences in learning patterns can play an important role in engagement with active learning. We aimed to examine process models of active learning to understand what works, for whom and why.MethodsForty-eight sixth- and seventh-year medical students with experience of active learning methods were purposively selected to participate in ten group interviews. Interactions around active learning were analysed using a realist evaluation framework to unpack the ‘context-mechanism-outcome’ (CMO) configurations.ResultsThree core CMO configurations, including cultural, training and individual domains, were identified. In the cultural context of a strong hierarchical culture, the mechanisms of fear prompted students to be silent (outcome) and dare not give their opinions. In the training context of teacher-student familiarity alongside teachers’ guidance, the mechanisms of learning motivation, self-regulation and enthusiasm were triggered, prompting positive learning outcomes and competencies (outcome). In the individual context of learning how to learn actively at an early stage within the medical learning environment, the mechanisms of internalisation, professional identity and stress resulted in recognising active learning and advanced preparation (outcomes).ConclusionsWe identified three CMO configurations of Taiwanese medical students’ active learning. The connections among hierarchical culture, fear, teachers’ guidance, motivation, the medical environment and professional identity have been shown to affect the complex interactions of learning outcomes. Fear derived from a hierarchical culture is a concern as it is a significant and specific contextual factor, often sparking fear with negative outcomes.

Perspectives of health workers on the referral of women with obstetric complications: a qualitative study in rural Sierra Leone

ObjectivesSierra Leone has one of the highest maternal mortality ratios in the world. Timely and well-coordinated referrals are necessary to reduce delays in providing adequate care for women with obstetric...

Stereotypes among health professions in Indonesia: an explorative study.

PurposeEffective and efficient health services require efforts to increase collaboration among health professionals. One of the barriers to effective collaboration is stereotypes. Stereotypes represent perceptions or perspectives about a person or group of people. This study aims to explore the perceptions of health professional students and practitioners regarding stereotypes.MethodsThis was a qualitative study using a phenomenology approach. A sample of health professions students from both preclinical and clinical stages, as well as health practitioners, was selected using a maximum variation sampling method. Primary data collection was conducted through focus group discussions. Data obtained were analyzed using thematic analysis. A total of nine focus group discussions were conducted.ResultsFour themes were identified from this study, including the types of stereotypes, factors affecting stereotype formation, the implications of stereotypes, and how to overcome stereotypes. Stereotype formation was affected by the lack of understanding of other health professions’ roles, hierarchical culture, personal experience in receiving healthcare, and community view. Stereotypes among health professionals created obstacles to healthcare team communication and reduced self-confidence in certain health professionals. These stereotypes may be overcome through competency development and knowledge sharing among professionals as well as through education on other health care professionals’ roles and competencies so that each profession possessed similar goals for patient safety.ConclusionBoth positive and negative stereotypes negatively affected collaboration. Stereotypes were greatly affected by multifactorial causes. Therefore, understanding other professions’ roles and conducting interprofessional education are important to overcome stereotypes.

Chinese Culture and Its Influence on Prison Society: Women’s Experience

Based on interviews with 30 female parolees/ex-inmates and 10 prison officers, this article argues that custody relationships among women incarcerated in China are “not easy,” and this is due primarily to distrust in prison society and a hierarchical prison culture. Even so, women inmates are motivated to form and maintain harmonious relationships with others. This article suggests that this behavior pattern is greatly influenced by the Chinese culture of pragmatic Confucianism, which further explains the women’s low interest in forming a prison subculture.

The Impact of the Organizational Culture on Hotel Outsourcing and Sustainable Performance an Empirical Application in the Egyptian Hotel Sector

In recent years, the concept of an organizational culture in hotels has held an important position on both a theoretical and practical level because this culture significantly affects organizational performance and the strategies adopted by hotels. Therefore, it is considered one of the key factors in determining hotels’ tendency towards outsourcing and sustainable performance. In this study, we aim to analyze the impact of the organizational culture on the level of outsourcing and sustainable performance. To do so, we will use the Competing Values Framework (CVF), which divides organizational culture into four typologies: hierarchical, group, rational, and development cultures. A personal questionnaire was administered to the directors or managers of 114 hotels located in two Egyptian cities: Hurgada and Sharm El Sheikh. The results of the structural model suggest the negative impact of the hierarchical and development cultures on the level of outsourcing. The results show a positive influence of the four types of organizational culture on sustainable performance, suggesting that these hotels have a strong interest in sustainability and the environment. The findings reveal a negative relationship between the level of outsourcing and sustainable performance. Finally, this study presents academic and practical implications, as well as recommendations for future research.

Organizational culture and organizational learning: does high performance work systems mediate?

PurposeThe primary purpose of this study is to examine the effect of organizational culture (OC), that is, group, developmental, hierarchical and rational culture on organizational learning (OL) of employees in electricity distribution companies of Isfahan province. Further, the role of the high-performance work system (HPWS) as a mediator between OC and OL has also been explored.Design/methodology/approachQuestionnaire survey method has been used for data collection, and data analysis was completed through a two-stage partial least squares structural equation modeling technique. At the first stage, the measurement model was examined for construct validity and reliability, whereas at the second stage, the structural model and by implication the research hypotheses were tested.FindingsResults indicate that OC positively affects OL. Further, HPWS act as a mediating variable between OC and OL.Originality/valueThe findings contribute to the existing literature by demonstrating the mediating role of HPWS in the relationship between OC and learning.

Work Culture and Turnover Intention: A Case of Restaurant Employees in Putrajaya, Malaysia

The growth of restaurants industry in Malaysia also reflect the continuous growth of employees in this industry. Having many employees at workplace is parallel with salary and benefits that employers need to provide to their employees. On the other hands, to retain employees at workplace quite challenging because employees may quit due to many reasons. The purpose of this study is to examine how work culture influence turnover intention among employees in restaurant industry particularly casual dining- typed restaurants. After reviewing past literature, three independent variables were used in this study that are: consensual culture, hierarchical culture and developmental culture. This study used quantitative method and survey research design approach. A total of 210 respondents were distributed to employees who were currently working in selected casual dining restaurants at the largest mall in Southern Klang Valley. After data screening and checking, 165 valid responses were returned and analyzed by using SPSS version 23. Based on the results obtained from Pearson Correlation, result found that all three variables had weak association with turnover intention. All variables were found to be weak correlated. Hierarchical culture found to be weak positively correlated r= .141, p = .036. Similarly, Consensual culture also had weak positive relationship with turnover intention r=.055, p= .248 whereas developmental culture had negative relationship with r = -.122, p=.060. Additionally results also showed that majority of the employees disagreed that work culture in restaurants they worked for influenced their intention to leave a job. Next, comparing all the independent variables, developmental work culture had the highest mean score with 4.0370. Moreover, majority disagreed that they find their job easy when there is no leader assist with their job. While, another majority agreed that they felt sad when superior did not listen to their opinion. This statements indicated positive work culture has been practicing at casual dining restaurants. Findings from this study hoped to help managers and casual dining restaurant operator to highlight those work culture so that more positive environment can be sustained in this restaurant.

Hierarchy, “Kreng Jai” and Feedback: A Grounded Theory Study Exploring Perspectives of Clinical Faculty and Medical Students in Thailand

Phenomenon: Institutional learning culture influences how feedback is provided, accepted, and acted upon. The Thai societal culture, characterized by strict hierarchy and collectivism, may have a significant impact on the learning culture and, therefore, feedback conversations between teachers and learners. This study explored: common approaches used by faculty to provide feedback to students; and faculty and student perspectives regarding sociocultural factors that impact feedback seeking, provision, and acceptance. Approach: Using a constructivist paradigm, we explored perspectives of clinical faculty and medical students at an academic medical center in Thailand using focus groups (students) and a focus group and individual interviews (faculty). Sessions were audiotaped, transcribed, and de-identified prior to analysis. Constant comparative analysis was performed on transcripts, focusing on perceived cultural factors that impacted feedback conversations. Findings: Thirty faculty participated in the study, four participated in a focus group, and 27 participated in individual interviews. Twenty-two medical students participated in four focus groups. We identified the following key themes, which could be grouped under three categories: (1) Faculty approaches to providing feedback (1.1) Feedback should be initiated by faculty. (1.2) Feedback is initiated primarily for deficit identification and correction. (2) Factors impacting students’ feedback seeking and acceptance. (2.1) Students are willing to accept harsh feedback when it provides suggestions for improvement. (2.2) Feedback is most credible when faculty have direct knowledge of the student’s effort. (2.3) Feedback seeking is considered a burden on teachers. (3) Cultural factors that influence feedback (3.1) Societal hierarchy perpetuates unidirectional top-down feedback. (3.2) Kreng jai (the balance between consideration for others and self-interests) affects feedback seeking and provision. Insights: Though the value of feedback on learning was emphasized by all participants, the hierarchical culture of Thai society was perceived to have a significant influence on feedback seeking, provision, and acceptance. Identifying and addressing societal as well as institutional cultural factors would be key in designing growth-enhancing feedback initiatives relevant to the local context. One size feedback training does not fit all.

A Study on the Determinants of Public Officials’ Organizational Citizenship Behavior - Focusing on the Moderating Effect of Organizational Culture -

본 연구는 공무원의 직무동기･태도(공공봉사동기, 직무만족, 조직몰입) 요인이 직무행동(조직시민행동)에 미치는 영향을 분석하고, 이 각각의 관계에서 조직문화의 조절효과를 규명하였다. 분석결과로 첫째, 공공봉사동기, 직무만족, 조직몰입 모두 조직시민행동에 긍정적인 영향을 미치는 것으로 나타났다. 둘째, 직무만족과 조직시민행동의 관계를 발전집단문화가 조절하는 것으로 분석되어 직무만족은 높은 수준의 발전집단문화를 인식할 때 조직시민행동에 보다 긍정적 영향을 줄 수 있음을 검증하였다. 셋째, 직무만족과 조직시민행동의 관계 및 조직몰입과 조직시민행동의 관계에서 위계문화의 조절효과가 나타났는데, 높은 위계문화 수준이 직무만족과 조직몰입이 조직시민행동에게 미치는 긍정적 영향력을 약화시키는 것을 확인하였다. 본 연구가 조직시민행동의 영향요인에 관한 실증연구의 외연을 확장하고 공무원의 직무동기･태도와 조직시민행동 간 관계에 대한 조직문화의 조절효과를 분석한 연구가 아직 없다는 점에서, 특히 위계문화의 조절효과와 같은 연구결과를 중심으로 조직시민행동 강화를 위해 조직문화에 초점을 둔 인적자원관리에 대한 실무적 제언을 했다는 점에서 의의가 있다.This study is to examine the impacts of work motivation and attitude - public service motivation, job satisfaction, organizational commitment - on organizational citizenship behavior(OCB), determining the moderating effects of organizational culture. The results of the analysis indicate that PSM, job satisfaction, and organizational commitment have positive influences on OCB. Second, the moderating effects of developmental/group culture show that there is a weak positive relation when developmental/group culture is low, but a strong positive relation when developmental/group culture is high. Third, the moderating effects of hierarchical culture show that there is a weak positive relation when hierarchical culture is high, but a strong positive relation when hierarchical culture is low. Based on empirical findings, this study suggests theoretical and practical implications for human resource management in order to promote OCB.

Influence of gender role conflict, resilience, and nursing organizational culture on nursing work performance among clinical nurses

Purpose: The purpose of this study was to identify the factors influencing nursing work performance among clinical nurses in the hospital.Methods: This descriptive correlational study collected data from 122 clinical nurses who were working in three tertiary referral hospitals in Busan. The data were collected, using self-reported questionnaires, from September 2 to October 14, 2019. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression using SPSS/WIN 25.0 program.Results: Nursing work performance was significantly associated with resilience, innovation oriented culture, relationship oriented culture, and hierarchy oriented culture. The factors significantly influencing nursing work performance of the participants included relationship oriented culture (<i>β</i>=.27, <i>p</i>=.015), hierarchy oriented culture (<i>β</i>=.25, <i>p</i>=.003), resilience (<i>β</i>=.19, <i>p</i>=.035), and total clinical career (<i>β</i>=.18, <i>p</i>=.030), which explained 27.3% of nursing work performance (F=8.59, <i>p</i><.001).Conclusion: The results indicate that there is a need to improve communication skills among multidisciplinary team members and to harmonize hierarchical and relational cultures in order to enhance nursing work performance. In addition, this study suggests developing interventions for enhancing the resilience of clinical nurses.

Munkajog kialakulása és fejlődése a gazdaságszociológiai folyamatok tükrében

A tanulmány a munkajog intézményrendszerének a kifejlődését és átalakulását mutatja be, összefüggésbe hozva azt a társadalomgazdasági igények, valamint a gazdasági és a technikai-technológiai fejlődés alakulásával. Rávilágít arra, hogy milyen tényezők játszottak közre abban, hogy a vállalkozások és az ott kialakult paternalista munkaviszonyok túlnyomó többsége helyébe a nagyüzem és a nagyüzemben történő hierarchizált munkavégzés lépett. A tanulmány bemutatja, hogy a klasszikus kapitalizmusra jellemző munkáltatóbarát és a munkavállalói érdekeket antiszociálisan elnyomó munkajog miként vált a szociális piacgazdaság filozófiájának és a jóléti államkoncepció hatására munkavállaló-barátivá. Ezt követően a tanulmány azokkal a társadalmi mozgatórugókkal foglalkozik, amelyek hatására napjaink munkajoga megint kezdi alárendelni a munkavállalói érdekeket a munkáltatói érdekérvényesítésnek.

Integrating positive financial attitudes to nurture students’ identity as informed financial decision-makers in high power distance Chinese contexts

Research on financial literacy has focused on the influence of teachers and parents in financial literacy education, which mediates the impact on students’ financial behaviour. Much less attention has been given to the influence of traditional Chinese hierarchical culture on a child’s identity as a student. This paper applies Lee’s (2017) theory of identity grafting to examine how student self-identity towards personal financial management is reflected in their financial behaviour, and whether nurturing students with positive financial attitudes can improve the financial behaviour of students who are challenged by power distance values. We surveyed 1164 students from 39 secondary schools. We first focus on the influence of power distance on students that endorse the traditional Chinese values that superiors and subordinates should know their place and behave accordingly. Second, we focus on how students’ positive financial attitude interact with power distance effects. The results from structural equation modelling show that that high endorsement of power distance has a negative impact on financial behaviour in spending and that positive financial attitude has a positive influence on financial behaviour in spending, protection and planning. Further, students who highly endorse power distance values but have positive financial attitudes can still demonstrate positive financial behaviour. This paper is the first to validate identity grafting effects on students via statistical study. The implications of the findings on identity grafting are discussed.

외식기업의 위계적 조직문화가 조직침묵과 반생산적 과업행동에 미치는 영향

The purpose of this study is to identify the effect of hierarchical organizational culture of food service company on organizational silence and semi-productive task behavior. In order to achieve this purpose, hierarchical organizational culture was composed of authority culture and formal culture, organizational silence was composed of defensive silence and acquiescent silence, and counterproductive work behavior consisted of a single factor. The survey was conducted from December 2nd to December 31st, 2019 at 24:00 pm for employees of food service companies, including hotels located in Seoul, Gyeonggi-do, and Incheon, and finally 277 copies were used for empirical analysis. The results of the hypothesis are as follows: Hypothesis 1 Hierarchical organizational culture has been shown to have a positive effect on organizational silence. Hypothesis 2 Hierarchical organizational culture has been shown to have positive effects on counterproductive work behavior. Hypothesis 3 Organizational silence has been shown to have positive effects on counterproductive work behavior. The results of this study presented a new organizational theory and produced practical implications for human resource management in food service companies.

Antecedents of Employees’ Entrepreneurial Orientation: The role of Organizational Culture and the Enabling Environment

There is an abundant literature on Entrepreneurship within organization, but the evidence on how it is caused, is still dispersed. Moreover, it still lacks a proper theoretical framework. Brettel et al., (2015) used Competing Values Model in explaining the effect of organisational culture on Entrepreneurial Orientation. We modified this model, including enabling environment factors, as well as more enriched dimensions of Entrepreneurial Orientation. Hence we hypothesized that organizational culture (Clan, Hierarchical, Developmental, Rational, and Open Culture), and enabling environment (Flexibility/ support, Open Communication, External Orientation, and Team Work) affect Employees’ Entrepreneurial Orientation measured by new product innovation, new organizational practice, proactivity, and risk-taking. We applied this model by conducted a survey using likert scale type questionnaire. The data was collected from 325 employees working in various organizations in Karachi. Data was analyzed utilizing corroborative factor analysis and organized equation modeling. The results disclosed that new product innovation was positively influenced by Rational Culture, Open Culture, Flexibility, and External Orientation. And negatively affected by Clan Culture. Similarly, risk taking ability is positively influenced by Developmental Culture, External Orientation, and Team Work. Proactivity is positively affected by Rational Culture, and External Orientation. Unlike Innovation, which was negatively affected by Clan culture, New Organizational Practice got positively affected along with Open Communication.

Impacts of external involvement on new product development performance: moderating role of organisational culture

ABSTRACT In this work, the impact of external involvement on new product development (NPD) performance was explored from the knowledge-based and resources-based views. By placing organisational culture within the competing value framework, the moderating effects of multiple dimensions of organisational culture were investigated. With empirical survey data from the high-performance manufacturing project across 10 countries and 3 industries, the hypothesised relationships were tested by hierarchical regression approach. The results highlighted that the specific cultural dimensions are statistically related to external involvement effectiveness. Development culture and group culture positively moderate the impacts of customer/supplier involvement on NPD performance. By contrast, rational culture’s moderating effects are not significant and hierarchical culture negatively moderates the relationship between customer involvement and NPD performance. In particular, the information and resource derived from external customers and suppliers cannot be effectively integrated into NPD process in the absence of appropriate organisational culture, thus leading to a poor NPD performance.

Descifrando la cultura dominante y preferida en el ámbito universitario desde el Modelo de Valores por Competencia

El objetivo del trabajo fue descifrar la cultura dominante y preferida en el ámbito universitario, desde el Modelo de Valores por Competencia (MVC), aplicado a dos facultades de Ciencias Administrativas. Las hipótesis fueron: (1) la cultura de las dos organizaciones responde a una combinación de diferentes tipos culturales, (2) existe una semejante cultura dominante; y (3) la cultura organizacional es similar. El instrumento de validación (OCAI), después de haber probado la confiabilidad y validez de sus indicadores, a través de la prueba de Alfa de Cronbach, fue aplicado a 93 respondientes. Las similitudes de las percepciones de profesores y personal administrativo, acerca de las culturas existentes y esperadas, fueron validadas empíricamente por medio de un análisis factorial que reveló una combinación de los tipos culturales jerárquico, de mercado, adhocrático y clan, en ese orden; y, una cultura dominante jerárquica. Los posibles cambios organizacionales pueden configurarse con base al diagnóstico efectuado.

EVALUATING COMPLIANCE TO WORLD HEALTH ORGANIZATION SURGICAL SAFETY CHECK LIST IN OPERATING ROOM

Background: The Surgical safety check list is an inexpensive tool capable ofshifting the hierarchical culture in the operating room and fostering patient safety attitudesAim of the study:The present study aimed to: 1) Evaluate compliance to World HealthOrganization surgical safety check list in operating room in selected setting, 2) Todetermine barriers of compliance to World Health Organization surgical safety check list(WHO SSC) in selected hospital. Method:Descriptive Comparative design was utilized toattain the aim of the present study. Sample: Convenience sample from all available healthcare workers in operating room including 107 surgeons, 51 anesthesiologists and 120nurses. Was collected with using tool consisted of two tools: Tool I: Part 1) Demographiccharacteristics, Part II)Barriers of compliance to world health organization Surgical SafetyChecklist.Tool II: Compliance to world health organization surgical safety check list.Reliability:The reliability test was made by Cranach Alfa = 0.818for clarify andapplicability. Results: Thestudy revealed that, there were statistically significantdifferences regarding sign in for both nurses and anesthetists. Also, a strong statisticallysignificant difference was found regarding total score of both sign in and time out in twohospitals. Mostly (83.3%) of the health care workers reported that lack of training aboutSSC is the greatest barrier found.Conclusion:Majority of the health care workers reportedthat lack of training about Surgical Safety Check list was the greatest barrier found, Therewas no statistically significant difference between the two hospitals as regard complianceto world health organization surgical safety in “time out “ and sign out .Recommendations: applying surgical safety check list in operating room includingsurgeons, anesthesiologists and nurses.

Investigation the Relationship between Full Range Leadership and Team Effectiveness : Focused on the Case of Vietnamese National Soccer Team Coach, Park Hangseo

This study focuses on the full range leadership that Park Hangseo exercised. Full range leadership is based on the assumption that combination of various leadership behaviors can create a synergy effect. Park Hangseo’s case demonstrates leadership behaviors such as idealized influence, individualized consideration, intellectual stimulation, contingent reward, and management by exception. His leadership behaviors can be described in specific as follows. First, Park Hangseo priotized soccer development in Vietnam over immediate noticeable winning record and laid groundwork for the future. He emphasized ‘Vietnamese spirit’ and built up trust as a foreign coach from team members, Second, Park Hangseo tried to remove regionalism in choosing players, which was driving force in building ‘One Team’ finally. This brought Vietnamese feel together and made them feel united. Third, Park Hangseo broke hierarchical organizational culture in athletic team and built a family like relationship, which touched his team members. He won team members’ heart, which was the power of the leader Park Hangseo in the end.

Antecedents of Employees’ Entrepreneurial Orientation: The Role of Organizational Culture and the Enabling Environment

There is an abundant literature on Entrepreneurship within organization, but the evidence on how it is caused, is still dispersed. Moreover, it still lacks a proper theoretical framework. Brettelet. al. (2015) used Competing Values Model in explaining the effect of organisational culture on Entrepreneurial Orientation. We modified this model, including enabling environment factors, as well as more enriched dimensions of Entrepreneurial Orientation. Hence we hypothesized that organizational culture (Clan, Hierarchical, Developmental, Rational, and Open Culture), and enabling environment (Flexibility/ support, Open Communication, External Orientation, and Team Work) affect Employees’ Entrepreneurial Orientation measured by new product innovation, new organizational practice, proactivity, and risk-taking. We applied this model by conducted a survey using likert scale type questionnaire. The data was collected from 325 employees working in different organisations in Karachi. Data was analyzed using confirmatory factor analysis and structured equation modeling. The results showed that new product innovation was positively influenced by Rational Culture, Open Culture, Flexibility, and External Orientation. And negatively affected by Clan Culture. Similarly, risk taking ability is positively influenced by Developmental Culture, External Orientation, and Team Work. Proactivity is positively affected by Rational Culture, and External Orientation. Unlike Innovation, which was negatively affected by Clan culture, New Organizational Practice got positively affected along with Open Communication. Keywords: Clan Culture, Hierarchical Culture, Developmental Culture, Rational Culture, Open Culture, Flexibility, Open Communication, External Orientation, Team Work, new product innovation, new organizational practice, proactivity, risk-taking DOI: 10.7176/RHSS/10-11-02 Publication date: June 30th 2020

Research on the Effect of the Different Empathy Ability of Supervisor on the Turnover Intention in the Organizational Culture

Background/Objectives: This research is made to find out what kind of moderating effect the empathy ability of supervisor makes on the turnover intention in the hierarchical organizational culture.Methods/Statistical analysis: The subjects for this research are the employees working for small and mid-sized companies in Korea and the questionnaires were distributed to them for the research. The questionnaire was made up of 16 questions including 4 demographical questions and the measuring was made by using 5-point Likert scale. For the empirical analysis, SPSS 23.0 program was used and the feasibility analysis, reliability analysis, regression analysis and the test of moderating effect were performed.Findings: As the number of independent variable was just one, the factory analysis was not conducted. The results of reliability analysis showed that Cronbach Alpha values were all 0.6 or more. In addition, the correlation analysis results showed that the correlation between the hierarchical organizational culture and turnover intention was 0.931 and the correlation between the hierarchical organizational culture and the empathy ability of supervisor was 0.242, thus showing the low correlation. On the other hand, the correlation between the turnover intention and the empathy ability of supervisor was 0.661, thus showing a little high correlation. All of them showed the significance probabilities of 0.0000. The regression analysis showed that the hierarchical organizational culture made a significant effect on the turnover intention. As the analysis of moderating effect shows the increase in the value R2 with the significance probability of less than 0.05, it was confirmed that the empathy ability of supervisor has the moderating effect. This means that even though the hierarchical organizational culture may affect the turnover intention, the empathy ability of supervisor may lower the turnover intention.Improvements/Applications: The future researches are required to focus on the methodology of enhancing the empathy ability and the tools for measuring the empathy ability along with the development of program.