Physician Involvement in Healthcare Reform: How Physician Professional and Organizational Identification Relate to Physician Work Engagement in Clinical and Organizational Work Settings in Ontario
Notice bibliographique
Résumé
Hospital physicians play a vital role in healthcare systems, and their engagement in leadership and organizational activities—such as planning, decision-making, and quality improvement—is known to enhance hospital performance and support system-level change. Despite this, hospitals continue to face challenges engaging physicians in these non-clinical roles. These challenges are partly rooted in structural issues within the health system and are further complicated by the dual identity hospital physicians experience—balancing clinical responsibilities with organizational expectations that may conflict with their professional values. This study aimed to advance understanding of these challenges by exploring the concepts of physician work engagement and physician identification (with both their profession and their organization) in the context of the multiple roles physicians perform. A comprehensive literature review informed the development of the Physician Work Engagement and Identification Conceptual Framework (PWEICF) and a corresponding survey instrument—the Physician Work Engagement and Identification Survey (PWEIS). The PWEIS was distributed electronically to physicians (n=264) across five academic and community hospital sites. Data were analyzed using descriptive statistics, t-tests, factor analysis, and path analysis. Findings provided good support for the PWEICF and several hypotheses. Results revealed that physicians identify more strongly with their profession than with their organization and report higher engagement and fulfillment from clinical work compared to organizational work. Path analysis further demonstrated that professional fulfillment, perceived organizational support, and burnout are significant antecedents of physician work engagement. Additionally, alignment between physicians’ professional values and those of their organization was associated with stronger organizational identification, which in turn was significantly related to physicians’ engagement as members of the organization. This research offers a novel conceptualization of physician work engagement and provides new insights into the mechanisms of physician work engagement and identification by highlighting the contextual factors that shape how physicians engage and identify with their organizations. The findings contribute to the limited literature on physician engagement and offer practical insights for healthcare leaders aiming to foster more meaningful physician involvement in organizational life.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,017 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,006 | 0,003 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,001 | 0,004 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».