Skip to main content
PMC home page
BioMed Research International logoLink to BioMed Research International
. 2021 Apr 7;2021:6646980. doi: 10.1155/2021/6646980

The Relationship between Achievement Motivation and Job Performance among Chinese Physicians: A Conditional Process Analysis

Botang Guo 1, Binbin Qiang 2, Jiawei Zhou 1, Xiuxian Yang 1, Xiaohui Qiu 1, Zhengxue Qiao 1, Yanjie Yang 1,✉, Depin Cao 2,✉
PMCID: PMC8049801  PMID: 33928157

Abstract

Background

To explore the relationship between achievement motivation and job performance among physicians, this study investigated the impacts of different personality traits on job performance among the physicians.

Methods

This cross-sectional study was conducted in 2017 and 1,523 physicians from eight tertiary grade A hospitals in Harbin, China. The type of data collected included the achievement motivation of the physicians, job performance, organizational commitment, personality traits, and other demographic variables. To assess and compare the demographic data, independent t-test and ANOVA were applied. Further, Pearson correlation coefficients were used to evaluate the correlation among the variables. Moderated mediation analysis was performed to test the correlation among the job performance, achievement motivation, organizational commitment, neuroticism, extraversion, openness, agreeableness, and conscientiousness.

Results

Achievement motivation directly influences job performance and organizational commitment partially mediates the direct effects of achievement motivation on job performance. Additionally, our findings demonstrated that agreeableness and conscientiousness moderate the strength of the relationships between achievement motivation and job performance mediated by organizational commitment.

Conclusion

We propose that hospital managers should pay attention to the personal growth of the physicians and improve their organizational commitment via creating a positive working climate and training for career planning and education. Moreover, managers should identify conscientiousness and agreeableness individuals and increase their responsibilities geared towards improving the performance of the organization.

1. Background

With the growing economy, the medical system of China is gradually advancing; yet, there still exist serious challenges. The number of licensed physicians per 1000 people in China was 2.12 in 2014 [1], which was lower than the UK's at 2.8 and the USA's at 2.4 per 1000 and better than India's 0.6 per 1000, respectively [2]. Unlike their counterparts in developed countries, Chinese physicians work under immense pressure. The characteristics and nature of their work are unique since it involves life and health of humans. Notably, Chinese physicians handle multiple tasks, including routine diagnosis, clinical teaching, and scientific research [3]. At the same time, they practice under unfavorable conditions, for instance, frequent medical injury cases, low salaries, and handing voluminous cases of diagnosis and treatment which adversely affect the work attitude of the physicians, causing low work motivation and performance [4, 5]. As a result, this reduction in performance impairs medical services and further triggering dissatisfaction among the patients [6]. Job performance is a parameter that describing all attitudes, behaviors, and task completion level of employees; it is divided into individual performance and organizational performance [7]. Individual performance is often evaluated by superiors and peers [8], while organizational performance refers to the quantity, quality, and efficiency of assigned tasks [9]. Generally, an increase in organizational performance is attributed to high individual performance. Therefore, the job performance of the physicians has undoubtedly become a subject of important focus among hospital administrators and researchers.

Achievement motivation has become one of the essential organizational behaviors that influence job performance. Research evidence shows that within a specific range, work efficiency is enhanced with an increase in motivation intensity [10]. Numerous scholars have confirmed the role of achievement-motivation in job performance [11, 12]. Also, a meta-analysis in the field of public administration showed that intrinsic motivation positively affects job satisfaction and job performance [13]. Notably, unlike in other fields, physicians are trained for a prolonged period in the medical field and they have clear professional goals. They desire to correctly and efficiently complete their tasks in their hospitals. According to the achievement need hypothesis coined by McClelland, people exhibiting high achievement motivation are more devoted to work, and they further achieve higher performance by enjoying an adventurous work environment through positive feedback [14]. Additional research evidence indicates that internal drive and motivation positively influence job performance among Chinese physicians [15]. By the inference, we hypothesized that

H1: there is a positive correlation between achievement motivation and job performance among physicians.

Although some studies argue that achievement motivation promotes job performance, the underlying mechanisms of this relationship are controversial. Whether there exists an intermediate variable that plays a crucial role remains unknown.

In recent years, organizational commitment has been an area of interest of enterprises. Organizational commitment is the relative strength of the recognition and participation of individuals in a particular organization [16]. Considerable research evidence shows that employees with high organizational commitment exhibit a strong sense of identity and belonging to their organizations [17, 18]. They take pride in being a member of the particular organization and willing to make sacrifices for the benefit of the organization [19]. Similarly, the theory of social exchange postulates that employees with high organizational commitment have a great sense of participation and dedication, translating to better performance [20]. Elsewhere, findings from a meta-analysis showed that there is a strong association between emotional commitment and job performance [21]. Additional reports suggest that organizational commitment positively influences job performance, embodied in patient care and business effectiveness [22]. Further, a study in England revealed that staff invests more in the hospital, and the financial performance is better [23].

Additionally, employees with high achievement motivation are more connected to the organization [24]. A study in south-west, Nigeria, indicated that achievement motivation and organizational commitment are significantly and positively correlated [25]. Moreover, a cross-sectional study involving university academic staff showed that achievement motivation is positively related to organizational commitment [26]. Achievement motivation constitutes the predecessor of organizational commitment, which in turn is an antecedent variable for significant work outcomes. Therefore, based on this, we speculate that

H2: the organizational commitment of doctors mediates the effect of achievement motivation on job performance.

Personality is the internal tendency of individual behaviors. It is manifested in the integration of individual needs, motivation, attitude, personality, and performance when people adapt to environments. A stable personality is formed with the adaptation in a particular environment. Personality psychology postulates that when adapting to organizations and society, people with different personalities exhibit different needs, attitudes, characters, and performances, which affect their learning, life, and work [27, 28]. A literature review on organizational behavior validated the predictive effect of big five personalities on job performance [29]. Among the five types of occupational groups, conscientiousness personality is closely related to the performance in all occupational jobs. Similarly, extroversion, neuroticism, agreeableness, and openness are closely related to the performance in a particular occupation [30]. Additional research evidence confirms that in a task that requires cooperative communication, conscientiousness and agreeableness have a significant impact on job performance [31]. In Indonesia, it was shown that the extrovert personality among physicians results in optimal work performance [32]. Another study showed that personality moderates the coping styles to influence the anxiety symptoms among Chinese physicians [33]. In this study, we speculate that personality plays a similar role. Moreover, information on whether personality moderates the mediating effect of organizational commitment on job performance is unknown. Therefore, the current study used personality as the moderator and hypothesized further that

H3: personality moderates the mediating effect of organizational commitment on job performance.

2. Methods

2.1. Participants and Study Design

This cross-sectional survey was conducted in Harbin City, Heilongjiang Province, located in the northeast of China between March and September 2017. Harbin City has 13 tertiary grade A hospitals, with a bed capacity of over 500 providing both comprehensive and specialized medical care with a high level of medical training and research [34]. Using a random number table, a total of 8 hospitals were selected. Thereafter, the cluster sampling procedure was used to recruit 1,600 physicians from the 8 tertiary grade A hospitals. Data was collected by filling the questionnaires in the hospitals.

In total, 1,523 questionnaires from the 8 hospitals were received (response rate = 95.1%). Out of these, a total of 1509 questionnaires were obtained (94.3%) after excluding invalid and missing data. Again, physicians aged between 24 and 60 as well as doctors under training were excluded. Here, the term physician encompassed medical practitioners from different clinical sections including surgery, obstetrics, gynecology, and pediatrics. The participants were 769 male (50.96%), 740 female (49.04%), age M = 36.67, and SD = 7.78. The samples were representative, with a relatively wide coverage based on characteristics.

2.2. Job Performance

The job performance of the physicians was evaluated using the Job Performance Scale developed in 2009 to assess job performance levels by Motowidle et al. and revised by Chinese scholars [35]. The scale comprised three subscales (task performance, interpersonal facilitation, and work engagement). The scale included 33 items, with each item, scored on a 5-point scale (1, never and 5, always). A high score indicated a higher level of job performance. In this study, the CFA of the scale indicated a good fit: χ2/df = 1.63, CFI = 0.98, TLI = 0.96, SRMR = 0.04, RMSEA = 0.04, and the Cronbach's alpha was 0.96.

2.3. Achievement Motivation

The 30-item Achievement Motivation Scale modified by Li et al. [36] was utilized to assess the level of achievement-motivation in physicians. The scale comprised two subscales (pursue success and avoid failure), and each subscale had 15 items. Each item was scored from 1 (completely nonconforming) to 4 (completely conforming). A high score indicated a high level of achievement motivation. In this study, the CFA of the scale indicated a good fit: χ2/df = 1.94, CFI = 0.93, TLI = 0.92, SRMR = 0.05, RMSEA = 0.05, and the Cronbach's alpha were 0.89 and 0.91.

2.4. Organizational Commitment

Organizational Commitment Questionnaire revised by Sharif et al. [37] was used to estimate organizational commitment. The scale comprised three subscales (emotional commitment, continuous commitment, and normative commitment). It contained 18 items, and each item is scored on a 5-point scale, where 1 denotes strongly disagree, and 5 implies strongly agree. A high score indicated a higher level of organizational commitment. Notably, the questionnaire was highly reliable and suitable for the Chinese population. In this study, the CFA of the scale indicated a good fit: χ2/df = 1.93, CFI = 0.95, TLI = 0.94, SRMR = 0.05, RMSEA = 0.05, and the Cronbach's alpha was 0.91.

2.5. Personality

Personality was measured using the Neuroticism, Extraversion, and Openness Personality Inventory (NEO-PI), which was introduced by the American psychologists, Costa and colleagues in 1987 and revised by Wang et al.[38]. It consisted of 25 items, with a five-point scale of 1~5 points used to divide into five subscales, including neuroticism, extraversion, openness, agreeableness, and conscientiousness. Each item consists of two words with opposite meanings; the subjects need to choose the most suitable description from each number table. If the attitude is moderate, mark it at 3. The items of neuroticism were reverse-scored. The scale was suitable for the Chinese population and had suitable validity and reliability. In this study, the CFA of the scale indicated a good fit: χ2/df = 1.28, CFI = 0.96, TLI = 0.95, SRMR = 0.05, RMSEA = 0.03, and the Cronbach's alpha is 0.84.

2.6. Statistical Analyses

2.6.1. Preliminary Analyses

The demographic data (sex, age, education level, marital status, and professional qualifications) were assessed and compared using descriptive analysis, one-way analysis of variance (ANOVA), and an independent t-test. Moreover, Pearson correlation coefficients were used to examine the correlations between the study variables. Correlational analyses of job performance, achievement motivation, organizational commitment, neuroticism, extraversion, openness, agreeableness, and conscientiousness were performed using SPSS 22.0 for Windows. Statistical significance was defined at a two-tailed p value of less than 0.05 (p < 0.05).

2.6.2. Mediation and Moderation Analyses

Further, the hypothesized moderated mediation model was tested using Process macro 2 (model 58) developed for SPSS [39]. This macro leverages a bootstrapping approach to estimate the conditional indirect effects of an independent variable (achievement motivation) through a mediator (organizational commitment) on a dependent variable (job performance) at five dimensions of a moderator (personality). The present study used 5000 bootstraps in and determined the mediating effect at the 95% confidence interval. This effect was presented in a forest graph using Stata. To better display the moderation effect, the procedure designed by Aiken et al. was adopted to assess the conditional indirect effects of one SD above the mean, at the mean, and one SD below the mean for the personality values used as the moderator variable of interest.

3. Results

3.1. Demographic Characteristics and Descriptive Statistics and Preliminary Analyses

Data on age, sex, marital status, education, and professional qualifications were obtained in this study. Age was classified as up to 30 years old, 31-40 years of age, and over 41 years old. Marital status was categorized as single, married, or divorced/widowed. The level of education was classified as junior college or lower, college, and postgraduate or above. Professional qualifications were categorized as primary title, intermediate title, senior vice title, senior title, and none. The effective responses in the present study were obtained from 1509 physicians (770 males [51.0%] and 739 females [49.0%]).

The characteristics of the participants and the distribution of job performance are shown in Table 1. We collected data from 770 male (51.0%) and 739 female physicians (49.0%). The average age of the study population was 36.70 ± 7.79 years (mean ± SD). The average score for job performance of the participants in this study was 126.84 ± 18.21. There were no significant differences in job performance associated with sex. Mean comparison showed there were significant associations between job performance and age (F = 10.930, p = 0.000), education (F = 4.574, p = 0.010), professional qualifications (F = 7.723, p = 0.000), and marital status (F = 15.495, p = 0.010). There is a significant difference of job performance among physicians in varied aged groups, different educational background, marital status, and the professional levels.

Table 1.

Participants'characteristics and the distribution of job performance.

Variables Group N (%) Job performance (M ± SD) F/t p
Sex
Male 770 (51.0) 126.16 ± 19.04 -1.499 0.134
Female 739 (49.0) 127.56 ± 17.28
Age
≤30 439 (29.1) 124.14 ± 17.76 10.930 0.000
31-40 685 (45.4) 126.78 ± 17.57
≥41 385 (25.5) 130.04 ± 19.33
Marital status
Single 394 (26.1) 123.84 ± 18.16 15.495 0.000
Married/cohabiting 1051 (69.6) 128.44 ± 17.83
Divorced/separated/widowed 64 (4.3) 119.09 ± 20.36
Education
Junior college or lower 29 (1.9) 117.04 ± 17.52 4.574 0.010
College 328 (21.7) 127.68 ± 18.90
Postgraduate or above 1152 (76.4) 126.86 ± 17.97
Professional qualifications
Primary title 264 (17.5) 124.80 ± 17.65 7.723 0.000
Intermediate title 493 (32.7) 127.16 ± 18.32
Senior vice title 378 (25.1) 126.97 ± 17.81
Senior title 216 (14.3) 132.38 ± 18.09
None 158 (10.4) 121.42 ± 17.93
Open in a new tab

The means, standard deviations, and intercorrelations of all variables are presented in Table 2. Achievement motivation was positively correlated with organizational commitment (r = 0.43, p < 0.01) and job performance (r = 0.41, p < 0.01), and organizational commitment was positively correlated with job performance (r = 0.48, p < 0.01). In addition, intercorrelations among all study variables are presented separately for neuroticism, extraversion, openness, agreeableness, and conscientiousness in Table 2.

Table 2.

Means, standard deviations, and correlations for all study variables (N = 1509).

Variable M SD 1 2 3 4 5 6 7 8 9
1. Age 36.67 7.78 1
2. Achievement motivation 3.03 10.270 .019 1
3. Organizational commitment 63.32 10.751 .061∗ .429∗∗ 1
4. Neuroticism 15.23 3.251 -.046 .200∗∗ .706∗∗ 1
5. Extraversion 16.40 3.247 -.032 .179∗∗ .135∗∗ -.255∗∗ 1
6. Openness 18.66 3.580 -.002 .443∗∗ .597∗∗ .117∗∗ .161∗∗ 1
7. Agreeableness 18.49 4.062 -.043 .225∗∗ .109∗∗ .019 .637∗∗ .257∗∗ 1
8. Conscientiousness 18.00 3.918 -.015 .233∗∗ .110∗∗ .003 .574∗∗ .232∗∗ .808∗∗ 1
9. Job performance 126.72 18.160 .138∗∗ .410∗∗ .483∗∗ .187∗∗ .232∗∗ .574∗∗ .388∗∗ .384∗∗ 1
Open in a new tab

3.2. Moderated Mediational Analyses

Table 3 and Figure 1 presented the main results generated by Hayes' (2013) SPSS macro PROCESS, and they included mediator and dependent variable model and conditional indirect effect analysis. As can be seen from the mediator and dependent variable model, achievement motivation positively predicted organizational commitment (β = 0.45, p < 0.001), organizational commitment positively predicted job performance (β = 0.64, p < 0.001), and achievement motivation positively predicted job performance (β = 0.43, p < 0.001). These results indicated organizational commitment partially mediated the relationship between achievement motivation and job performance. Therefore, H1 and H2 were supported. Besides, the interaction of organizational commitment and personality (agreeableness and conscientiousness) showed significant effects on job performance (β = −0.07, p < 0.001; β = −0.06, p < 0.001). These results indicated that the mediating effect of organizational commitment in the association between achievement motivation and job performance was moderated by personality (agreeableness and conscientiousness). To clarify the direction and trend of moderation, the agreeableness and conscientiousness dimensions were plotted in the personality moderated effect diagram based on the Aiken et al. recommended method. Figure 2 presents the predicted job performance value as a function of organizational commitment and personality (agreeableness and conscientiousness). Simple slope tests revealed a significant regression slope of organizational commitment on job performance in the level of agreeableness and conscientiousness dimensions being above that of 1 SD deviations (Bsimple = 0.269, p < 0.001; Bsimple = 0.319, p < 0.001). However, the effect of organizational commitment on job performance was much stronger in the level of agreeableness and conscientiousness dimensions being below 1 SD deviations (Bsimple = 0.606, p < 0.001; Bsimple = 0.612, p < 0.001). Thus, H1, H2, and H3 were supported.

Table 3.

Conditional process analysis.

β SE t p
Mediator variable model for predicting
 Organizational commitment
 Constant 61.98 0.26 237.93 0.000
 Achievement motivation 0.45 0.02 18.21 0.000
Dependent variable model for predicting
 Job performance
 Constant 84.70 2.59 32.73 0.000
 Achievement motivation 0.43 0.04 9.90 0.000
 Organizational commitment 0.64 0.41 15.63 0.000
 Agreeableness 0.36 0.04 9.03 0.000
 Organizational commitment×agreeableness -0.07 0.01 -7.91 0.000
 Conscientiousness 0.35 0.04 8.70 0.000
 Organizational commitment×conscientiousness -0.06 0.01 -6.38 0.000
Open in a new tab

Figure 1.

Figure 1

Open in a new tab

Moderating effect. Agreeableness dimension and conscientiousness dimension moderate the relationship between organizational commitment and job performance among Chinese physicians.

Figure 2.

Figure 2

Open in a new tab

Conditional indirect effect at specific levels of the moderator when treating organizational commitment as a mediator (N = 1509).

This work used the bootstrap method to evaluate the conditional indirect effects of the achievement motivation level on job performance through organizational commitment, as a function of different ranges of the agreeableness and conscientiousness dimensions. The indirect effects at three levels of the agreeableness and conscientiousness dimensions were examined at 95% CIs of the bootstrap method. The conditional indirect impact on job performance originated from achievement motivation through organizational commitment (Figure 1). This effect changed according to the range of agreeableness and conscientiousness dimension which was weakest at 1 SD above the mean of the agreeableness and conscientiousness dimensions. These findings indicate that the more the points on agreeableness and conscientiousness dimensions a physician exhibits, the lower the organizational commitment mediating the effect of achievement motivation on job performance. The final moderated mediation model is presented in Figure 3(b).

Figure 3.

Figure 3

Open in a new tab

(a) The moderated mediation model applied in this study. (b) The final moderated mediation model. The link associating the achievement motivation and organizational commitment with job performance is moderated by personality traits.

4. Discussion

Herein, we investigated the job performance among Chinese physicians and explored a model of the relationship between achievement motivation, personality traits, organizational commitment, and job performance through a moderated mediation analysis. It was found that achievement motivation directly influences job performance of Chinese physicians, while organizational commitment partially mediates the direct effects of achievement motivation on job performance. It was further established that only agreeableness and conscientiousness moderate the strength of the relationships between achievement motivation and job performance. These findings coincide with the need for more cooperation in medical activities. Previous studies were limited to the direct effect of achievement motivation in job performance; however, these studies neglected the mechanism of this effect. Therefore, the present study reveals the mechanism of achievement motivation and job performance, geared towards providing better suggestions for hospital managers to improve the performance of doctors thereby achieving the social benefits of the hospital.

Consistent with our hypothesis, the current study found that organizational commitment was an important factor that mediated the association between achievement motivation and job performance. Specifically, achievement motivation and job performance use had a positive predicting effect on organizational commitment, which in turn predicted higher job performance. This finding is also consistent with earlier studies indicating organizational commitment as a psychosocial mechanism that may link the relationship between motivation and job performance [40, 41]. Also, this finding is not also consistent with Widarto and Anindita's study [42] where they found that there was no mediate effect in the relationship. These findings reveal a strong positive correlation between achievement motivation and job performance in physicians, which corroborates with the results from previous studies [43]. Based on the achievement need theory coined by McClelland, the achievement motivation is the desire to do well relative to the standard of excellence [44]. Employees having high achievement motivation tend to be more realistic in their career aspirations and consequently work harder and better compared to their counterparts with low achievement motivation [45]. Physicians represent a high-knowledge group, with advanced professional training, a clear career goal, high expectations in life, and value and pay more attention to individual development [46]. In our study, we established that physicians exhibiting high achievement motivation levels are motivated to succeed and more efficient at work than physicians with a low level of achievement motivation. As a result, they have a high job performance.

Notably, physicians undergo prolonged training and continuously acquire professional knowledge and clinical practice skills. They have a clear career goal and a higher level of achievement motivation [47]. Physicians with high achievement motivation are highly recognized and willing to devote extra time and energy working for their organizations with enthusiasm, hence a high organizational commitment [48]. Also, such people have high levels of emotional input to their organizations. In such an organizational environment, besides devoting themselves to work under the organization, employees take responsibilities [49]. In addition, they actively help others fronting the interests of their organizations, hence improving the performance of employees [50]. At the same time, the high organizational commitment of physicians is reflected in the importance of patient safety [51]. This spiritual concept from the internal organization guides physicians in paying more attention to patient safety. Patient safety is among the crucial indices of evaluating the performance of a physician [52].

Notably, our integrated moderated mediation analyses demonstrated general support for hypothesis 3. The results indicate that agreeableness and conscientiousness moderate the mediated effect of achievement motivation for job performance. The moderate point is in the second half of the mediation chain, i.e., the personality of the physicians affects the relationship between organizational commitment and job performance. However, neuroticism, extraversion, and openness showed no significant effect on this relationship. This is because agreeableness and conscientiousness focus more on teamwork, supporting the idea that medical activities are accomplished jointly by many departments [53]. Conversely, openness, extraversion, and neuroticism are crucial in personal performance and more prominent in the sales industry [54]. Figures 1 and 2 show the relationship between agreeableness and conscientiousness with organizational commitment and job performance. Agreeableness and conscientiousness enhance the relationship between organizational commitment and job performance. Also, the moderator role of conscientiousness personality was reported by previous studies [55, 56]. Physicians with high conscientiousness are more self-disciplined, planned, and organized. They devote themselves to every patient and have a comprehensive treatment plan; hence, they perform optimally, thereby enhancing the strength of organizational commitment and job performance [57]. Unlike in previous studies [58, 59], we found that agreeableness personality moderates job performance. This could be attributed to the study population consisting of sales employees, who draw inspiration from high competition to achieve high job performance. In contrast, the complexity and uncertainty of diseases demand physicians to consult and cooperate on multiple disciplinary teams. Physicians with high agreeableness scores are more willing to help others, pay more attention to cooperation, and prioritize organizational interests [60]. Therefore, such physicians show high job performance, translating to high numbers of improving patients. Several lines of evidence show that the management ability of medical workers promotes work performance, and people with high levels of conscientiousness and agreeableness exhibit high management ability [61]. These findings are consistent with our results.

Therefore, based on our findings, we provide recommendations for the hospital managers to improve the performance of physicians. First, we propose that hospital managers should pay close attention to the growth of young doctors. In addition to providing them with more opportunities to practice independent medical activities, more consideration should focus on their guardianship in the growth process, vigorous advocacy, and excellent practice by experienced doctors training young apprentices. Secondly, managers should utilize advanced management strategies to achieve scientific management, such as creating a positive working environment and training for career planning and education, and to improve the level of organizational commitment of physicians. Finally, managers should identify conscientious and agreeable individuals and offer them leadership roles, so that they improve organizational performance. At the same time, in the undergraduate and subsequent training of physicians, managers should strengthen the conscientiousness and agreeableness of physicians.

This study had worth mentioning limitations. First, we used a cross-sectional study design, which cannot infer the causal relationships between variables. In future studies, the use of the traced design in verifying our findings is recommended. Secondly, given the large sample size of this study, the variable measurement adopted the self-reporting method, which could result in a method effect. Therefore, we recommend a third-party evaluation of work performance and other more objective methods to collect data. Additionally, only the top 8 hospitals in Harbin were sampled. This influences the reliability of our results, and generalizing these findings in other parts of China requires validation. Therefore, future research should include other hospitals at different levels in China.

5. Conclusion

In conclusion, this study, for the first time, used the moderated mediation model to reveal the association between achievement motivation and job performance among Chinese physicians. It enriches the connotation of job performance-related theories and emphasizes the impacts of individual psychological factors on job performance. Also, it enriched the research scope of achievement motivation and job performance theory. We reveal that job performance and sex of physicians are not strongly correlated. Also, organizational commitment partially mediates the association between achievement motivation and job performance. Agreeableness and conscientiousness traits moderate the strength of the relationship between motivation achievement and job performance. Moreover, the mediated relationship is more robust for highly agreeable and conscious physicians compared to those with low scores of these traits.

Acknowledgments

This study was supported by the National Natural Science Foundation of China (81773536). We would like to thank the eight hospitals involved in the investigation for their cooperation.

Abbreviations

CFA:

Confirmatory factor analysis.

Contributor Information

Yanjie Yang, Email: yanjie1965@163.com.

Depin Cao, Email: caodp211@163.com.

Data Availability

The datasets and/or analyses from the current study are available from the corresponding authors upon reasonable request.

Ethical Approval

The Ethics Committee of the Public Health College of Harbin Medical University approved all procedures involving human subjects.

Consent

We obtained the consent from all participants and signed an informed consent form before the investigation.

Disclosure

And we have closed the submission, but the manuscript is still on BMC Health Services Research's preprint platform.

Conflicts of Interest

The authors declare that they have no competing interests.

Authors' Contributions

Botang Guo and Binbin Qiang contributed equally to this work.

References

  • 1.Gao Y., Zhou H., Singh N. S., et al. Progress and challenges in maternal health in western China: a countdown to 2015 national case study. Lancet Global Health. 2017;5(5):e523–e536. doi: 10.1016/S2214-109X(17)30100-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Hou J., Michaud C., Li Z., et al. Transformation of the education of health professionals in China: progress and challenges. The Lancet. 2014;384(9945):819–827. doi: 10.1016/S0140-6736(14)61307-6. [DOI] [PubMed] [Google Scholar]
  • 3.Zhang Y., Feng X. The relationship between job satisfaction, burnout, and turnover intention among physicians from urban state-owned medical institutions in Hubei, China: a cross-sectional study. BMC Health Services Research. 2011;11(1):1–13. doi: 10.1186/1472-6963-11-235. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.Jingang A. Which future for doctors in China? Lancet. 2013;382(9896):936–937. doi: 10.1016/S0140-6736(13)61928-5. [DOI] [PubMed] [Google Scholar]
  • 5.Qin X., Li L., Hsieh C.-R. Too few doctors or too low wages? Labor supply of health care professionals in China. China Economic Review. 2013;24(1):150–164. doi: 10.1016/j.chieco.2012.12.002. [DOI] [Google Scholar]
  • 6.Lyu H., Wick E. C., Housman M., Freischlag J. A., Makary M. A. Patient satisfaction as a possible indicator of quality surgical care. JAMA Surgery. 2013;148(4):362–367. doi: 10.1001/2013.jamasurg.270. [DOI] [PubMed] [Google Scholar]
  • 7.Kim S., Park Y., Headrick L. Daily micro-breaks and job performance: general work engagement as a cross-level moderator. Journal of Applied Psychology. 2018;103(7):772–786. doi: 10.1037/apl0000308. [DOI] [PubMed] [Google Scholar]
  • 8.Lechermeier J., Fassnacht M. How do performance feedback characteristics influence recipients' reactions? A state-of-the-art review on feedback source, timing, and valence effects. Management Review Quarterly. 2018;68(2):145–193. doi: 10.1007/s11301-018-0136-8. [DOI] [Google Scholar]
  • 9.Shanker R., Bhanugopan R., van der Heijden B. I. J. M., Farrell M. Organizational climate for innovation and organizational performance: the mediating effect of innovative work behavior. Journal of Vocational Behavior. 2017;100:67–77. doi: 10.1016/j.jvb.2017.02.004. [DOI] [Google Scholar]
  • 10.Corbett M. From law to folklore: work stress and the Yerkes-Dodson Law. Journal of Managerial Psychology. 2015;30(6):741–752. doi: 10.1108/JMP-03-2013-0085. [DOI] [Google Scholar]
  • 11.Yi Y. J., Park K. H. Motivational needs on team performance of Korean nursing students. International Nursing Review. 2015;62(1):47–53. doi: 10.1111/inr.12164. [DOI] [PubMed] [Google Scholar]
  • 12.Ogunleye A. J., Osekita D. A. Effect of job status, gender, and employees’ achievement motivation behavior on work performance: a case study of selected local government employees in Ekiti State, Nigeria. European Scientific Journal, ESJ. 2016;12(26):p. 235. doi: 10.19044/esj.2016.v12n26p235. [DOI] [Google Scholar]
  • 13.Cantarelli P., Belardinelli P., Belle N. A meta-analysis of job satisfaction correlates in the public administration literature. Review of Public Personnel Administration. 2015;36(2):115–144. doi: 10.1177/0734371x15578534. [DOI] [Google Scholar]
  • 14.Brunstein J. C., Heckhausen H. Achievement Motivation. Encyclopedia of Adolescence. 2018;50(2):10–19. [Google Scholar]
  • 15.Kim Y. S. Prosocial motivation and physicians' work attitudes. Effects of a triple synergy on prosocial orientation in a healthcare organization. World Hospitals and Health Services. 2015;51(1):12–21. [PubMed] [Google Scholar]
  • 16.Steers R. M. Antecedents and outcomes of organizational commitment. Administrative Science Quarterly. 1977;22(1):46–56. doi: 10.2307/2391745. [DOI] [PubMed] [Google Scholar]
  • 17.Dávila M. C., García G. J. Organizational identification and commitment: correlates of sense of belonging and affective commitment. The Spanish journal of psychology. 2012;15(1):244–255. doi: 10.5209/rev_SJOP.2012.v15.n1.37316. [DOI] [PubMed] [Google Scholar]
  • 18.Ng T. W. H. The incremental validity of organizational commitment, organizational trust, and organizational identification. Journal of Vocational Behavior. 2015;88:154–163. doi: 10.1016/j.jvb.2015.03.003. [DOI] [Google Scholar]
  • 19.Meyer J. P., Allen N. J. A three-component conceptualization of organizational commitment. Human Resource Management Review. 1991;1(1):61–89. doi: 10.1016/1053-4822(91)90011-Z. [DOI] [Google Scholar]
  • 20.de Clercq D., Dimov D., Thongpapanl N. T. The moderating impact of internal social exchange processes on the entrepreneurial orientation-performance relationship. Journal of Business Venturing. 2010;25(1):87–103. doi: 10.1016/j.jbusvent.2009.01.004. [DOI] [Google Scholar]
  • 21.Riketta M. Attitudinal organizational commitment and job performance: a meta-analysis. Journal of Organizational Behavior. 2002;23(3):257–266. doi: 10.1002/job.141. [DOI] [Google Scholar]
  • 22.Baird K. M., Tung A., Yu Y. Employee organizational commitment and hospital performance. Health Care Management Review. 2017;44(3):206–215. doi: 10.1097/HMR.0000000000000181. [DOI] [PubMed] [Google Scholar]
  • 23.West M., Dawson J. NHS staff management and health service quality. Birmingham, England: Aston Business School; 2011. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_129643. [Google Scholar]
  • 24.Siburian T. A. The effect of interpersonal communication, organizational culture, job satisfaction, and achievement motivation to organizational commitment of state high school teacher in the district humbang hasundutan. Indonesia: North Sumatera; 2013. [Google Scholar]
  • 25.Olaojo P. O., Oyeboade J. A., Gbotosho A. S. Social support, work motivation and work commitment of library personnel in selected private university libraries in South-West, Nigeria. International Journal of Information Science & Management. 2017;15(2):55–78. [Google Scholar]
  • 26.Irfan S., Marzuki N. A. The moderating effects of organizational culture on the relationship between work motivation and work commitment of university academic staff. International Journal of Learning & Development. 2018;8(1) doi: 10.5296/ijld.v8i1.12484. [DOI] [Google Scholar]
  • 27.Tetzner J., Becker M., Brandt N. D. Personality‐achievement associations in adolescence—examining associations across grade levels and learning environments. Journal of Personality. 2019;88(2):356–372. doi: 10.1111/jopy.12495. [DOI] [PubMed] [Google Scholar]
  • 28.Sibley C. G., Osborne D., Duckitt J. Personality and political orientation: Meta-analysis and test of a Threat- Constraint Model. Journal of Research in Personality. 2012;46(6):664–677. doi: 10.1016/j.jrp.2012.08.002. [DOI] [Google Scholar]
  • 29.Penney L. M., David E., Witt L. A review of personality and performance: identifying boundaries, contingencies, and future research directions. Human Resource Management Review. 2011;21(4):297–310. doi: 10.1016/j.hrmr.2010.10.005. [DOI] [Google Scholar]
  • 30.Sitser T., Dimitri V. D. L., Born M. P. Predicting sales performance criteria with personality measures: the use of the general factor of personality, the big five and narrow traits. Human Performance. 2013;26(2):126–149. doi: 10.1080/08959285.2013.765877. [DOI] [Google Scholar]
  • 31.Guay R. P., Oh I. S., Choi D., Mitchell M. S., Mount M. K., Shin K. The Interactive Effect of Conscientiousness and Agreeableness on Job Performance Dimensions in South Korea. Social Science Electronic Publishing. 2013;21(2):233–238. doi: 10.1111/ijsa.12033. [DOI] [Google Scholar]
  • 32.Hastut H., Tamtomo D., Sulaeman E. S. Effect of doctor's personality, job characteristic, payment method, facility, on performance and quality of doctor service. Journal of Health Policy and Management. 2017;2(1):42–55. doi: 10.26911/thejhpm.2017.01.02.04. [DOI] [Google Scholar]
  • 33.Jiawei Z., Yanjie Y., Xiaohui Q., et al. Relationship between anxiety and burnout among Chinese physicians: a moderated mediation model. Plos One. 2016;11(8, article e0157013) doi: 10.1371/journal.pone.0157013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 34.Wang W., Fu C., Zhuo H., Luo J., Xu B. Factors affecting costs and utilization of type 2 diabetes healthcare: a cross-sectional survey among 15 hospitals in urban China. BMC Health Services Research. 2010;10(1):244–244. doi: 10.1186/1472-6963-10-244. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 35.Scotter J. R. V. Relationships of task performance and contextual performance with turnover, job satisfaction, and affective commitment. Human Resource Management Review. 2000;10(1):79–95. doi: 10.1016/S1053-4822(99)00040-6. [DOI] [Google Scholar]
  • 36.Li Y., Lan J., Ju C. Achievement motivation and attributional style as mediators between perfectionism and subjective well-being in Chinese university students. Personality and Individual Differences. 2015;79:146–151. doi: 10.1016/j.paid.2015.01.050. [DOI] [Google Scholar]
  • 37.Sharif S., Dullah J. J., Osman K., Sulaiman S. Headmaster's leadership style and teachers' commitment in Malaysian rural primary schools. International Journal of Learning. 2010;16(12):229–244. doi: 10.18848/1447-9494/cgp/v16i12/46708. [DOI] [Google Scholar]
  • 38.Wang J. L., Jackson L. A., Zhang D. J., Su Z. Q. The relationships among the Big Five Personality factors, self-esteem, narcissism, and sensation-seeking to Chinese University students' uses of social networking sites (SNSs) Computers in Human Behavior. 2012;28(6):2313–2319. doi: 10.1016/j.chb.2012.07.001. [DOI] [Google Scholar]
  • 39.Hayes A. Introduction to mediation, moderation, and conditional process analysis. Journal of Educational Measurement. 2013;51(3):335–337. [Google Scholar]
  • 40.Trivellas P. Work motivation and job performance of frontline employees: the mediating role of organizational commitment. 2011 IEEE International Conference on Industrial Engineering and Engineering Management; 2011; Singapore. [DOI] [Google Scholar]
  • 41.Rosmariani A. G. The relationship between work motivation and job performance: organizational commitment as a mediator. Universiti Malaysia Sarawak; 2011. [Google Scholar]
  • 42.Widarto I., Anindita R. Analysis of the effect of motivation, job satisfaction, and organizational commitment on performance. IARJSET. 2018;5(9):21–29. doi: 10.17148/IARJSET.2018.594. [DOI] [Google Scholar]
  • 43.Dobre O. I. Employee motivation and organizational performance. Review of Applied Socio Economic Research. 2013;5:53–60. [Google Scholar]
  • 44.Moore L. L., Grabsch D. K., Rotter C. Using achievement motivation theory to explain student participation in a residential leadership learning community. The Journal of Leadership Education. 2010;9(2):22–34. doi: 10.12806/V9/I2/RF2. [DOI] [Google Scholar]
  • 45.Ahmadinejad M., Yaghoubidoost M. The relationship between achievement motivation and job efficiency of agricultural faculty staff, Islamic Azad University, Shoushtar Branch. International Journal of Agricultural Science Research & Technology in Extension & Education Systems. 2013:159–162. [Google Scholar]
  • 46.Lassey A. T., Lassey P. D., Boamah M. Career destinations of University of Ghana Medical School graduates of various year groups. Ghana Medical Journal. 2013;47(2):87–91. [PMC free article] [PubMed] [Google Scholar]
  • 47.Babenko O., Daniels L. M., White J., Oswald A., Ross S. Achievement goals of medical students and physicians. Educational Research and Reviews. 2018;13(2):74–80. doi: 10.5897/err2017.3392. [DOI] [Google Scholar]
  • 48.Singh S. P. Achievement motivation, emotional intelligence and job satisfaction predicting organizational commitment among university teachers. International Business Review. 2014;4(3):8–16. [Google Scholar]
  • 49.Miedaner F., Kuntz L., Enke C., Roth B., Nitzsche A. Exploring the differential impact of individual and organizational factors on organizational commitment of physicians and nurses. BMC Health Services Research. 2018;18(1):p. 180. doi: 10.1186/s12913-018-2977-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 50.van Gelderen B. R., Bik L. W., Bik L. W. Affective organizational commitment, work engagement and service performance among police officers. Policing. 2016;39(1):206–221. doi: 10.1108/PIJPSM-10-2015-0123. [DOI] [Google Scholar]
  • 51.Horwitz S. K., Horwitz I. B. The effects of organizational commitment and structural empowerment on patient safety culture. Journal of Health Organization & Management. 2017;31(1):10–27. doi: 10.1108/JHOM-07-2016-0150. [DOI] [PubMed] [Google Scholar]
  • 52.Shemesh D., Olsha O., Goldin I., Danin S. Patient safety: the doctor’s perspective. Journal of Vascular Access. 2015;16:S118–S120. doi: 10.5301/jva.5000370. [DOI] [PubMed] [Google Scholar]
  • 53.Lehrmann S., Schlieter H., Burwitz M. Conceptual modeling for cooperation-based evolution of medical treatment. Springer International Publishing; 2015. [Google Scholar]
  • 54.Yongjie Z., Zhongqiang C., Mei Y., et al. Comorbid generalized anxiety disorder and its association with quality of life in patients with major depressive disorder. Scientific Reports. 2017;7(1) doi: 10.1038/srep40511. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 55.Mack K. G. Conscientiousness as a Moderator of the Relationship between Work Autonomy and Job Satisfaction. Dissertations & Theses - Gradworks; 2012. [Google Scholar]
  • 56.Turiano N. A., Whiteman S. D., Hampson S. E., Roberts B. W., Mroczek D. K. Personality and substance use in midlife: conscientiousness as a moderator and the effects of trait change. Journal of Research in Personality. 2012;46(3):295–305. doi: 10.1016/j.jrp.2012.02.009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 57.Scheepers R. A. Physicians' professional performance: an occupational health psychology perspective. Perspectives on Medical Education. 2017;6(6):425–428. doi: 10.1007/s40037-017-0382-9. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 58.Jiang C., Wang D., Zhou F. Personality traits and job performance in local government organizations in China. Social Behavior & Personality An International Journal. 2009;37(4):451–457. doi: 10.2224/sbp.2009.37.4.451. [DOI] [Google Scholar]
  • 59.Barrick M. R., Mount M. K., Judge T. A. Personality and performance at the beginning of the new millennium: what do we know and where do we go next? International Journal of Selection & Assessment. 2001;9(1&2):9–30. doi: 10.1111/1468-2389.00160. [DOI] [Google Scholar]
  • 60.He C. X. Sleep problems need multidisciplinary cooperation—report on the International Conference: Clinical Update Sleep 2016. Journal of Thoracic Disease. 2016;8(7):E637–E640. doi: 10.21037/jtd.2016.05.84. [DOI] [Google Scholar]
  • 61.Vainieri M., Ferrè F., Giacomelli G., Nuti S. Explaining performance in health care: how and when top management competencies make the difference. Health Care Management Review. 2019;44(4):306–317. doi: 10.1097/HMR.0000000000000164. [DOI] [PMC free article] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The datasets and/or analyses from the current study are available from the corresponding authors upon reasonable request.

Articles from BioMed Research International are provided here courtesy of Wiley

RESOURCES