Abstract

BackgroundThe measures put in place by health authorities to ensure the professionalism of doctors are important. Hospitals in China have included academic outputs in the promotion criteria to incentive medical clinicians to engage in scientific research so that to improve job performance (JP). However, such practice disproportionally focuses on academic outputs but ignores the force of needs fulfilled brought by intrinsic incentive. This study aims to discuss the realistic problem regarding the promotion mechanism and the potential drivers to clinical JP.MethodsThis study was based on multi-source data collection on clinical performance from electric medical record (EMR), person-environment (P–E) fit from the survey, and academic output from personnel files of ward clinicians (n = 244) of general public hospitals who sought for career progression in Shanghai in 2020. Independent-Sample t-test and chi-square test were used for comparison of two sample means or constituent ratio between promoted and not promoted clinicians. Linear multilevel regression was conducted to examine the relationship between clinical performance and academic outputs and P–E fit.ResultsClinicians who were promoted were more productive in producing academic outputs than those who were not (t = −5.075, p < 0.001). However, there was no difference in clinical performance between the two groups (t = −1.728 to 0.167, p > 0.05). The regression showed that academic outputs were not related to clinical performance, while higher P–E fit was associated with the improvement of various clinical performances.ConclusionThis study shows that P–E fit plays a more important role in facilitating clinical performance than academic performance and highlights the importance of intrinsic motivation of clinicians in achieving clinical performance.

Highlights

  • The controls put in place by health authorities to ensure the professionalism among licensed doctors are paramount in influencing the ultimate quality of care they provide [1]

  • For the former question, we find that people with more academic outputs have greater advantages in the promotion, and for the latter question, we find that P–E fit is more important in determining clinical performance than academic outputs

  • It may relate to the promotion criteria of professional title that advocate for the academic performance

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Summary

Introduction

The controls put in place by health authorities to ensure the professionalism among licensed doctors are paramount in influencing the ultimate quality of care they provide [1]. The career ladders of Chinese clinicians have four levels, including residents, attending doctors, associate chief doctors, and chief doctors The former two levels are examination based, and doctors are given the title primarily based on the test of their skills and application of clinical knowledge. The latter two levels are appraisal-based and involved in the comprehensive assessment of overall achievement including clinical, scientific, and innovative competency. Hospitals in China have included academic outputs in the promotion criteria to incentive medical clinicians to engage in scientific research so that to improve job performance (JP).

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