Organizational socialization of physical therapists.

Organizational Socialization of Physical Therapists Organizational socialization is the process by which an individual enters an organization and becomes a fully participating and effective member. [1] It includes recruiting and selecting job applicants, training them, instilling in them attitudes appropriate for the job, and eventually allowing them to develop professionally and contribute to the development of the organization.

Socialization is not a single event; it involves the ongoing development of both the individual and the organization in an interactive process. For the individual, development of skills and knowledge, role behavior, and adjustment to the norms and values of the work group occur in response to the needs and expectations of the organization. [2] The organization in turn develops as it responds to the needs of the individual and as the individual institutes change. Thus, socialization is a continuing interaction between the two, resulting in the formation of a psychological contract--an evolving, implicit agreement specifying what each expects to give and receive in the relationship. [3-5]

An employee who is successfully socialized will perform job tasks dependably and will contribute spontaneously to achieving the goals of the organization. The employee will demonstrate attitudes of internal work motivation, commitment to work, and general satisfaction. [3] Job satisfaction is negatively correlated with turnover rates in a general population, [2,6,7] although among physical therapists turnover is also correlated with personal factors such as the desire to pursue a different area of physical therapy or to move to a new location. [8] Turnover is costly to a physical therapy organization (center) financially. It is associated with a loss of knowledge, skills, and experience specific to the setting, and it may be costly in terms of co-worker relationships and morale.

Management theory and research suggest that methods of organizational socialization influence the success of promoting desirable attitudes and behaviors, including turnover rates, among employees. The purpose of this article is to describe the process of organizational socialization, as it pertains to physical therapy, and management methods that may contribute to success throughout the process.

A stage model developed by Feldman [2] is one of several that describe this process and is useful in discussion of management concepts in the medical setting. Feldman describes three stages of socialization: 1) anticipatory socialization, 2) encounter-accommodation, and 3) role management.

Anticipatory Socialization

Anticipatory socialization is also known as "prearrival" or "pre-entry" socialization. [10] For a physical therapist, anticipatory socialization encompasses all the learning achieved before the therapist accepts a job. This learning includes physical therapy knowledge and skills, a set of expectations about the job role, and information about the specific center. Much of this learning occurs in physical therapy school, but it is based on attitudes, knowledge, and role expectations developed throughout the individual's early life. [4] Typically, graduates of professional schools have expectations that are overinflated and idealistic, [11] because the schools tend to teach what should be done rather than what is actually common practice. [7] Those who teach physical therapy curricula often are not involved in either clinical practice or research [12]; this isolation of educators increases the tendency of the knowledge of graduate therapists to be theoretical (and sometimes not current). The therapist who has had one or more jobs since graduation may have developed more reasonable expectations, but the further learning and attitudes appropriate to the other jobs may not meet the needs of the new center.

A critical part of anticipatory socialization is the information transmitted during recruitment and interviewing. During this period, the center and the therapist try to learn as much as possible about each other to create a good match of needs and resources. The individual and the organization, however, are also concerned with "selling" themselves to each other, so they emphasize positive attributes and downplay characteristics that might be thought of as negative, [4,10] althopugh the organization usually finds out more than the applicant does. [13]

There are several reasons why inaccurate information is projected in inte rviews. Both parties often fear rejection if their "bad sides" are exposed. [10] Also, a well-socialized interviewer may unintentionally bias information by denying or failing to recognize some negative aspects of the center. Enthusiasm about long-range aspects of the job may create unrealistic expectations about the nature of the job at hand. [10] One party may not recognize some information as being important to the other party and, therefore, will neglect to share it. The employer and the applicant typically have different concerns. Although the employer is primarily interested in the ability match, the main concern of the applicant is usually the work climate and whether human needs will be met by it. Lastly, either party may have basic assumptions or needs that they do not normally conceptualize or express but that are important to the employee-employer match. [10] If a physical therapist and employer have not portrayed themselves accurately to each other, they build mismatches of expectations into the psychological contract, with negative consequences for both the individual and the organization. [14] The job applicant has a greater chance of being hired for a job to which he or she is poorly suited, [9,11] may not receive needed training, will be more anxious about performance, will tend to leave the job sooner, and will be less satisfied with the job. [15]

The more realistic the perception job applicants have of a work situation, however, the greater the chances they will choose a job that meets their needs. [2,7] The job may not meet all expectations, but if the employee recognizes incongruencies and adjusts his or her expectations, the incongruencies are less likely to be a source of strain and dissatisfaction. Psychological contracts that are made up primarily of matched expectations are related to greater job satisfaction and productivity and to reduced turnover. [3] It should be emphasized that matching of expectations is more critical than the content of the expectations. [3]

The way in which an employee and an employer initially find out about each other affects the amount and kind of knowledge they have and thus affects the chances for a good match. Sources with the lowest turnover rates are informal (eg, referrals by present employees and reemployment of former personnel) in contrast to formal sources (eg, newspaper or journal advertisements). [11] This difference may be explained by the fact that in these case both the center and the applicant have alternate sources of information.

Realistic Job Preview 

Some authors have offered the concept of the "realistic job preview" (RJP) as a means for improving job matches and creating more realistic expectations. [6,11] The essence of the RJP is letting the job applicant decide whether the climate of the organization matches his or her needs by providing accurate and detailed information. The applicant feels more in control of the decision process and will perceive the organization as being honest and caring. [11] The RJP usually does not affect job decisions and has not been shown to affect job performance. [11] Although the conclusions from individual studies are inconsistent, [6] however, accumulated research has shown several benefits: job turnover is lower, job expectations are more realistic, and job satisfaction is higher. [11]

Factors Influencing Effectiveness

of Realistic Job Preview

Four factors influence the effectiveness of the RJP: 1) method, 2) timing, 3) source, and 4) content.

Method. Methods that have been suggested for presentation of the RJP include written information, audiovisual presentations, oral presentations, job visits, and work samples. [16] The last two methods have the advantage of being interactive, thus providing a two-way exchange of information and integrating realistic recruitment with accurate selection procedures. [11] Clinical affiliations are an ideal example of the work sample method. Center directors would be wise to take full advantage of the recruitment opportunities available through the clinical education program. Applicants who have not formally affiliated with the center can be encouraged to spend one or more days observing in the center. Following a therapist through a full day's activity, as students might do on their first day of an affiliation, will provide much information about the climate and requirements of the job.

Another method that could be applied to physical therapy recruitment is the use of assessment centers. Assessment centers use multiple testing methods, including work behavior simulations, to assess job knowledge and skills. At the same time, the individual being tested has an opportunity to perceive what it would be like to work in a certain type of job. One such center has been developed by the Missouri Physical Therapy Association as a means for self-assessment of clinical competency. [17] The possible use of similar centers for physical therapy recruitment purposes could be explored.

Timing. For maximum effectiveness, the center should administer the RJP as early as possible in the recruitment process, preferably before a position is offered and definitely before the applicant has accepted the position. [6]

Source. The credibility of information is enhanced if the information is provided by job incumbents, rather than by management. Those actually working in the job are more expert as to the real nature of the work, and applicants will perceive their motives as being more "pure." [16]

Content. Negative aspects of the job should be described honestly but not overemphasized or anxiety will result. Applicants accept negative information more easily if it is presented following positive information, which is probably more consistent with their overinflated expectations. [16]

The specific information presented should include as many elements as possible, because the psychological contract will be based in part on this information. Both job content and job context factors should be covered. Job content is the nature of the work itself and the extent to which it is interesting, challenging, and inherently rewarding. [4] A center director might create false expectations by talking enthusiastically about research projects and program development if the demands of the patient load allow little time for the pursuit of such activities. Job context refers to working conditions, such as the physical facility; pay rate and benefits; opportunities for promotion; and relationships with co-workers, referring physicians, and management. [4] Anticipated changes in any conditions should be included. One area for potential expectation discrepancies might be the amount of time outside of work hours that is spent on work-related activities, such as continuing education, in-service preparation, or public relations projects.

Encounter-Accommodation

The next stage of organizational socialization, encounter-accommodation, is the period in which the individual sees what the organization is actually like and begins to take his or her place in it. [2] If the individual and the organization have inaccurate knowledge of each other, and the psychological contract contains mismatched expectations, "reality shock" is likely to create disillusionment, anxiety, or frustration, interfering with effective role socialization. If the mismatches concern critical, or pivotal, issues or if the contractual parties allow noncritical mismatches to persist, dissatisfaction may result in early termination or impaired performance. If the anticipatory stage has been well-managed, however, discrepancies will involve noncritical, or peripheral, issues. The employee and management can renegotiate these issues through open discussion, and thus they will not be perceived as violations of the psychological contract. The new staff member can devote full attention to the tasks of the encounter-accommodation stage--developing job competency, establishing relationships with other employees of the center, and clarifying his or her role definition. [2] Providing adequate training and appropriate feedback can further facilitate development.

Training for Competency

Immediate staffing needs sometimes lead to a new therapist receiving little or no formal training. It is assumed that physical therapy school, clinical affiliations, and experience in other jobs have provided adequate development of knowledge and skills. Although this assumption should be true in a general sense, it is also true that specific centers and patient populations may require specific skills and particular approaches to evaluation and treatment. A therapist who uses predominantly equipment-centered and independent exercise, although effective, may appear to be incompetent in a center where hands-on treatment is the norm (or vice versa). Individuals may also have strong points and weak points in their knowledge, and deficiencies must be addressed. This need is particularly important because performance is one of the strongest predictors of an individual's general satisfaction with a job. [18]

The design of an appropriate training program depends on adequate needs assessment. [18] Needs assessment can be accomplished either during the hiring process (anticipatory socialization) or during the early period of employment (encounter-accommodation). The method of assessment may be formal, using competency-testing or assessment center methods; it may be informal, with a supervising therapist evaluating performance as patients with certain needs are evaluated and treated; or a combination of informal and formal methods may be used, supplementing informal assessment with testing when necessary clinical experiences are not readily available. Training can likewise combine formal and informal methods. Two factors are critical in the design of an appropriate assessment-training program. First, those providing the assessment-training should present it as a learning experience and ensure that it is not perceived as a judgment. They should appreciate competencies and special skills that the new therapist has to offer, making learning a two-way process. Second, the center should clearly define the knowledge and skills that are necessary for adequate performance in the particular job so that the needs of the individual can be easily identified and fulfillment of needs can be recognized. The American Physical Therapy Association's Competencies in Physical Therapy: An Analysis of Practice, [19] can be used as guidelines, as well as the competencies defined for specialty areas such as sports physical therapy. [20]

Performance Evaluation 

Feedback is important to the socialization of a new employee. It guides and encourages the employee's learning efforts and confirms the center's interest in his or her professional and personal development. Two characteristics of feedback influence its effectiveness: 1) timing and 2) specificity.

Timing. Formal feedback such as probationary performance evaluation is most effective if given during the first few weeks of employment. If a full year passes before evaluation, the therapist may develop anxiety about his or her performance or may not recognize deficiencies. Informal feedback is most effective when provided frequently and on a random schedule. [21]

Specificity. An employee may perceive performance evaluations as inequitable if standards are subjective or unclear. Feedback, therefore, should be based on measurable objectives. [18] Both positive and negative feedback are more effective if supported by specific examples of behavior. Typically, evaluations include clear and specific examples of problems, but only general description of good performance, so the specificity of positive feedback needs special attention.

Mentoring

Mentoring is a relationship between a junior employee and a senior colleague that contributes to the professional and personal development of the junior. [22] The mentor relationship can benefit both the organization and the individual therapist. [23] The mentor can facilitate organizational socialization for the physical therapist in several ways. One function is to provide coaching. Coaching includes "teaching the ropes" of the center and providing feedback and insights to help with the development of professional competency. Another function is protection, helping the protege avoid situations for which he or she is not fully prepared. The mentor can be a confidant with whom the individual can discuss problems and ideas, and can provide valuable counseling as well as acceptance and confirmation of the junior's worth. Perhaps most importantly, the mentor is a role model "demonstrating valued behavior, attitudes, and/or skills that aid the junior in achieving competence, confidence, and a clear professional identity." [10]

Mentors can be assigned to new employees, but research indicates that the more valuable relationships are ones that emerge spontaneously. [22] Center directors can encourage or sponsor mentorship by educating staff members as to the nature of the relationship and by creating the conditions that are considered necessary for an effective mentoring process. First, opportunities must exist for frequent and open communication between therapists of different levels. Weekly "rounds" are an example. The assignment of office space might also be a factor. Second, senior staff members must have adequate interpersonal skills such as self-disclosure, conflict management, and giving and receiving feedback. Last, the reward and management system must value and encourage relationship-building. [22] An example of encouraging reltionship-building might be the existence of senior therapist positions, which include guidance of more junior members as part of their responsibilities.

Role Management

The last stage of the socialization process is role management, also referred to as mutual acceptance. [10] In this stage, the individual masters work tasks, "settles in" to the job role, and becomes a contributing member of the organization. The psychological contract is more clearly defined as the individual internalizes organization norms and values, and the organization in turn makes changes to accommodate the needs of the individual.

Socialization represents a balance between development of the individual and organizational change via role development. [18] During the encounter-accommodation stage, the dominant mode is individual development. With the development of competence (the amount of time required for this transition takes longer for some therapists than for others), however, the therapist becomes confident enough to be creative and innovative and to make positive contributions to the center. Competence gives a therapist credibility so that others will tend to seek out and respond to his or her suggestions. At this point, role innovation can occur to adapt the role to the individual. If the individual is unwilling to accept certain practices or norms of the center, he or she can become an agent of change. As long as the areas of disagreement are not pivotal ones for the center, the psychological contract can be renegotiated and refined to reflect the changing needs and expectations of the therapist. This process is healthy. As long as the new therapist and the center's management communicate openly, and recognize and respond to each other's needs and expectations, mutual development will continue, and the satisfaction of both will be enhanced.

Conclusions

The following recommendations are offered for more effective management of organizational socialization in a physical therapy setting:

1. Take the time to find a therapist who matches the center's needs.

2. Use word-of-mouth recruitment sources as much as possible, rather than advertising.

3. Provide to job applicants honest and thorough information about the job, letting them decide whether it matches their needs.

4. Make use of clinical affiliation as a recruitment tool.

5. Consider providing other types of realistic job preview, such as job visits or work samples.

6. Provide training on the basis of an assessment of needs.

7. Provide frequent feedback based on defined behavioral objectives.

8. Encourage mentor relationships through education and by creating a climate that allows them to develop.

9. Maintain a viable psychological contract through open communication of needs and expectations.

References

[1] Wanous JP, Reichers AE: Organizational socialization and group development: Toward an integrative perspective. Academy of Management Review 9:670-683, 1984

[2] Feldman DC: Organizational socialization of hospital employees: A comparative view of occupational groups. Med Care 15:799-813, 1977

[3] Kotter JP: The psychological contract: Managing the joining-up process. California Management Review 15(3):91-99, 1973

[4] Hunsaker PL, Cook CW: Managing Organizational Behavior. Reading, PA, Addison-Wesley Publishing Co Inc, 1986

[5] Schein EH: The psychological contract. In Tosi HL, Hamner WC (eds): Organizational Behavior and Management: A Contingency Approach. New York, NY, John Wiley & Sons Inc, 1982, pp 96-98

[6] Breaugh TA: Realistic job previews: A critical appraisal and future research directions. Academy of Management Review 8:612-619, 1983

[7] Feldman DC: The multiple socialization of organization members. Academy of Management Review 6:309-318, 1981

[8] Harkson DG, Unterreiner AS, Shepard KF: Factors related to job turnover in physical therapy. Phys Ther 62:1465-1470, 1982

[9] Porter LW, Lawler EE, Hackman JR: Behavior in Organizations. New York, NY, McGraw-Hill Inc, 1974

[10] Schein EH: Cancer Dynamics: Matching Individual and Organizational Needs. Reading, PA, Addison-Wesley Publishing Co Inc, 1978, pp 81-123

[11] Wanous JP: The entry of newcomers into organizations. In Hackman R Jr, et al (eds): Perspectives on Behavior and Organizations, ed 2. New York, NY, McGraw-Hill Inc, 1983

[12] Rose S: Academics versus teachers: A dilemma in physical therapy education. Journal of Orthopaedic and Sports Physical Therapy 3:160-163, 1982

[13] Davis CM, Anderson MJ, Jagger D: Competency: The what, why, and how of it. Phys Ther 59:1088-1094, 1979

[14] Brief AP: Undoing the educational process of the newly-hired professional. Personnel Administrator 27(9):55-58, 1982

[15] Feldman DC, Brent JM: Coping with new jobs: A comparative study of new hires and job changers. Academy of Management Journal 26:258-272, 1983

[16] Popovich P, Wanous JP: The realistic job preview as a persuasive communication. Academy of Management Review 7:570-578, 1982

[17] Deusinger SS, Sindelar B, Stritter FT: Assessment Center: A model for professional development and evaluation. Phys Ther 66:1119-1123, 1986

[18] Feldman DC: A socialization process that helps new recruits succeed. Personnel 57:163-174, 1980

[19] American Physical Therapy Association: Competencies in Physical Therapy: An Analysis of Practice. San Diego, CA, Courseware Inc, 1977

[20] Zachazewski J, Brown L, Murphy T, et al: Sports physical therapy: Advanced clinical competency workshops. Journal of Orthopaedic and Sports Physical Therapy 8:213-216, 1986

[21] Curtis K: Coaching for Student Success: Skills for the Instructor. Los Angeles, CA, Los Angeles Health Directions, 1985

[22] Kram KE: Mentoring in the workplace. In Hall DT, et al (eds): Career Development in Organizations. San Francisco, CA, Jossey-Bass Inc, Publishers, 1986, pp 160-210

[23] Bohannon RW: Mentorship--A relationship important to professional development: A special communication. Phys Ther 65:920-923, 1985

of the work sample method. Center directors would be wise to take full advantage of the recruitment opportunities available through the clinical education program. Applicants who have not formally affiliated with the center can be encouraged to spend one or more days observing in the center. Following a therapist through a full day's activity, as students might do on their first day of an affiliation, will provide much information about the climate and requirements of the job.

Another method that could be applied to physical therapy recruitment is the use of assessment centers. Assessment centers use multiple testing methods, including work behavior simulations, to assess job knowledge and skills. At the same time, the individual being tested has an opportunity to perceive what it would be like to work in a certain type of job. One such center has been developed by the Missouri Physical Therapy Association as a means for self-assessment of clinical competency. [17] The possible use of similar centers for physical therapy recruitment purposes could be explored.

Timing. For maximum effectiveness, the center should administer the RJP as early as possible in the recruitment process, preferably before a position is offered and definitely before the applicant has accepted the position. [6]

Source. The credibility of information is enhanced if the information is provided by job incumbents, rather than by management. Those actually working in the job are more expert as to the real nature of the work, and applicants will perceive their motives as being more "pure." [16]

Content. Negative aspects of the job should be described honestly but not overemphasized or anxiety will result. Applicants accept negative information more easily if it is presented following positive information, which is probably more consistent with their overinflated expectations. [16]

The specific information presented should include as many elements as possible, because the psychological contract will be based in part on this information. Both job content and job context factors should be covered. Job content is the nature of the work itself and the extent to which it is interesting, challenging, and inherently rewarding. [4] A center director might create false expectations by talking enthusiastically about research projects and program development if the demands of the patient load allow little time for the pursuit of such activities. Job context refers to working conditions, such as the physical facility; pay rate and benefits; opportunities for promotion; and relationships with co-workers, referring physicians, and management. [4] Anticipated changes in any conditions should be included. One area for potential expectation discrepancies might be the amount of time outside of work hours that is spent on work-related activities, such as continuing education, in-service preparation, or public relations projects.

Encounter-Accommodation

The next stage of organizational socialization, encounter-accommodation, is the period in which the individual sees what the organization is actually like and begins to take his or her place in it. [2] If the individual and the organization have inaccurate knowledge of each other, and the psychological contract contains mismatched expectations, "reality shock" is likely to create disillusionment, anxiety, or frustration, interfering with effective role socialization. If the mismatches concern critical, or pivotal, issues or if the contractual parties allow noncritical mismatches to persist, dissatisfaction may result in early termination or impaired performance. If the anticipatory stage has been well-managed, however, discrepancies will involve noncritical, or peripheral, issues. The employee and management can renegotiate these issues through open discussion, and thus they will n ot be perceived as violations of the psychological contract. The new staff member can devote full attention to the tasks of the encounter-accommodation stage--developing job competency, establishing relationships with other employees of the center, and clarifying his or her role definition. [2] Providing adequate training and appropriate feedback can further facilitate development.

Training for Competency

Immediate staffing needs sometimes lead to a new therapist receiving little or no formal training. It is assumed that physical therapy school, clinical affiliations, and experience in other jobs have provided adequate development of knowledge and skills. Although this assumption should be true in a general sense, it is also true that specific centers and patient populations may require specific skills and particular approaches to evaluation and treatment. A therapist who uses predominatly equipment-centered and independent exercise, although effective, may appear to be incompetent in a center where hands-on treatment is the norm (or vice versa). Individuals may also have strong points and weak points in their knowledge, and deficiencies must be addressed. This need is particularly important because performance is one of the strongest predictors of an individual's general satisfaction with a job. [18]

The design of an appropriate training program depends on adequate needs assessment. [18] Needs assessment can be accomplished either during the hiring process (anticipatory socialization) or during the early period of employment (encounter-accommodation). The method of assessment may be formal, using competency-testing or assessment center methods; it may be informal, with a supervising therapist evaluating performance as patients with certain needs are evaluated and treated; or a combination of informal and formal methods may be used, supplementing informal assessment with testing when necessary clinical experiences are not readily available. Training can likewise combine formal and informal methods. Two factors are critical in the design of an appropriate assessment-training program. First, those providing the assessment-training should present it as a learning experience and ensure that it is not perceived as a judgment. They should appreciate competencies and special skills that the new therapist has to offer, making learning a two-way process. Second, the center should clearly define the knowledge and skills that are necessary for adequate performance in the particular job so that the needs of the individual can be easily identified and fulfillment of needs can be recognized. The American Physical Therapy Association's Competencies in Physical Therapy: An Analysis of Practice, [19] can be used as guidelines, as well as the competencies defined for specialty areas such as sports physical therapy. [20]

Performance Evaluation

Feedback is important to the socialization of a new employee. It guides and encourages the employee's learning efforts and confirms the center's interest in his or her professional and personal development. Two characteristics of feedback influence its effectiveness: 1) timing and 2) specificity.

Timing. Formal feedback such as probationary performance evaluation is most effective if given during the first few weeks of employment. If a full year passes before evaluation, the therapist may develop anxiety about his or her performance or may not recognize deficiencies. Informal feedback is most effective when provided frequently and on a random schedule. [21]

Specificity. An employee may perceive performance evaluations as inequitable if standards are subjective or unclear. Feedback, therefore, should be based on measurable objectives. [18] Both positive and negative feedback are more effective if supported by specific examples of behavior. Typically, evaluations include clear and specific examples of problems, but only general descriptions of good performance, so the specificity to positive feedback needs special attention.

Mentoring

Mentoring is a relationship between a junior employee and a senior colleague that contributes to the professional and personal development of the junior. [22] The mentor relationship can be benefited both the organization and the individual therapist. [23] The mentor can facilitate organizational socialization for the physical therapist in several ways. One function is to provide coaching. Coaching includes "teaching the ropes" of the center and the providing feedback and insights to help with the development of professional competency. Another function is protection, helping the protege avoid situations for which he or she is not fully prepared. The mentor can be a confidant with whom the individual can discuss problems and ideas, and can provide valuable counseling as well as acceptance and confirmation of the junior's worth. Perhaps most importantly, the mentor is a role model "demonstrating valued behavior, attitudes, and/or skills that aid the junior in achieving competence, confidence, and a clear professional identity." [10]

Mentors can be assigned to new employees, but research indicates that the more valuable relationships are ones that emerge spontaneously. [22] Center directors can encourage or sponsor mentorship by educating staff members as to the nature of the relationship and by creating the conditions that are considered necessary for an effective mentoring process. First, opportunities must exist for frequent and open communication between therapists of different levels. Weekly "rounds" are an example. The assignment of office space might also be a factor. Second, senior staff members must have adequate interpersonal skills such as self-disclosure, conflict management, and giving and receiving feedback. Last, the reward and management system must value and encourage relationship-building. [22] An example of encouraging relationship-building might be the existence of senior therapist positions, which include guidance of more junior members as part of their responsibilities.

Role Management

The last stage of the socialization process is role management, also referred to as mutual acceptance. [10] In this stage, the individual masters work tasks, "settles in" to the job role, and becomes a contributing member of the organization. The psychological contract is more clearly defined as the individual internalizes organization norms and values, and the organization in turn makes changes to accommodate the needs of the individual.

Socialization represents a balance between development of the individual and organizational change via role development. [18] During the encounter-accommodation stage, the dominant mode is individual development. With the development of competence (the amount of time required for this transition takes longer for some therapists than for others), however, the therapist becomes confident enough to be creative and innovative and to make positive contributions to the center. Competence gives a therapist credibility so that others will tend to seek out and respond to his or her suggestions. At his point, role innovation can occur to adapt the role to the individual. If the individual is unwilling to accept certain practices or norms of the center, he or she can become an agent of change. As long as the areas of disagreement are not pivotal ones for the center, the psychological contract can be renegotiated and refined to reflect the changing needs and expectations of the therapist. This process is healthy. As long as the new therapist and the center's management communicate openly, and recognize and respond to each other's needs and expectations, mutual development will continue, and the satisfaction of both will be enhanced.

Conclusions

The following recommendations are offered for more effective management of organizational socialization in a physical therapy setting:

1. Take the time to find a therapist who matches the center's needs.

2. Use word-of-mouth recruitment sources as much as possible, rather than advertising.

3. Provide to job applicants honest and thorough information about the job, letting them decide whether it matches their needs.

4. Make use of clinical affiliation as a recruitment tool.

5. Consider providing other types of realistic job preview, such as job visits or work samples.

6. Provide training on the basis of an assessment of needs.

7. Provide frequent feedback based on defined behavioral objectives.

8. Encourage mentor relationships through education and by creating a climate that allows them to develop.

9. Maintain a viable psychological contract through open communication of needs and expectations.

References

[1] Wanous JP, Reichers AE: Organizational socialization and group development: Toward an integrative perspective. Academy of Management Review 9:670-683, 1984

[2] Feldman DC: Organizational socialization of hospital employees: A comparative view of occupational groups. Med Care 15:799-813, 1977

[3] Kotter JP: The psychological contract: Managing the joining-up process. California Management Review 15(3):91-99, 1973

[4] Hunsaker PL, Cook CW: Managing Organizational Behavior. Reading, PA, Addison-Wesley Publishing Co Inc, 1986

[5] Schein EH: The psychological contract. In Tosi HL. Hamner WC (eds): Organizational Behavior and Management: A Contingency Approach. New York, NY, John Wiley & Sons Inc, 1982, pp 96-98

[6] Breaugh TA: Realistic job previews: A critical appraisal and future research directions. Academy of Management Review 8:612-619, 1983

[7] Feldman DC: The multiple socialization of organization members. Academy of Management Review 6:309-318, 1981

[8] Harkson DG, Unterreiner AS, Shepard KF: Factors related to job turnover in physical therapy. Phys Ther 62:1465-1470, 1982

[9] Porter LW, Lawler EE, Hackman JR: Behavior in Organizations. New York, NY, McGraw-Hill Inc, 1974

[10] Schein EH: Career Dynamics: Matching Individual and Organizational Needs. Reading, PA, Addison-Wesley Publishing Co Inc, 1978, pp 81-123

[11] Wanous JP: the entry of newcomers into organizations. In Hackman R Jr, et al (eds): Perspective on Behavior and Organizations, ed 2. New York, NY, McGraw-Hill Inc, 1983

[12] Rose S: Academics versus teachers: A dilemma in physical therapy education. Journal of Orthopaedic and Sports Physical Therapy 3: 160-163, 1982

[13] Davis CM, Anderson MJ, Jagger D: Competency: The what, why, and how of it. Phys Ther 59:1088-1094, 1979

[14] Brief AP: Undoing the educational process of the newly-hired professional. Personnel Administrator 27(9):55-58, 1982

[15] Feldman DC, Brent JM: Coping with new jobs: A comparative study of new hires and job changers. Academy of Management Journal 26: 258-272, 1983

[16] Popovich P, Wanous JP: The realistic job preview as a persuasive communication Academy of Management Review 7:570-578, 1982

[17] Deusinger SS, Sindelar B, Stritter FT: Assessment Center: A model for professional development and evaluation. Phys Ther 66:1119-1123, 1986

[18] Feldman DC: A socialization process that helps new recruits succeed. Personnel 57:163-174, 1980

[19] American Physical Therapy Association: Competencies in Physical Therapy: An analysis of Practice. San Diego, CA, Courseware Inc, 1977

[20] Zachazewski J, Brown L, Murphy T, et al: Sports physical therapy: Advanced clinical competency workshops. Journal of Orthopaedic and Sports Physical Therapy 8:213-216, 1986

[21] Curtis K: Coaching for Student Success: Skills for the Instructor. Los Angeles, CA, Los Angeles Health Directions, 1985

[22] Kram KE: Mentoring in the workplace. In Hall DT, et al (eds): Career Development in Organizations. San Francisco, CA, Jossey-Bass Inc, Publishers, 1986, pp 160-210

[23] Bohannon RW: Mentorship--A relationship important to professional development: A special communication. Phys Ther 65:920-923, 1985

D Smith, MA, PT, is Senior Sports Physical Therapist, Scripps Clinic Sports Medicine Center, 10666 N Torrey Pines Rd, La Jolla, CA 92037 (USA), and Clinical Education Consultant, Health Directions, Los Angeles, CA 90049. She was a student in the Graduate School of Business, University of San Diego, San Diego, CA, when the article was written.

This article was submitted September 11, 1987; was with the author for revision for 50 weeks; and was accepted October 11, 1988.