ArticleMedical education2019
Speaking up, support, control and work engagement of medical residents. A structural equation modelling analysis.
Article in Medical education, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Classification of influencing factors of speaking-up behaviour in hospitals: a systematic review.BMC health services research · 2024Pooled it
- Trends in patient safety education research for healthcare professional students over the past two decades: a bibliometric and content analysis.Medical education online · 2024Review
- Towards inclusive learning environments in post-graduate medical education: stakeholder-driven strategies in Dutch GP-specialty training.BMC medical education · 2024Article
- The effects of psychological safety and employee voice behavior on flight attendants' mindful safety practices adoption.Frontiers in public health · 2024Article
- An integrative systematic review of employee silence and voice in healthcare: what are we really measuring?Frontiers in psychiatry · 2023Review
- An act of performance: Exploring residents' decision-making processes to seek help.Medical education · 2021Article
- Students' social networks are diverse, dynamic and deliberate when transitioning to clinical training.Medical education · 2021Article
- Time for change: Overcoming perpetual feelings of inadequacy and silenced struggles in medicine.Medical education · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesMedical 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.
methodsSpeaking 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.
resultsA 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.
conclusionsThis 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.
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