Dataset Information

Speaking up, support, control and work engagement of medical residents. A structural equation modelling analysis.

ABSTRACT: OBJECTIVES:Medical residents can play key roles in improving health care quality by speaking up and giving suggestions for improvements. However, previous research on speaking up by medical residents has shown that speaking up is difficult for residents. This study explored: (i) whether two main aspects of medical residents' work context (job control and supervisor support) are associated with speaking up by medical residents, and (ii) whether these associations differ between in-hospital and out-of-hospital settings. METHODS:Speaking up was operationalised and measured as voice behaviour. Structural equation modelling using a cross-sectional survey design was used to identify and test factors pertaining to speaking up and to compare hospital settings. RESULTS:A total of 499 medical residents in the Netherlands participated in the study. Correlational analysis showed significant positive associations between each of support and control, and voice behaviour. The authors assumed that the associations between support and control, and voice behaviour would be partially mediated by engagement. This partial mediation model fitted the data best, but showed no association between support and voice. However, multi-group analysis showed that for residents in hospital settings, support is associated with voice behaviour. For residents outside hospital settings, control is more important. Engagement mediated the effects of control and support outside hospital settings, but not within the hospital. CONCLUSIONS:This study shows that in order to enable medical residents to share their suggestions for improvement, it is beneficial to invest in supportive supervision and to increase their sense of control. Boosting medical residents' support would be most effective in hospital settings, whereas in other health care organisations it would be more effective to focus on job control.

SUBMITTER: Voogt JJ

PROVIDER: S-EPMC6856833 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Speaking up, support, control and work engagement of medical residents. A structural equation modelling analysis.

Voogt Judith J JJ Taris Toon W TW van Rensen Elizabeth L J ELJ Schneider Margriet M E MME Noordegraaf Mirko M van der Schaaf Marieke F MF

Medical education 20190930 11

<h4>Objectives</h4>Medical residents can play key roles in improving health care quality by speaking up and giving suggestions for improvements. However, previous research on speaking up by medical residents has shown that speaking up is difficult for residents. This study explored: (i) whether two main aspects of medical residents' work context (job control and supervisor support) are associated with speaking up by medical residents, and (ii) whether these associations differ between in-hospita ...[more]

PMID: 31568600

Similar Datasets

Project description:IntroductionInfection prevention and speaking up on errors are core qualities of health care providers. Heuristic effects (e.g. overconfidence) may impair behavior in daily routine, while speaking up can be inhibited by hierarchical barriers and medical team factors. Aim of this investigation was to determine, how medical students experience these difficulties for hand hygiene in daily routine.MethodsOn the base of prior investigations we developed a questionnaire with 5-point Likert ordinal scaled items and free text entries. This was tested for validity and reliability (Cronbach's Alpha 0.89). Accredited German, Swiss and Austrian universities were contacted and medical students asked to participated in the anonymous online survey. Quantitative statistics used parametric and non-parametric tests and effect size calculations according to Lakens. Qualitative data was coded according to Janesick.Results1042 undergraduates of 12 universities participated. All rated their capabilities in hand hygiene and feedback reception higher than those of fellow students, nurses and physicians (p<0.001). Half of the participants rating themselves to be best educated, realized that faulty hand hygiene can be of lethal effect. Findings were independent from age, sex, academic course and university. Speaking-up in case of omitted hand hygiene was rated to be done seldomly and most rare on persons of higher hierarchic levels. Qualitative results of 164 entries showed four main themes: 1) Education methods in hand hygiene are insufficient, 2) Hierarchy barriers impair constructive work place culture 3) Hygiene and feedback are linked to medical ethics and 4) There is no consequence for breaking hygiene rules.DiscussionAlthough partially limited by the selection bias, this study confirms the overconfidence-effects demonstrated in post-graduates in other settings and different professions. The independence from study progress suggests, that the effect occurs before start of the academic course with need for educational intervention at the very beginning. Qualitative data showed that used methods are insufficient and contradictory work place behavior in hospitals are frustrating. Even 20 years after "To err is human", work place culture still is far away from the desirable.

Project description:Body condition is an important concept in behaviour, evolution and conservation, commonly used as a proxy of an individual's performance, for example in the assessment of environmental impacts. Although body condition potentially encompasses a wide range of health state dimensions (nutritional, immune or hormonal status), in practice most studies operationalize body condition using a single (univariate) measure, such as fat storage. One reason for excluding additional axes of variation may be that multivariate descriptors of body condition impose statistical and analytical challenges. Structural equation modelling (SEM) is used in many fields to study questions relating multidimensional concepts, and we here explain how SEM is a useful analytical tool to describe the multivariate nature of body condition. In this 'Research Methods Guide' paper, we show how SEM can be used to resolve different challenges in analysing the multivariate nature of body condition, such as (a) variable reduction and conceptualization, (b) specifying the relationship of condition to performance metrics, (c) comparing competing causal hypothesis and (d) including many pathways in a single model to avoid stepwise modelling approaches. We illustrated the use of SEM on a real-world case study and provided R-code of worked examples as a learning tool. We compared the predictive power of SEM with conventional statistical approaches that integrate multiple variables into one condition variable: multiple regression and principal component analyses. We show that model performance on our dataset is higher when using SEM and led to more accurate and precise estimates compared to conventional approaches. We encourage researchers to consider SEM as a flexible framework to describe the multivariate nature of body condition and thus understand how it affects biological processes, thereby improving the value of body condition proxies for predicting organismal performance. Finally, we highlight that it can be useful for other multidimensional ecological concepts as well, such as immunocompetence, oxidative stress and environmental conditions.

Project description:BackgroundThe organization's work ethics is the cornerstone to promoting positive nurses' behaviours and overcoming counterproductive ones.PurposeThe current study aims to explore the relationship between work ethics (WEs) and counterproductive work behaviours (CWB) among nurses and testify to the mediating role of workplace ostracism (WO) in this relationship.MethodsA descriptive correlational study was conducted in an Egyptian hospital. A convenient sample of staff nurses (N = 369) who agreed to participate in the study answered work ethics, counterproductive work behaviours, and workplace ostracism questionnaires, which were proven to be valid and reliable study measures. Descriptive and inferential statistics were applied, and relationships were presented using structural equation modelling.Ethical considerationsEthics Committee approval, written informed consent, data privacy and confidentiality, and participants' rights to voluntary participation and withdrawal were maintained.ResultsThe majority of nurses (78.5%) perceived a high level of work ethics while majority of nurses reporting low levels of counterproductive work behaviours and workplace ostracism (82.25%, 75.75%), respectively. In addition to the negative correlations, the findings revealed that WEs have a significant negative influence on each of CWB (β - 0.482, p < 0.005) and WO (β - 0.044, p < 0.005). The regression analysis showed that WEs can negatively predict about 15% of the variance in each of CWB and WO. On the other hand, WO has a positive effect on CWB (β 0.035, p < 0.021) and mediates the relationship between WEs and CWB.DiscussionOstracism negatively affects the attitudes of nurses, which in turn results in negative behavioural outcomes (i.e., deviant behaviour).ConclusionIt is imperative for the hospital and nurse managers to establish a work environment that fosters support and cultivate work ethics and ethical work climate with the aim of managing negative work behaviours, enhancing nurses' retention and satisfaction, and eventually improving the quality of patient care.

Dataset Information

Speaking up, support, control and work engagement of medical residents. A structural equation modelling analysis.

Publications

Speaking up, support, control and work engagement of medical residents. A structural equation modelling analysis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets