research paper for job performance

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• BMC Health Serv Res

Job performance in healthcare: a systematic review

Marcel krijgsheld.

1 School of Governance, Utrecht University, Utrecht, The Netherlands

Lars G. Tummers

Floortje e. scheepers.

2 Department of Psychiatry, Brain Center, UMC, Utrecht, The Netherlands

Associated Data

Data is available at https://osf.io/xn9r4/?view_only=aa9cf6c701644e1bac7bc30d853877be

Healthcare organisations face major challenges to keep healthcare accessible and affordable. This requires them to transform and improve their performance. To do so, organisations must influence employee job performance. Therefore, it is necessary to know what the key dimensions of job performance in healthcare are and how these dimensions can be improved. This study has three aims. The first aim is to determine what key dimensions of job performance are discussed in the healthcare literature. The second aim is to determine to which professionals and healthcare organisations these dimensions of job performance pertain. The third aim is to identify factors that organisations can use to affect the dimensions of job performance in healthcare.

A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The authors searched Scopus, Web of Science, PubMed, and Google Books, which resulted in the identification of 763 records. After screening 92 articles were included.

The dimensions – task, contextual, and adaptative performance and counterproductive work behaviour – are reflected in the literature on job performance in healthcare. Adaptive performance and counterproductive work behaviour appear to be under-researched. The studies were conducted in different healthcare organisations and pertain to a variety of healthcare professionals. Organisations can affect job performance on the macro-, meso-, and micro-level to achieve transformation and improvement.

Based on more than 90 studies published in over 70 journals, the authors conclude that job performance in healthcare can be conceptualised into four dimensions: task, contextual and adaptive performance, and counterproductive work behaviour. Generally, these dimensions correspond with the dimensions discussed in the job performance literature. This implies that these dimensions can be used for further research into job performance in healthcare. Many healthcare studies on job performance focus on two dimensions: task and contextual performance. However, adaptive performance, which is of great importance in constantly changing environments, is under-researched and should be examined further in future research. This also applies to counterproductive work behaviour. To improve job performance, interventions are required on the macro-, meso-, and micro-levels, which relate to governance, leadership, and individual skills and characteristics.

Together with governments and policymakers, healthcare organisations face major challenges to ensure healthcare remains accessible and affordable. This requires healthcare organisations to transform and improve their performance. These challenges cannot be met without the involvement and excellent performance of healthcare employees.

The Organisation for Economic Cooperation and Development (OECD) expects that in 2050, almost 27% of the population will be over 65 years old and more than 10% will be over 80 [ 1 ]. This may lead to increasing demand for healthcare. According to the OECD, healthcare expenditure in terms of gross domestic product will grow from 8.8% in 2017 to 10.2% in 2030 in OECD countries [ 1 ]. A record amount of money is being spent on healthcare, and this is expected to further increase due to pressure arising from, among other factors, an ageing population. However, advances in medical technology and rising public expectations regarding healthcare services also contribute to increasing health expenditure [ 2 , 3 ]. Accessibility is not the only challenge arising from an ageing population and the consequent increasing demand for care; a shortage of healthcare professionals is another major challenge healthcare organisations face [ 4 , 5 ]. All these challenges make healthcare perhaps one of the most important areas in which the change and improvement of organisational performance are necessary [ 2 ]. As healthcare is mainly people work, change and improvement in organisational performance will be closely linked to the performance (i.e., the actions and behaviours) of employees [ 6 ]. In other words, the job performance of healthcare professionals is of crucial importance to achieve organisational goals [ 6 – 8 ].

Job performance has been widely discussed and conceptualised in various ways [ 8 ]. This is reflected in Koopmans et al.’s [ 9 ] systematic review, in which the authors identify 17 generic and 18 job-specific frameworks. The job-specific frameworks in that study relate to the army and employees and management in the service and sales sector. However, Greenslade and Jimmieson’s (2007) framework was developed for the healthcare sector [ 10 ] based on Borman and Motowidlo’s theoretical model [ 11 ]. Based on the 35 frameworks Koopmans et al. identify four main dimensions: task performance, contextual performance, adaptive performance, and counterproductive work behaviour [ 9 ].

Task performance has a direct relationship with the organisational technical core [ 11 – 14 ]. The term refers to direct activities (such as treating patients) and indirect activities (such as hiring nurses) that are a formal part of a worker’s job [ 15 ]. Task performance is seen as an encompassing dimension that also includes aspects such as task behaviour [ 16 ], job and non-job specific tasks [ 17 ], role performance [ 18 ], technical activities [ 19 ], and action orientation [ 20 ]. Contextual performance includes, among other items, interpersonal behaviour [ 16 ], organisational citizenship behaviour [ 21 ], extra role performance [ 22 ], and peer team interaction [ 23 ]. Contextual performance concerns the broader organisational, social, and psychological environment in which a technical core must function [ 11 – 14 ]; it includes activities such as volunteering for extra work and maintaining good interpersonal relationships [ 15 ]. Adaptive performance refers to the extent to which an individual adapts to changes in work systems or work roles [ 9 ]. It is also defined as adaptability and pro-activity [ 24 ] and creative performance [ 21 ]. Attention towards adaptive performance has increased in recent decades due to the dynamic nature of work environments [ 25 ]. In earlier frameworks, adaptive performance was seen as a separate dimension [ 26 – 28 ] instead of a component of contextual performance [ 29 ]. Finally, counterproductive work behaviour refers to behaviour that is harmful to the performance of an organisation [ 30 ]. It includes, for instance, off-task behaviour, unruliness, theft, drug abuse [ 29 ], absenteeism (not attending work) and presenteeism (attending work while ill [ 31 – 33 ];).

To change and improve the performance of healthcare professionals, and thus the performance of healthcare organisations, it is important to determine whether the four dimensions can be used as a reference for job performance research in healthcare. Although Greenslade and Jimmieson (2007) propose a framework, it focuses specifically on nurses and only includes the task and contextual performance dimensions, thus having little applicability in healthcare research in general. Therefore, it is important to determine how job performance in healthcare is treated in the research literature and whether it relates to the dimensions of task, contextual, and adaptive performance and counterproductive work behaviour. To arrive at findings about whether the four dimensions can be applied to the broad field of healthcare, it is important to investigate in which sectors of healthcare and in relation to which professionals the dimensions have been used in research. Finally, to change and improve the performance of the healthcare professional, it is relevant to determine how and at which level organisations can implement changes to affect job performance. In summary, the purpose of this review is to answer the following questions:

• Which of the four job performance dimensions are described in studies focusing on job performance in healthcare?
• To which professionals and health organisations do the dimensions of job performance discussed in the studies pertain?
• How and on which level can organisations affect the job performance of healthcare professionals?

This research was accomplished by conducting a systematic literature review. The method section describes the process of identification, screening, and assessing the eligibility of studies. The results section begins with an overview that sets out the distribution of the studies. The overview reveals in which year, and in which journal the articles were published. It also details whether studies were carried out in developed or developing countries. Further, this paper explains how it assesses the methodological quality of the studies. Following this overview, this paper presents the answers to the research questions, beginning first with the job dimensions identified in the selected studies, and then proceeding to an analysis of the type of organisations the studies examined and the healthcare professionals to which the studies pertain. Finally, the results section describes the factors that can affect job performance at different organisational levels. The discussion section discusses the results and reflects on a few of this paper’s limitations. The conclusion section provides suggestions that can be used for future research on job performance in healthcare based on this study’s findings.

The literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement [ 34 ]. To find eligible studies, four databases were searched: Scopus, Web of Science, PubMed, and Google Books. The goal of the research strategy was to find articles and books that relate to job performance in healthcare and include a broad scope of healthcare professionals. The search strategy is detailed in Appendix A .

Eligibility criteria

Studies included in the review must meet the following criteria. They must relate to job performance in the field of healthcare. Job performance or comparable terms, such as work performance or work behaviour, must appear in the title or abstract. Studies that examine at least one of the four dimensions or related terms are also eligible. Studies published between 1996 and December 2019 were selected. As part of the pragmatic approach to gathering literature, only studies written in English were considered. All articles published in international journals that were selected for this study must have been peer-reviewed.

Study selection

Through the search strategy, 763 records were identified, including four books. After 17 duplicates were removed, the titles and abstracts of the remaining 747 records were screened. This resulted in the exclusion of 497 records (including three books). Although the studies are related to healthcare, job performance was not the main objective of these studies. For example, a few studies examine musculoskeletal disorders and their impact on nursing tasks [ 16 , 17 ]. Other studies focus on job satisfaction [ 18 , 19 ]. After the exclusion of these 497 studies, the authors read the remaining 250 articles in detail and analysed their eligibility. This resulted in the exclusion of another 158 studies. The grounds for exclusion are as follows. Studies that focus on a specific task, such as working with electronic healthcare systems [ 20 , 21 ], radiation therapy [ 35 ], cervical screening [ 36 ], and communication in the operating theatre [ 24 , 25 ], were excluded.

Full-text articles were not available for two studies. After completing the process of screening and analysing the articles, a total of 92 articles, including one book chapter, met the eligibility criteria. The study selection process is depicted schematically in Fig.  1 using the PRISMA flowchart [ 34 ].

Flowchart study selection

After categorising the articles by year of publication and the journals and countries in which they were published, the methodological quality of the studies was assessed using the integrated quality criteria for the review of multiple study designs [ 37 ]. Studies that could not be assessed using the ICROMS tool were assessed using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers [ 38 ]. Because not all the selected studies directly refer to task, contextual, or adaptive performance or counterproductive work behaviour, it was imperative to assign terms, such as nursing work, tasks, or activities and indirect or direct care [ 27 , 28 ] to one of the dimensions. The assignment of the terms was accomplished using the definitions of the four dimensions. To determine whether the dimensions of job performance were used in the broad field of health care, the type of organisation in which job performance was studied was examined. In addition, it was analysed to which professionals these studies related. Finally, the factors influencing job performance were categorised into macro-, meso-, and micro-level factors. All coding can be viewed on the Open Science Framework (OSF) database.

Before answering the research questions, this paper provides an overview that sets out the distribution of the studies. The overview reveals in which year and in which journal the articles were published. It also shows whether the studies were carried out in developed or developing countries. Results of the assessment of the methodological quality of the studies are provided below.

Distribution of the studies

Table  1 reveals that most studies (82.6%) were conducted in developed countries (e.g., [ 39 – 41 ]), with the United States being the most common study location (29.4% of all studies; e.g., [ 42 – 44 ]). With regard to developing countries, China was the most common study location (e.g., [ 45 , 46 ]).

Distribution of the articles in developed and developing countries

a Based on the IMF World Economic Outlook Database, October 2018: https://www.imf.org/en/Publications/WEO/weo-database/2018/October

b See Appendix B . c Studies conducted in two countries

The articles included in this review were published in 76 different journals ( Appendix C ). The journals can be divided into healthcare fields, such as nursing [ 47 ], medicine [ 42 ], healthcare [ 48 ], and psychology [ 49 ], and into journals with a focus on specific topics, such as maternity [ 50 ] , ergonomics [ 51 ], and critical care [ 52 ]. Almost 20% of the articles were published in the following four journals: BMC Health Services Research, the Journal of Advanced Nursing , the International Journal of Medical Informatics, and the Journal of Managerial Psychology . Most of the studies were conducted in a single country, which raises questions about their external validity.

Figure  2 illustrates the publication years of the studies, divided into publications in developed and developing countries. It indicates that job performance in healthcare has been studied almost continuously over the years and is still of interest. Figure ​ Figure2 2 also suggests that the interest in job performance in healthcare has increased in developing countries over the last decade.

Number of publications on job performance in healthcare, 1996–2019

Design and quality of the studies

To assess the methodological quality of the studies, the ICROMS quality assessment tool was used [ 37 ]. The tool provides a comprehensive set of general and specific quality criteria for randomised controlled trials (RCTs), controlled before-after (CBA) studies, non-controlled interrupted time series (NCITS) studies, cluster-randomised controlled trials (cRCTs), and non-controlled before-after (NCBA) studies. The ICROMS tool also provides a clear and transparent scoring system with a minimum required score per study design. The results of the study designs are listed in Table  2 . The ICROMS scores of the assessed studies are shown in the OSF database. Qualitative and cohort studies, CBA studies, RCTs, and NCITS studies all achieved the minimum required score. Although the minimum required score was achieved in these studies, room for improvement exists. About 60% of the studies suffer from selective outcome reporting due to unavailable study protocols. Clear statements as to whether or not the studies were selectively reported did not solve the issue with the lack of protocols. On average, only the NCBA studies failed to meet the minimum required score because no baseline measurements were conducted, and no attempt was made to mitigate the effect of not having a control group. Although the quality of these NCBA studies is low, one can nonetheless provide some commentary on them. For instance, not all ICROMS items could be evaluated because it is unclear whether the criteria were met. The lack of evidence that this cannot be ascertained from an article does not mean that the criteria have not been applied. Researchers can accomplish improvement by providing a better description of the method of subject selection and its characteristics.

Results of the assessment of the methodological quality of the studies, assessed using ICROMS

The ICROMS tool has a scope for further development of quality criteria applicable to additional study designs, such as surveys and cross-sectional studies [ 37 ]. Therefore, studies that rely solely on data from questionnaires could not be assessed using the ICROMS tool. These studies (e.g., [ 30 , 53 ]) were assessed using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers [ 38 ]. The overall score ranged from 0.72–1.0 (mean: 0.91, standard deviation: 0.07).

Dimensions of job performance

The first research question examines which of the four dimensions of work performance (i.e., task, context, and adaptive performance and counterproductive work behaviour) are described in studies of work performance in healthcare. The results show that these dimensions are applicable to work performance in healthcare.

The review of the literature revealed studies that directly refer to Motowidlo et al. [ 11 ], who classify and define job performance as task and contextual performance (e.g., [ 46 , 49 , 54 ]). Studies were also found that directly refer to Greenslade and Jamieson [ 10 ], who suggest a model based on Motowidlo and Van Scotter’s [ 55 ] classification of methods to measure the job performance of nurses, which is directly linked to two dimensions, task and contextual performance (e.g., [ 56 – 58 ]). Studies referring to organisational citizen behaviour (e.g., [ 59 , 60 ]) were classified as contextual performance because there is significant overlap between the definitions of organisational citizen behaviour and contextual performance [ 9 ]. Overlap was also found in studies that directly refer to counterproductive work behaviour (e.g., [ 61 , 62 ]). In addition to the studies that directly refer to the dimensions of job performance, other studies described task, skill, and behavioural performance without a direct reference to the dimensions of job performance. The definitions [ 9 ] listed in Table  3 were used by the researchers to assign these tasks, skills, and behaviours to one of the dimensions of job performance if they were in alignment with those definitions.

Definitions of the four dimensions of job performance based on Koopmans et al.’s review (2011)

Patient feeding [ 63 ], direct patient contact [ 64 ], scheduling toileting [ 65 ], and speaking with other professionals concerning patient care [ 66 ] are examples of tasks that were attributed to the task performance dimension because these examples are part of a healthcare professional’s job. Visiting unit and hospital meetings [ 67 ], continuing professional development [ 68 ], and tutoring trainees [ 69 ] were attributed to contextual performance because these examples contribute to the improvement of an organisation overall. The willingness to implement organisational changes [ 70 ] and the eagerness to require professional information [ 71 ] are examples of behaviours that were attributed to adaptive performance because they are important to adapt to changes in work systems and roles. Purposely failing to help a colleague [ 72 ] and rude behaviour among supervisors [ 73 ] are examples of behaviours that were attributed to the dimension of counterproductive work behaviour because these behaviours can lead to employee illness and increase turnover and therefore harm an organisation’s well-being. A full description of the allocation of the studies within this paper’s sample to the dimensions is available on the OSF database. All tasks, skills, and behaviours can be assigned to one of the four dimensions of job performance. Along with the studies that directly refer to these dimensions, Table  4 lists the assignment results.

The distribution (or combinations) of dimensions of job performance

a See Appendix B . b References in bold italics concern studies in which task and contextual performance both occur. c Underlined references concern studies that bring together task, contextual, and adaptive performance. d References in italics refer to studies about task and contextual performance and counterproductive work behaviour. e Underlined and italicised references refer to studies with combined dimensions

The results reveal that over 47% of the studies focus on task performance, such as primary care tasks [ 36 ], supportive care [ 50 ], and manual tasks [ 74 ]. They also show a focus on contextual performance, which is about team interdependence, communication, synchronicity, coordination and confidence in interprofessional collaboration, and knowledge sharing [ 75 ]. A total of 45 studies investigates contextual performance in combination with task performance. This follows logically from Motowidlo et al.’s [ 11 ] frequently used definition of job performance. Thirteen studies focus on counterproductive work behaviour, which includes abuse, production deviance, sabotage, theft, absence, early and late arrival [ 61 ], workplace violence, verbal aggression, harassment, intimidation, threats, and bullying [ 76 ]. Only eight studies include the adaptive performance dimension; for example, some studies examine adopting electronic health record systems [ 77 ], adopting new innovations [ 71 ], creativity, or personal initiatives [ 59 ].

Healthcare organisations and professionals

The second research question concerns the type of healthcare organisations in which the studies investigate job performance and the type of healthcare professionals to which the studies pertain. The studies examine job performance in several healthcare fields and with respect to various types of healthcare professionals. Table  5 lists the types of healthcare organisations the studies examine. It indicates that over 77% of the studies were performed in hospitals (e.g., [ 78 , 79 ]), including in cardiology, general surgery, anaesthetics [ 80 ], and psychiatry [ 39 ] wards or in special hospitals such as children’s hospitals [ 45 , 81 ]. Other studies investigate job performance in hospices [ 82 ], organisations for patients with special needs [ 59 ], and nursing homes [ 36 ]. In six studies, the research was performed in both hospitals and other healthcare organisations. One study did not specify the type of healthcare organisation the authors studied [ 83 ].

Healthcare organisations where research into job performance was conducted

a See Appendix B . b References in bold italics indicate studies conducted in both hospitals and other health care organisations. c Includes homes for special needs patients and hospices, outpatient care, pharmacies, and community centres

About 52% of studies in the sample concern the job performance of nurses (e.g., [ 53 , 84 ]; see Table  6 ). Besides general nurses, several studies also focus on intensive care nurses [ 52 , 85 ] and maternity nurses [ 50 ]. In about 26% of the studies, physicians (e.g., [ 42 , 86 ]), such as paediatricians [ 81 ] and gynaecologists [ 77 ], are the focus of attention. Eighteen studies investigate the job performance of other healthcare professionals, such as pharmacists [ 87 , 88 ], lab technicians [ 61 ], and administrative employees [ 72 ]. Five studies do not specify the type of professional the authors examined. Markon, Chiocchio, and Fleury discuss healthcare professionals in general [ 75 ].

Investigated healthcare professionals in each study

a See Appendix B . b References in bold italics concern studies on both nurses and physicians. c References in italics that are underlined concern studies on nurses and other healthcare professionals. d Includes personal care workers, mental healthcare professionals, pharmacy staff, caregivers, administrative employees, final-year medical students, care assistants, administrative staff, counsellors, psychologists, pharmacists, social workers, lab technicians, and supervisors

Factors affecting the job performance of healthcare professionals

To answer the third research question, which concerns factors that affect the healthcare professionals’ job performance, this study distinguishes between the macro-level (organisation), meso-level (management/team), and micro-level (individual). This distinction reveals that the job performance of healthcare professionals can be affected on all three levels.

On the macro-level, job performance can be affected by how an organisation is structured [ 82 ], the extent to which a healthcare professional perceives that they have organisational support [ 53 , 73 ], and organisational culture [ 89 ]. Employee performance can flourish in an innovative atmosphere [ 71 ]. In contrast, job performance is likely to decrease in a toxic organisational climate and in cases where supervisors act abusively [ 61 , 90 ]. Turnover of high-performing employees can also affect an organisation’s performance negatively [ 54 ].

At the meso-level, managerial support and supervision and training programmes contribute to job performance levels [ 75 , 76 , 91 ]. In addition, factors such as interdependence [ 75 ], team structure [ 88 ], and the presence of social support [ 57 , 92 ] can affect job performance. Positive views towards work and innovation in organisations with employee-centred designs [ 93 ] contribute positively to job performance. Factors that negatively affect job performance on the meso-level include abusive supervision [ 94 ], limited resources, heavy workloads and dissatisfaction with co-workers [ 76 ], and burnout [ 95 ].

On the micro-level, the extent of work engagement, role clarity, and autonomy [ 53 , 96 ], as well as employee skills and education levels [ 58 ], overwork [ 69 ], and the prevalence of multitasking [ 64 ] are relevant factors that influence job performance. Other relevant factors that influence job performance applies to employees’ personal characteristics, such as openness to change and extraversion [ 56 , 67 , 97 ], seeking challenges [ 70 ], eagerness [ 71 ], and creativity [ 59 ]. Low emotional intelligence [ 98 ] and Machiavellianism – pragmatic, emotionally detached, and task oriented as.

opposed to person oriented – affect job performance in a negative manner [ 45 ]. In summary, the governance of an organisation, the style of management or leadership, and the individual skills and characteristics of the professionals at an organisation can improve or diminish the performance of individual employees. This, in turn, can affect organisational performance (Table  7 ).

Factors affecting job performance on the macro-, meso-, and micro-levels

To the best of the authors’ knowledge, this paper appears to be the first systematic review of the dimensions of job performance in healthcare, given that the study selection research process only produced one study that examine frameworks on job performance in healthcare. This one exception concerns Greenslade and Jimmieson’s framework; however, their study focuses specifically on nurses and thus is not broadly applicable to the field of healthcare [ 10 ]. The review in the instant paper also provides an important contribution by gathering knowledge on job performance in healthcare through an examination of articles published in 76 different journals. Most of these studies were conducted in single countries and often within the same types of healthcare organisations, which limits their generalisability. The interest in job performance in developing countries has only become apparent over the last decade. The methodological quality of the sample studies was assessed, revealing that most studies met the minimum required score. Although this minimum score was required, there is room for improvement in the literature, as over 60% of the studies suffer from selective outcome reporting due to the unavailability of study protocols. Along with improving generalisability, these issues should be considered in future research on this topic.

Studies concerning job performance in healthcare tend to apply at least one of the four dimensions of job performance. Studies without a direct reference to the task, contextual, or adaptive performance or counterproductive work behaviour dimensions offer descriptions of the activities, skills, and behaviours of healthcare employees. Based on the definitions of the dimensions, these activities, skills, and behaviours are attributable to at least one of the dimensions of job performance. Therefore, future studies about job performance in healthcare could be built on these dimensions.

Although the four dimensions do appear in healthcare literature concerning job performance, there is a discrepancy in the extent to which the dimensions have been studied. Task performance (49%) and contextual performance (39%) have been exhaustively investigated, whereas adaptive performance (8%) – which is also of great importance in constantly changing environments such as healthcare – appears to be under-researched. The same is true of the counterproductive work behaviour dimension, which can have a substantial and negative effect on job performance. Authors should consider this gap in job performance research in future research endeavours.

This review shows that scholars have studied the dimensions in different types of healthcare organisations and with reference to a variety of healthcare professionals. The main type of healthcare organisation the studies examine is hospitals and the departments and wards within them. About 22% of the studies were conducted in nursing homes, community centres, and home care organisations (among other organisations). Because most studies were conducted in hospitals, it was expected that most of the surveyed professionals would be physicians (26%) and nurses (52%). Other professionals the studies examine include mental healthcare professionals, psychologists, pharmacists, lab technicians, and supervisors. Consequently, the results show that the task, contextual, and adaptive performance and counterproductive work behaviour dimensions all apply to the broad field of healthcare and pertain to professions that exist within the healthcare sector. As such, these dimensions are useful for examining job performance in the broad context of healthcare and healthcare professionals.

This research not only investigated which dimensions of job performance can be used in the context of healthcare but also how and at what level these dimensions could be affected. The results show that the job performance of healthcare professionals can be affected on three levels. On the macro-level, the structure of an organisation, support for the board among an organisation’s employees, and organisational culture are examples of factors that affect job performance. At the meso-level, job performance can be affected to how management acts, how work is organised, and how teams function. On the micro-level, job performance is affected by employee motivation, the educational levels of the professionals in question, and employees’ personal characteristics. These levels are interdependent. Thus, organisations cannot simply improve the job performance of healthcare professionals in isolation from other efforts, and research aimed at improving job performance must be conducted with reference to these three levels. Given the apparently limited research regarding the adaptive performance and counterproductive work behaviour dimensions in healthcare, this paper suggests researchers investigate these dimensions with reference to the factors at the aforementioned levels to influence these dimensions.

Limitations

The review set out in this paper has a few limitations. First, it is not certain that the review identified and covered all studies concerning job performance in healthcare. One reason for this is the fact that only English articles were eligible for inclusion based on the eligibility criteria. By including studies that were conducted in non-English speaking regions and in both developed and developing countries, this paper tries to reduce the impact of this potential limitation. Second, since the search criteria focused on at least one of the four dimensions, there is a possibility that other potential dimensions may not have emerged from the results. A possible third limitation is based on the fact that job performance is described in many ways, and there are many different terms that could be related to dimensions of job performance. Finally, the ratio between studies that were conducted in developed and developing countries within the sample implies a validation risk. However, studies that were conducted in either developed or developing countries are referred to in Greenslade and Jimmieson’s [ 10 ] and Motowidlo et al. [ 11 ] works. Despite these limitations, the findings in this review provide support for further research on job performance in healthcare.

This research aimed to provide a concept that can be used for research on job performance in healthcare. Based on an examination of more than 90 studies published in over 70 journals, this research shows that job performance in healthcare can be conceptualised into four dimensions: task, contextual, and adaptive performance, and counterproductive work behaviour. While some of the studies directly refer to these dimensions, other studies describe tasks, skills, and behaviours without making direct reference to the four dimensions. However, these tasks, skills, and behaviours were assigned to one of the dimensions of job performance if they were in alignment with their definitions. In healthcare studies on job performance, the focus is on task and contextual performance. However, adaptive performance, which is of great importance in a constantly changing environment, is under-researched and should be considered a topic for future research. This is also suggested for the counterproductive work behaviour dimension. To improve job performance, interventions – in conjunction with one another – are required on the macro-, meso-, and micro-levels, which concern governance, leadership, and individual skills and characteristics.

Acknowledgements

Not applicable.

Abbreviations

Search strategies.

Scopus : (TITLE ({job} OR {work} OR “worker*” OR {personnel} OR {staff} OR {professionals} OR {performance}) AND TITLE ({healthcare} OR {health-care} OR doctor* OR nurse* OR {nursing} OR hospital* OR physician*) AND TITLE-ABS-KEY ({task performance} OR {contextual performance} OR {adaptive performance} OR {counterproductive} OR {counter-productive}).

Pubmed : (“Work Performance”[Mesh] OR work performance[tiab] OR job performance[tiab]) AND (Task*[tiab] OR Contextual[tiab] OR Adaptive[tiab] OR Counterproductive[tiab] OR counter-productive[tiab]) AND (“Health Personnel”[Mesh] OR health personnel[tiab] OR healthcare personnel[tiab] OR care personnel[tiab] OR care worker*[tiab] OR healthcare provider*[tiab] OR care provider*[tiab] OR healthcare worker*[tiab] OR caregiver*[tiab] OR medical staff[tiab] OR hospital staff[tiab] OR hospital personnel[tiab] OR nurse[tiab] OR nurses[tiab] OR doctor*[tiab] OR physician*[tiab]).

Web of Science : TS = (job OR work OR worker* OR personnel OR staff OR professionals) AND TS = (“task performance” OR “contextual performance” OR “adaptive performance” OR “counterproductive behavio$r”) AND TS = (care OR healthcare OR doctor* OR nurse* OR hospital* OR physician*).

Google Books : “job|work performance” “Task|contextual|adaptive performance”|Counterproductive intitle:healthcare|care|doctors|nurses|hospital|physicians intitle:performance|teamwork|competency|job|work|potential|professional|skill|behavior|behaviour.

Articles referred to in Tables  1 , ​ ,4, 4 , ​ ,5 5 and ​ and6 6

1. Bhatti, M. A., Mat, N., & Juhari, A. S. (2018). Effects of job resources factors on nurse’s job performance (mediating role of work engagement). International Journal of Health Care Quality Assurance , 31 (8), 1000–1013.

2. Malik, N. (2018). Authentic leadership an antecedent for contextual performance of Indian nurses. Personnel Review , 47 (6), 1244–1260.

3. Bhatti, M. A., Alshagawi, M., & Syah Juhari, A. (2018). Mediating the role of work engagement between personal resources (self-efficacy, the big five model) and nurses’ job performance. International Journal of Human Rights in Healthcare , 11 (3), 176–191.

4. Schenk, E., Schleyer, R., Jones, C. R., Fincham, S., Daratha, K. B., & Monsen, K. A. (2018). Impact of Adoption of a Comprehensive Electronic Health Record on Nursing Work and Caring Efficacy. CIN:Computers Informatics Nursing , 36 (7), 331–338.

5. Tong, L. (2018). Relationship between meaningful work and job performance in nurses. International Journal of Nursing Practice , 24 (2).

6. Gordon, H. J., Demerouti, E., Le Blanc, P. M., Bakker, A. B., Bipp, T., & Verhagen, M. A. M. T. (2018). Individual job redesign: Job crafting interventions in healthcare. Journal of Vocational Behavior , 104 , 98–114.

7. Ying, L., & Cohen, A. (2018). Dark triad personalities and counterproductive work behaviors among physicians in China. International Journal of Health Planning and Management .

8. Zawawi, A. A., & Nasurdin, A. M. (2017). The impact of task characteristics on the performance of nursing teams. International Journal of Nursing Sciences, 4 (3), 285–290.

9. Roche, M. A., Friedman, S., Duffield, C., Twigg, D. E., & Cook, R. (2017). A comparison of nursing tasks undertaken by regulated nurses and nursing support workers: a work sampling study. Journal of Advanced Nursing , 73 (6), 1421–1432.

10. Ugwu, L. I., Enwereuzor, I. K., Fimber, U. S., & Ugwu, D. I. (2017). Nurses’ burnout and counterproductive work behavior in a Nigerian sample: The moderating role of emotional intelligence. International Journal of Africa Nursing Sciences , 7 , 106–113.

11. Higgins, L. W., Shovel, J. A., Bilderback, A. L., Lorenz, H. L., Martin, S. C., Rogers, D. J., & Minnier, T. E. (2017). Hospital nurses’ work activity in a technology-rich environment: A triangulated quality improvement assessment. Journal of Nursing Care Quality , 32 (3), 208–217.

12. Gabriel, J. M. O. (2016). Supervisors’ toxicity as predictor of subordinates’ counter-productive work behavior in Nigerian public hospitals. Journal of Applied Business Research , 32 (5), 1363–1374.

13. Park, I. S., Suh, Y. O., Park, H. S., Ahn, S. Y., Kang, S. Y., & Ko, I. S. (2016). The job analysis of Korean nurses as a strategy to improve the Korean Nursing Licensing Examination. Journal of Educational Evaluation for Health Professions , 13 .

14. Wolff, J., McCrone, P., Patel, A., Auber, G., & Reinhard, T. (2015). A time study of physicians’ work in a german university eye hospital to estimate unit costs. PLoS ONE , 10 (3).

15. White, D. E., Jackson, K., Besner, J., & Norris, J. M. (2015). The examination of nursing work through a role accountability framework. Journal of Nursing Management , 23 (5), 604–612.

16. Brown, M., Shaw, D., Sharples, S., Jeune, I. L., & Blakey, J. (2015). A survey-based cross-sectional study of doctors’ expectations and experiences of non-technical skills for out of hours work. BMJ Open , 5 (2).

17. Heydari, A., Mazloom, R., Najar, A. V, & Bakhshi, M. (2015). Awareness and performance of Iranian nurses with regard to health economics: A cross-sectional study. North American Journal of Medical Sciences , 7 (9), 384–389.

18. Hamblin, L. E., Essenmacher, L., Upfal, M. J., Russell, J., Luborsky, M., Ager, J., & Arnetz, J. E. (2015). Catalysts of worker-to-worker violence and incivility in hospitals. Journal of Clinical Nursing , 24 (17–18), 2458–2467.

19. Yuan, Y., & Zhong, S. (2014). The compensation plan on doctors considering the contextual performance. Advances in Intelligent Systems and Computing . Business School, Sichuan University, Chengdu, 610,065, China.

20. Yun, S., Kang, J., Lee, Y.-O., & Yi, Y. (2014). Work Environment and workplace bullying among Korean intensive care unit nurses. Asian Nursing Research , 8 (3), 219–225.

21. Weigl, M., Hoffmann, F., Mueller, A., Barth, N., & Angerer, P. (2014). Hospital paediatricians’ workflow interruptions, performance, and care quality: a unit-based controlled intervention. Europena Journal of Pediatrics , 173 (5), 637–645.

22. Weigl, M., Mueller, A., Sevdalis, N., & Angerer, P. (2013). Relationships of Multitasking, Physicians’ Strain, and Performance: An Observational Study in Ward Physicians. Journal of Patient Safety , 9 (1), 18–23.

23. Estes, B. C. (2013). Abusive Supervision and Nursing Performance. Nursing Forum , 48 (1), 3–16.

24. Douglas, S., Cartmill, R., Brown, R., Hoonakker, P., Slagle, J., Schultz Van Roy, K., … Carayon, P. (2013). The work of adult and pediatric intensive care unit nurses. Nursing Research , 62 (1), 50–58.

25. Anderson, D. R., St. Hilaire, D., & Flinter, M. (2012). Primary care nursing role and care coordination: An observational study of nursing work in a community health center. Online Journal of Issues in Nursing , 17 (2).

26. Qian, S.-Y., Yu, P., Zhang, Z.-Y., Hailey, D. M., Davy, P. J., & Nelson, M. I. (2012). The work pattern of personal care workers in two Australian nursing homes: A time-motion study. BMC Health Services Research , 12 (1).

27. Gimeno, D., Barrientos-Gutiãrrez, T., Burau, K. D., & Felknor, S. A. (2012). Safety climate and verbal abuse among public hospital-based workers in Costa Rica. Work , 42 (1), 29–38.

28. Hsiao, J.-L., & Chen, R.-F. (2012). An investigation on task-technology fit of mobile nursing information systems for nursing performance. CIN - Computers Informatics Nursing , 30 (5), 265–273.

29. Beckman, T. J., Reed, D. A., Shanafelt, T. D., & West, C. P. (2012). Resident physician well-being and assessments of their knowledge and clinical performance. Journal of General Internal Medicine , 27 (3), 325–330.

30. Abbey, M., Chaboyer, W., & Mitchell, M. (2012). Understanding the work of intensive care nurses: A time and motion study. Australian Critical Care , 25 (1), 13–22.

31. Westbrook, J. I., Duffield, C., Li, L., & Creswick, N. J. (2011). How much time do nurses have for patients? A longitudinal study quantifying hospital nurses’ patterns of task time distribution and interactions with health professionals. BMC Health Services Research , 11 .

32. Greenslade, J. H., & Jimmieson, N. L. (2011). Organizational factors impacting on patient satisfaction: A cross sectional examination of service climate and linkages to nurses’ effort and performance. International Journal of Nursing Studies , 48 (10), 1188–1198.

33. Barker, L. M., & Nussbaum, M. A. (2011). The effects of fatigue on performance in simulated nursing work. Ergonomics , 54 (9), 815–829.

34. Yousefi, V. (2011). How Canadian hospitalists spend their time - A work-sampling study within a hospital medicine program in Ontario. Journal of Clinical Outcomes Management , 18 (4), 159–164.

35. Gardner, G., Gardner, A., Middleton, S., Della, P., Kain, V., & Doubrovsky, A. (2010). The work of nurse practitioners. Journal of Advanced Nursing , 66 (10), 2160–2169.

36. Williams, H., Harris, R., & Turner-Stokes, L. (2009). Work sampling: A quantitative analysis of nursing activity in a neuro-rehabilitation setting. Journal of Advanced Nursing , 65 (10), 2097–2107.

37. Westbrook, J. I., Ampt, A., Kearney, L., & Rob, M. I. (2008). All in a day’s work: An observational study to quantify how and with whom doctors on hospital wards spend their time. Medical Journal of Australia , 188 (9), 506–509.

38. Paquay, L., De Lepeleire, J., Milisen, K., Ylieff, M., Fontaine, O., & Buntinx, F. (2007). Tasks performance by registered nurses and care assistants in nursing homes: A quantitative comparison of survey data. International Journal of Nursing Studies , 44 (8), 1459–1467.

39. Greenslade, J. H., & Jimmieson, N. L. (2007). Distinguishing between task and contextual performance for nurses: Development of a job performance scale. Journal of Advanced Nursing , 58 (6), 602–611.

40. Fawcett, J., Schutt, R. K., Gail, G. B., Cruz, E. R., & Woodford, M. L. (2007). The work of nurse case managers in a Cancer and Cardiovascular Disease Risk Screening Program. Professional Case Management , 12 (2), 93–105.

41. Velasquez, D. (2007). The development and testing of a questionnaire to measure complexity of nursing work performed in nursing homes: NCCQ-NH. Geriatric Nursing , 28 (2), 90–98.

42. Roud, D., Giddings, L. S., & Koziol-McLain, J. (2005). A longitudinal survey of nurses’ self-reported performance during an entry to practice programme. Nursing Praxis in New Zealand Inc. , 21 (2), 37–46.

43. Van Der Weide, M., & Smits, J. (2004). Adoption of innovations by specialised nurses: Personal, work and organisational characteristics. Health Policy , 68 (1), 81–92.

44. Ogata, Y., Kobayashi, Y., Fukuda, T., Mori, K., Hashimoto, M., & Otosaka, K. (2004). Measuring relative work values for home care nursing services in Japan. Nursing Research , 53 (3), 145–153.

45. Skilbeck, J., & Seymour, J. (2002). Meeting complex needs: an analysis of Macmillan nurses’ work with patients. International Journal of Palliative Nursing , 8 (12), 574–582.

46. Hall, L. M., & O’Brien-Pallas, L. (2000). Redesigning nursing work in long-term care environments. Nursing Economics , 18 (2), 79–87.

47. Rasmussen, B. H., & Sandman, P. O. (2000). Nurses’ work in a hospice and in an oncological unit in Sweden. The Hospice Journal , 15 (1), 53–75.

48. Kitai, E., Kushnir, T., Herz, M., Melamed, S., Vigiser, D., & Granek, M. (1999). Correlation off work structure and job satisfaction among israeli family physicians. Israel Medical Association Journal , 1 (4), 236–240.

49. Upenieks, V. V. (1998). Work sampling. Assessing nursing efficiency. Nursing Management , 29 (4), 27–29.

50. Kushnir, T., Melamed, S., & Ribak, J. (1997). Occupational physicians in Israel: Work structure, job and personal characteristics, and job satisfaction. Journal of Occupational and Environmental Medicine , 39 (9), 874–881.

51. Gagnon, A. J., & Waghorn, K. (1996). Supportive Care by Maternity Nurses: A Work Sampling Study in an Intrapartum Unit. Birth , 23 (1), 1–6.

52. Giorgi, F., Mattei, A., Notarnicola, I., Petrucci, C., & Lancia, L. (2018). Can sleep quality and burnout affect the job performance of shift-work nurses? A hospital cross-sectional study. Journal of Advanced Nursing , 74 (3), 698–708.

53. Markon, M. P., Chiocchio, F., & Fleury, M. J. (2017). Modelling the effect of perceived interdependence among mental healthcare professionals on their work role performance. Journal of Interprofessional Care , 31 (4), 520–528.

54. Irwin, A., & Weidmann, A. E. (2015). A mixed methods investigation into the use of non-technical skills by community and hospital pharmacists. Research in Social & Administrative Pharmacy: RSAP , 11 (5), 675–685.

55. Binnewies, C., Sonnentag, S., & Mojza, E. J. (2009). Feeling recovered and thinking about the good sides of one’s work. Journal of Occupational Health Psychology , 14 (3), 243–256.

56. Pulich, M., & Tourigny, L. (2004). Workplace deviance: strategies for modifying employee behavior. The Health Care Manager , 23 (4), 290–301.

57. Bemus, A. M., Lindley, C. M., Sawyer, W. T., & McAllister III, J. C. (1996). Task analysis of home care pharmacy. American journal of health-system pharmacy , 53(23), 2831–2839.

58. Schweikhart, S. B. (1996). Reengineering the work of caregivers: role redefinition, team structures, and organizational redesign. Hospital & Health Services Administration , 41 (1), 19–36.

59. Bugaj, T. J., Nikendei, C., Groener, J. B., Stiepak, J., Huber, J., Moeltner, A., … Koechel, A. (2018). Ready to run the wards? - A descriptive follow-up study assessing future doctors’ clinical skills. BMC Medical Education , 18 (257), 1–8.

60. Seren, A. K. H., Tuna, R., & Bacaksiz, F. E. (2018) Reliability and Validity of the Turkish Version of the Job Performance Scale Instrument. Journal of Nursing Research,26 (1), 27–35.

61. Rowan, B. H., Robinson, J., Granato, A., Bla, C. K., Kouyate, S., Djety, G. V., … Gloyd, S. (2018). Workforce patterns in the prevention of mother to child transmission of HIV in Cote d’Ivoire: a qualitative model. Human Resources Health,16 (4).

62. Becton, J. B., Carr, J. C., Mossholder, K. W., & Walker, H. J. (2017). Differential Effects of Task Performance, Organizational Citizenship Behavior, and Job Complexity on Voluntary Turnover. Journal of Business and Psychology , 3 (4), 495–508.

63. Riskin, A., Erez, A., Foulk, T. A., Riskin-Geuz, K. S., Ziv, A., Sela, R., … Bamberger, P. A. (2017). Rudeness and Medical Team Performance. Pediatrics , 139 (2).

64. De Carlo, N. A., Dal Corso, L., Falco, A., Girardi, D., & Piccirelli, A. (2016). ``To be, rather than to seem”: The impact of supervisor’s and personal responsibility on work engagement, job performance, and job satisfaction in a positive healthcare organization. TPM:Testing, Psychometrics, Methodology in Applied Psychology , 23 (4), 561–580.

65. Chiocchio, F., Lebel, P., & Dube, J.-N. (2016). Informational role self-efficacy: a validation in interprofessional collaboration contexts involving healthcare service and project teams. BMC Health Services Research , 16 (1) 153.

66. Raglan, G. B., Margolis, B., Paulus, R. A., & Schulkin, J. (2015). Obstetrician/Gynecologists’ Experiences with Electronic Health Record Systems: A Narrative Study. Journal of Reproductive Medicine , 60 (3–4), 95–102.

67. Gordon, H. J., Demerouti, E., Bipp, T., & Le Blanc, P. M. (2015). The Job Demands and Resources Decision Making (JD-R-DM) Model. European Journal of Work and Organizational Psychology , 24 (1), 44–58.

68. Gordon, H. J., Demerouti, E., Le Blanc, P. M., Bakker, A. B., Bipp, T., & Verhagen, M. A. M. T. (2018). Individual job redesign: Job crafting interventions in healthcare. Journal of Vocational Behavior , 104 , 98–114.

69. Yousaf, A., Yang, H., & Sanders, K. (2015). Effects of intrinsic and extrinsic motivation on task and contextual performance of Pakistani professionals. Journal of Managerial Psychology , 30 (2), 133–150.

70. Calhoun, A. W., Boone, M. C., Dauer, A. K., Campbell, D. R., & Montgomery, V. L. (2014). Using simulation to investigate the impact of hours worked on task performance in an intensive care unit. American Journal of Critical Care , 23 (5), 387–395.

71. Chui, M. A., Look, K. A., & Mott, D. A. (2014). The association of subjective workload dimensions on quality of care and pharmacist quality of work life. Research in Social & Administrative Pharmacy , 10 (2), 328–340.

72. Feys, M., Anseel, F., & Wille, B. (2013). Responses to co-workers receiving recognition at work. Journal of Managerial Psychology, 28 (5), 492–510.

73. Pohl, S., Dal Santo, L., & Battistelli, A. (2012). Perceived organizational support, job characteristics and intrinsic motivation as antecedents of organizational citizenship behaviours of nurses. Revue internationale de psychologie sociale , 25 (3), 39–52.

74. Flowerdew, L., Brown, R., Vincent, C., & Woloshynowych, M. (2012). Development and Validation of a Tool to Assess Emergency Physicians’ Nontechnical Skills. ANNALS.

75. Muse, L. A., & Wadsworth, L. L. (2012). An examination of traditional versus non-traditional benefits. Journal of Managerial Psychology, 27 (2), 112–131.

76. Viitanen, J., Hypponen, H., Laaveri, T., Vanska, J., Reponen, J., & Winblad, I. (2011). National questionnaire study on clinical ICT systems proofs: Physicians suffer from poor usability. International Journal of Medical Informatics , 80 (10), 708–725.

77. Haun, S., Steinmetz, H., & Dormann, C. (2011). Objective work-nonwork conflict: From incompatible demands to decreased work role performance. Journal of Vocational Behavior , 79 (2), 578–587.

78. Veloski, J., Boex, J. R., Grasberger, M. J., Evans, A., & Wolfson, D. W. (2006). Systematic review of the literature on assessment, feedback and physicians’ clinical performance*: BEME Guide No. 7. Medical Teacher , 28 (2), 117–128.

79. Christensen, T., Faxvaag, A., Laerum, H., & Grimsmo, A. (2009). Norwegians GPs’ use of electronic patient record systems. International Journal of Medical Informatics, 78 (12), 808–814.

80. Weigl, M., Mueller, A., Zupanc, A., & Angerer, P. (2009). Participant observation of time allocation, direct patient contact and simultaneous activities in hospital physicians. BMC Health Services Research , 9 (1)110.

81. Johnson, J., Truxillo, D. M., Erdogan, B., Bauer, T. N., & Hammer, L. (2009). Perceptions of Overall Fairness: Are Effects on Job Performance Moderated by Leader-Member Exchange? Human Performance, 22 (5), 432–449.

82. Caldwell, B. S. (2008). Knowledge sharing and expertise coordination of event response in organizations. Applied Ergonomics , 39 , 427–438.

83. Cao, C. G. L., Weinger, M. B., Slagle, J., Zhou, C., Ou, J., Gillin, S., … Mazzei, W. (2008). Differences in day and night shift clinical performance in anesthesiology. Human Factors , 50 (2), 276–290.

84. Rotundo, M. (2002). The relative importance of task, citizenship, and counterproductive performance to global ratings of job performance: a policy-capturing approach. The Journal of Applied Psychology , 87 (1), 66–80.

85. Tang, Z., Weavind, L., Mazabob, J., Thomas, E. J., Chu-Weininger, M. Y. L., & Johnson, T. R. (2007). Workflow in intensive care unit remote monitoring: A time-and-motion study. Critical Care Medicine, 35 (9), 2057–2063.

86. Yule, S., Flin, R., Paterson-Brown, S., Maran, N., & Rowley, D. (2006). Development of a rating system for surgeons’ non-technical skills. Medical Education, 40 (11), 1098–1104.

87. Chisholm, C. D., Collison, E. K., Nelson, D. R., & Cordell, W. H. (2000). Emergency department workplace interruptions: Are emergency physicians ``interrupt-driven” and ``multitasking”? Academic Emergency Medicine, 7 (11), 1239–1243.

88. Westbrook, J. I., Li, L., Shah, S., Lehnbom, E. C., Prgomet, M., Schofield, B., ... & Sheikh, A. (2019). A cross-country time and motion study to measure the impact of electronic medication management systems on the work of hospital pharmacists in Australia and England. International Journal of Medical Informatics .

89. Chen, F. L., Chen, K. C., Chiou, S. Y., Chen, P. Y., Du, M. L., & Tung, T. H. (2019). The longitudinal study for the work-related factors to job performance among nurses in emergency department. Medicine , 98 (12), e14950.

90. Palenzuela, P., Delgado, N., & Rodríguez, J. A. (2019). Exploring the Relationship between Contextual Performance and Burnout in Healthcare Professionals. Journal of Work and Organizational Psychology, 35(2), 115–121.

91. Low, Y. M., Sambasivan, M., & Ho, J. A. (2019). Impact of abusive supervision on counterproductive work behaviors of nurses. Asia Pacific Journal of Human Resources.

92. Michie, S., & West, M. A. (2004). Managing people and performance: an evidence based framework applied to health service organizations. International journal of management reviews, 5(2), 91–111.

Table ​ Table8 8

Overview Journals of publications

Authors’ contributions

The work has been drafted by MK. MK also carried out the selection of the studies. LT and FS have reviewed the content of the work throughout the process. In addition, LT gave advice on methods that are most suitable for conducting a systematic review. LT also pointed out the tools to assess the methodological quality of the studies. MK carried out these assessments. In addition to the substantive review, FS has brought structure into the article. MK, LT and FS discussed the results and implications. All the authors have read and approved the manuscript.

This review has been realized without funding.

Availability of data and materials

Declarations.

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Contributor Information

Marcel Krijgsheld, Email: [email protected] .

Lars G. Tummers, Email: [email protected] .

Floortje E. Scheepers, Email: [email protected] .

Employee psychological well-being and job performance: exploring mediating and moderating mechanisms

International Journal of Organizational Analysis

ISSN : 1934-8835

Article publication date: 12 August 2020

Issue publication date: 7 May 2021

Given the importance of employee psychological well-being to job performance, this study aims to investigate the mediating role of affective commitment between psychological well-being and job performance while considering the moderating role of job insecurity on psychological well-being and affective commitment relationship.

Design/methodology/approach

The data were gathered from employees working in cellular companies of Pakistan using paper-and-pencil surveys. A total of 280 responses were received. Hypotheses were tested using structural equation modeling technique and Hayes’s Model 1.

Findings suggest that affective commitment mediates the association between psychological well-being (hedonic and eudaimonic) and employee job performance. In addition, perceived job insecurity buffers the association of psychological well-being (hedonic and eudaimonic) and affective commitment.

Practical implications

The study results suggest that fostering employee psychological well-being may be advantageous for the organization. However, if interventions aimed at ensuring job security are not made, it may result in adverse employee work-related attitudes and behaviors.

Originality/value

The study extends the current literature on employee well-being in two ways. First, by examining psychological well-being in terms of hedonic and eudaimonic well-being with employee work-related attitude and behavior. Second, by highlighting the prominent role played by perceived job insecurity in explaining some of these relationships.

• Psychological well-being
• Affective commitment
• Job insecurity
• Job performance
• Eudaimonic wellbeing
• Hedonic wellbeing

Kundi, Y.M. , Aboramadan, M. , Elhamalawi, E.M.I. and Shahid, S. (2021), "Employee psychological well-being and job performance: exploring mediating and moderating mechanisms", International Journal of Organizational Analysis , Vol. 29 No. 3, pp. 736-754. https://doi.org/10.1108/IJOA-05-2020-2204

Emerald Publishing Limited

Copyright © 2020, Yasir Mansoor Kundi, Mohammed Aboramadan, Eissa M.I. Elhamalawi and Subhan Shahid.

Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode

1. Introduction

Does the employee well-being have important implications both at work and for other aspects of an employees’ life? Of course! For years, we have known that they impact life at work and a plethora of research has examined the impact of employee well-being on work outcomes (Karapinar et al. , 2019 ; Turban and Yan, 2016 ). What is less understood is how employee well-being impacts job performance. Evidence suggests that employee health and well-being are among the most critical factors for organizational success and performance (Bakker et al. , 2019 ; Turban and Yan, 2016 ). Several studies have documented that employee well-being leads to various individual and organizational outcomes such as increased organizational performance and productivity (Hewett et al. , 2018 ), customer satisfaction (Sharma et al. , 2016 ), employee engagement (Tisu et al. , 2020 ) and organizational citizenship behavior (OCB; Mousa et al. , 2020 ).

The organizations’ performance and productivity are tied to the performance of its employees (Shin and Konrad, 2017 ). Much evidence has shown the value of employee job performance (i.e. the measurable actions, behaviors and outcomes that employee engages in or bring about which are linked with and contribute to organizational goals; Viswesvaran and Ones, 2017 ) for organizational outcomes and success (Al Hammadi and Hussain, 2019 ; Shin and Konrad, 2017 ), which, in turn, has led scholars to seek to understand what drives employee performance. Personality traits (Tisu et al. , 2020 ), job conditions and organizational characteristics (Diamantidis and Chatzoglou, 2019 ) have all been identified as critical antecedents of employee job performance.

However, one important gap remains in current job performance research – namely, the role of psychological well-being in job performance (Hewett et al. , 2018 ). Although previous research has found happy workers to be more productive than less happy or unhappy workers (DiMaria et al. , 2020 ), a search of the literature revealed few studies on psychological well-being and job performance relationship (Salgado et al. , 2019 ; Turban and Yan, 2016 ). Also, very little is known about the processes that link psychological well-being to job performance. Only a narrow spectrum of well-being related antecedents of employee performance has been considered, especially in terms of psychological well-being. Enriching our understanding of the consequences and processes of psychological well-being in the workplace, the present study examines the relationship between psychological well-being and job performance in the workplace setting. Such knowledge will not only help managers to attain higher organizational performance during the uncertain times but will uncover how to keep employees happy and satisfied (DiMaria et al. , 2020 ).

Crucially, to advance job performance research, more work is needed to examine the relationship between employees’ psychological well-being and their job performance (Ismail et al. , 2019 ). As Salgado et al. (2019) elaborated, we need to consider how an employees’ well-being affects ones’ performance at work. In an attempt to fill this gap in the literature, the present study seeks to advance job performance research by linking ones’ psychological well-being in terms of hedonic and eudaimonic well-being to ones’ job performance. Hedonic well-being refers to the happiness achieved through experiences of pleasure and enjoyment, while eudaimonic well-being refers to the happiness achieved through experiences of meaning and purpose (Huta, 2016 ; Rahmani et al. , 2018 ). We argue that employees with high levels of psychological well-being will perform well as compared to those having lower levels of psychological well-being. We connect this psychological well-being-job performance process through an employee affective commitment (employees’ perceptions of their emotional attachment to or identification with their organization; Allen and Meyer, 1996 ) – by treating it as a mediating variable between well-being-performance relationship.

Additionally, we also examine the moderating role of perceived job insecurity in the well-being-performance relationship. Perceived job insecurity refers to has been defined as the perception of being threatened by job loss or an overall concern about the continued existence of the job in the future (De Witte et al. , 2015 ). There is evidence that perceived job insecurity diminishes employees’ level of satisfaction and happiness and may lead to adverse job-related outcomes such as decreased work engagement (Karatepe et al. , 2020 ), deviant behavior (Soomro et al. , 2020 ) and reduced employee performance (Piccoli et al. , 2017 ). Thus, addressing the gap mentioned above, this study has two-fold objectives; First, to examine how the path between psychological well-being and job performance is mediated through employee affective commitment. The reason to inquire about this path is that well-being is associated with an employees’ happiness, pleasure and personal growth (Ismail et al. , 2019 ). Therefore, higher the well-being, higher will be the employees’ affective commitment, which, in turn, will lead to enhanced job performance. The second objective is to empirically test the moderating effects of perceived job insecurity on employees’ emotional attachment with their organizations. Thus, we propose that higher job insecurity may reduce the well-being of employees and their interaction may result in lowering employees’ emotional attachment with their organization.

The present study brings together employee well-being and performance literature and contributes to these research areas in two ways. First, we contribute to this line of inquiry by investigating the direct and indirect crossover from hedonic well-being and eudaimonic well-being to employees’ job performance. We propose that psychological well-being (hedonic and eudaimonic) influence job performance through employee affective commitment. Second, prior research shows that the effect of well-being varies across individuals indicating the presence of possible moderators influencing the relationship between employee well-being and job outcomes (Lee, 2019 ). We, therefore, extend the previous literature by proposing and demonstrating the general possibility that perceived job insecurity might moderate the relationship of psychological well-being (hedonic and eudaimonic) and affective commitment. While there is evidence that perceived job insecurity influence employees’ affective commitment (Schumacher et al. , 2016 ), what is not yet clear is the impact of perceived job insecurity on psychological well-being − affective commitment relationship. The proposed research model is depicted in Figure 1 .

2. Hypotheses development

2.1 psychological well-being and affective commitment.

Well-being is a broad concept that refers to individuals’ valued experience (Bandura, 1986 ) in which they become more effective in their work and other activities (Huang et al. , 2016 ). According to Diener (2009) , well-being as a subjective term, which describes people’s happiness, the fulfillment of wishes, satisfaction, abilities and task accomplishments. Employee well-being is further categorized into two types, namely, hedonic well-being and eudaimonic well-being (Ballesteros-Leiva et al. , 2017 ). Compton et al. (1996) investigated 18 scales that assess employee well-being and found that all the scales are categorized into two broad categories, namely, subjective well-being and personal growth. The former is referred to as hedonic well-being (Ryan and Deci, 2000 ) whereas, the latter is referred to as eudaimonic well-being (Waterman, 1993 ).

Hedonic well-being is based on people’s cognitive component (i.e. people’s conscious assessment of all aspects of their life; Diener et al. , 1985 ) and affective component (i.e. people’s feelings that resulted because of experiencing positive or negative emotions in reaction to life; Ballesteros-Leiva et al. , 2017 ). In contrast, eudaimonic well-being describes people’s true nature and realization of their actual potential (Waterman, 1993 ). Eudaimonic well-being corresponds to happy life based upon ones’ self-reliance and self-truth (Ballesteros-Leiva et al. , 2017 ). Diener et al. (1985) argued that hedonic well-being focuses on happiness and has a more positive affect and greater life satisfaction, and focuses on pleasure, happiness and positive emotions (Ryan and Deci, 2000 ; Ryff, 2018 ). Contrarily, eudaimonic well-being is different from hedonic well-being as it focuses on true self and personal growth (Waterman, 1993 ), recognition for ones’ optimal ability and mastery ( Ryff, 2018 ). In the past, it has been found that hedonic well-being and eudaimonic well-being are relatively correlated with each other but are distinct concepts (Sheldon et al. , 2018 ).

To date, previous research has measured employee psychological well-being with different indicators such as thriving at work (Bakker et al. , 2019 ), life satisfaction (Clark et al. , 2019 ) and social support (Cai et al. , 2020 ) or general physical or psychological health (Grey et al. , 2018 ). Very limited studies have measured psychological well-being with hedonic and eudaimonic well-being, which warrants further exploration (Ballesteros-Leiva et al. , 2017 ). Therefore, this study assesses employee psychological well-being based upon two validated measures, namely, hedonic well-being (people’s satisfaction with life in general) and eudaimonic well-being (people’s personal accomplishment feelings).

Employee well-being has received some attention in organization studies (Huang et al. , 2016 ). Prior research has argued that happier and healthier employees increase their effort, performance and productivity (Huang et al. , 2016 ). Similarly, research has documented that employee well-being has a positive influence on employee work-related attitudes and behaviors such as, increasing OCB (Mousa et al. , 2020 ), as well as job performance (Magnier-Watanabe et al. , 2017 ) and decreasing employees’ work-family conflict (Karapinar et al. , 2019 ) and absenteeism (Schaumberg and Flynn, 2017 ). Although there is evidence that employee well-being positively influences employee work-related attitudes, less is known about the relationship between psychological well-being (hedonic and eudaimonic) and employee affective commitment (Pan et al. , 2018 ; Semedo et al. , 2019 ). Moreover, the existing literature indicated that employee affective commitment is either used as an antecedent or an outcome variable of employee well-being (Semedo et al. , 2019 ; Ryff, 2018 ). However, affective commitment as an outcome variable of employee well-being has gained less scholarly attention, which warrants further investigation. Therefore, in the present study, we seek to examine employee affective commitment as an outcome variable of employee psychological well-being because employees who are happy and satisfied in their lives are more likely to be attached to their organizations (Semedo et al. , 2019 ).

Hedonic well-being positively predicts employee affective commitment.

Eudaimonic well-being positively predicts employee affective commitment.

2.2 Affective commitment and job performance

The concept of organizational commitment was first initiated by sit-bet theory in the early 1960s (Becker, 1960 ). Organizational commitment is defined as the psychological connection of employees to the organization and involvement in it (Cooper-Hakim and Viswesvaran, 2005 ). It is also defined as the belief of an individual in his or her organizational norms (Hackett et al. , 2001 ); the loyalty of an employee toward the organization (Cooper-Hakim and Viswesvaran, 2005 ) and willingness of an employee to participate in organizational duties (Williams and Anderson, 1991 ).

Organizational commitment is further categorized into three correlated but distinct categories (Meyer et al. , 1993 ), known as affective, normative and continuance. In affective commitment, employees are emotionally attached to their organization. In normative commitment, employees remain committed to their organizations due to the sense of obligation to serve. While in continuance commitment, employees remain committed to their organization because of the costs associated with leaving the organization (Allen and Meyer, 1990 , p. 2). Among the dimensions of organizational commitment, affective commitment has been found to have the most substantial influence on organizational outcomes (Meyer and Herscovitch, 2001 ). It is a better predictor of OCB (Paul et al. , 2019 ), low turnover intention (Kundi et al. , 2018 ) and job performance (Jain and Sullivan, 2019 ).

Affective commitment positively predict employee job performance.

2.3 Affective commitment as a mediator

Many studies had used the construct of affective commitment as an independent variable, mediator and moderating variable because of its importance as an effective determinant of work outcomes such as low turnover intention, job satisfaction and job performance (Jain and Sullivan, 2019 ; Kundi et al. , 2018 ). There is very little published research on employee well-being and affective commitment relationship. Surprisingly, the effects of employee psychological well-being in terms of hedonic well-being and eudaimonic well-being have not been closely examined.

Affective commitment mediates the association between hedonic well-being and job performance.

Affective commitment mediates the association between eudaimonic well-being and job performance.

2.4 The moderating role of job insecurity

Job insecurity is gaining importance because of the change in organizational structure as it is becoming flattered, change in the nature of the job as it requires a diverse skill set and change in human resource (HR) practices as more temporary workers are hired nowadays (Piccoli et al. , 2017 ; Kundi et al. , 2018 ). Such changes have caused several adverse outcomes such as job dissatisfaction (Bouzari and Karatepe, 2018 ), unethical pro-organizational behavior (Ghosh, 2017 ), poor performance (Piccoli et al. , 2017 ), anxiety and lack of commitment (Wang et al. , 2018 ).

Lack of harmony on the definition of job insecurity can be found among the researchers. However, a majority of them acknowledge that job insecurity is subjective and can be referred to as a subjective perception (Wang et al. , 2018 ). Furthermore, job insecurity is described as the perception of an employee regarding the menace of losing a job in the near future (De Witte et al. , 2015 ). When there is job insecurity, employees experience a sense of threat to the continuance and stability of their jobs (Shoss, 2017 ).

Although job insecurity has been found to influence employee work-related attitudes, less is known about its effects on behavioral outcomes (Piccoli et al. , 2017 ). As maintained by the social exchange theory, behaviors are the result of an exchange process (Blau, 1964 ). Furthermore, these exchanges can be either tangible or socio-emotional aspects of the exchange process (Kundi et al. , 2018 ). Employees who perceive and feel that their organization is providing them job security and taking care of their well-being will turn to be more committed to their organization (Kundi et al. , 2018 ; Wang et al. , 2018 ). Much research has found that employees who feel job security are happier and satisfied with their lives (Shoss, 2017 ; De Witte et al. , 2015 ) and are more committed to their work and organization (Bouzari and Karatepe, 2018 ; Wang et al. , 2018 ). Shoss (2017) conducted a thorough study on job insecurity and found that job insecurity can cause severe adverse consequences for both the employees and organizations.

Employees who are uncertain about their jobs (i.e. high level of perceived job insecurity) are less committed with their organizations.

Employees with temporary job contracts were found to have low organizational committed as compared to the employees with permanent job contracts.

Such a difference between temporary and permanent job contract holders was mainly due to the perceived job insecurity by the temporary job contract holders.

Job insecurity will moderate the relationship between hedonic well-being, eudaimonic well-being and affective organizational commitment.

3.1 Sample and procedure

The data for this study came from a survey of Pakistani employees, who worked in five private telecommunication organizations (Mobilink, Telenor, Ufone, Zong and Warid). These five companies were targeted because they are the largest and highly competitive companies in Pakistan. Moreover, the telecom sector is a private sector where jobs are temporary or contractual (Kundi et al. , 2018 ). Hence, the investigation of how employees’ perceptions of job insecurity influence their psychological well-being and its outcomes is highly relevant in this context. Studies exploring such a phenomenon are needed, particularly in the Pakistani context, to have a better insight and thereby strengthen the employee well-being and job performance literature.

Two of the authors had personal and professional contacts to gain access to these organizations. The paper-and-pencil method was used to gather the data. Questionnaires were distributed among 570 participants with a cover letter explaining the purpose of the study, noted that participation was voluntary, and provided assurances that their responses would be kept confidential and anonymous. After completion of the questionnaires, the surveys were collected the surveys on-site by one of the authors. As self-reported data often render itself to common method bias (CMB; Podsakoff et al. , 2012 ), we applied several procedural remedies such as reducing the ambiguity in the questions, ensuring respondent anonymity and confidentiality, separating of the predictor and criterion variable and randomizing the item order to limit this bias.

Of the 570 surveys distributed initially, 280 employees completed the survey form (response rate = 49%). According to Baruch and Holtom (2008) , the average response rate for studies at the individual level is 52.6% (SD = 19.7). Hence, our response rate meets the standard for a minimum acceptable response rate, which is 49%. Of the 280 respondents, 39% were female, their mean age was 35.6 years (SD = 5.22) and the average organizational tenure was 8.61 years (SD  =  4.21). The majority of the respondents had at least a bachelors’ degree (83 %). Respondents represented a variety of departments, including marketing (29%), customer services (26%), finance (20%), IT (13%) and HR (12%).

3.2 Measures

The survey was administered to the participants in English. English is the official language of correspondence for professional organizations in Pakistan (De Clercq et al. , 2019 ). All the constructs came from previous research and anchored on a five-point Likert scale ranging from 1 = Strongly disagree to 5 = Strongly agree.

Psychological well-being. We measured employee psychological well-being with two sub-dimensions, namely, hedonic well-being and eudaimonic well-being. Hedonic well-being was measured using five items (Diener et al. , 1985 ). A sample item is “my life conditions are excellent” ( α = 0.86). Eudaimonic well-being was measured using 21 items (Waterman et al. , 2010 ), of which seven items were reverse-scored due to its negative nature. Sample items are “I feel that I understand what I was meant to do in my life” and “my life is centered around a set of core beliefs that give meaning to my life” ( α = 0.81).

Affective commitment. The affective commitment was measured using a six-item inventory developed by Allen and Meyer (1990) . The sample items are “my organization inspires me to put forth my best effort” and “I think that I will be able to continue working here” ( α = 0.91).

Job insecurity. Job insecurity was measured using a five-item inventory developed by Chirumbolo et al. (2015) . The sample item is “I fear I will lose my job” ( α = 0.87).

Job performance . We measured employee job performance with the seven-item inventory developed by Williams and Anderson (1991) . The sample items are “I do fulfill my responsibilities, which are mentioned in the job description” and “I try to work as hard as possible” ( α = 0.87).

Controls. We controlled for respondents’ age (assessed in years), gender (1 = male, 2 = female) and organizational tenure (assessed in years) because prior research (Alessandri et al. , 2019 ; Edgar et al. , 2020 ) has found significant effects of these variables on employees’ job performance.

4.1 Descriptive statistics

Table 1 presents the means, standard deviations and correlations among study variables.

4.2 Construct validity

Before testing hypotheses, we conducted a series of confirmatory factor analyzes (CFAs) using AMOS 22.0 to examine the distinctiveness of our study variables. Following the guidelines of Hu and Bentler (1999) , model fitness was assessed with following fit indices; comparative fit index (CFI), root mean square error of approximation (RMSEA) and standardized root mean square residual (SRMR). We used a parceling technique (Little et al. , 2002 ) to ensure item to sample size ratio. According to Williams and O’Boyle (2008) , the item-parceling approach is widely used in HRM research, which allows estimation of fewer model parameters and subsequently leads to the optimal variable to sample size ratio and stable parameter estimates (Wang and Wang, 2019 ). Based on preliminary CFAs, we combined the highest item loading with the lowest item loading to create parcels that were equally balanced in terms of their difficulty and discrimination. Item-parceling was done only for the construct of eudaimonic well-being as it entailed a large number of items (i.e. 21 items). Accordingly, we made five parcels for the eudaimonic well-being construct (Waterman et al. , 2010 ).

As shown in Table 2 , the CFA results revealed that the baseline five‐factor model (hedonic well-being, eudaimonic well-being, job insecurity, affective commitment and job performance) was significant ( χ 2 = 377.11, df = 199, CFI = 0.971, RMSEA = 0.034 and SRMR = 0.044) and better than the alternate models, including a four‐factor model in which hedonic well-being and eudaimonic well-being were considered as one construct (Δ χ 2 = 203.056, Δdf = 6), a three-factor model in which hedonic well-being, eudaimonic well-being and affective commitment were loaded on one construct (Δ χ 2 = 308.99, Δdf = 8) and a one‐factor model in which all items loaded on one construct (Δ χ 2 = 560.77, Δdf = 11). The results, therefore, provided support for the distinctive nature of our study variables.

To ensure the validity of our measures, we first examined the convergent validity through the average variance extracted (AVE). We found AVE scores higher than the threshold value of 0.5 ( Table 1 ; Fornell and Larcker, 1981 ), supporting the convergent validity of our constructs. We also estimated discriminant validity by comparing the AVE of each construct with the average shared variance (ASV), i.e. mean of the squared correlations among constructs ( Hair et al. , 2010 ). As expected, all the values of AVE were higher than the ASV constructs, thereby supporting discriminant validity ( Table 1 ).

4.3 Common method variance

Harman’s one-factor test.

CFA ( Podsakoff et al. , 2012 ).

Harman’s one-factor test showed five factors with eigenvalues of greater than 1.0 accounted for 69.12% of the variance in the exogenous and endogenous variables. The results of CFA showed that the single-factor model did not fit the data well ( χ 2 = 937.88, df = 210, CFI = 0.642, RMSEA = 0.136, SRMR = 0.122). These tests showed that CMV was not a major issue in this study.

4.4 Hypotheses testing

The hypotheses pertaining to mediation were tested using a structural model in AMOS 22.0 ( Figure 2 ), which had an acceptable goodness of fit ( χ 2 = 298.01, df = 175, CFI = 0.97, RMSEA = 0.04 and SRMR = 0.04). Hypotheses about moderation were tested in SPSS (25 th edition) using PROCESS Model I ( Hayes, 2017 ; Table 3 ).

H1a and H1b suggested that hedonic well-being and eudaimonic well-being positively relate to employee affective commitment. According to Figure 2 , the results indicate that hedonic well-being ( β = 0.26, p < 0.01) and eudaimonic well-being ( β = 0.32, p < 0.01) are positively related to employee affective commitment. Taken together, these two findings provide support for H1a and H1b . In H2 , we predicted that employee affective commitment would positively associate with employee job performance. As seen in Figure 2 , employee affective commitment positively predicted employee job performance ( β = 0.41, p < 0.01), supporting H2 .

H3a and H3b suggested that employee affective commitment mediates the relationship between hedonic and eudaimonic well-being and employee job performance. According to Figure 2 , the results indicate that hedonic well-being is positively related to employee job performance via employee affective commitment ( β = 0.11, 95% CI = 0.09; 0.23). Similarly, eudaimonic well-being is positively related to employee job performance via employee affective commitment ( β = 0.15, 95% CI = 0.12; 0.35), supporting H3a and H3b .

Hedonic well-being.

Eudaimonic well-being and employee affective commitment.

In support of H4a , our results ( Table 3 ) revealed a negative and significant interaction effect between hedonic well-being and job insecurity on employee affective commitment ( β = −0.12, p < 0.05). The pattern of this interaction was consistent with our hypothesized direction; the positive relationship between hedonic well-being and employee affective commitment was weaker in the presence of high versus low job insecurity ( Figure 3 ). Likewise, the interaction effect between eudaimonic well-being and job insecurity on employee affective commitment was negatively significant ( β = −0.28, p < 0.01). The pattern of this interaction was consistent with our hypothesized direction; the positive relationship between eudaimonic well-being and employee affective commitment was weaker in the presence of high versus low job insecuritay ( Figure 4 ). Thus, H4a and H4b were supported. The pattern of these interactions was consistent with our hypothesized direction; the positive relationship of hedonic well-being and eudaimonic well-being with an employee affective commitment were weaker in the presence of high versus low perceived job insecurity.

5. Discussion

The present research examined the direct and indirect crossover from psychological well-being (hedonic and eudaimonic) to job performance through employee affective commitment and the moderating role of job insecurity between psychological well-being and affective commitment relationship. The results revealed that both hedonic well-being and eudaimonic well-being has a direct and indirect effect on employee job performance. Employee affective commitment was found to be a potential mediating mechanism (explaining partial variance) in the relationship between psychological well-being and job performance. Findings regarding the buffering role of job insecurity revealed that job insecurity buffers the positive relationship between psychological well-being and employee affective commitment such that higher the job insecurity, lower will be employee affective commitment. The findings generally highlight and reinforce that perceived job insecurity can be detrimental for both employees’ well-being and job-related behaviors (Soomro et al. , 2020 ).

5.1 Theoretical implications

The present study offers several contributions to employee well-being and job performance literature. First, the present research extends the employee well-being literature by investigating employee affective commitment as a key mechanism through which psychological well-being (hedonic and eudaimonic) influences employees’ job performance. In line with SDT, we found that both hedonic well-being and eudaimonic well-being enhanced employees’ affective commitment, which, in turn, led them to perform better in their jobs. Our study addresses recent calls for research to understand better how psychological well-being influence employees’ performance at work (Huang et al. , 2016 ), and adds to a growing body of work, which confirms the importance of psychological well-being in promoting work-related attitudes and behaviors (Devonish, 2016 ; Hewett et al. , 2018 ; Ismail et al. , 2019 ). Further, we have extended the literature on employee affective commitment, highlighting that psychological well-being is an important antecedent of employee’ affective commitment and thereby confirming previous research by Aboramadan et al. (2020) on the links between affective commitment and job performance.

Second, our results provide empirical support for the efficacy of examining the different dimensions of employee well-being, i.e. hedonic well-being and eudaimonic well-being as opposed to an overall index of well-being at work. Specifically, our results revealed that both hedonic well-being and eudaimonic well-being boost both employees’ attachment with his or her organization and job performance (Hewett et al. , 2018 ; Luu, 2019 ). Among the indicators of psychological well-being, eudaimonic well-being (i.e. realization and fulfillment of ones’ true nature) was found to have more influence on employee affective commitment and job performance as compared to hedonic well-being (i.e. state of happiness and sense of flourishing in life). Therefore, employees who experience high levels of psychological well-being are likely to be more attached to their employer, which, in turn, boosts their job performance.

Third, job insecurity is considered as an important work-related stressor (Schumacher et al. , 2016 ). However, the moderating role of job insecurity on the relationship between psychological well-being and affective commitment has not been considered by the previous research. Based on social exchange theory (Blau, 1964 ), we expected job insecurity to buffer the positive relationship between the psychological well-being and affective commitment. The results showed that employees with high levels of perceived job insecurity reduce the positive relationship of psychological well-being (hedonic and eudaimonic) and affective commitment. This finding is consistent with previous empirical evidence supporting the adverse role of perceived job insecurity in reducing employees’ belongingness with their organization (Jiang and Lavaysse, 2018 ). There is strong empirical evidence (Qian et al. , 2019 ; Schumacher et al. , 2016 ) that employee attitudes and health are negatively affected by increasing levels of job insecurity. Schumacher et al. (2016) suggested in an elaborate explanation of the social exchange theory that the constant worrying about the possibility of losing ones’ job promotes psychological stress and feelings of unfairness, which, in turn, affects employees’ affective commitment. Hence, employees’ psychological well-being and affective commitment are heavily influenced by the experience of high job insecurity.

5.2 Practical implications

Our study has several implications. First and foremost, this study will help managers in understanding the importance of employees’ psychological well-being for work-related attitudes and behavior. Based on our findings, managers need to understand how important psychological well-being is for employees’ organizational commitment and job performance. According to Hosie and Sevastos (2009) , several human resource-based interventions could foster employees’ psychological well-being, such as selecting and placing employees into appropriate positions, ensuring a friendly work environment and providing training that improves employees’ mental health and help them to manage their perceptions positively.

Besides, managers should provide their employees with opportunities to use their full potential, which will increase employees’ sense of autonomy and overall well-being (Sharma et al. , 2017 ). By promoting employee well-being in the workplace, managers can contribute to developing a workforce, which will be committed to their organizations and will have better job performance. However, based on our findings, in the presence of job insecurity, organizations spending on interventions to improve employees’ psychological well-being, organizational commitment and job performance might go in vain. In other words, organizations should ensure that employees feel a sense of job security or else the returns on such interventions could be nullified.

Finally, as organizations operate in a volatile and highly competitive environment, it is and will be difficult for them to provide high levels of job security to their employees, especially in developing countries such as Pakistan (Soomro et al. , 2020 ). Given the fact that job insecurity leads to cause adverse employee psychological well-being and affective commitment, managers must be attentive to subordinates’ perceptions of job insecurity and adverse psychological well-being and take action to prevent harmful consequences (Ma et al. , 2019 ). Organizations should try to avoid downsizings, layoffs and other types of structural changes, respectively, and find ways to boost employees’ perceptions of job security despite those changes. If this is not possible, i.e. the organization not able to provide job security, this should be communicated to employees honestly and early.

5.3 Limitations and future studies

There are several limitations to this study. First, we measured our research variables by using a self-report survey at a single point of time, which may result in CMB. We used various procedural remedies to mitigate the potential for CMB and conducted CFA as per the guidelines of Podsakoff et al. (2012) to ensure that CMV was unlikely to be an issue in our study. However, future research may rely on supervisors rated employees’ job performance or collect data at different time points to avoid the threat of such bias.

Second, the sample of this study consisted of employees working in cellular companies of Pakistan with different demographic characteristics and occupational backgrounds; thus, the generalizability of our findings to other industries or sectors is yet to be established. Future research should test our research model in various industries and cultures.

A final limitation pertains to the selection of a moderating variable. As this study was conducted in Pakistan, contextual factors such as the perceived threat to terrorism, law and order situation or perceived organizational injustice might also influence the psychological well-being of employees working in Pakistan (Jahanzeb et al. , 2020 ; Sarwar et al. , 2020 ). Future studies could consider the moderating role of such external factors in the relationship between employee psychological well-being, affective commitment and job performance.

6. Conclusion

This study proposed a framework to understand the relationship between employee psychological well-being, affective commitment and job performance. It also described how psychological well-being influences job performance. Additionally, this study examined the moderating role of perceived job insecurity on psychological well-being and affective commitment relationship. The results revealed that employee psychological well-being (hedonic and eudaimonic) has beneficial effects on employee affective commitment, which, in turn, enhance their job performance. Moreover, the results indicated that perceived job insecurity has ill effects on employee affective commitment, especially when the employee has high levels of perceived job insecurity.

Research model

Structural model with standardized coefficients; N = 280

Interactive effect of hedonic well-being and job insecurity on employee affective commitment

Interactive effect of eudaimonic well-being and job insecurity on employee affective commitment

Descriptive statistics and correlations among of variables

* p < 0.05,

** p < 0.01; Unstandardized coefficients and average bootstrap estimates are stated; demographic variables are controlled; bootstrapping procedure [5,000 iterations, bias-corrected, 95% CI]

Aboramadan , M. , Dahleez , K. and Hamad , M.H. ( 2020 ), “ Servant leadership and academics outcomes in higher education: the role of job satisfaction ”, International Journal of Organizational Analysis , Vol. 1 .

Alessandri , G. , Truxillo , D.M. , Tisak , J. , Fagnani , C. and Borgogni , L. ( 2019 ), “ Within-individual age-related trends, cycles, and event-driven changes in job performance: a career-span perspective ”, Journal of Business and Psychology , Vol. 1 , pp. 1 - 20 .

Allen , N.J. and Meyer , J.P. ( 1990 ), “ The measurement and antecedents of affective, continuance and normative commitment to the organization ”, Journal of Occupational Psychology , Vol. 63 No. 1 , pp. 1 - 18 .

Allen , N.J. and Meyer , J.P. ( 1996 ), “ Affective, continuance, and normative commitment to the organization: an examination of construct validity ”, Journal of Vocational Behavior , Vol. 49 No. 3 , pp. 252 - 276 .

Al Hammadi , F. and Hussain , M. ( 2019 ), “ Sustainable organizational performance: a study of health-care organizations in the United Arab Emirates ”, International Journal of Organizational Analysis , Vol. 27 No. 1 , pp. 169 - 186 .

Bakker , A.B. , Hetland , J. , Olsen , O.K. and Espevik , R. ( 2019 ), “ Daily strengths use and employee wellbeing: the moderating role of personality ”, Journal of Occupational and Organizational Psychology , Vol. 92 No. 1 , pp. 144 - 168 .

Ballesteros-Leiva , F. , Poilpot-Rocaboy , G. and St-Onge , S. ( 2017 ), “ The relationship between life-domain interactions and the wellbeing of internationally mobile employees ”, Personnel Review , Vol. 46 No. 2 , pp. 237 - 254 .

Bandura , A. ( 1986 ), Social Foundations of Thought and Action: A Social-Cognitive View , Prentice-Hall , Englewood Cliffs, NJ .

Baruch , Y. and Holtom , B.C. ( 2008 ), “ Survey response rate levels and trends in organizational research ”, Human Relations , Vol. 61 No. 8 , pp. 1139 - 1160 .

Blau , P.M. ( 1964 ), Exchange and Power in Social Life , Wiley , New York, NY .

Becker , H.S. ( 1960 ), “ Notes on the concept of commitment ”, American Journal of Sociology , Vol. 66 No. 1 , pp. 32 - 40 .

Bouzari , M. and Karatepe , O.M. ( 2018 ), “ Antecedents and outcomes of job insecurity among salespeople ”, Marketing Intelligence and Planning , Vol. 36 No. 2 , pp. 290 - 302 .

Cai , L. , Wang , S. and Zhang , Y. ( 2020 ), “ Vacation travel, marital satisfaction, and subjective wellbeing: a chinese perspective ”, Journal of China Tourism Research , Vol. 16 No. 1 , pp. 118 - 139 .

Chirumbolo , A. , Hellgren , J. , De Witte , H. , Goslinga , S. , NäSwall , K. and Sverke , M. ( 2015 ), “ Psychometrical properties of a short measure of job insecurity: a European cross-cultural study ”, Rassegna di Psicologia , Vol. 3 , pp. 83 - 98 .

Clark , B. Chatterjee , K. Martin , A. and Davis , A. ( 2019 ), “ How commuting affects subjective wellbeing ”, Transportation .

Compton , W.C. , Smith , M.L. , Cornish , K.A. and Qualls , D.L. ( 1996 ), “ Factor structure of mental health measures ”, Journal of Personality and Social Psychology , Vol. 71 No. 2 , pp. 406 - 413 .

Cooper-Hakim , A. and Viswesvaran , C. ( 2005 ), “ The construct of work commitment: testing an integrative framework ”, Psychological Bulletin , Vol. 131 No. 2 , pp. 241 - 259 .

De Clercq , D. , Haq , I.U. and Azeem , M.U. ( 2019 ), “ Perceived contract violation and job satisfaction: buffering roles of emotion regulation skills and work-related self-efficacy ”, International Journal of Organizational Analysis , Vol. 28 No. 2 , pp. 383 - 398 .

De Witte , H. and Näswall , K. ( 2003 ), “ Objective’ vs subjective’ job insecurity: consequences of temporary work for job satisfaction and organizational commitment in four European countries ”, Economic and Industrial Democracy , Vol. 24 No. 2 , pp. 149 - 188 .

De Witte , H. Vander Elst , T. and De Cuyper , N. ( 2015 ), “ Job insecurity, health and well-being ”, Sustainable Working Lives , pp. 109 - 128 .

Deci , E.L. and Ryan , R.M. ( 1985 ), Intrinsic Motivation and Self-Determination in Human Behavior , Springer Science and Business Media New York, NY .

Devonish , D. ( 2016 ), “ Emotional intelligence and job performance: the role of psychological well-being ”, International Journal of Workplace Health Management , Vol. 9 No. 4 , pp. 428 - 442 .

Diamantidis , A.D. and Chatzoglou , P. ( 2019 ), “ Factors affecting employee performance: an empirical approach ”, International Journal of Productivity and Performance Management , Vol. 68 No. 1 , pp. 171 - 193 .

Diener , E. ( 2009 ), “ Subjective well-being ”, In The Science of Wellbeing , Springer , Dordrecht , pp. 11 - 58 .

Diener , E. , Emmons , R.A. , Larsen , R.J. and Griffin , S. ( 1985 ), “ The satisfaction with life scale ”, Journal of Personality Assessment , Vol. 49 No. 1 , pp. 71 - 75 .

DiMaria , C.H. , Peroni , C. and Sarracino , F. ( 2020 ), “ Happiness matters: productivity gains from subjective well-being ”, Journal of Happiness Studies , Vol. 21 No. 1 , pp. 139 - 160 .

Edgar , F. , Blaker , N.M. and Everett , A.M. ( 2020 ), “ Gender and job performance: linking the high performance work system with the ability–motivation–opportunity framework ”, Personnel Review , Vol. 1

Fornell , C. and Larcker , D.F. ( 1981 ), “ Evaluating structural equation models with unobservable variables and measurement error ”, Journal of Marketing Research , Vol. 18 No. 1 , pp. 39 - 50 .

Ghosh , S.K. ( 2017 ), “ The direct and interactive effects of job insecurity and job embeddedness on unethical pro-organizational behavior ”, Personnel Review , Vol. 46 No. 6 , pp. 1182 - 1198 .

Grey , J.M. , Totsika , V. and Hastings , R.P. ( 2018 ), “ Physical and psychological health of family carers co-residing with an adult relative with an intellectual disability ”, Journal of Applied Research in Intellectual Disabilities , Vol. 31 , pp. 191 - 202 .

Hackett , R.D. , Lapierre , L.M. and Hausdorf , P.A. ( 2001 ), “ Understanding the links between work commitment constructs ”, Journal of Vocational Behavior , Vol. 58 No. 3 , pp. 392 - 413 .

Hair , J.F. , Black , W.C. , Babin , B.J. and Anderson , R.E. ( 2010 ), Multivariate Data Analysis: A Global Perspective 7e , Pearson , Upper Saddle River, NJ .

Hayes , A.F. ( 2017 ), Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach , Guilford publications , New York .

Hewett , R. , Liefooghe , A. , Visockaite , G. and Roongrerngsuke , S. ( 2018 ), “ Bullying at work: cognitive appraisal of negative acts, coping, well-being, and performance ”, Journal of Occupational Health Psychology , Vol. 23 No. 1 , pp. 71 .

Hosie , P.J. and Sevastos , P. ( 2009 ), “ Does the “happy‐productive worker” thesis apply to managers? ”, International Journal of Workplace Health Management , Vol. 2 No. 2 , pp. 131 - 160 .

Hu , L. and Bentler , P.M. ( 1999 ), “ Cut-off criteria for fit indices in covariance structure analysis: conventional criteria versus new alternatives ”, Structural Equation Modeling: A Multidisciplinary Journal , Vol. 6 No. 1 , pp. 1 - 55 .

Huang , L.-C. , Ahlstrom , D. , Lee , A.Y.-P. , Chen , S.-Y. and Hsieh , M.-J. ( 2016 ), “ High performance work systems, employee wellbeing, and job involvement: an empirical study ”, Personnel Review , Vol. 45 No. 2 , pp. 296 - 314 .

Huta , V. ( 2016 ), “ An overview of hedonic and eudaimonic well-being concepts ”, Handbook of Media Use and Wellbeing: International Perspectives on Theory and Research on Positive Media Effects , Routldge London pp. 14 - 33 .

Ismail , H.N. , Karkoulian , S. and Kertechian , S.K. ( 2019 ), “ Which personal values matter most? job performance and job satisfaction across job categories ”, International Journal of Organizational Analysis , Vol. 27 No. 1 , pp. 109 - 124 .

Jahanzeb , S. , De Clercq , D. and Fatima , T. ( 2020 ), “ Organizational injustice and knowledge hiding: the roles of organizational dis-identification and benevolence ”, Management Decision , Vol. 1 .

Jain , A.K. and Sullivan , S. ( 2019 ), “ An examination of the relationship between careerism and organizational commitment, satisfaction, and performance ”, Personnel Review , Vol. 1 .

Jiang , L. and Lavaysse , L.M. ( 2018 ), “ Cognitive and affective job insecurity: a meta-analysis and a primary study ”, Journal of Management , Vol. 44 No. 6 , pp. 2307 - 2342 .

Karapinar , P.B. , Camgoz , S.M. and Ekmekci , O.T. ( 2019 ), “ Employee well-being, workaholism, work–family conflict and instrumental spousal support: a moderated mediation model ”, Journal of Happiness Studies , Vol. 1 , pp. 1 - 21 .

Karatepe , O.M. , Rezapouraghdam , H. and Hassannia , R. ( 2020 ), “ Job insecurity, work engagement and their effects on hotel employees’ non-green and nonattendance behaviors ”, International Journal of Hospitality Management , Vol. 87 , p. 102472 .

Kundi , M. , Ikramullah , M. , Iqbal , M.Z. and Ul-Hassan , F.S. ( 2018 ), “ Affective commitment as mechanism behind perceived career opportunity and turnover intentions with conditional effect of organizational prestige ”, Journal of Managerial Sciences , Vol. 1 .

Lee , Y. ( 2019 ), “ JD-R model on psychological wellbeing and the moderating effect of job discrimination in the model: findings from the MIDUS ”, European Journal of Training and Development , Vol. 43 No. 3/4 , pp. 232 - 249 .

Little , T.D. , Cunningham , W.A. , Shahar , G. and Widaman , K.F. ( 2002 ), “ To parcel or not to parcel: exploring the question, weighing the merits ”, Structural Equation Modeling: A Multidisciplinary Journal , Vol. 9 No. 2 , pp. 151 - 173 .

Luu , T.T. ( 2019 ), “ Discretionary HR practices and employee well-being: the roles of job crafting and abusive supervision ”, Personnel Review , Vol. 49 No. 1 , pp. 43 - 66 .

Ma , B. , Liu , S. , Lassleben , H. and Ma , G. ( 2019 ), “ The relationships between job insecurity, psychological contract breach and counterproductive workplace behavior: does employment status matter? ”, Personnel Review , Vol. 48 No. 2 , pp. 595 - 610 .

Magnier-Watanabe , R. , Uchida , T. , Orsini , P. and Benton , C. ( 2017 ), “ Organizational virtuousness and job performance in Japan: does happiness matter? ”, International Journal of Organizational Analysis , Vol. 25 No. 4 , pp. 628 - 646 .

Meyer , J.P. and Herscovitch , L. ( 2001 ), “ Commitment in the workplace: toward a general model ”, Human Resource Management Review , Vol. 11 No. 3 , pp. 299 - 326 .

Meyer , J.P. , Allen , N.J. and Smith , C.A. ( 1993 ), “ Commitment to organizations and occupations: extension and test of a three-component conceptualization ”, Journal of Applied Psychology , Vol. 78 No. 4 , pp. 538 - 551 .

Mousa , M. , Massoud , H.K. and Ayoubi , R.M. ( 2020 ), “ Gender, diversity management perceptions, workplace happiness and organisational citizenship behaviour ”, Employee Relations: The International Journal , Vol. 1 .

Pan , S.-L. , Wu , H. , Morrison , A. , Huang , M.-T. and Huang , W.-S. ( 2018 ), “ The relationships among leisure involvement, organizational commitment and well-being: viewpoints from sport fans in Asia ”, Sustainability , Vol. 10 No. 3 , p. 740 .

Paul , H. , Bamel , U. , Ashta , A. and Stokes , P. ( 2019 ), “ Examining an integrative model of resilience, subjective well-being and commitment as predictors of organizational citizenship behaviours ”, International Journal of Organizational Analysis , Vol. 27 No. 5 , pp. 1274 - 1297 .

Piccoli , B. , Callea , A. , Urbini , F. , Chirumbolo , A. , Ingusci , E. and De Witte , H. ( 2017 ), “ Job insecurity and performance: the mediating role of organizational identification ”, Personnel Review , Vol. 46 No. 8 , pp. 1508 - 1522 .

Podsakoff , P.M. , MacKenzie , S.B. and Podsakoff , N.P. ( 2012 ), “ Sources of method bias in social science research and recommendations on how to control it ”, Annual Review of Psychology , Vol. 63 No. 1 , pp. 539 - 569 .

Qian , S. , Yuan , Q. , Niu , W. and Liu , Z. ( 2019 ), “ Is job insecurity always bad? The moderating role of job embeddedness in the relationship between job insecurity and job performance ”, Journal of Management and Organization , Vol. 1 , pp. 1 - 17 .

Rahmani , K. , Gnoth , J. and Mather , D. ( 2018 ), “ Hedonic and eudaimonic well-being: a psycholinguistic view ”, Tourism Management , Vol. 69 , pp. 155 - 166 .

Ryan , R.M. and Deci , E.L. ( 2000 ), “ Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being ”, American Psychologist , Vol. 55 No. 1 , pp. 68 - 78 .

Ryff , C.D. ( 2018 ), “ Eudaimonic well-being: highlights from 25 years of inquiry ”, in Shigemasu , K. , Kuwano , S. , Sato , T. and Matsuzawa , T. (Eds),  Diversity in Harmony – Inghts from Psychology: Proceedings of the 31st International Congress of Psychology , John Wiley & Sons , pp. 375 - 395 .

Salgado , J.F. , Blanco , S. and Moscoso , S. ( 2019 ), “ Subjective well-being and job performance: Testing of a suppressor effect ”, Revista de Psicología Del Trabajo y de Las Organizaciones , Vol. 35 No. 2 , pp. 93 - 102 .

Sarwar , F. , Panatik , S.A. and Jameel , H.T. ( 2020 ), “ Does fear of terrorism influence psychological adjustment of academic sojourners in Pakistan? Role of state negative affect and emotional support ”, International Journal of Intercultural Relations , Vol. 75 , pp. 34 - 47 .

Schaumberg , R.L. and Flynn , F.J. ( 2017 ), “ Clarifying the link between job satisfaction and absenteeism: the role of guilt proneness ”, Journal of Applied Psychology , Vol. 102 No. 6 , p. 982 .

Schoemmel , K. and Jønsson , T.S. ( 2014 ), “ Multiple affective commitments: quitting intentions and job performance ”, Employee Relations , Vol. 36 No. 5 , pp. 516 - 534 .

Schumacher , D. , Schreurs , B. , Van Emmerik , H. and De Witte , H. ( 2016 ), “ Explaining the relation between job insecurity and employee outcomes during organizational change: a multiple group comparison ”, Human Resource Management , Vol. 55 No. 5 , pp. 809 - 827 .

Semedo , A.S. , Coelho , A. and Ribeiro , N. ( 2019 ), “ Authentic leadership, happiness at work and affective commitment: an empirical study in Cape Verde ”, European Business Review , Vol. 31 No. 3 , pp. 337 - 351 .

Sharma , S. , Conduit , J. and Rao Hill , S. ( 2017 ), “ Hedonic and eudaimonic well-being outcomes from co-creation roles: a study of vulnerable customers ”, Journal of Services Marketing , Vol. 31 Nos 4/5 , pp. 397 - 411 .

Sharma , P. , Kong , T.T.C. and Kingshott , R.P.J. ( 2016 ), “ Internal service quality as a driver of employee satisfaction, commitment and performance: exploring the focal role of employee well-being ”, Journal of Service Management , Vol. 27 No. 5 , pp. 773 - 797 .

Sheldon , K.M. , Corcoran , M. and Prentice , M. ( 2018 ), “ Pursuing eudaimonic functioning versus pursuing hedonic well-being: the first goal succeeds in its aim, whereas the second does not ”, Journal of Happiness Studies , Vol. 20 No. 3 , pp. 1 - 15 .

Shin , D. and Konrad , A.M. ( 2017 ), “ Causality between high-performance work systems and organizational performance ”, Journal of Management , Vol. 43 No. 4 , pp. 973 - 997 .

Shoss , M.K. ( 2017 ), “ Job insecurity: an integrative review and agenda for future research ”, Journal of Management , Vol. 43 No. 6 , pp. 1911 - 1939 .

Soomro , S.A. , Kundi , Y.M. and Kamran , M. ( 2020 ), “ Antecedents of workplace deviance: role of job insecurity, work stress, and ethical work climate ”, Problemy Zarzadzania , Vol. 17 No. 6 .

Staw , B.M. and Barsade , S.G. ( 1993 ), “ Affect and managerial perfornnance: a test of the sadder-but-Wiser hypotheses ”, Administrative Science Quarterly , Vol. 38 No. 2 , pp. 304 - 331 .

Thoresen , C.J. , Kaplan , S.A. , Barsky , A.P. , Warren , C.R. and de Chermont , K. ( 2003 ), “ The affective underpinnings of job perceptions and attitudes ”, Psychological Bulletin , Vol. 129 No. 6 , pp. 914 - 945 .

Tisu , L. , Lupșa , D. , Vîrgă , D. and Rusu , A. ( 2020 ), “ Personality characteristics, job performance and mental health the mediating role of work engagement ”, Personality and Individual Differences , Vol. 153 .

Turban , D.B. and Yan , W. ( 2016 ), “ Relationship of eudaimonia and hedonia with work outcomes ”, Journal of Managerial Psychology , Vol. 31 No. 6 , pp. 1006 - 1020 .

Viswesvaran , C. and Ones , D.S. ( 2017 ), “ Job performance: assessment issues in personnel selection ”, The Blackwell Handbook of Personnel Selection , Blackwell London , pp. 354 - 375 .

Wang , J. and Wang , X. ( 2019 ), Structural Equation Modeling: Applications Using Mplus , John Wiley and Sons New York, NY .

Wang , W. , Mather , K. and Seifert , R. ( 2018 ), “ Job insecurity, employee anxiety, and commitment: the moderating role of collective trust in management ”, Journal of Trust Research , Vol. 8 No. 2 , pp. 220 - 237 .

Waterman , A.S. ( 1993 ), “ Two conceptions of happiness: contrasts of personal expressiveness (eudaimonia) and hedonic enjoyment ”, Journal of Personality and Social Psychology , Vol. 64 No. 4 , p. 678 .

Waterman , A.S. , Schwartz , S.J. , Zamboanga , B.L. , Ravert , R.D. , Williams , M.K. , Bede Agocha , V. and Yeong Kim , S. ( 2010 ), “ The questionnaire for eudaimonic well-being: psychometric properties, demographic comparisons, and evidence of validity ”, The Journal of Positive Psychology , Vol. 5 No. 1 , pp. 41 - 61 .

Williams , L.J. and Anderson , S.E. ( 1991 ), “ Job satisfaction and organizational commitment as predictors of organizational citizenship and in-role behaviors ”, Journal of Management , Vol. 17 No. 3 , pp. 601 - 617 .

Williams , L.J. and O’Boyle , E.H. Jr ( 2008 ), “ Measurement models for linking latent variables and indicators: a review of human resource management research using parcels ”, Human Resource Management Review , Vol. 18 No. 4 , pp. 233 - 242 .

Further reading

Sabella , A.R. , El-Far , M.T. and Eid , N.L. ( 2016 ), “ The effects of organizational and job characteristics on employees' organizational commitment in arts-and-culture organizations ”, International Journal of Organizational Analysis , Vol. 24 No. 5 , pp. 1002 - 1024 .

Acknowledgements

Funding and Support statement : The authors did not receive any external funding or additional support from third parties for this work.

Corresponding author

Related articles, we’re listening — tell us what you think, something didn’t work….

Report bugs here

All feedback is valuable

Please share your general feedback

Join us on our journey

Platform update page.

Visit emeraldpublishing.com/platformupdate to discover the latest news and updates

Questions & More Information

Answers to the most commonly asked questions here

Academia.edu no longer supports Internet Explorer.

To browse Academia.edu and the wider internet faster and more securely, please take a few seconds to  upgrade your browser .

Enter the email address you signed up with and we'll email you a reset link.

• We're Hiring!
• Help Center

JOB SATISFACTION AND EMPLOYEE PERFORMANCE: A THEORETICAL REVIEW OF THE RELATIONSHIP BETWEEN THE TWO VARIABLES

In today's increasing competitive environment, organizations recognize the internal human element as a fundamental source of improvement. On one hand, managers are concentrating on employees' wellbeing, wants, needs, personal goals and desires, to understand the job satisfaction. And on the other hand, managers take organizational decisions based on the employees' performance. The purpose of this study is to identify the factors influencing job satisfaction and the determinants of employee performance, and accordingly reviewing the relationship between them. This study is an interpretivist research that focuses on exploring the influence of job satisfaction on employee performance and vice, the influence of employee performance on job satisfaction. The study also examines the nature of the relationship between these two variables. The study reveals the dual direction of the relationship that composes a cycle cause and effect relationship, so satisfaction leads to performance and performance leads to satisfaction through number of mediating factors. Successful organizations are those who apply periodic satisfaction and performance measurement tests to track the level of these important variables and set the corrective actions.

Related Papers

SCIE Australia

http://www.scie.org.au/ Abstract: The purpose of this paper is to discuss on the concept of job satisfaction and how job satisfaction can make impact on the performance of employees in an organization. The paper will be limited to the positive and negative effects of Job satisfaction. Secondly, the literature review will discuss the relationship between employee motivation, job satisfaction and employee performance

Tolossa Chaffa

Employee attitude is very important for management to determine the behavior of workers in the organization. The usually judgment about employees is that " A satisfied worker is a productive worker ". If employees are satisfied then it will create a pleasant atmosphere within the organization to perform in a better and efficient manner, therefore, job satisfaction and its relation with organizational performance has become a major topic for research studies. The specific problem covered in this study is to scrutinize the impact of job satisfaction on organizational performance. It considered which rewards (intrinsic and extrinsic) determine job satisfaction of an employee and its relation with organizational performance. It also reviewed the influence of age, sex and experience of employees on level of job satisfaction. It also covered and investigated different events which can satisfy the employees on jobs, their retention in the job, and why employees stay and leave the organization. Data were collected through conducting detailed field survey using questionnaires from different employee (exit interview of outgoing employees) groups like management, senior managers, managers, professionals and support staff from five profit/non-profit sector organizations. The data analysis shows that there exists positive correlation between job satisfaction and organizational performance. Introduction Job satisfaction of employees plays a very vital role on the performance of an organization. It is essential to know as to how employees can be retained through making them satisfied and motivated to achieve extraordinary results. Target and achievement depends on employee satisfaction and in turn contribute for organizational success and growth, enhances the productivity, and increases the quality of work.

Advances in economics, business and management research

Teten mohamad Sapril Mubarok

Review of Behavioral Aspect in Organizations and Society

Vita Yuli Alfiyana

Basically, performance is something that is individual because each employee has a different level of ability to do their jobs. Performance depends on the combination of ability, effort, and opportunity obtained. Employee performance is capital for companies to survive and develop in responding to business and business competition today, advanced and developing companies are very dependent on reliable human resources so that the output is high performance on employee performance which will later affect the company&#39;s performance. However, it is not easy to maintain and improve employee performance. There are many factors that can affect performance. Many employee turnovers occur due to a lack of satisfaction with work. Employee performance is very dependent on the value of employee satisfaction in the workplace. The fulfillment of employee rights greatly affects the performance of the organization. So, in this study the focus of the study would like to see the extent of the influ...

Prof (Dr). MD Pushpakumari

Employee attitudes are important to management because they determine the behavior of workers in the organization. The commonly held opinion is that “A satisfied worker is a productive worker”. A satisfied work force will create a pleasant atmosphere within the organization to perform well. Hence job satisfaction has become a major topic for research studies. The specific problem addressed in this study is to examine the impact of job satisfaction on performance. It considered which rewards (intrinsic and extrinsic) determine job satisfaction of an employee. It also considered influence of age, sex and experience of employees on level of job satisfaction. In addition it investigated in most satisfying event of an employee in the job, why employees stay and leave the organization. Data were collected through a field survey using a questionnaire from three employee groups, namely Professionals, Managers and Non-managers from twenty private sector organizations covering five industries...

Journal ijmr.net.in(UGC Approved)

Employee attitudes are important to management because they determine the behaviour of workers in the organization. The commonly held opinion is that “A satisfied worker is a productive worker”. A satisfied work force will create a pleasant atmosphere within the organization to perform well. It investigated the most satisfying event of an employee in the job, why employees stay and leave the organization. Job satisfaction is a general attitude towards one’s job, the difference between the amount of reward workers receive and the amount they believe they should receive. Employee is a back bone of every organization, without employee no work can be done. So employee’s satisfaction is very important. Employees will be more satisfied if they get what they expected, job satisfaction relates to inner feelings of workers. Key words: Job satisfaction, Rewards, Effort, Performance INTRODUCTION The correlation between the Job

Dhanashree Kulkarni

Haziq Sheikh

The research reported in this thesis was on “Effects of job satisfaction on employee‟s performance”. The purpose of research was to study the various factors that have been significant in determining employee performance and their importance with respect to the employees of Pakistan. The secondary data was collected by Internet and also from the material printed by different Scholars from all over the world. The primary data was gathered by floating questionnaires in Hassan leather industry Sheikhupura, Pakistan. SPSS was applied to analyze the gathered information through running Correlation tests on the variables in the study. The reliability of the data was measured with the help of the Cronbach‟s Alpha value which too was calculated using the SPSS software. The findings provided an insight and estimation towards the impact of financial and Non-Financial reward system on employee‟s performance. All the variables have been found to be significant in determining employee‟s performa...

Dr Ali Iftikhar Choudhary , Asad Humayon

Journal of emerging technologies and innovative research

Sourav Gangopadhyay

RELATED PAPERS

Christian Orient

Yonatan Moss

ALESSANDRA TRINDADE

Burcu Selek

Constantino Cronemberger Mendes

Revista electrónica de …

paola guillen

Arian Mobasser

Children and Youth Services Review

Edmund Kanmiki

The Journal of the Egyptian Public Health Association

Soha Rashed

Applied and Environmental Microbiology

Udenika Wijesinghe

Journal of Microbial & Biochemical Technology

Nageh abo-dahab

Principia Iuris

Oscar Londoño

Erik Charles

Eckhard Schinkel

Scholars Journal of Applied Medical Sciences

Kamrul Hasan

Geoscientific Model Development

Andre Coleman

Biomimetics

Hamayun Farooq

Survey Practice

Timothy Triplett

Vìsnik Nacìonalʹnoï akademìï nauk Ukraïni

Hanna Yailymova

Neotropical Ichthyology

Paulo Petry

Mario U Perez-Zepeda

Gastroenterology

jacques CALLEBERT

RELATED TOPICS

•   We're Hiring!
•   Help Center
• Find new research papers in:
• Health Sciences
• Earth Sciences
• Cognitive Science
• Mathematics
• Computer Science
• Academia ©2024

• Open access
• Published: 04 September 2021

Employee motivation and job performance: a study of basic school teachers in Ghana

• Joseph Ato Forson   ORCID: orcid.org/0000-0002-5997-5713 1 ,
• Eric Ofosu-Dwamena 2 ,
• Rosemary Afrakomah Opoku 3 &
• Samuel Evergreen Adjavon   ORCID: orcid.org/0000-0002-2713-3327 4  

Future Business Journal volume  7 , Article number:  30 ( 2021 ) Cite this article

79k Accesses

12 Citations

Metrics details

Motivation as a meaningful construct is a desire to satisfy a certain want and is a central pillar at the workplace. Thus, motivating employees adequately is a challenge as it has what it takes to define employee satisfaction at the workplace. In this study, we examine the relationship between job motivation factors and performance among teachers of basic schools in Ghana. The study employs a quantitative approach on a sample of 254 teachers from a population of 678 in the Effutu Municipality of Ghana, of which 159 questionnaires were duly answered and returned (representing 62.6% return rate). Using multiple regression and ANOVA, the study finds compensation package, job design and environment and performance management system as significant factors in determining teacher’s motivation in the municipality. Thus, these motivation factors were significant predictors on performance when regressed at a decomposed and aggregated levels. These findings support the self-determination theory, more specifically on the explanations advanced under the controlled and autonomous motivation factors. Significant differences were also observed in teachers’ performance among one of the age cohorts. The study urges the municipal directorate of education to make more room for young teacher trainees and interns who are at the formative stage of their careers to be engaged to augment the experienced staff strength. More should be done to make the profession attain some level of autonomy in the discharge of duty to breed the next genre of innovative educators in the municipality.

Introduction

Motivation as a meaningful construct is a central pillar at the workplace. Thus, motivating employees adequately is a challenge as it has what it takes to define employee satisfaction at the workplace. Quite a number of studies have been devoted to the link between motivation and its constituent factors and employee performance in different organizations [ 7 , 46 ]. Our study draws inspiration from the self-determination theory (SDT) advanced by Deci et al. [ 14 ] as a framework that can be applied to teachers motivation and performance in basic schools in Ghana. It is worth noting that SDT differentiates between controlled motivation and autonomous motivation. The latter is evident when individuals are faced with pressure and control. The former on the other hand emphasizes on the volitional nature of the behavior of individuals. The SDT provides evidence that suggests that motivation fuels performance [ 14 , 57 ].

In Ghana, the subject of motivation has always been at the apex of national agenda and is evident in the number of strike actions in the public service. In the early part of the 2000s, teachers were part of the public servants whose agitation for improved condition of service did not go unnoticed. Forson and Opoku [ 16 ] had stated that teachers’ emolument accounted for less than 35% of the public service wage bill although teachers were perceived to be in the majority in terms of numbers. This phenomenon did spark a wave of attrition of trained teachers to other sectors of the Ghanaian economy. The teaching profession as a matter of fact became a launched pad for the youth. It should be said that the nature of the school setting is basically a function of internal management and leadership. The head teacher or director of education as the Chief Executive needs to appreciate and recognize that results can be obtained through people. In today’s world, organizations are concerned with what should be done to achieve sustained high level of performance through people who are innovative thinkers [ 4 , 17 , 41 ]. These include paying more attention to how individuals can best be motivated and provision of an atmosphere that helps individuals to deliver on their mandates in accordance with the expectations of management [ 25 ]. This means that an educational manager or an individual engaged as a teacher cannot do this job without knowing what motivates people. The building of motivating factors into organizational roles and the entire process of leading people should be contingent on knowledge of motivation. Koontz and Weinrich [ 25 ] agree that the educational managers’ job is not to manipulate people but rather to recognize what motivates people.

A national debate ensued on the significant role played by teachers in nation building and the need to address the shortfall in the condition of service of teachers to motivate them to perform. Wider consultative meetings were held with stakeholders in the teaching fraternity and the outcome and the panacea was the introduction of a uniform pay structure based on qualification. The legislative arm of government passed Act 737 in 2007 that saw the birth of the Fair Wages Salary Commission (FWSC). The mandate of the commission was to ensure a fair and systematic implementation of government pay policy [ 18 ]. Although this has stabilized the teaching profession in terms of the level of attrition, concerns on how this inducement translate into teacher’s performance seem to dominate national discourse especially in the face of fallen standard of education in Ghana. Such concerns have raised questions such as the following: (1) Does pay rise correlate with performance? (2) Are there other factors that ought to be considered in the nexus between motivation and performance? (3) Are there any significant differences in the level of performance among various age cohorts (4) Do educational background motivate teachers to perform better? These and other questions are addressed in this study.

The objective of this paper is to examine the link between job motivation factors and performance among basic school teachers in Ghana. This is against the backdrop that teachers have for some time now complained about condition of service and with the passage of FWSC bill, one would have thought that would have impacted on performance of teachers as it has been proven that motivation leads to satisfaction and ultimately to high performance. The standard of education continues to be a major concern in the educational setup of Ghana.

We organize the paper as follows: section one is the introduction that sets the tone for the paper. The problem is defined in this section, and the necessary questions that warrant redress are asked. We continue with a brief literature review on the concept of motivation, leading to the development of a conceptual framework and hypothesis based on the self-determination theory (SDT). Section two focuses on the method deployed, with emphasis on the aim, design and setting of the study. The theoretical equation for the multiple regression is brought to the fore here. Section three is the results and discussion, and section four concludes with policy implications.

The concept of motivation and self-determination theory (SDT)

Maslow [ 33 ] is credited for being part of the early contributors of human motivation concept. Maslow classifies human needs that motivate them into two: (1) homeostasis and (2) finding that appetites (preferential choices among foods). The former refers to the body’s automatic efforts to maintain a constant, normal state of the blood stream. The latter concept, on the other hand, is of the view that if the body lacks some chemical, the individual will tend (in an imperfect way) to develop a specific appetite or partial hunger for that missing food element. Thus, Maslow was of the view that any of the physiological needs and the consummatory behavior involved with them serve as channels for all sorts of other needs. Relating this assertion to teachers and the need for a salary pay rise, it should be pointed out that a person who thinks he is hungry may actually be seeking more for comfort, or dependence and managers in the educational sector ought to know this. Contemporary researches have expanded on the theory of motivation as advanced by Maslow [ 33 , 34 ]. For an organization to thrive and be efficient, certain conditions ought to be available in order for managers to get the best out of its human resources (workers/employees). Employees of an organization are the greatest asset in a dynamic and competitive environment [ 49 ]. In the words of Martin [ 32 ], if an organization wants to be effective and aims to sustain the success for a longer period of time, it is important for it to have a motivated workforce made up of employees ready to learn. The last three decades have witnessed an avalanche of studies that emphasizes on the point that employee motivation is essential for the success of a business [ 2 ].

In exploring further on this connection, Mifflin [ 35 ] delved into the fundamental meaning of the word “motivation” and pointed out that it is a Latin word which means to move. Therefore, it is near impossible to move peoples’ behavior in an organization unless such move is triggered by certain incentives. Robins and Coulter [ 49 ] explained the term motivation as the desire and willingness to exert high level of inspiration to reach organizational goals, conditioned by the efforts ability to satisfy some individual need. In this study, we define motivation simply as the act of moving people triggered by the provision of some incentives to achieve a desired goal.

In the words of Deci and Ryan [ 13 ], the SDT focuses on human beings inherent desire to bring change and progress as they advance to their fullest potential. Several studies have applied the SDT in various research areas that includes education, medicine and other organizational context. The SDT is of the view that individuals are by nature active entities who will do everything possible to be integrated into the wider social environment in an attempt to be responsive to the behavior consistent with existing self. The theory according to Trépanier et al. [ 57 ] defines social context as the workplace which facilitate or frustrate ones striving toward self-determination.

The SDT theory has two major forms of motivation which may be differentiated on the basis of its nature and quality according to Howard et al. [ 22 ]. When employees engage in interesting activities or in pursuance of their needs, such a form of motivation is ascribed as autonomous motivation. Such a form of motivation facilitates employees’ vitality and energy including satisfaction and well-being [ 14 ]. When employees engage in activities out of pressure as a result of external factors such as attaining rewards including threat of being punished, or even endogenous sources of such pressure as maintaining self-esteem, want of approval, image management or avoiding guilt, such a form of motivation can be ascribed as controlled motivation. Gillet et al. [ 20 ] explain that people with controlled motivational behavior do so out of reason as long as these contingencies exist and thus it predicts maladaptive work outcomes (e.g., exhaustion of personal energy) and turnover intentions.

SDT and job performance

According to Motowildo et al. [ 38 ], job performance is a construct that elicits behavior related to achievement with evaluative components. Most studies on this relationship have emphasized on the role of autonomous and intrinsic motivation on performance with the argument that individuals autonomously motivated have certain inherent values and behaviors and thus give off optimal performance. The theory of self-determination explains that autonomous motivation should be the necessary ingredient for better performance. That is, when individuals are better informed about the purpose of their job and have a sense of ownership and the degree of freedom to operate (autonomy), the possibility of they performing better at work may be high. The source of such motivation according to Deci et al. [ 14 ] may be from one’s interest and values. It is purpose-driven, amplifies energy, enjoyable and provides enough rationalization for tasks to be accomplished effectively. Moreover, the intrinsic component of autonomous motivation has been linked with job performance in related literature and types of performance [ 7 ].

Empirically, there are evidence to suggest that autonomous motivation is linked with performance. Evidence pertaining to controlled motivation is less dispositive. Proponents of the SDT have argued that controlled motivation (e.g., performance management systems) could reduce employee functioning because action derived from personal values and interest may be disconnected, therefore leading to negative effects on performance [ 48 ]. Counter argument posits that controlled motivation may foster employee willingness to complete tasks in an attempt to avoid guilt or punishment or to earn external reward which may come in the form of compensation package [ 27 ]. In this study, we focus on both the controlled and autonomous motivational factors. More specifically, we focus on Herzberg et al. [ 21 ] motivators validated by Harvard Business Review in 2003 which were made up of two motivators: (1) intrinsic factors such as achievement, recognition for achievement, the work itself, growth, responsibility and advancement, and (2) extrinsic factors such as supervision, working conditions, payment, interpersonal relationship, appreciation and company policy. Therefore, the bundle of motivators used in this study are similar to the aforementioned ones and may include performance management systems, external rewards that come in the form of compensation packages, job environment and training and development [ 30 ]. We explain these constructs further with the empirical evidence leading to the development of the conceptual framework.

• Compensation package

Rasheed et al. [ 44 ] posit that package of compensation offered to teachers in institutions of higher learning has to be made based on several factors that may include the experience that underpins the abilities of the teacher, qualifications and perhaps market rates. This is supported by Bohlander et al. [ 6 ] who argued that teachers compensation ought to be the most central concern for managers and administrators of schools in stimulating them. Most of these research studies are premised on the fact that compensation should be designed to meet the needs of teachers and has be fashioned in the form of tangible rewards. In corroborating this assertion, Marlow et al. [ 31 ] observed that low condition of service defined by salary creates stress among teachers in schools. Thus, teachers’ condition of service should be market competitive in order to get higher motivation and to maintain them. Other studies have found that salary levels have been the main challenge for education managers and are the reason for the high attrition and that education planners and managers should pay attention to the design of compensation packages.

Job design and working environment

The needs of teachers on the job ought to be planned properly. The workload on teachers should not be such that it will de-motivate [ 44 ], p. 103. Teachers at all levels should have a learning environment, and educational administrators should make a point to treat existing human resource (teachers) with maximum respect devoid of any discrimination.

Nowadays, job design is the central focus of managers and human resource researchers. Thus, a well-designed job has what it takes in getting interest of employees. On the contrary, poorly designed job breeds boredom among employees. Davidson [ 12 ] makes an important observation and remarked in his research that when teachers are overloaded and burdened with so many non-teaching activities, it portends as a hindrance in the job design. Other scholars such as Clarke and Keating [ 9 ] have argued that the working environment of an educational institution affects teachers’ motivation. Clarke and Keating [ 9 ] found students to be the main reason why teachers are motivated in schools. His emphasis was on talented and hardworking students who boost the morale of teachers. Students who do not produce the desired results, on the other hand, de-motivate teachers. Moreover, class size is another important consideration in motivating teachers. Other variants of the job design and environment are captured in Ofoegbu [ 39 ] research in which he argued that institutions provide support in the form of resources to the teachers in the form of computers with Internet connections. Moreover, other factors such as the provision of e-libraries and research equipment, and other logistics for students may also serve as an effective motivator for teachers.

Performance management system

Management of teachers and educational administrators in all levels of education should focus on implementing basic performance management systems to continually appraise teachers’ accomplishments. For instance, the use of a so-called 360-degree feedback system is important where students’ feedback is attended to with the attention it deserves.

Stafyarakis [ 53 ] corroborated this and asserted that ‘Annual Confidential Reports’ have become obsolete. Yet there has been an emergence of a scientific approach on the field of performance management as time goes on. In discussing this further, Milliman [ 37 ] is of the view that although there are many practices available in this field, but a performance management system based on 360-degree feedback approach is the most effective.

Contrary to the norm that teachers are most motivated by the intrinsic factors and least motivated by the monetary aspects of teaching, Rao [ 43 ] demonstrates that poor appraisal systems, lack of recognition and lack of respect from the head and other co-workers are some common reasons of distress and de-motivation among teachers in educational institutions. The lack of recognition from supervisors is one of the many reasons why teachers would want to leave the teaching profession Stafyarakis [ 53 ].

Moreover, Rasheed et al. [ 45 ] points out that teachers are much concerned about students’ feedback; hence, feedback from the students should be given a proper weightage and in appraising and managing teachers’ performance in the institutions of higher education. Jordan [ 23 ] stressed that the feedback of students is a major issue of that motivates teachers and therefore teachers should be given feedback from their students in scientific manners.

Training and development

It is of significance that educational administrators focus on training activities as an essential means of both motivating employees and sustaining the survival of that organization according to Photanan [ 42 ] and Bohlander et al. [ 6 ]. Leslie [ 28 ] identified professional growth as basic motivator for teachers. He stressed that the professional learning platform available to a teacher is the basic path of his/her career development [ 29 ].

Conceptual framework and hypothesis development

In this section, the study harmonizes the components of the SDT theory into a conceptual framework on motivation and performance connection. The framework developed in this research may be useful as a guide by academicians and practitioners in understanding the mechanisms through which motivational factors affect job performance among teachers in the Effutu Municipality of Ghana. On elucidating on what a framework is, Chinn and Kramer [ 8 ] explained that a framework can be seen as a complex mental formulation of experience. Further clarification was given to distinguish conceptual framework from a theoretical framework. They assert that while theoretical framework is the theory on which the study is based, the conceptual framework deals with the operationalization of the theory. Put in another way, it represents the position of the researcher on the problem at hand and at the same time gives direction to the study. It may be entirely new, or an adoption of, or adaptation of, a model used in previous research with modification to fit the context of the inquiry [ 8 ].

The framework developed in this research has three components: the first component looks at the factors necessary to induce motivation among teachers. The second component focuses on motivation as a concept. The last component which is on job performance looks at the link between the aggregate motivational factors and performance. The extant literature survey on motivational factors and performance provides all the necessary ingredients for the construction of the framework. First, the extant literature shows that motivation as a concept is simply the act of moving people triggered by the provision of some incentives to achieve a desired goal. The triggers of motivation may include such factors such as compensation packages, job design and working environment, performance management system and training and development which are controlled and autonomous factors as crucial elements for motivation.

The second component of the framework is the aggregate motivation, which is the interaction of the controlled and autonomous factors of motivation. Motivation according to Reeve (2001) refers to the excitement level, the determination and the way a person works hard at his work setting. Ricks et al. [ 47 ] explicating on the thesis of motivation was of the view that motivation is an internal aspiration of a man that compels him to reach an objective or the goal set for him.

The third component of the framework is performance. According to Culture IQ [ 11 ] and Motowildo et al. [ 38 ], job performance is the assessment of whether an employee has done their job well. It is an individual evaluation (one measured based on a single person’s effort). In the words of Viswesvaran and Ones [ 58 ], p. 216, the term job performance is used in reference to actions that are scalable, behavior and outcomes that employees engage in or bring about that are linked with and contribute to the goals of an organization. It is linked to both employee- and organizational-level outcomes. A distinctive feature of the framework developed in this research is that it shows the interaction between autonomous and controlled factors and motivation and how it affects the performance of teachers in Fig.  1 .

Source : Created by the authors

A Conceptual model of the relationship between Motivation and Teachers’ Performance.

It can be visibly seen from the framework that teachers motivation may be defined by both controlled and intrinsic motivational factors that may include those that fall under compensation packages, working environment, performance management system and training and development of teachers [ 44 ]. Yet the performance of teachers in itself motivates management and policy makers to institute compensation packages, improved psychological aura through enhanced working environment and job design and implementing appropriate performance management policy for a continued performance enhancement. It should also be emphasized here that these job satisfaction factors may pass as job motivational factors and theorize that a highly motivated teacher may be related to the level of satisfaction.

Scholars such as Thus Milda et al. [ 36 ] and Spector [ 52 ] collectively share the opinion that teachers differ from typical employees in various ways. Therefore, instruments that usually measure such job satisfaction and motivation dimensions as appreciation, communication, coworkers, fringe benefits, job conditions, nature of work, organization itself, organizations’ policies and procedures, pay, personal growth, promotion opportunities, recognition, security, supervision may not always match with teachers’ motivation aspects on the teaching field. However, some of these factors according to some researchers can be used in understanding motivation and performance among teachers. The consensus on these dimensions is especially on supervision, work itself, promotion and recognition being important dimensions of teachers’ motivation at work [ 50 , 51 , 56 ]. In addition, several researchers have used the same measurement or dimension but with different wording (synonym). For instance, Kreitner and Kinici [ 26 ] define job satisfaction with the synonym “motivation” which they argue contains “those psychological processes that cause the arousal, direction and persistence of voluntary actions that are goal directed” Motivation depends on certain intrinsic, as well as extrinsic factors which in collaboration results in fully committed employees. Based on this relationship, we hypothesize that:

Hypothesis 1

Teachers’ compensation package, job environment and design, performance management systems, training and development significantly affect teachers’ motivation.

In a similar manner, Board [ 5 ] asserted that tangible incentives are effective in increasing performance for task not done before, to encourage “thinking smarter” and to support both quality and quantity to achieve goals. Incentives, rewards and recognitions are the prime factors that impact on employee motivation. Aarabi et al. [ 1 ] confirmed this assertion by making use of factors such as payment, job security, promotion, freedom, friendly environment, and training and employee job performance to measure the term organizational motivation with positive relationship found on these factors. On rewards (which comes in various forms, e.g., income/pay, bonus, fringe benefits among others ) and recognition/appreciation, according to other researchers keep high spirit among employees which boost employee’s morale which may have a direct impact on performance and output. The study hypothesizes that:

Hypothesis 2

Teacher’s motivation positively affects their performance.

The aim, design and setting of the study

The paper aims to examine the link between motivation factors and performance among basic school teachers in Ghana. Data for this study were collected from primary. Primary data were sourced from the field of study through questionnaire administration. The researchers sought for permission from the municipal directorate of education to engage with teachers within the municipality. A written permission was granted, and questionnaires were administered to all basic schools’ teachers in the municipality.

At the preparatory stage, the questionnaires designed were tested to make sure participants understood the demands of the questions in the questionnaires. Informal interviews method has been adopted to make sure that additional information that could not have been gathered through the use of questionnaires was captured. The formal interviews using questionnaires ensured that we stayed focused on the background objective that formed the basis of the study.

Sampling technique and data analysis

On the determination of the sample size, different authors have differing views, but in most cases, the recommendation is that it should be large. Stevens [ 54 ] recommends at least 15 participants per predictor for reliable equation in the case of factor analysis. Tabachnick and Fidel [ 55 ] provides a formula for calculating sample size requirements, taking into consideration the number of independent variables that one wish to use: N  > 50 + 8  m (where m  = number of independent variables). In line with these and other requirements like Yamane [ 60 ], the exact sample size will be determined and questionnaires distributed accordingly to the selected public and private schools in the Effutu Municipality.

The human resource unit of the educational directorate of education in the municipality has indicated that there are over 678 teachers teaching at various levels in the municipality [ 15 ]. Thus, the 678 teachers become the population in the municipality. Using Yamane [ 60 ] and validating with other sampling size technique, a sample size of 254 has been adopted with a 0.5 level of precision. Thus, 254 questionnaires were distributed among the various schools, but 159 were filled and returned (representing 62.6% return rate).

Quantitative data are analyzed by means of a software called Statistical Package for Social Sciences (SPSS version 20). This is necessitated by the fact that the analyzed quantitative data ought to be presented by graphs to give quick visual impression of what it entails.

The scale measurement of the questionnaires included nominal scale, ordinal and intervals. Questionnaires used were segmented to capture the demographic characteristics of the respondents and the constructs that feeds into the multi-level latent variables using a five-point Likert scale (see [ 19 , 24 ]). A verification was done to assess the suitability of the data for factor analysis with the expectation that Kaiser–Meyer–Olkin Measure of Sampling Adequacy ( \({\mathrm{i.e}}., {\rm KMo}\ge 0.6)\) and Bartlett’s Test of Sphericity value are significant ( p  = 0.05), which was the case for our sample data. In measuring some of the latent variables, the study developed a 9-scale item on compensation package with the following loadings (e.g., how high is your qualification and pay ( \(\alpha =0.72)\) , “is your experience linked to your current pay?” ( \(\alpha =0.80)\) , “are you satisfied with the market premium” ( \(\alpha =0.75)\) etc.). All items were rated on a five-point Likert scale ranging from 1 = “not important” to 5 = “very important.” A confirmatory factor analysis (CFA) indicates that the hypothesized correlated 3-factor structure fits well with the responds of the participants ( \({\chi }^{2}/df = 2.01, {\rm RMR}=0.05,{\rm RMSEA}=0.06,{\rm TLC}=0.94,{\rm CFI}=0.94)\) .

Job design and working environment was measured by a 7-item scale based on questions such as “how do you perceive your workload” ( \(\alpha =0.88)\) , “does your work type offer learning environment?” ( \(\alpha =0.83),\) “Are you inspired by your working environment?” ( \(\alpha =0.87)\) , “Talented student boost morale” ( \(\alpha =0.84)\) etc. Similarly, all items were rated on a five-point Likert scale ranging from 1 = “not important” to 5 = “very important.” A confirmatory factor analysis reveals that the hypothesized one-factor structure fits well with the data ( \({\chi }^{2}/df = 3.06, {\rm RMR}=0.05,{\rm RMSEA}=0.06,{\rm TLC}=0.94,{\rm CFI}=0.94)\) .

Performance management system was assessed using a 9-item scale based on these inferences (e.g., “number of times supervisor visits” ( \(\alpha =0.69)\) , “how often are you visited by the municipal director of education” ( \(\alpha =0.78)\) , “work recognition” ( \(\alpha =0.72)\) , etc.). All constructs were rated as 1 = “not important” to 5 = “very important.” A confirmatory factor analysis reveals that the hypothesized two-factor structure was in line with the data ( \({\chi }^{2}/df=2.86, {\rm RMR}=0.05,{\rm RMSEA}=0.06,{\rm TLC}=0.94,{\rm CFI}=0.94)\) .

The last but not the least concept explored was job performance. It was assessed on a 12-item scale based on the inferences such as (e.g., “are pupils treated with respect?” ( \(\alpha\) =0.77), “do you help pupils work on their social-emotional skills?” ( \(\alpha\) = 0.69), “are you fair and consistent with pupils” ( \(\alpha\) = 0.87), etc.). All items were rated on a five-point Likert scale ranging from 1 = “not important” to 5 = “very important.” A confirmatory factor analysis reveals that the hypothesized two-factor structure was in line with the data ( \({\chi }^{2}/df = 2.06, {\rm RMR} = 0.05,{\rm RMSEA} = 0.06,{\rm TLC} = 0.94,{\rm CFI} = 0.93)\) . The study proceeds to make use of the proposed measurement models to assess the relationship outlined in the conceptual model in Fig.  1 .

Hypothesized theoretical equation

Based on the conceptual model in Fig.  1 , the study makes a number of hypothesis on the relation between motivational factors and motivation itself and subsequently the link between motivation and performance. Consequently, the study model leads to two structural equations as presented below:

where JM = job motivation, CP = compensation package, JDWE = job design and working environment, PMS = performance management system, TD = training and development, JP = job performance.

Results and discussion

The study begins with a frequency distribution and descriptive statistics to capture the responses of teachers regarding the itemized construct identified in the conceptual model. Beginning with these two is borne out of the fact that the data category used in the study included categorical, ordinal and nominal variables which may be difficult to have a summary descriptive statistic.

With the understanding that every statistical approach is guided by certain principles or in most cases what has come to be known as assumptions, a diagnostic check was undertaken. Multicollinearity and singularity, for instance, look at the relationship among the independent variables. Thus, multicollinearity exists when the independent variables are highly correlated (r = 0.5 and above). The study was particular about these assumptions because multiple regression abhors them (singularity and multicollinearity). Issues concerning outliers (i.e., very high and low scores) was dealt with given the fact that multiple regression is sensitive to them. On normality, the results of the Kolmogorov–Smirnov statics were used to assess the distribution of scores. The test result was insignificant (i.e., sig. value of more than 0.05), which pointed to normality. Having done these, the study was sure there were no errors in the data and that the descriptive phase of the data used can begin.

Consistent with the general distribution of gender in the demographic characteristics of Ghana, about 63 of the teachers were female (39.6%) with 59.1% made up of male and 1.3% being transgender. The transgender teachers were foreign teachers who were here on an exchange program. Most of the teachers in the sample taught at the primary level (46.5%), followed by junior high level (43.4%) and kindergarten (8.8%), respectively. About 34.6% of the respondent responded they have taught between 6 and 10 years and 22.0% had spent between 11 and 20 years teaching. In terms of educational background, about 50.3% of the respondent have had first degree, with the remaining 49.7% being holders of teachers Cert. A or Diploma from the training colleges, and master’s degree of the returned samples. The average number of years participants have taught was observed to be 2.34 years with a corresponding standard deviation of 1.010. We present the demographic characteristics of our participants in Table 1 .

As shown in Table 2 , the compensation package scale has good internal consistency, with a Cronbach alpha coefficient reported to be around 0.725. According to Pallant [ 40 ], Cronbach alpha values above 0.7 are considered acceptable; however, values above 0.8 are preferable. Therefore, the threshold value of 0.725 means our scale is internally consistent and acceptable. Similarly, the job design and working environment scale recorded a Cronbach alpha coefficient of 0.793.

Performance management on the other hand had a Cronbach alpha coefficient of 0.70, yet training and development recorded a lower Cronbach alpha of 0.53, which meant it lacked internal consistency. The study had to drop training and development as factor for job motivation and proceed with the others. Job performance, however conspicuously recorded a Cronbach alpha of 0.83. In terms of the output from the correlation matrix, it can be visibly seen that the scales computed were not highly correlated and fallen below the threshold of 0.8 as recommended (see [ 40 ], p. 56). Both the assumption of singularity and multicollinearity by extension have not been violated (see Durbin Watson results) and thus the study can proceed to run the regression as per the set objectives and the conceptual model.

We go further to examine the causal effect of the factors identified as triggers of motivation on teachers’ level of motivation using ordinary least square method with multiple regression as the exact approach. Having gained credence from the test of reliability and validity, examining the causal effect becomes imperative. Using the baseline model in Eq. ( 1 ), the study concurrently runs the regression with the output shown in Tables 2 , 3 and 4 .

In model one, the study regresses compensation package with the dependent variable without controlling for other related factors. By implication what the results in model (1) seeks to explain is that, as the value of compensation package for teachers increases by 73 percentage points in the municipality, the mean of job motivation increases by that same margin. The high compensation is evidenced by government of Ghana reform in salary structure and bolstered by the effort of the Member of Parliament (MP) through the sharing of teaching and learning materials (TLMs) in the municipality. By this gesture by the MP, teachers feel appreciated and derive high motivation. Moreover, the presence of a university (University of Education, Winneba) has helped to deepen the level of motivation. The model has cross-variable variance of 52 percentage and with close to about 48 percentage unexplained as inferred from the coefficients of both coefficient of determination ( R 2 ) and adjusted coefficient of determination. Generally, the model is jointly significant ( F  = 170, p  < 0.01) with a corresponding tolerance and variable inflationary factor (VIF) of 1.

In model (2), the study varies the variables used with the inclusion of job design and working environment to examine how well the model can be through it cross-variable variance. Controlling for job design and environment shows a significant drop in the coefficient of compensation package from 0.73 to 0.53 although highly significant. Job design and environment recorded a coefficient of 0.49 which meant this indicator increases teachers’ satisfaction and thus motivation by 49 percentage points. In explaining this phenomenon, one would say that jobs that are rich in positive behavioral essentials such as autonomy, task significance and identity and feedback contribute to employees’ motivation. Government has since the introduction of its flagship program on free senior high education emphasized the significance of education across all the strata. The autonomy of heads of unit was by this directive curtailed. Heads of unit were barred from initiating policies to ease their operations. This finding is supported in the literature [ 7 , 30 , 46 ] and is aligned with the SDT. For example, head teachers who had levied pupils with printing fees were sanctioned for such initiative. Thus, by this gesture, the autonomy of the profession was in doubt and this explains why the level of motivation when this parameter is mentioned is low. With this addition, model (2) marginally sees an improvement of 0.73 in the cross-variable variance which is a significant. Model (2) was jointly significant ( F  = 170, p  < 0.01).

All the identified job motivation variables are concurrently used in model (3) to infer whether there was going to be a significant increase in the coefficient of determination and a drop in the residue. As a confirmation to the priori assumption, there was a marginal improvement of the explanatory strength of the model (R 2  = 0.88). However, the model witnessed significant drop in the coefficients. Thus, compensation package dropped further from 0.53 to 0.42 and job design and environment from 0.49 to 0.34.

It is important to note that the value of Durbin Watson test results when all the identified factors are brought together in model (3) indicate a no autocorrelation in the model which validates the earlier point of having dealt with critical assumptions that borders on autocorrelation. Moreover, both our VIF and tolerance were within the acceptable level. For instance, models (1)–(3) had a VIF score less than or equal to 1, which meant there were no issues concerning a possibility of high multicollinearity. For tolerance, there are no clear-cut cut-off point, but there is a suggestion of a tolerance greater than 0.40 according to Allison [ 3 ]. Yet Weisburd and Britt [ 59 ] are of the view that anything below 0.2 is an indication of serious multicollinearity. Inferring from these, it therefore goes to suggest that the tolerance levels of above 1 meant no multicollinearity.

In examining the relationship between the aggregated motivational factors and performance, the study brings to the fore the following findings as shown in Table 3 . The study presents four (4) different models on the relationship between motivation and performance. Model (1) regresses the aggregate motivational factors on job performance, and the findings are quite interesting to note. The job performance indicator is increased by 46% for every unit increase in motivation. This relationship can further be explained to mean a teacher within the municipality with a sense of satisfaction with his/her teaching job may feel more inclined to be at post no matter what the prevailing circumstances are. The snowball effect of this phenomenon is the reduction in absenteeism with a corresponding curb on teachers’ turnover. Although the coefficient of determination which explains the cross-variable variance is by far lower than expected ( R 2  = 0.214), the model is jointly significant ( F  = 41.44, p  < 0.01). The VIF and tolerance levels are within acceptable threshold with a Durbin Watson of 2.04 that signals a no concern of autocorrelation in the model.

Models (2)–(4) regress the decomposed job motivation factors on performance to ascertain their level of significance, and indeed, as theorized, these factors were positively significant except with lower coefficient of determinations ( R 2 ). To explain the relation in model (2), it is important to note that compensation is the output and the benefit that a teacher within the municipality receives in the form of pay, or even any form of exchanges (in kind or in cash) to increase performance. The Member of Parliament for the area as part of effort to ensure teachers are well compensated shared over 700 laptops to teachers within the municipality for effective teaching and learning. This certainly explains why the attrition rate in the municipality is low vis-à-vis high morale of teachers which largely explains the level of motivation and satisfaction.

Model (3) touches on the psychological state the teacher finds him or herself owed to the nature and state of the job. This may include the job environment and the degree of specialization. Yet in model (4), there is an exponential increase in the coefficient of performance management systems as it increases job performance within the municipality by 51 percentage point. It should be noted that performance management sets expectations for teachers’ performance and thus motivates them to work harder in ways expected by the municipal directorate of education under GES. The results in model (5) confirm earlier ones, but the inclusion of the other variables as control seems to have increased the coefficients of the various motivational factors. This partly explains the performance of the municipality in the central region in successive BECE.

Further investigation is made to understand which of the age groups is responsible for the ensuing level of performance in the municipality. To do this, the study relies on one-way analysis of variance (ANOVA). Here, the mean scores of more than two groups are compared using a continuous variable as the dependent variable. Having transformed the ordinal variables to continuous, it makes it quite straightforward to do this. Using the categorical independent variable of age which has more than three categories and the job performance variable which we have transformed to be continuous variable, the study undertakes a one-way between groups ANOVA with post hoc tests. Teachers were divided into four groups according to their ages (group 1: 20–30 yrs.; group 2: 31–40 yrs.; group 3: 41–50 yrs.; group 4: above 51 yrs.). There was a statistically significant difference at the \(p<0.10\) level in job performance scores for the four age groups: F (4, 159) = 0.042, p  = 0.10. Despite reaching statistical significance for one of the groups, the actual difference in mean scores between the groups was quite small. The effect size was calculated using eta squared (eta squared = 179.1/8513 = 0.02) which in Cohen’s ([ 10 ], pp. 248–7) terms is considered far too small a size. Note should be taking that Cohen categorizes 0.01 as a small effect, 0.06 as a medium effect and 0.14 as a large effect. Post hoc comparisons using the Tukey HSD test indicated that the mean score for group 1 (56.12, SD = 4.26) is significantly different from the other three groups which were insignificant. The result has theoretical soundness. Group 1 was made up of young teachers who had either returned from training colleges after completion or on internship and thus had cause to perform for a possibility of being retained or given a very good report since internship supervision forms part of the trainees’ assessment.

In this study, we examined among a host of autonomous and controlled motivational factors and their relationship to performance among basic schools’ teachers in the Effutu Municipality of Ghana. A conceptual model was developed with the necessary hypotheses formulated. Using multiple regression and one-way analysis of variance (ANOVA), the causal effect as shown in the model is tested.

The study finds compensation package, job design and environment and performance management system to be positively significant factors in explaining teacher’s motivation in the municipality. These job motivation factors were significant predictors on job performance. The aggregated job motivation indicator when regressed on job performance reveals a positive and significant effect. Based on the results from the ANOVA, the study recommends the municipal directorate of education to make more room for young teacher trainees who are at the formative stage of their career to be engaged to augment the experienced staff strength. More should be done to make the profession attain some level of autonomy in the discharge of duty to breed the next genre of innovative educators in the municipality. A limitation of the study is its inability to treat job motivation as a mediatory variable as captured in the framework. The study recommends future research to explore this connection.

Availability of data and material

Not applicable.

Abbreviations

Analysis of variance

Self-determination theory

Single spine salary structure

Fair wages salary commission

Teaching and learning materials

Member of parliament

Job motivation

Job performance

Kaiser–Meyer–Olkin

Confirmatory factor analysis

Standardized root mean square residual

Root mean square error of approximation

Statistical package for social science

Variable inflationary factor

Aarabi MS, Subramaniam IV, Akeel AB (2013) Relationship between motivational factors and job performance of employees in Malaysian Service Industry. Asian Soc Sci 9(9):301–310. https://doi.org/10.5539/ass.v9n9p301

Article   Google Scholar  

Al-Alawi AI (2005) Motivating factors on information technology employees in Bahrain Hotel Industry.

Allison P (1999) Multiple regression: a primer. Pine Forge Press

Armstrong M (2003) Handbook of management and leadership: a guide to management for results. Kogan

Board LM (2007) Coaching a stockholder on performance improvement option. In: ASTD international conference

Bohlander G, Snell S, Sherman A (2001) Managing human resources. South-Western College

Cerasoli CP, Nicklin JM, Ford MT (2014) Intrinsic motivation and extrinsic incentives jointly predict performance: a 40-year meta-analysis. Psychol Bull 140(4):980–1008

Chinn PL, Kramer MK (1999) Theory and nursing: integrated knowledge development, 5th edn. Mosby Inc

Clarke R, Keating WF (1995) A fresh look at teacher job satisfaction (ED 391; 795).

Cohen JW (1988) Statistical power analysis for the behavorial sciences, 2nd edn. Lawrence Erlbaum Associates

Culture IQ (2018) Understanding job performance in your company. Job Performance.

Davidson E (2005) Understanding and improving quality in Tanzanian primary schooling. University of East Anglia

Deci EL, Ryan RM (2000) The ‘what’ and ‘why’ of goal pursuits: human needs and the self-determination of behavior. Psychol Inq 11(4):227–268

Deci EL, Olafsen AH, Ryan RM (2017) Self-determination theory in work organizations: the state of a science. Annu Rev Organ Psych Organ Behav 4(1):19–43

EMA (2019) Effutu Municipal Directorate

Forson JA, Opoku RA (2014) Government’s restructuring pay policy and job satisfaction: the case of teachers in the Ga West Municipal Assembly of Ghana. Int J Manag Knowl Learn 3(1):79–99. https://doi.org/10.2139/ssrn.2457629

Forson JA, Opoku RA, Appiah MO, Kyeremeh E, Ahmed IA, Addo-quaye R, Peng Z, Acheampong EY, Bekuni B, Bingab B, Bosomtwe E (2020) Innovation, institutions and economic growth in sub-Saharan Africa—an IV estimation of a panel threshold model. J Econ Admin Sci. https://doi.org/10.1108/JEAS-11-2019-0127

FWSC (2013) Is performance management in Ghana’s public service a mirage? The fair wages and salaries commission’s role in public service performance management. http://www.fairwages.gov.gh/index.php/Slideshow-News/is-performance-management-in-ghanas-public-service-a-mirage/The-Fair-Wages-and-Salaries-Commissions-Role-in-Public-Service-Performance-Management.html

Gall P, Gall D, Borg W (2007) Applying educational research. Pearson Education Inc

Gillet N, Vallerand RJ, Lafreniere MAK, Bureau JS (2013) The mediating role of positive and negative affect in the situational motivation-performance relationship. Motiv Emot 37(3):465–479

Herzberg F, Mausner B, Synderman B (1959) Motivation to work. Wiley

Google Scholar  

Howard JL, Gagné M, Bureau JS (2017) Testing a continuum structure of self-determined motivation: a meta-analysis. Psychol Bull 143(12):1346–1377

Jordan JL (1992) Performance appraisal satisfaction and supervisor’s traits. Psychol Rep 66(1):1337–1338

Kerlinger FN (1978) Foundation of behavioral research. Holt, Rinehart and Winston, New York

Koontz H, Weinrich H (1998) Essentials of management, 5th edn. McGraw-Hill, London

Kreitner R, Kinici A (2004) Organizational behavior. McGraw-Hill, Irwin

Kuvaas B, Buch R, Weibel A, Dysvik A, Nerstad CGL (2017) Do intrinsic and extrinsic motivation relate differently to employee outcomes? J Econ Psychol 61(1):244–258

Leslie K (1989) Administrators must consider and improve teacher satisfaction. NASSP Bull 73(1):19–22

Lynn S (2002) The winding path: understanding the career cycle of teachers. Clearing House J Educ Strat Issues Ideas 75(4):179–182

Manolopoulos D (2008) An evaluation of employee motivation in the extended public sector in Greece. Empl Relat 30(1):63–85

Marlow L, Inman D, Bentancourt-Smith M (1996) Teacher job satisfaction (ED 393; 802)

Martin AJ (2003) The student motivation scale: further testing of an instrument that measures school students motivation. Aust J Educ 47(1):88–106

Maslow AH (1943) A theory of human motivation. Psychol Rev 50:370–396. https://doi.org/10.1037/h0054346

Maslow AH (1954) Motivation and personality. Harper & Row

Mifflin (1995) Management and organization. South-Western Publishing Co

Milda A, Raimundas V, Aidas P (2011) Job satisfaction survey: a confirmatory factor analysis based on secondary school teachers’ sample. Int J Bus Manag 6(5):41–50

Milliman JZ (1994) Companies evaluate employees from all perspectives. Pers J 73(11):99–103

Motowildo SJ, Borman WC, Schmit MJ (1997) A theory of individual differences in task and contextual performance. Hum Perform 10(2):71–83

Ofoegbu FI (2004) Teacher motivation as an essential factor for classroom effectiveness and school improvement. Coll Stud J 3(1):54–61

Pallant J (2011) SPSS survival manual. Allen & Unwin, Australia

Peng Z, Lian Y, Forson JA (2020) Peer effects in R&D investment policy: Evidence from China. Int J Finance Econ. https://doi.org/10.1002/ijfe.2028

Photanan T (2004) Human resource focus. Innographics Ltd

Rao TV (2004) Performance management and appraisal systems: HR tools for global competitiveness. Sage Publications Inc

Rasheed MI, Humayon AA, Awan U, Din Ahmed A (2016) Factors affecting teachers’ motivation. Norwich 30(1):101–114. https://doi.org/10.1108/IJEM-04-2014-0057

Rasheed MI, Sarwar S, Aslam HD (2010) Motivational issues for teachers in higher education: a critical case of IUB. J Manag Res 2(2):1–23

Reizer A, Brender-Ilan Y, Sheaffer Z (2019) Employee motivation, emotions and performance: a longitudinal diary study. J Manag Pschol 34(6):415–428

Ricks BR, Glinn ML, Daughtrey AS (1995) Contemporary supervision, managing people and technology. McGraw-Hill Inc, New York

Rigby CS, Ryan RM (2018) Self-determination theory in human resource development: new directions and practical considerations. Adv Dev Hum Resour 20(2):133–147

Robins SP, Coulter M (2005) Management, 7th edn. A Pearson Education Company

Rosser VJ (2005) Measuring the change in faculty perceptions over time: An examination of their work life and satisfaction. Res High Educ 46(1):81–107. https://doi.org/10.1007/s11162-004-6290-y

Sharma RD, Jyoti J (2009) Job satisfaction of university teachers: an empirical study. J Serv Res 9(2)

Spector PE (1997) Job satisfaction: application, assessment, causes, and consequences. Sage Publications Ltd

Stafyarakis M (2002) HRD and performance management. University of Manchester

Stevens J (1996) Applied multivariate statistics for the social sciences. Lawrence Erlbaum

Tabachnick BG, Fidel S (2013) Using multivariate statistics. New Jersey Education Inc

Tillman WR, Tillman CJ (2008) And you thought it was the apple: a study of job satisfaction among teachers. Acad Educ Leadersh J 12(3):1–18

Trépanier SG, Forest J, Fernet C, Austin S (2015) On the psychological and motivational processes linking job characteristics to employee functioning: insights from self-determination theory. Work Stress 29(3):286–305

Viswesvaran C, Ones DS (2000) Perspectives on models of job performance. Int J Sel Assess 8(4):216–226

Weisburd D, Britt C (2013) Statistics in criminal justice, 4th edn. Springer, Berlin

Yamane T (1967) Statistics, an introductory analysis, 2nd edn. New York Harper and Row, New York

Download references

Acknowledgements

The authors would like to acknowledge the support of the Effutu Directorate of Education, particularly the Municipal Director of Education for the support during the data collection stage. We thank all the basic school teachers in the municipality who devoted time to fill and return questionnaires sent to them. We are also grateful to the Directorate for the secondary materials given to the team.

Author information

Authors and affiliations.

Department of Applied Finance and Policy Management, University of Education, Winneba, P.O. Box 25, Winneba, Ghana

Joseph Ato Forson

Department of Educational Foundations, University of Education, Winneba, Winneba, Ghana

Eric Ofosu-Dwamena

Department of Educational Administration and Management, University of Education, Winneba, Winneba, Ghana

Rosemary Afrakomah Opoku

Department of Applied Finance and Policy Management, University of Education, Winneba, Winneba, Ghana

Samuel Evergreen Adjavon

You can also search for this author in PubMed   Google Scholar

Contributions

JAF contributed 50%, EOD contributed 25%, RAO contributed 20%, and SEA contributed 5%, respectively. All authors have read and approved the manuscript.

Corresponding author

Correspondence to Joseph Ato Forson .

Ethics declarations

Competing interests.

The authors declare that they have no competing interests.

Additional information

Publisher's note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ .

Reprints and permissions

About this article

Cite this article.

Forson, J.A., Ofosu-Dwamena, E., Opoku, R.A. et al. Employee motivation and job performance: a study of basic school teachers in Ghana. Futur Bus J 7 , 30 (2021). https://doi.org/10.1186/s43093-021-00077-6

Download citation

Received : 21 February 2021

Accepted : 11 June 2021

Published : 04 September 2021

DOI : https://doi.org/10.1186/s43093-021-00077-6

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Performance
• Performance management systems
• Single spine salary structure (SSSS)

JEL Classification

• Research article
• Open access
• Published: 04 February 2022

Job performance in healthcare: a systematic review

• Marcel Krijgsheld   ORCID: orcid.org/0000-0003-3096-7055 1 ,
• Lars G. Tummers 1 &
• Floortje E. Scheepers 2  

BMC Health Services Research volume  22 , Article number:  149 ( 2022 ) Cite this article

21k Accesses

16 Citations

8 Altmetric

Metrics details

Healthcare organisations face major challenges to keep healthcare accessible and affordable. This requires them to transform and improve their performance. To do so, organisations must influence employee job performance. Therefore, it is necessary to know what the key dimensions of job performance in healthcare are and how these dimensions can be improved. This study has three aims. The first aim is to determine what key dimensions of job performance are discussed in the healthcare literature. The second aim is to determine to which professionals and healthcare organisations these dimensions of job performance pertain. The third aim is to identify factors that organisations can use to affect the dimensions of job performance in healthcare.

A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The authors searched Scopus, Web of Science, PubMed, and Google Books, which resulted in the identification of 763 records. After screening 92 articles were included.

The dimensions – task, contextual, and adaptative performance and counterproductive work behaviour – are reflected in the literature on job performance in healthcare. Adaptive performance and counterproductive work behaviour appear to be under-researched. The studies were conducted in different healthcare organisations and pertain to a variety of healthcare professionals. Organisations can affect job performance on the macro-, meso-, and micro-level to achieve transformation and improvement.

Based on more than 90 studies published in over 70 journals, the authors conclude that job performance in healthcare can be conceptualised into four dimensions: task, contextual and adaptive performance, and counterproductive work behaviour. Generally, these dimensions correspond with the dimensions discussed in the job performance literature. This implies that these dimensions can be used for further research into job performance in healthcare. Many healthcare studies on job performance focus on two dimensions: task and contextual performance. However, adaptive performance, which is of great importance in constantly changing environments, is under-researched and should be examined further in future research. This also applies to counterproductive work behaviour. To improve job performance, interventions are required on the macro-, meso-, and micro-levels, which relate to governance, leadership, and individual skills and characteristics.

Peer Review reports

Together with governments and policymakers, healthcare organisations face major challenges to ensure healthcare remains accessible and affordable. This requires healthcare organisations to transform and improve their performance. These challenges cannot be met without the involvement and excellent performance of healthcare employees.

The Organisation for Economic Cooperation and Development (OECD) expects that in 2050, almost 27% of the population will be over 65 years old and more than 10% will be over 80 [ 1 ]. This may lead to increasing demand for healthcare. According to the OECD, healthcare expenditure in terms of gross domestic product will grow from 8.8% in 2017 to 10.2% in 2030 in OECD countries [ 1 ]. A record amount of money is being spent on healthcare, and this is expected to further increase due to pressure arising from, among other factors, an ageing population. However, advances in medical technology and rising public expectations regarding healthcare services also contribute to increasing health expenditure [ 2 , 3 ]. Accessibility is not the only challenge arising from an ageing population and the consequent increasing demand for care; a shortage of healthcare professionals is another major challenge healthcare organisations face [ 4 , 5 ]. All these challenges make healthcare perhaps one of the most important areas in which the change and improvement of organisational performance are necessary [ 2 ]. As healthcare is mainly people work, change and improvement in organisational performance will be closely linked to the performance (i.e., the actions and behaviours) of employees [ 6 ]. In other words, the job performance of healthcare professionals is of crucial importance to achieve organisational goals [ 6 , 7 , 8 ].

Job performance has been widely discussed and conceptualised in various ways [ 8 ]. This is reflected in Koopmans et al.’s [ 9 ] systematic review, in which the authors identify 17 generic and 18 job-specific frameworks. The job-specific frameworks in that study relate to the army and employees and management in the service and sales sector. However, Greenslade and Jimmieson’s (2007) framework was developed for the healthcare sector [ 10 ] based on Borman and Motowidlo’s theoretical model [ 11 ]. Based on the 35 frameworks Koopmans et al. identify four main dimensions: task performance, contextual performance, adaptive performance, and counterproductive work behaviour [ 9 ].

Task performance has a direct relationship with the organisational technical core [ 11 , 12 , 13 , 14 ]. The term refers to direct activities (such as treating patients) and indirect activities (such as hiring nurses) that are a formal part of a worker’s job [ 15 ]. Task performance is seen as an encompassing dimension that also includes aspects such as task behaviour [ 16 ], job and non-job specific tasks [ 17 ], role performance [ 18 ], technical activities [ 19 ], and action orientation [ 20 ]. Contextual performance includes, among other items, interpersonal behaviour [ 16 ], organisational citizenship behaviour [ 21 ], extra role performance [ 22 ], and peer team interaction [ 23 ]. Contextual performance concerns the broader organisational, social, and psychological environment in which a technical core must function [ 11 , 12 , 13 , 14 ]; it includes activities such as volunteering for extra work and maintaining good interpersonal relationships [ 15 ]. Adaptive performance refers to the extent to which an individual adapts to changes in work systems or work roles [ 9 ]. It is also defined as adaptability and pro-activity [ 24 ] and creative performance [ 21 ]. Attention towards adaptive performance has increased in recent decades due to the dynamic nature of work environments [ 25 ]. In earlier frameworks, adaptive performance was seen as a separate dimension [ 26 , 27 , 28 ] instead of a component of contextual performance [ 29 ]. Finally, counterproductive work behaviour refers to behaviour that is harmful to the performance of an organisation [ 30 ]. It includes, for instance, off-task behaviour, unruliness, theft, drug abuse [ 29 ], absenteeism (not attending work) and presenteeism (attending work while ill [ 31 , 32 , 33 ];).

To change and improve the performance of healthcare professionals, and thus the performance of healthcare organisations, it is important to determine whether the four dimensions can be used as a reference for job performance research in healthcare. Although Greenslade and Jimmieson (2007) propose a framework, it focuses specifically on nurses and only includes the task and contextual performance dimensions, thus having little applicability in healthcare research in general. Therefore, it is important to determine how job performance in healthcare is treated in the research literature and whether it relates to the dimensions of task, contextual, and adaptive performance and counterproductive work behaviour. To arrive at findings about whether the four dimensions can be applied to the broad field of healthcare, it is important to investigate in which sectors of healthcare and in relation to which professionals the dimensions have been used in research. Finally, to change and improve the performance of the healthcare professional, it is relevant to determine how and at which level organisations can implement changes to affect job performance. In summary, the purpose of this review is to answer the following questions:

Which of the four job performance dimensions are described in studies focusing on job performance in healthcare?

To which professionals and health organisations do the dimensions of job performance discussed in the studies pertain?

How and on which level can organisations affect the job performance of healthcare professionals?

This research was accomplished by conducting a systematic literature review. The method section describes the process of identification, screening, and assessing the eligibility of studies. The results section begins with an overview that sets out the distribution of the studies. The overview reveals in which year, and in which journal the articles were published. It also details whether studies were carried out in developed or developing countries. Further, this paper explains how it assesses the methodological quality of the studies. Following this overview, this paper presents the answers to the research questions, beginning first with the job dimensions identified in the selected studies, and then proceeding to an analysis of the type of organisations the studies examined and the healthcare professionals to which the studies pertain. Finally, the results section describes the factors that can affect job performance at different organisational levels. The discussion section discusses the results and reflects on a few of this paper’s limitations. The conclusion section provides suggestions that can be used for future research on job performance in healthcare based on this study’s findings.

The literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement [ 34 ]. To find eligible studies, four databases were searched: Scopus, Web of Science, PubMed, and Google Books. The goal of the research strategy was to find articles and books that relate to job performance in healthcare and include a broad scope of healthcare professionals. The search strategy is detailed in Appendix A .

Eligibility criteria

Studies included in the review must meet the following criteria. They must relate to job performance in the field of healthcare. Job performance or comparable terms, such as work performance or work behaviour, must appear in the title or abstract. Studies that examine at least one of the four dimensions or related terms are also eligible. Studies published between 1996 and December 2019 were selected. As part of the pragmatic approach to gathering literature, only studies written in English were considered. All articles published in international journals that were selected for this study must have been peer-reviewed.

Study selection

Through the search strategy, 763 records were identified, including four books. After 17 duplicates were removed, the titles and abstracts of the remaining 747 records were screened. This resulted in the exclusion of 497 records (including three books). Although the studies are related to healthcare, job performance was not the main objective of these studies. For example, a few studies examine musculoskeletal disorders and their impact on nursing tasks [ 16 , 17 ]. Other studies focus on job satisfaction [ 18 , 19 ]. After the exclusion of these 497 studies, the authors read the remaining 250 articles in detail and analysed their eligibility. This resulted in the exclusion of another 158 studies. The grounds for exclusion are as follows. Studies that focus on a specific task, such as working with electronic healthcare systems [ 20 , 21 ], radiation therapy [ 35 ], cervical screening [ 36 ], and communication in the operating theatre [ 24 , 25 ], were excluded.

Full-text articles were not available for two studies. After completing the process of screening and analysing the articles, a total of 92 articles, including one book chapter, met the eligibility criteria. The study selection process is depicted schematically in Fig.  1 using the PRISMA flowchart [ 34 ].

Flowchart study selection

After categorising the articles by year of publication and the journals and countries in which they were published, the methodological quality of the studies was assessed using the integrated quality criteria for the review of multiple study designs [ 37 ]. Studies that could not be assessed using the ICROMS tool were assessed using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers [ 38 ]. Because not all the selected studies directly refer to task, contextual, or adaptive performance or counterproductive work behaviour, it was imperative to assign terms, such as nursing work, tasks, or activities and indirect or direct care [ 27 , 28 ] to one of the dimensions. The assignment of the terms was accomplished using the definitions of the four dimensions. To determine whether the dimensions of job performance were used in the broad field of health care, the type of organisation in which job performance was studied was examined. In addition, it was analysed to which professionals these studies related. Finally, the factors influencing job performance were categorised into macro-, meso-, and micro-level factors. All coding can be viewed on the Open Science Framework (OSF) database.

Before answering the research questions, this paper provides an overview that sets out the distribution of the studies. The overview reveals in which year and in which journal the articles were published. It also shows whether the studies were carried out in developed or developing countries. Results of the assessment of the methodological quality of the studies are provided below.

Distribution of the studies

Table  1 reveals that most studies (82.6%) were conducted in developed countries (e.g., [ 39 , 40 , 41 ]), with the United States being the most common study location (29.4% of all studies; e.g., [ 42 , 43 , 44 ]). With regard to developing countries, China was the most common study location (e.g., [ 45 , 46 ]).

The articles included in this review were published in 76 different journals ( Appendix C ). The journals can be divided into healthcare fields, such as nursing [ 47 ], medicine [ 42 ], healthcare [ 48 ], and psychology [ 49 ], and into journals with a focus on specific topics, such as maternity [ 50 ] , ergonomics [ 51 ], and critical care [ 52 ]. Almost 20% of the articles were published in the following four journals: BMC Health Services Research, the Journal of Advanced Nursing , the International Journal of Medical Informatics, and the Journal of Managerial Psychology . Most of the studies were conducted in a single country, which raises questions about their external validity.

Figure  2 illustrates the publication years of the studies, divided into publications in developed and developing countries. It indicates that job performance in healthcare has been studied almost continuously over the years and is still of interest. Figure 2 also suggests that the interest in job performance in healthcare has increased in developing countries over the last decade.

Number of publications on job performance in healthcare, 1996–2019

Design and quality of the studies

To assess the methodological quality of the studies, the ICROMS quality assessment tool was used [ 37 ]. The tool provides a comprehensive set of general and specific quality criteria for randomised controlled trials (RCTs), controlled before-after (CBA) studies, non-controlled interrupted time series (NCITS) studies, cluster-randomised controlled trials (cRCTs), and non-controlled before-after (NCBA) studies. The ICROMS tool also provides a clear and transparent scoring system with a minimum required score per study design. The results of the study designs are listed in Table  2 . The ICROMS scores of the assessed studies are shown in the OSF database. Qualitative and cohort studies, CBA studies, RCTs, and NCITS studies all achieved the minimum required score. Although the minimum required score was achieved in these studies, room for improvement exists. About 60% of the studies suffer from selective outcome reporting due to unavailable study protocols. Clear statements as to whether or not the studies were selectively reported did not solve the issue with the lack of protocols. On average, only the NCBA studies failed to meet the minimum required score because no baseline measurements were conducted, and no attempt was made to mitigate the effect of not having a control group. Although the quality of these NCBA studies is low, one can nonetheless provide some commentary on them. For instance, not all ICROMS items could be evaluated because it is unclear whether the criteria were met. The lack of evidence that this cannot be ascertained from an article does not mean that the criteria have not been applied. Researchers can accomplish improvement by providing a better description of the method of subject selection and its characteristics.

The ICROMS tool has a scope for further development of quality criteria applicable to additional study designs, such as surveys and cross-sectional studies [ 37 ]. Therefore, studies that rely solely on data from questionnaires could not be assessed using the ICROMS tool. These studies (e.g., [ 30 , 53 ]) were assessed using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers [ 38 ]. The overall score ranged from 0.72–1.0 (mean: 0.91, standard deviation: 0.07).

Dimensions of job performance

The first research question examines which of the four dimensions of work performance (i.e., task, context, and adaptive performance and counterproductive work behaviour) are described in studies of work performance in healthcare. The results show that these dimensions are applicable to work performance in healthcare.

The review of the literature revealed studies that directly refer to Motowidlo et al. [ 11 ], who classify and define job performance as task and contextual performance (e.g., [ 46 , 49 , 54 ]). Studies were also found that directly refer to Greenslade and Jamieson [ 10 ], who suggest a model based on Motowidlo and Van Scotter’s [ 55 ] classification of methods to measure the job performance of nurses, which is directly linked to two dimensions, task and contextual performance (e.g., [ 56 , 57 , 58 ]). Studies referring to organisational citizen behaviour (e.g., [ 59 , 60 ]) were classified as contextual performance because there is significant overlap between the definitions of organisational citizen behaviour and contextual performance [ 9 ]. Overlap was also found in studies that directly refer to counterproductive work behaviour (e.g., [ 61 , 62 ]). In addition to the studies that directly refer to the dimensions of job performance, other studies described task, skill, and behavioural performance without a direct reference to the dimensions of job performance. The definitions [ 9 ] listed in Table  3 were used by the researchers to assign these tasks, skills, and behaviours to one of the dimensions of job performance if they were in alignment with those definitions.

Patient feeding [ 63 ], direct patient contact [ 64 ], scheduling toileting [ 65 ], and speaking with other professionals concerning patient care [ 66 ] are examples of tasks that were attributed to the task performance dimension because these examples are part of a healthcare professional’s job. Visiting unit and hospital meetings [ 67 ], continuing professional development [ 68 ], and tutoring trainees [ 69 ] were attributed to contextual performance because these examples contribute to the improvement of an organisation overall. The willingness to implement organisational changes [ 70 ] and the eagerness to require professional information [ 71 ] are examples of behaviours that were attributed to adaptive performance because they are important to adapt to changes in work systems and roles. Purposely failing to help a colleague [ 72 ] and rude behaviour among supervisors [ 73 ] are examples of behaviours that were attributed to the dimension of counterproductive work behaviour because these behaviours can lead to employee illness and increase turnover and therefore harm an organisation’s well-being. A full description of the allocation of the studies within this paper’s sample to the dimensions is available on the OSF database. All tasks, skills, and behaviours can be assigned to one of the four dimensions of job performance. Along with the studies that directly refer to these dimensions, Table  4 lists the assignment results.

The results reveal that over 47% of the studies focus on task performance, such as primary care tasks [ 36 ], supportive care [ 50 ], and manual tasks [ 74 ]. They also show a focus on contextual performance, which is about team interdependence, communication, synchronicity, coordination and confidence in interprofessional collaboration, and knowledge sharing [ 75 ]. A total of 45 studies investigates contextual performance in combination with task performance. This follows logically from Motowidlo et al.’s [ 11 ] frequently used definition of job performance. Thirteen studies focus on counterproductive work behaviour, which includes abuse, production deviance, sabotage, theft, absence, early and late arrival [ 61 ], workplace violence, verbal aggression, harassment, intimidation, threats, and bullying [ 76 ]. Only eight studies include the adaptive performance dimension; for example, some studies examine adopting electronic health record systems [ 77 ], adopting new innovations [ 71 ], creativity, or personal initiatives [ 59 ].

Healthcare organisations and professionals

The second research question concerns the type of healthcare organisations in which the studies investigate job performance and the type of healthcare professionals to which the studies pertain. The studies examine job performance in several healthcare fields and with respect to various types of healthcare professionals. Table  5 lists the types of healthcare organisations the studies examine. It indicates that over 77% of the studies were performed in hospitals (e.g., [ 78 , 79 ]), including in cardiology, general surgery, anaesthetics [ 80 ], and psychiatry [ 39 ] wards or in special hospitals such as children’s hospitals [ 45 , 81 ]. Other studies investigate job performance in hospices [ 82 ], organisations for patients with special needs [ 59 ], and nursing homes [ 36 ]. In six studies, the research was performed in both hospitals and other healthcare organisations. One study did not specify the type of healthcare organisation the authors studied [ 83 ].

About 52% of studies in the sample concern the job performance of nurses (e.g., [ 53 , 84 ]; see Table  6 ). Besides general nurses, several studies also focus on intensive care nurses [ 52 , 85 ] and maternity nurses [ 50 ]. In about 26% of the studies, physicians (e.g., [ 42 , 86 ]), such as paediatricians [ 81 ] and gynaecologists [ 77 ], are the focus of attention. Eighteen studies investigate the job performance of other healthcare professionals, such as pharmacists [ 87 , 88 ], lab technicians [ 61 ], and administrative employees [ 72 ]. Five studies do not specify the type of professional the authors examined. Markon, Chiocchio, and Fleury discuss healthcare professionals in general [ 75 ].

Factors affecting the job performance of healthcare professionals

To answer the third research question, which concerns factors that affect the healthcare professionals’ job performance, this study distinguishes between the macro-level (organisation), meso-level (management/team), and micro-level (individual). This distinction reveals that the job performance of healthcare professionals can be affected on all three levels.

On the macro-level, job performance can be affected by how an organisation is structured [ 82 ], the extent to which a healthcare professional perceives that they have organisational support [ 53 , 73 ], and organisational culture [ 89 ]. Employee performance can flourish in an innovative atmosphere [ 71 ]. In contrast, job performance is likely to decrease in a toxic organisational climate and in cases where supervisors act abusively [ 61 , 90 ]. Turnover of high-performing employees can also affect an organisation’s performance negatively [ 54 ].

At the meso-level, managerial support and supervision and training programmes contribute to job performance levels [ 75 , 76 , 91 ]. In addition, factors such as interdependence [ 75 ], team structure [ 88 ], and the presence of social support [ 57 , 92 ] can affect job performance. Positive views towards work and innovation in organisations with employee-centred designs [ 93 ] contribute positively to job performance. Factors that negatively affect job performance on the meso-level include abusive supervision [ 94 ], limited resources, heavy workloads and dissatisfaction with co-workers [ 76 ], and burnout [ 95 ].

On the micro-level, the extent of work engagement, role clarity, and autonomy [ 53 , 96 ], as well as employee skills and education levels [ 58 ], overwork [ 69 ], and the prevalence of multitasking [ 64 ] are relevant factors that influence job performance. Other relevant factors that influence job performance applies to employees’ personal characteristics, such as openness to change and extraversion [ 56 , 67 , 97 ], seeking challenges [ 70 ], eagerness [ 71 ], and creativity [ 59 ]. Low emotional intelligence [ 98 ] and Machiavellianism – pragmatic, emotionally detached, and task oriented as.

opposed to person oriented – affect job performance in a negative manner [ 45 ]. In summary, the governance of an organisation, the style of management or leadership, and the individual skills and characteristics of the professionals at an organisation can improve or diminish the performance of individual employees. This, in turn, can affect organisational performance (Table  7 ).

To the best of the authors’ knowledge, this paper appears to be the first systematic review of the dimensions of job performance in healthcare, given that the study selection research process only produced one study that examine frameworks on job performance in healthcare. This one exception concerns Greenslade and Jimmieson’s framework; however, their study focuses specifically on nurses and thus is not broadly applicable to the field of healthcare [ 10 ]. The review in the instant paper also provides an important contribution by gathering knowledge on job performance in healthcare through an examination of articles published in 76 different journals. Most of these studies were conducted in single countries and often within the same types of healthcare organisations, which limits their generalisability. The interest in job performance in developing countries has only become apparent over the last decade. The methodological quality of the sample studies was assessed, revealing that most studies met the minimum required score. Although this minimum score was required, there is room for improvement in the literature, as over 60% of the studies suffer from selective outcome reporting due to the unavailability of study protocols. Along with improving generalisability, these issues should be considered in future research on this topic.

Studies concerning job performance in healthcare tend to apply at least one of the four dimensions of job performance. Studies without a direct reference to the task, contextual, or adaptive performance or counterproductive work behaviour dimensions offer descriptions of the activities, skills, and behaviours of healthcare employees. Based on the definitions of the dimensions, these activities, skills, and behaviours are attributable to at least one of the dimensions of job performance. Therefore, future studies about job performance in healthcare could be built on these dimensions.

Although the four dimensions do appear in healthcare literature concerning job performance, there is a discrepancy in the extent to which the dimensions have been studied. Task performance (49%) and contextual performance (39%) have been exhaustively investigated, whereas adaptive performance (8%) – which is also of great importance in constantly changing environments such as healthcare – appears to be under-researched. The same is true of the counterproductive work behaviour dimension, which can have a substantial and negative effect on job performance. Authors should consider this gap in job performance research in future research endeavours.

This review shows that scholars have studied the dimensions in different types of healthcare organisations and with reference to a variety of healthcare professionals. The main type of healthcare organisation the studies examine is hospitals and the departments and wards within them. About 22% of the studies were conducted in nursing homes, community centres, and home care organisations (among other organisations). Because most studies were conducted in hospitals, it was expected that most of the surveyed professionals would be physicians (26%) and nurses (52%). Other professionals the studies examine include mental healthcare professionals, psychologists, pharmacists, lab technicians, and supervisors. Consequently, the results show that the task, contextual, and adaptive performance and counterproductive work behaviour dimensions all apply to the broad field of healthcare and pertain to professions that exist within the healthcare sector. As such, these dimensions are useful for examining job performance in the broad context of healthcare and healthcare professionals.

This research not only investigated which dimensions of job performance can be used in the context of healthcare but also how and at what level these dimensions could be affected. The results show that the job performance of healthcare professionals can be affected on three levels. On the macro-level, the structure of an organisation, support for the board among an organisation’s employees, and organisational culture are examples of factors that affect job performance. At the meso-level, job performance can be affected to how management acts, how work is organised, and how teams function. On the micro-level, job performance is affected by employee motivation, the educational levels of the professionals in question, and employees’ personal characteristics. These levels are interdependent. Thus, organisations cannot simply improve the job performance of healthcare professionals in isolation from other efforts, and research aimed at improving job performance must be conducted with reference to these three levels. Given the apparently limited research regarding the adaptive performance and counterproductive work behaviour dimensions in healthcare, this paper suggests researchers investigate these dimensions with reference to the factors at the aforementioned levels to influence these dimensions.

Limitations

The review set out in this paper has a few limitations. First, it is not certain that the review identified and covered all studies concerning job performance in healthcare. One reason for this is the fact that only English articles were eligible for inclusion based on the eligibility criteria. By including studies that were conducted in non-English speaking regions and in both developed and developing countries, this paper tries to reduce the impact of this potential limitation. Second, since the search criteria focused on at least one of the four dimensions, there is a possibility that other potential dimensions may not have emerged from the results. A possible third limitation is based on the fact that job performance is described in many ways, and there are many different terms that could be related to dimensions of job performance. Finally, the ratio between studies that were conducted in developed and developing countries within the sample implies a validation risk. However, studies that were conducted in either developed or developing countries are referred to in Greenslade and Jimmieson’s [ 10 ] and Motowidlo et al. [ 11 ] works. Despite these limitations, the findings in this review provide support for further research on job performance in healthcare.

This research aimed to provide a concept that can be used for research on job performance in healthcare. Based on an examination of more than 90 studies published in over 70 journals, this research shows that job performance in healthcare can be conceptualised into four dimensions: task, contextual, and adaptive performance, and counterproductive work behaviour. While some of the studies directly refer to these dimensions, other studies describe tasks, skills, and behaviours without making direct reference to the four dimensions. However, these tasks, skills, and behaviours were assigned to one of the dimensions of job performance if they were in alignment with their definitions. In healthcare studies on job performance, the focus is on task and contextual performance. However, adaptive performance, which is of great importance in a constantly changing environment, is under-researched and should be considered a topic for future research. This is also suggested for the counterproductive work behaviour dimension. To improve job performance, interventions – in conjunction with one another – are required on the macro-, meso-, and micro-levels, which concern governance, leadership, and individual skills and characteristics.

Availability of data and materials

Data is available at https://osf.io/xn9r4/?view_only=aa9cf6c701644e1bac7bc30d853877be

Abbreviations

Controlled Before After

Cluster-Randomised Controlled Trial

Integrated quality Criteria for the Review Of Multiple Study designs

Not Controlled Before After

Non-Cotrolled Interrupted Time Series

Organisation for Economic Cooperation and Development

Open Science Framework

Preferred Reporting Items for Systematic Review and Meta-Analyses

Randomised Controlled Trial

OECD. Health at a Glance 2019 [Internet]. OECD iLibrary. OECD; 2019. 150–151 p. (Health at a Glance). Available from: https://edu.nl/evgen .

Becton JB, Matthews MC, Hartley DL, Whitaker DH. Using biodata to predict turnover, organizational commitment, and job performance in healthcare. Int J Sel Assess 2009 ;17(2):189–202. https://doi.org/ https://doi.org/10.1111/j.1468-2389.2009.00462.x

Huber M, Orosz E. Health expenditure trends in OECD countries, 1990-2001. Health Care Financ Rev. 2003;25(1):1-22.

Heilmann P. Review article: to have and to hold: personnel shortage in a Finnish healthcare organisation. Scand J Public Health. 2010;38(5):518–23 Available from: http://journals.sagepub.com/doi/10.1177/1403494810370231 . https://doi.org/10.1177/1403494810370231 .

Article   PubMed   Google Scholar  

Iacobucci G. Ongoing GP shortage puts NHS long term plan at risk, warn experts. BMJ. 2019;364 https://doi.org/10.1136/bmj.l686 .

Viswesvaran C, Ones DS. Perspectives on models of job performance. Int J Sel Assess. 2000;8(4):216–26 https://doi.org/10.1111/1468-2389.00151 .

Article   Google Scholar  

Kahya E. The effects of job performance on effectiveness. Int J Ind Ergon. 2009;39(1):96–104 https://doi.org/10.1016/j.ergon.2008.06.006 .

Varela OE, Landis RS. A general structure of job performance: evidence from two studies. J Bus Psychol. 2010;25(4):625–38 https://doi.org/10.1007/s10869-010-9155-8 .

Koopmans L, Bernaards CM, Hildebrandt VH, Schaufeli WB, de Vet Henrica CW, van der Beek AJ. Conceptual frameworks of individual work performance. J Occup Environ Med. 2011;53(8):856–66 https://doi.org/10.1097/JOM.0b013e318226a763 .

Greenslade JH, Jimmieson NL. Distinguishing between task and contextual performance for nurses: development of a job performance scale. J Adv Nurs. 2007;58(6):602–11 https://doi.org/10.1111/j.1365-2648.2007.04256.x .

Motowidlo SJ, Borman WC, Schmit MJ. A theory of individual differences in task and contextual performance. Hum Perform. 1997;10(2):71–83 https://doi.org/10.1207/s15327043hup1002_1 .

Arvey RD, Murphy KR. Performance evaluation in work settings. Annu Rev Psychol. 1998;49(1):141–68 https://doi.org/10.1146/annurev.psych.49.1.141 .

Article   CAS   PubMed   Google Scholar  

Hattrup K, Rock J, Scalia C. The effects of varying conceptualizations of job performance on adverse impact, minority hiring, and predicted performance. J Appl Psychol. 1997;82(5):656–64 https://doi.org/10.1037/0021-9010.82.5.656 .

Jawahar IM, Meurs JA, Ferris GR, Hochwarter WA. Self-efficacy and political skill as comparative predictors of task and contextual performance: a two-study constructive replication. Hum Perform. 2008;21(2):138–57 https://doi.org/10.1080/08959280801917685 .

Conway JM. Additional construct validity evidence for the task/contextual performance distinction. Hum Perform. 1996;9(4):309–29 https://doi.org/10.1207/s15327043hup0904_1 .

Murphy KR. Dimensions of job performance. Test Theor Appl Perspect. 1989;(619) https://doi.org/10.21236/ADA194951 .

Campbell JP. Modeling the performance prediction problem in industrial and organizational psychology. In: Dunnette MD, Hough LM, editors. Handbook of industrial and organizational psychology: Consulting Psychologists Press; 1990. p. 687–732.

Google Scholar  

Bakker AB, Demerouti E, Verbeke W. Using the job demands-resources model to predict burnout and performance. Hum Resour Manage. 2004;43(1) https://doi.org/10.1002/hrm.20004 .

Borman WC, Brush DH. More Progress toward a taxonomy of managerial performance requirements. Hum Perform. 1993;6(1) https://doi.org/10.1207/s15327043hup0601_1 .

Engelbrecht AS, Fischer AH. The managerial performance implications of a developmental assessment center process. Hum Relations. 1995;48(4) https://doi.org/10.1177/001872679504800405 .

Fluegge ER. Who put the fun in functional? Fun at work and its effects on job performance. Dissertation Abstr Int Sect A Hum Soc Sci. 2009;69:2781.

Maxham JG, Netemeyer RG, Lichtenstein DR. The retail value chain: linking employee perceptions to employee performance, customer evaluations, and store performance. Mark Sci. 2008;27(2) https://doi.org/10.1287/mksc.1070.0282 .

Wisecarver MM, Carpenter TD, Kilcullen RN. Capturing interpersonal performance in a latent performance model. Mil Psychol. 2007;19(2) https://doi.org/10.1080/08995600701323376 .

Griffin B, Hesketh B. Adaptable Behaviours for successful work and career adjustment. Aust J Psychol. 2003; https://doi.org/10.1080/00049530412331312914 .

Johnson JW. The relative importance of task and contextual performance dimensions to supervisor judgments of overall performance. J Appl Psychol. 2001;86(5):984–96 https://doi.org/10.1037/0021-9010.86.5.984 .

Allworth E, Hesketh B. Construct-oriented biodata: capturing change-related and contextually relevant future performance. Int J Sel Assess. 1999;7(2) https://doi.org/10.1111/1468-2389.00110 .

Pulakos ED, Arad S, Donovan MA, Plamondon KE. Adaptability in the workplace: development of a taxonomy of adaptive performance. J Appl Psychol. 2000;85(4):612–24 https://doi.org/10.1037/0021-9010.85.4.612 .

Sinclair RR, Tucker JS. Stress-Care: An integrated model of individual differences in soldier performance under stress. In: Military Life: The psychology of serving in peace and combat; 2006.

Hunt ST. Generic work behavior: an investigation into the dimensions of entry-level, hourly job performance. Pers Psychol. 1996;49(1) https://doi.org/10.1111/j.1744-6570.1996.tb01791.x .

Rotundo M, Sackett PR. The relative importance of task, citizenship, and counterproductive performance to global ratings of job performance: a policy-capturing approach. J Appl Psychol. 2002;87(1):66–80 https://doi.org/10.1037/0021-9010.87.1.66 .

Allen H. Using routinely collected data to augment the management of health and productivity loss. J Occup Environ Med. 2008;50(6) https://doi.org/10.1097/JOM.0b013e31817b610c .

Burton WN, Pransky G, Conti DJ, Chen CY, Edington DW. The association of medical conditions and presenteeism. J Occup Environ Med. 2004;46(6 SUPPL). https://doi.org/10.1097/01.jom.0000126687.49652.44 .

Escorpizo R. Understanding work productivity and its application to work-related musculoskeletal disorders. Int J Ind Ergon. 2008;38(3–4) https://doi.org/10.1016/j.ergon.2007.10.018 .

Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097 https://doi.org/10.1371/journal.pmed.1000097 .

Article   PubMed   PubMed Central   Google Scholar  

Mazur LM, Mosaly PR, Hoyle LM, Jones EL, Marks LB. Subjective and objective quantification of physician's workload and performance during radiation therapy planning tasks. Pract Radiat Oncol. 2013;3(4):e171–7 https://doi.org/10.1016/j.prro.2013.01.001 .

Paquay L, De Lepeleire J, Milisen K, Ylieff M, Fontaine O, Buntinx F. Tasks performance by registered nurses and care assistants in nursing homes: a quantitative comparison of survey data. Int J Nurs Stud. 2007;44(8):1459–67 https://doi.org/10.1016/j.ijnurstu.2007.02.003 .

Zingg W, Castro-Sanchez E, Secci FV, Edwards R, Drumright LN, Sevdalis N, et al. Innovative tools for quality assessment: integrated quality criteria for review of multiple study designs (ICROMS). Public Health. 2016;133:19–37 https://doi.org/10.1016/j.puhe.2015.10.012 .

Kmet LM, Lee RC, Cook LS. Standard quality assessment criteria for evaluating primary research papers from a variety of fields: HTA Initiative; 2004. Available from: https://edu.nl/fufru

Giorgi F, Mattei A, Notarnicola I, Petrucci C, Lancia L. Can sleep quality and burnout affect the job performance of shift-work nurses? A hospital cross-sectional study. J Adv Nurs. 2018;74(3):698–708 https://doi.org/10.1111/jan.13484 .

Haun S, Steinmetz H, Dormann C. Objective work-nonwork conflict: from incompatible demands to decreased work role performance. J Vocat Behav. 2011;79(2):578–87 https://doi.org/10.1016/j.jvb.2011.05.001 .

Velasquez D. The development and testing of a questionnaire to measure complexity of nursing work performed in nursing homes: NCCQ-NH. Geriatr Nurs (Minneap). 2007;28(2):90–8 https://doi.org/10.1016/j.gerinurse.2007.01.009 .

Beckman TJ, Reed DA, Shanafelt TD, West CP. Resident physician well-being and assessments of their knowledge and clinical performance. J Gen Intern Med. 2012;27(3):325–30 https://doi.org/10.1007/s11606-011-1891-6 .

Bemus AM, Lindley CM, Sawyer WT, McAllister JC 3rd. Task analysis of home care pharmacy. Am J Heal Pharm AJHP. 1996;53(23):2831–9 https://doi.org/10.1093/ajhp/53.23.2831 .

CAS   Google Scholar  

Rowan BH, Robinson J, Granato A, Bla CK, Kouyate S, Djety GV, et al. Workforce patterns in the prevention of mother to child transmission of HIV in cote d'Ivoire: a qualitative model. Hum Resour. Health. 2018;16(4) https://doi.org/10.1186/s12960-018-0268-x .

Ying L, Cohen A. Dark triad personalities and counterproductive work behaviors among physicians in China. Int J Health Plann Manag. 2018; https://doi.org/10.1002/hpm.2577 .

Yuan Y, Zhong S. The compensation plan on doctors considering the contextual performance. Vol. 281. In: Advances in intelligent systems and computing. Chengdu: Business School, Sichuan University; 2014. p. 1133–44. https://doi.org/10.1007/978-3-642-55122-2_98 .

Roche MA, Friedman S, Duffield C, Twigg DE, Cook R. A comparison of nursing tasks undertaken by regulated nurses and nursing support workers: a work sampling study. J Adv Nurs. 2017;73(6):1421–32 https://doi.org/10.1111/jan.13224 .

Chiocchio F, Lebel P, Dubé J-N. Informational role self-efficacy: a validation in interprofessional collaboration contexts involving healthcare service and project teams. BMC Health Serv Res. 2016;16(1):153 https://doi.org/10.1186/s12913-016-1382-x .

Muse LA, Wadsworth LL. An examination of traditional versus non-traditional benefits. J Manag Psychol. 2012;27(2):112–31 https://doi.org/10.1108/02683941211199527 .

Gagnon AJ, Waghorn K. Supportive care by maternity nurses: a work sampling study in an Intrapartum unit. Birth. 1996;23(1):1–6 https://doi.org/10.1111/j.1523-536X.1996.tb00453.x .

Barker LM, Nussbaum MA. The effects of fatigue on performance in simulated nursing work. Ergonomics. 2011;54(9):815–29 Available from: https://edu.nl/wpjav .

Calhoun AW, Boone MC, Dauer AK, Campbell DR, Montgomery VL. Using simulation to investigate the impact of hours worked on task performance in an intensice care unit. Am J Crit Care. 2014;23(5):387–95 https://doi.org/10.4037/ajcc2014756 .

Malik N. Authentic leadership - an antecedent for contextual performance of Indian nurses. Pers Rev. 2018;47(6):1248–64 https://doi.org/10.1108/PR-07-2016-0168 .

Becton JB, Carr JC, Mossholder KW, Walker HJ. Differential effects of task performance, organizational citizenship behavior, and job complexity on voluntary turnover. J Bus Psychol. 2017;32(4):495–508 https://doi.org/10.1007/s10869-016-9461-x .

Motowidlo SJ, Van Scotter JR. Evidence that task performance should be distinguished from contextual performance. J Appl Psychol. 1994;79(4):475–80 https://doi.org/10.1037/0021-9010.79.4.475 .

Bhatti MA, Alshagawi M, Syah JA. Mediating the role of work engagement between personal resources (self-efficacy, the big five model) and nurses' job performance. Int J Hum Rights Healthc. 2018;11(3):176–91 https://doi.org/10.1108/IJHRH-10-2017-0056 .

Gordon HJ, Demerouti E, Le Blanc PM, Bipp T. Job crafting and performance of Dutch and American health care professionals. J Pers Psychol. 2015;14(4):192–202 https://doi.org/10.1027/1866-5888/a000138 .

Tong L. Relationship between meaningful work and job performance in nurses. Int J Nurs Pract. 2018;24(2) https://doi.org/10.1111/ijn.12620 .

Binnewies C, Sonnentag S, Mojza EJ. Feeling recovered and thinking about the good sides of one's work. J Occup Health Psychol. 2009;14(3):243–56 https://doi.org/10.1037/a0014933 .

Yousaf A, Yang H, Sanders K. Effects of intrinsic and extrinsic motivation on task and contextual performance of Pakistani professionals. J Manag Psychol. 2015;30(2):133–50 https://doi.org/10.1108/JMP-09-2012-0277 .

Gabriel JMO. Supervisors' toxicity as predictor of subordinates' counter-productive work behavior in Nigerian public hospitals. J Appl Bus Res. 2016;32(5):1363–74 https://doi.org/10.19030/jabr.v32i5.9765 .

Lievens F, Conway JM, De Corte W. The relative importance of task, citizenship and counterproductive performance to job performance ratings: do rater source and team-based culture matter? J Occup Organ Psychol. 2008;81(1):11–27 https://doi.org/10.1348/096317907X182971 .

Hall LM, O'Brien-Pallas L. Redesigning nursing work in long-term care environments. Nurs Econ. 2000;18(2):79–87 Available from: https://edu.nl/3b84g .

CAS   PubMed   Google Scholar  

Weigl M, Müller A, Sevdalis N, Angerer P. Relationships of multitasking, physicians' strain, and performance: an observational study in ward physicians. J Patient Saf. 2013;9(1):18–23 https://doi.org/10.1097/PTS.0b013e31826b7b87 .

Qian S-Y, Yu P, Zhang Z-Y, Hailey DM, Davy PJ, Nelson MI. The work pattern of personal care workers in two Australian nursing homes: a time-motion study. BMC Health Serv Res. 2012;12(1) https://doi.org/10.1186/1472-6963-12-305 .

Chisholm CD, Collison EK, Nelson DR, Cordell WH. Emergency department workplace interruptions are emergency physicians 'Interrupt-driven' and 'Multitasking'? Acad Emerg Med. 2000;7(11):1239–43 Available from: http://doi.wiley.com/10.1111/j.1553-2712.2000.tb00469.x https://doi.org/10.1111/j.1553-2712.2000.tb00469.x .

Williams H, Harris R, Turner-Stokes L. Work sampling: a quantitative analysis of nursing activity in a neuro-rehabilitation setting. J Adv Nurs. 2009;65(10):2097–107 https://doi.org/10.1111/j.1365-2648.2009.05073.x .

Gardner G, Gardner A, Middleton S, Della P, Kain V, Doubrovsky A. The work of nurse practitioners. J Adv Nurs. 2010;66(10):2160–9 https://doi.org/10.1111/j.1365-2648.2010.05379.x .

Kitai E, Kushnir T, Herz M, Melamed S, Vigiser D, Granek M. Correlation off work structure and job satisfaction among israeli family physicians. Isr Med Assoc J. 1999;1(4):236–40.

Gordon HJ, Demerouti E, Le Blanc PM, Bakker AB, Bipp T, Verhagen MAMT. Individual job redesign: job crafting interventions in healthcare. J Vocat Behav. 2018;104:98–114 https://doi.org/10.1016/j.jvb.2017.07.002 .

Van Der Weide M, Smits J. Adoption of innovations by specialised nurses: personal, work and organisational characteristics. Health Policy (New York). 2004;68(1):81–92 https://doi.org/10.1016/j.healthpol.2003.09.007 .

Feys M, Anseel F, Wille B. Responses to co-workers receiving recognition at work. J Manag Psychol. 2013;28(5):492–510 https://doi.org/10.1108/JMP-08-2011-0025 .

Riskin A, Erez A, Foulk TA, Riskin-Geuz KS, Ziv A, Sela R, et al. Rudeness and medical team performance. Pediatrics. 2017;139(2):e20162305 https://doi.org/10.1542/peds.2016-2305 .

Cao CGL, Weinger MB, Slagle J, Zhou C, Ou J, Gillin S, et al. Differences in day and night shift clinical performance in anesthesiology. Hum Factors. 2008;50(2):276–90 https://doi.org/10.1518/001872008X288303 .

Markon MP, Chiocchio F, Fleury MJ. Modelling the effect of perceived interdependence among mental healthcare professionals on their work role performance. J Interprof Care. 2017;31(4):520–8 https://doi.org/10.1080/13561820.2017.1305951 .

Hamblin LE, Essenmacher L, Upfal MJ, Russell J, Luborsky M, Ager J, et al. Catalysts of worker-to-worker violence and incivility in hospitals. J Clin Nurs. 2015;24(17–18):2458–67 https://doi.org/10.1111/jocn.12825 .

Raglan GB, Margolis B, Paulus RA, Schulkin J. Obstetrician/Gynecologists' experiences with electronic health record systems: a narrative study. J Reprod Med. 2015;60(3–4):95–102 Available from: https://edu.nl/tugvf .

PubMed   Google Scholar  

Yousefi V. How Canadian hospitalists spend their time - a work-sampling study within a hospital medicine program in Ontario. J Clin Outcomes Manag. 2011;18(4):159–64.

Yule S, Flin R, Paterson-Brown S, Maran N, Rowley D. Development of a rating system for surgeons' non-technical skills. Med Educ. 2006;40(11):1098–104 https://doi.org/10.1111/j.1365-2929.2006.02610.x .

Bhatti MA, Mat N, Juhari AS. Effects of job resources factors on nurses job performance (mediating role of work engagement). Int J Health Care Qual Assur. 2018;31(8):1000–13 https://doi.org/10.1108/IJHCQA-07-2017-0129 .

Weigl M, Hoffmann F, Mueller A, Barth N, Angerer P. Hospital paediatricians' workflow interruptions, performance, and care quality: a unit-based controlled intervention. Eur J Pediatr. 2014;173(5):637–45 https://doi.org/10.1007/s00431-013-2232-z .

Rasmussen BH, Sandman PO. Nurses' work in a hospice and in an oncological unit in Sweden. Hosp J. 2000;15(1):53–75 https://doi.org/10.1080/0742-969X.2000.11882947 .

Pulich M, Tourigny L. Workplace deviance: strategies for modifying employee behavior. Health Care Manag (Frederick). 2004;23(4):290–301 https://doi.org/10.1097/00126450-200410000-00002 .

Higgins LW, Shovel JA, Bilderback AL, Lorenz HL, Martin SC, Rogers DJ, et al. Hospital nurses' work activity in a technology-rich environment: a triangulated quality improvement assessment. J Nurs Care Qual. 2017;32(3):208–17. https://doi.org/10.1097/NCQ.0000000000000237 .

Douglas S, Cartmill R, Brown R, Hoonakker P, Slagle J, Schultz Van Roy K, et al. The work of adult and pediatric intensive care unit nurses. Nurs Res. 2013;62(1):50–8 https://doi.org/10.1097/NNR.0b013e318270714b .

Wolff J, McCrone P, Patel A, Auber G, Reinhard T. A time study of physicians' work in a german university eye hospital to estimate unit costs. PLoS One. 2015;10(3) https://doi.org/10.1371/journal.pone.0121910 .

Chui MA, Look KA, Mott DA. The association of subjective workload dimensions on quality of care and pharmacist quality of work life. Res Soc Adm Pharm. 2014;10(2):328–40 https://doi.org/10.1016/j.sapharm.2013.05.007 .

Irwin A, Weidmann AE. A mixed methods investigation into the use of non-technical skills by community and hospital pharmacists. Res Soc Adm Pharm. 2015;11(5):675–85 https://doi.org/10.1016/j.sapharm.2014.11.006 .

Article   CAS   Google Scholar  

Michie S, West MA. Managing people and performance: an evidence based framework applied to health service organizations. Int J Manag Rev. 2004;5-6(2):91–111 https://doi.org/10.1111/j.1460-8545.2004.00098.x .

Low YM, Sambasivan M, Ho JA. Impact of abusive supervision on counterproductive work behaviors of nurses. Asia Pacific J Hum Resour. 2019; https://doi.org/10.1111/1744-7941.12234 .

De Carlo NA, Dal Corso L, Falco A, Girardi D, Piccirelli A. To be, rather than to seem'; the impact of supervisor's ad personal responsibility on work engagement, job performance, and job satisfaction in a postive healthcare organization. TPM. 2016;23(4):561–80 https://edu.nl/84grd .

Chen FL, Chen KC, Chiou SY, Chen PY, Du ML, Tung TH. The longitudinal study for the work-related factors to job performance among nurses in emergency department. Medicine (Baltimore). 2019;98(12) https://doi.org/10.1097/MD.0000000000014950 .

Christensen T, Faxvaag A, Laerum H, Grimsmo A. Norwegians GPs' use of electronic patient record systems. Int J Med Inform. 2009;78(12):808–14 https://doi.org/10.1016/j.ijmedinf.2009.08.004 .

Estes BC. Abusive supervision and nursing performance. Nurs Forum. 2013;48(1):3–16 https://doi.org/10.1111/nuf.12004 .

Palenzuela P, Delgado N, Rodríguez JA. Exploring the relationship between contextual performance and burnout in healthcare professionals. J Work Organ Psychol. 2019;35(2):115–21 https://doi.org/10.5093/jwop2019a13 .

Gordon HJ, Demerouti E, Bipp T, Le Blanc PM. The job demands and resources decision making (JD-R-DM) model. Eur J Work Organ Psychol. 2015;24(1):44–58 https://doi.org/10.1080/1359432X.2013.842901 .

Pohl S, Dal Santo L, Battistelli A. Perceived organizational support, job characteristics and intrinsic motivation as antecedents of organizational citizenship behaviours of nurses. Int Rev Soc Psychol. 2012;25(3–4):39–52 Available from: https://edu.nl/e8978 .

Ugwu LI, Enwereuzor IK, Fimber US, Ugwu DI. Nurses' burnout and counterproductive work behavior in a Nigerian sample: the moderating role of emotional intelligence. Int J Africa Nurs Sci. 2017;7:106–13 https://doi.org/10.1016/j.ijans.2017.11.004 .

Download references

Acknowledgements

Not applicable.

This review has been realized without funding.

Author information

Authors and affiliations.

School of Governance, Utrecht University, Utrecht, The Netherlands

Marcel Krijgsheld & Lars G. Tummers

Department of Psychiatry, Brain Center, UMC, Utrecht, The Netherlands

Floortje E. Scheepers

You can also search for this author in PubMed   Google Scholar

Contributions

The work has been drafted by MK. MK also carried out the selection of the studies. LT and FS have reviewed the content of the work throughout the process. In addition, LT gave advice on methods that are most suitable for conducting a systematic review. LT also pointed out the tools to assess the methodological quality of the studies. MK carried out these assessments. In addition to the substantive review, FS has brought structure into the article. MK, LT and FS discussed the results and implications. All the authors have read and approved the manuscript.

Corresponding author

Correspondence to Marcel Krijgsheld .

Ethics declarations

Ethics approval and consent to participate, consent for publication, competing interests.

The authors declare that they have no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Search strategies

Scopus : (TITLE ({job} OR {work} OR “worker*” OR {personnel} OR {staff} OR {professionals} OR {performance}) AND TITLE ({healthcare} OR {health-care} OR doctor* OR nurse* OR {nursing} OR hospital* OR physician*) AND TITLE-ABS-KEY ({task performance} OR {contextual performance} OR {adaptive performance} OR {counterproductive} OR {counter-productive}).

Pubmed : (“Work Performance”[Mesh] OR work performance[tiab] OR job performance[tiab]) AND (Task*[tiab] OR Contextual[tiab] OR Adaptive[tiab] OR Counterproductive[tiab] OR counter-productive[tiab]) AND (“Health Personnel”[Mesh] OR health personnel[tiab] OR healthcare personnel[tiab] OR care personnel[tiab] OR care worker*[tiab] OR healthcare provider*[tiab] OR care provider*[tiab] OR healthcare worker*[tiab] OR caregiver*[tiab] OR medical staff[tiab] OR hospital staff[tiab] OR hospital personnel[tiab] OR nurse[tiab] OR nurses[tiab] OR doctor*[tiab] OR physician*[tiab]).

Web of Science : TS = (job OR work OR worker* OR personnel OR staff OR professionals) AND TS = (“task performance” OR “contextual performance” OR “adaptive performance” OR “counterproductive behavio$r”) AND TS = (care OR healthcare OR doctor* OR nurse* OR hospital* OR physician*).

Google Books : “job|work performance” “Task|contextual|adaptive performance”|Counterproductive intitle:healthcare|care|doctors|nurses|hospital|physicians intitle:performance|teamwork|competency|job|work|potential|professional|skill|behavior|behaviour.

Articles referred to in Tables  1 , 4 , 5 and 6

1. Bhatti, M. A., Mat, N., & Juhari, A. S. (2018). Effects of job resources factors on nurse’s job performance (mediating role of work engagement). International Journal of Health Care Quality Assurance , 31 (8), 1000–1013.

2. Malik, N. (2018). Authentic leadership an antecedent for contextual performance of Indian nurses. Personnel Review , 47 (6), 1244–1260.

3. Bhatti, M. A., Alshagawi, M., & Syah Juhari, A. (2018). Mediating the role of work engagement between personal resources (self-efficacy, the big five model) and nurses’ job performance. International Journal of Human Rights in Healthcare , 11 (3), 176–191.

4. Schenk, E., Schleyer, R., Jones, C. R., Fincham, S., Daratha, K. B., & Monsen, K. A. (2018). Impact of Adoption of a Comprehensive Electronic Health Record on Nursing Work and Caring Efficacy. CIN:Computers Informatics Nursing , 36 (7), 331–338.

5. Tong, L. (2018). Relationship between meaningful work and job performance in nurses. International Journal of Nursing Practice , 24 (2).

6. Gordon, H. J., Demerouti, E., Le Blanc, P. M., Bakker, A. B., Bipp, T., & Verhagen, M. A. M. T. (2018). Individual job redesign: Job crafting interventions in healthcare. Journal of Vocational Behavior , 104 , 98–114.

7. Ying, L., & Cohen, A. (2018). Dark triad personalities and counterproductive work behaviors among physicians in China. International Journal of Health Planning and Management .

8. Zawawi, A. A., & Nasurdin, A. M. (2017). The impact of task characteristics on the performance of nursing teams. International Journal of Nursing Sciences, 4 (3), 285–290.

9. Roche, M. A., Friedman, S., Duffield, C., Twigg, D. E., & Cook, R. (2017). A comparison of nursing tasks undertaken by regulated nurses and nursing support workers: a work sampling study. Journal of Advanced Nursing , 73 (6), 1421–1432.

10. Ugwu, L. I., Enwereuzor, I. K., Fimber, U. S., & Ugwu, D. I. (2017). Nurses’ burnout and counterproductive work behavior in a Nigerian sample: The moderating role of emotional intelligence. International Journal of Africa Nursing Sciences , 7 , 106–113.

11. Higgins, L. W., Shovel, J. A., Bilderback, A. L., Lorenz, H. L., Martin, S. C., Rogers, D. J., & Minnier, T. E. (2017). Hospital nurses’ work activity in a technology-rich environment: A triangulated quality improvement assessment. Journal of Nursing Care Quality , 32 (3), 208–217.

12. Gabriel, J. M. O. (2016). Supervisors’ toxicity as predictor of subordinates’ counter-productive work behavior in Nigerian public hospitals. Journal of Applied Business Research , 32 (5), 1363–1374.

13. Park, I. S., Suh, Y. O., Park, H. S., Ahn, S. Y., Kang, S. Y., & Ko, I. S. (2016). The job analysis of Korean nurses as a strategy to improve the Korean Nursing Licensing Examination. Journal of Educational Evaluation for Health Professions , 13 .

14. Wolff, J., McCrone, P., Patel, A., Auber, G., & Reinhard, T. (2015). A time study of physicians’ work in a german university eye hospital to estimate unit costs. PLoS ONE , 10 (3).

15. White, D. E., Jackson, K., Besner, J., & Norris, J. M. (2015). The examination of nursing work through a role accountability framework. Journal of Nursing Management , 23 (5), 604–612.

16. Brown, M., Shaw, D., Sharples, S., Jeune, I. L., & Blakey, J. (2015). A survey-based cross-sectional study of doctors’ expectations and experiences of non-technical skills for out of hours work. BMJ Open , 5 (2).

17. Heydari, A., Mazloom, R., Najar, A. V, & Bakhshi, M. (2015). Awareness and performance of Iranian nurses with regard to health economics: A cross-sectional study. North American Journal of Medical Sciences , 7 (9), 384–389.

18. Hamblin, L. E., Essenmacher, L., Upfal, M. J., Russell, J., Luborsky, M., Ager, J., & Arnetz, J. E. (2015). Catalysts of worker-to-worker violence and incivility in hospitals. Journal of Clinical Nursing , 24 (17–18), 2458–2467.

19. Yuan, Y., & Zhong, S. (2014). The compensation plan on doctors considering the contextual performance. Advances in Intelligent Systems and Computing . Business School, Sichuan University, Chengdu, 610,065, China.

20. Yun, S., Kang, J., Lee, Y.-O., & Yi, Y. (2014). Work Environment and workplace bullying among Korean intensive care unit nurses. Asian Nursing Research , 8 (3), 219–225.

21. Weigl, M., Hoffmann, F., Mueller, A., Barth, N., & Angerer, P. (2014). Hospital paediatricians’ workflow interruptions, performance, and care quality: a unit-based controlled intervention. Europena Journal of Pediatrics , 173 (5), 637–645.

22. Weigl, M., Mueller, A., Sevdalis, N., & Angerer, P. (2013). Relationships of Multitasking, Physicians’ Strain, and Performance: An Observational Study in Ward Physicians. Journal of Patient Safety , 9 (1), 18–23.

23. Estes, B. C. (2013). Abusive Supervision and Nursing Performance. Nursing Forum , 48 (1), 3–16.

24. Douglas, S., Cartmill, R., Brown, R., Hoonakker, P., Slagle, J., Schultz Van Roy, K., … Carayon, P. (2013). The work of adult and pediatric intensive care unit nurses. Nursing Research , 62 (1), 50–58.

25. Anderson, D. R., St. Hilaire, D., & Flinter, M. (2012). Primary care nursing role and care coordination: An observational study of nursing work in a community health center. Online Journal of Issues in Nursing , 17 (2).

26. Qian, S.-Y., Yu, P., Zhang, Z.-Y., Hailey, D. M., Davy, P. J., & Nelson, M. I. (2012). The work pattern of personal care workers in two Australian nursing homes: A time-motion study. BMC Health Services Research , 12 (1).

27. Gimeno, D., Barrientos-Gutiãrrez, T., Burau, K. D., & Felknor, S. A. (2012). Safety climate and verbal abuse among public hospital-based workers in Costa Rica. Work , 42 (1), 29–38.

28. Hsiao, J.-L., & Chen, R.-F. (2012). An investigation on task-technology fit of mobile nursing information systems for nursing performance. CIN - Computers Informatics Nursing , 30 (5), 265–273.

29. Beckman, T. J., Reed, D. A., Shanafelt, T. D., & West, C. P. (2012). Resident physician well-being and assessments of their knowledge and clinical performance. Journal of General Internal Medicine , 27 (3), 325–330.

30. Abbey, M., Chaboyer, W., & Mitchell, M. (2012). Understanding the work of intensive care nurses: A time and motion study. Australian Critical Care , 25 (1), 13–22.

31. Westbrook, J. I., Duffield, C., Li, L., & Creswick, N. J. (2011). How much time do nurses have for patients? A longitudinal study quantifying hospital nurses’ patterns of task time distribution and interactions with health professionals. BMC Health Services Research , 11 .

32. Greenslade, J. H., & Jimmieson, N. L. (2011). Organizational factors impacting on patient satisfaction: A cross sectional examination of service climate and linkages to nurses’ effort and performance. International Journal of Nursing Studies , 48 (10), 1188–1198.

33. Barker, L. M., & Nussbaum, M. A. (2011). The effects of fatigue on performance in simulated nursing work. Ergonomics , 54 (9), 815–829.

34. Yousefi, V. (2011). How Canadian hospitalists spend their time - A work-sampling study within a hospital medicine program in Ontario. Journal of Clinical Outcomes Management , 18 (4), 159–164.

35. Gardner, G., Gardner, A., Middleton, S., Della, P., Kain, V., & Doubrovsky, A. (2010). The work of nurse practitioners. Journal of Advanced Nursing , 66 (10), 2160–2169.

36. Williams, H., Harris, R., & Turner-Stokes, L. (2009). Work sampling: A quantitative analysis of nursing activity in a neuro-rehabilitation setting. Journal of Advanced Nursing , 65 (10), 2097–2107.

37. Westbrook, J. I., Ampt, A., Kearney, L., & Rob, M. I. (2008). All in a day’s work: An observational study to quantify how and with whom doctors on hospital wards spend their time. Medical Journal of Australia , 188 (9), 506–509.

38. Paquay, L., De Lepeleire, J., Milisen, K., Ylieff, M., Fontaine, O., & Buntinx, F. (2007). Tasks performance by registered nurses and care assistants in nursing homes: A quantitative comparison of survey data. International Journal of Nursing Studies , 44 (8), 1459–1467.

39. Greenslade, J. H., & Jimmieson, N. L. (2007). Distinguishing between task and contextual performance for nurses: Development of a job performance scale. Journal of Advanced Nursing , 58 (6), 602–611.

40. Fawcett, J., Schutt, R. K., Gail, G. B., Cruz, E. R., & Woodford, M. L. (2007). The work of nurse case managers in a Cancer and Cardiovascular Disease Risk Screening Program. Professional Case Management , 12 (2), 93–105.

41. Velasquez, D. (2007). The development and testing of a questionnaire to measure complexity of nursing work performed in nursing homes: NCCQ-NH. Geriatric Nursing , 28 (2), 90–98.

42. Roud, D., Giddings, L. S., & Koziol-McLain, J. (2005). A longitudinal survey of nurses’ self-reported performance during an entry to practice programme. Nursing Praxis in New Zealand Inc. , 21 (2), 37–46.

43. Van Der Weide, M., & Smits, J. (2004). Adoption of innovations by specialised nurses: Personal, work and organisational characteristics. Health Policy , 68 (1), 81–92.

44. Ogata, Y., Kobayashi, Y., Fukuda, T., Mori, K., Hashimoto, M., & Otosaka, K. (2004). Measuring relative work values for home care nursing services in Japan. Nursing Research , 53 (3), 145–153.

45. Skilbeck, J., & Seymour, J. (2002). Meeting complex needs: an analysis of Macmillan nurses’ work with patients. International Journal of Palliative Nursing , 8 (12), 574–582.

46. Hall, L. M., & O’Brien-Pallas, L. (2000). Redesigning nursing work in long-term care environments. Nursing Economics , 18 (2), 79–87.

47. Rasmussen, B. H., & Sandman, P. O. (2000). Nurses’ work in a hospice and in an oncological unit in Sweden. The Hospice Journal , 15 (1), 53–75.

48. Kitai, E., Kushnir, T., Herz, M., Melamed, S., Vigiser, D., & Granek, M. (1999). Correlation off work structure and job satisfaction among israeli family physicians. Israel Medical Association Journal , 1 (4), 236–240.

49. Upenieks, V. V. (1998). Work sampling. Assessing nursing efficiency. Nursing Management , 29 (4), 27–29.

50. Kushnir, T., Melamed, S., & Ribak, J. (1997). Occupational physicians in Israel: Work structure, job and personal characteristics, and job satisfaction. Journal of Occupational and Environmental Medicine , 39 (9), 874–881.

51. Gagnon, A. J., & Waghorn, K. (1996). Supportive Care by Maternity Nurses: A Work Sampling Study in an Intrapartum Unit. Birth , 23 (1), 1–6.

52. Giorgi, F., Mattei, A., Notarnicola, I., Petrucci, C., & Lancia, L. (2018). Can sleep quality and burnout affect the job performance of shift-work nurses? A hospital cross-sectional study. Journal of Advanced Nursing , 74 (3), 698–708.

53. Markon, M. P., Chiocchio, F., & Fleury, M. J. (2017). Modelling the effect of perceived interdependence among mental healthcare professionals on their work role performance. Journal of Interprofessional Care , 31 (4), 520–528.

54. Irwin, A., & Weidmann, A. E. (2015). A mixed methods investigation into the use of non-technical skills by community and hospital pharmacists. Research in Social & Administrative Pharmacy: RSAP , 11 (5), 675–685.

55. Binnewies, C., Sonnentag, S., & Mojza, E. J. (2009). Feeling recovered and thinking about the good sides of one’s work. Journal of Occupational Health Psychology , 14 (3), 243–256.

56. Pulich, M., & Tourigny, L. (2004). Workplace deviance: strategies for modifying employee behavior. The Health Care Manager , 23 (4), 290–301.

57. Bemus, A. M., Lindley, C. M., Sawyer, W. T., & McAllister III, J. C. (1996). Task analysis of home care pharmacy. American journal of health-system pharmacy , 53(23), 2831–2839.

58. Schweikhart, S. B. (1996). Reengineering the work of caregivers: role redefinition, team structures, and organizational redesign. Hospital & Health Services Administration , 41 (1), 19–36.

59. Bugaj, T. J., Nikendei, C., Groener, J. B., Stiepak, J., Huber, J., Moeltner, A., … Koechel, A. (2018). Ready to run the wards? - A descriptive follow-up study assessing future doctors’ clinical skills. BMC Medical Education , 18 (257), 1–8.

60. Seren, A. K. H., Tuna, R., & Bacaksiz, F. E. (2018) Reliability and Validity of the Turkish Version of the Job Performance Scale Instrument. Journal of Nursing Research,26 (1), 27–35.

61. Rowan, B. H., Robinson, J., Granato, A., Bla, C. K., Kouyate, S., Djety, G. V., … Gloyd, S. (2018). Workforce patterns in the prevention of mother to child transmission of HIV in Cote d’Ivoire: a qualitative model. Human Resources Health,16 (4).

62. Becton, J. B., Carr, J. C., Mossholder, K. W., & Walker, H. J. (2017). Differential Effects of Task Performance, Organizational Citizenship Behavior, and Job Complexity on Voluntary Turnover. Journal of Business and Psychology , 3 (4), 495–508.

63. Riskin, A., Erez, A., Foulk, T. A., Riskin-Geuz, K. S., Ziv, A., Sela, R., … Bamberger, P. A. (2017). Rudeness and Medical Team Performance. Pediatrics , 139 (2).

64. De Carlo, N. A., Dal Corso, L., Falco, A., Girardi, D., & Piccirelli, A. (2016). ``To be, rather than to seem”: The impact of supervisor’s and personal responsibility on work engagement, job performance, and job satisfaction in a positive healthcare organization. TPM:Testing, Psychometrics, Methodology in Applied Psychology , 23 (4), 561–580.

65. Chiocchio, F., Lebel, P., & Dube, J.-N. (2016). Informational role self-efficacy: a validation in interprofessional collaboration contexts involving healthcare service and project teams. BMC Health Services Research , 16 (1) 153.

66. Raglan, G. B., Margolis, B., Paulus, R. A., & Schulkin, J. (2015). Obstetrician/Gynecologists’ Experiences with Electronic Health Record Systems: A Narrative Study. Journal of Reproductive Medicine , 60 (3–4), 95–102.

67. Gordon, H. J., Demerouti, E., Bipp, T., & Le Blanc, P. M. (2015). The Job Demands and Resources Decision Making (JD-R-DM) Model. European Journal of Work and Organizational Psychology , 24 (1), 44–58.

68. Gordon, H. J., Demerouti, E., Le Blanc, P. M., Bakker, A. B., Bipp, T., & Verhagen, M. A. M. T. (2018). Individual job redesign: Job crafting interventions in healthcare. Journal of Vocational Behavior , 104 , 98–114.

69. Yousaf, A., Yang, H., & Sanders, K. (2015). Effects of intrinsic and extrinsic motivation on task and contextual performance of Pakistani professionals. Journal of Managerial Psychology , 30 (2), 133–150.

70. Calhoun, A. W., Boone, M. C., Dauer, A. K., Campbell, D. R., & Montgomery, V. L. (2014). Using simulation to investigate the impact of hours worked on task performance in an intensive care unit. American Journal of Critical Care , 23 (5), 387–395.

71. Chui, M. A., Look, K. A., & Mott, D. A. (2014). The association of subjective workload dimensions on quality of care and pharmacist quality of work life. Research in Social & Administrative Pharmacy , 10 (2), 328–340.

72. Feys, M., Anseel, F., & Wille, B. (2013). Responses to co-workers receiving recognition at work. Journal of Managerial Psychology, 28 (5), 492–510.

73. Pohl, S., Dal Santo, L., & Battistelli, A. (2012). Perceived organizational support, job characteristics and intrinsic motivation as antecedents of organizational citizenship behaviours of nurses. Revue internationale de psychologie sociale , 25 (3), 39–52.

74. Flowerdew, L., Brown, R., Vincent, C., & Woloshynowych, M. (2012). Development and Validation of a Tool to Assess Emergency Physicians’ Nontechnical Skills. ANNALS.

75. Muse, L. A., & Wadsworth, L. L. (2012). An examination of traditional versus non-traditional benefits. Journal of Managerial Psychology, 27 (2), 112–131.

76. Viitanen, J., Hypponen, H., Laaveri, T., Vanska, J., Reponen, J., & Winblad, I. (2011). National questionnaire study on clinical ICT systems proofs: Physicians suffer from poor usability. International Journal of Medical Informatics , 80 (10), 708–725.

77. Haun, S., Steinmetz, H., & Dormann, C. (2011). Objective work-nonwork conflict: From incompatible demands to decreased work role performance. Journal of Vocational Behavior , 79 (2), 578–587.

78. Veloski, J., Boex, J. R., Grasberger, M. J., Evans, A., & Wolfson, D. W. (2006). Systematic review of the literature on assessment, feedback and physicians’ clinical performance*: BEME Guide No. 7. Medical Teacher , 28 (2), 117–128.

79. Christensen, T., Faxvaag, A., Laerum, H., & Grimsmo, A. (2009). Norwegians GPs’ use of electronic patient record systems. International Journal of Medical Informatics, 78 (12), 808–814.

80. Weigl, M., Mueller, A., Zupanc, A., & Angerer, P. (2009). Participant observation of time allocation, direct patient contact and simultaneous activities in hospital physicians. BMC Health Services Research , 9 (1)110.

81. Johnson, J., Truxillo, D. M., Erdogan, B., Bauer, T. N., & Hammer, L. (2009). Perceptions of Overall Fairness: Are Effects on Job Performance Moderated by Leader-Member Exchange? Human Performance, 22 (5), 432–449.

82. Caldwell, B. S. (2008). Knowledge sharing and expertise coordination of event response in organizations. Applied Ergonomics , 39 , 427–438.

83. Cao, C. G. L., Weinger, M. B., Slagle, J., Zhou, C., Ou, J., Gillin, S., … Mazzei, W. (2008). Differences in day and night shift clinical performance in anesthesiology. Human Factors , 50 (2), 276–290.

84. Rotundo, M. (2002). The relative importance of task, citizenship, and counterproductive performance to global ratings of job performance: a policy-capturing approach. The Journal of Applied Psychology , 87 (1), 66–80.

85. Tang, Z., Weavind, L., Mazabob, J., Thomas, E. J., Chu-Weininger, M. Y. L., & Johnson, T. R. (2007). Workflow in intensive care unit remote monitoring: A time-and-motion study. Critical Care Medicine, 35 (9), 2057–2063.

86. Yule, S., Flin, R., Paterson-Brown, S., Maran, N., & Rowley, D. (2006). Development of a rating system for surgeons’ non-technical skills. Medical Education, 40 (11), 1098–1104.

87. Chisholm, C. D., Collison, E. K., Nelson, D. R., & Cordell, W. H. (2000). Emergency department workplace interruptions: Are emergency physicians ``interrupt-driven” and ``multitasking”? Academic Emergency Medicine, 7 (11), 1239–1243.

88. Westbrook, J. I., Li, L., Shah, S., Lehnbom, E. C., Prgomet, M., Schofield, B., ... & Sheikh, A. (2019). A cross-country time and motion study to measure the impact of electronic medication management systems on the work of hospital pharmacists in Australia and England. International Journal of Medical Informatics .

89. Chen, F. L., Chen, K. C., Chiou, S. Y., Chen, P. Y., Du, M. L., & Tung, T. H. (2019). The longitudinal study for the work-related factors to job performance among nurses in emergency department. Medicine , 98 (12), e14950.

90. Palenzuela, P., Delgado, N., & Rodríguez, J. A. (2019). Exploring the Relationship between Contextual Performance and Burnout in Healthcare Professionals. Journal of Work and Organizational Psychology, 35(2), 115–121.

91. Low, Y. M., Sambasivan, M., & Ho, J. A. (2019). Impact of abusive supervision on counterproductive work behaviors of nurses. Asia Pacific Journal of Human Resources.

92. Michie, S., & West, M. A. (2004). Managing people and performance: an evidence based framework applied to health service organizations. International journal of management reviews, 5(2), 91–111.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Krijgsheld, M., Tummers, L.G. & Scheepers, F.E. Job performance in healthcare: a systematic review. BMC Health Serv Res 22 , 149 (2022). https://doi.org/10.1186/s12913-021-07357-5

Download citation

Received : 09 September 2020

Accepted : 30 November 2021

Published : 04 February 2022

DOI : https://doi.org/10.1186/s12913-021-07357-5

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Systematic review
• Job performance
• Task performance
• Contextual performance
• Adaptive performance
• Counterproductive work behaviour

BMC Health Services Research

ISSN: 1472-6963

• General enquiries: [email protected]

Help | Advanced Search

Computer Science > Artificial Intelligence

Title: inquire, interact, and integrate: a proactive agent collaborative framework for zero-shot multimodal medical reasoning.

Abstract: The adoption of large language models (LLMs) in healthcare has attracted significant research interest. However, their performance in healthcare remains under-investigated and potentially limited, due to i) they lack rich domain-specific knowledge and medical reasoning skills; and ii) most state-of-the-art LLMs are unimodal, text-only models that cannot directly process multimodal inputs. To this end, we propose a multimodal medical collaborative reasoning framework \textbf{MultiMedRes}, which incorporates a learner agent to proactively gain essential information from domain-specific expert models, to solve medical multimodal reasoning problems. Our method includes three steps: i) \textbf{Inquire}: The learner agent first decomposes given complex medical reasoning problems into multiple domain-specific sub-problems; ii) \textbf{Interact}: The agent then interacts with domain-specific expert models by repeating the ``ask-answer'' process to progressively obtain different domain-specific knowledge; iii) \textbf{Integrate}: The agent finally integrates all the acquired domain-specific knowledge to accurately address the medical reasoning problem. We validate the effectiveness of our method on the task of difference visual question answering for X-ray images. The experiments demonstrate that our zero-shot prediction achieves state-of-the-art performance, and even outperforms the fully supervised methods. Besides, our approach can be incorporated into various LLMs and multimodal LLMs to significantly boost their performance.

Submission history

Access paper:.

• HTML (experimental)
• Other Formats

References & Citations

• Google Scholar
• Semantic Scholar

BibTeX formatted citation

Bibliographic and Citation Tools

Code, data and media associated with this article, recommenders and search tools.

• Institution

arXivLabs: experimental projects with community collaborators

arXivLabs is a framework that allows collaborators to develop and share new arXiv features directly on our website.

Both individuals and organizations that work with arXivLabs have embraced and accepted our values of openness, community, excellence, and user data privacy. arXiv is committed to these values and only works with partners that adhere to them.

Have an idea for a project that will add value for arXiv's community? Learn more about arXivLabs .

Special Issue on Education | Education Collection

The “Special Issue on Education”, featured within the International Journal of Research and Innovation in Social Science, serves as a dynamic platform to explore and discuss cutting-edge developments in the realm of education.

Call For Paper

Embrace the opportunity to showcase your research and insights in our forthcoming Special Issue on Education. We invite submissions from scholars and educators across diverse disciplines. By contributing to this Special Issue, you’ll be part of a collaborative effort to advance knowledge and influence the future of education. Join us in shaping the discourse and submit your work for a chance to be featured in this enriching publication.

20th May 2024

Special Issue Themes

Special Issue on Education (Education Collection) comprises the following specialized topics

Explores the significance of education for both individuals and society

82 ( Total)

Authors from 40+Countries

Published Articles

Publication Timeline

Time to First Decision

Review Time

Submission to Acceptance

Acceptance to Publication

Latest Articles

Determinants of cash waqf donation to support islamic schools in thailand, delinquency among university students and parenting attitudes in kenya, most viewed articles.

United Kingdom

An Analysis of the Impact of Motivation on Employee Performance: A Case Study of Selected Private Universities in Lusaka

Submit your Paper

Most Cited Article

Students’ perception of online learning during covid-19 pandemic: a survey study of it students, effectiveness of google classroom as a digital tool in teaching and learning: students’ perceptions.

Diverse Global Reviewer Network

Fostering Global Excellence

Total number of reviewers and the countries they are based in

SUBSCRIBE TO OUR NEWSLETTER.

Research area, you can mention multiple research areas in which you are willing to review the paper, subscribe to our newsletter.

Sign up for our newsletter, to get updates regarding the Call for Paper, Papers & Research.

Email Address * Subscribe

Track Your Paper

Enter the following details to get the information about your paper

• Computer Vision
• Federated Learning
• Reinforcement Learning
• Natural Language Processing
• New Releases
• AI Dev Tools
• Advisory Board Members
• 🐝 Partnership and Promotion

A detailed analysis showed that full finetuning resulted in weight perturbations that ranked 10 to 100 times greater than those typically used in LoRA configurations. For instance, full finetuning required ranks as high as 256, while LoRA configurations typically used ranks of 16 or 256. This significant difference in rank likely explains some of the performance gaps observed. The research indicated that LoRA’s lower rank perturbations contributed to maintaining more diverse output generations than full finetuning, often leading to limited solutions. This diversity in output is beneficial in applications requiring varied and creative solutions.

In conclusion, while LoRA is less effective than full finetuning in accuracy and sample efficiency, it offers significant advantages in regularization and memory efficiency. The study suggests that optimizing hyperparameters, such as learning rates and target modules, and understanding the trade-offs between learning and forgetting can enhance LoRA’s application to specific tasks. The research highlighted that although full finetuning generally performs better, LoRA’s ability to maintain the base model’s capabilities and generate diverse outputs makes it valuable in certain contexts. This research provides essential insights into balancing performance and computational efficiency in finetuning LLMs, offering a pathway for more sustainable and versatile AI development.

Check out the  Paper. All credit for this research goes to the researchers of this project. Also, don’t forget to follow us on  Twitter . Join our  Telegram Channel ,   Discord Channel , and  LinkedIn Gr oup .

If you like our work, you will love our  newsletter..

Don’t Forget to join our  42k+ ML SubReddit

Asif Razzaq

Asif Razzaq is the CEO of Marktechpost Media Inc.. As a visionary entrepreneur and engineer, Asif is committed to harnessing the potential of Artificial Intelligence for social good. His most recent endeavor is the launch of an Artificial Intelligence Media Platform, Marktechpost, which stands out for its in-depth coverage of machine learning and deep learning news that is both technically sound and easily understandable by a wide audience. The platform boasts of over 2 million monthly views, illustrating its popularity among audiences.

Gradient AI Introduces Llama-3 8B Gradient Instruct 1048k: Setting New Standards in Long-Context AI

• Abacus AI Releases Smaug-Llama-3-70B-Instruct: The New Benchmark in Open-Source Conversational AI Rivaling GPT-4 Turbo
• Meet Verba 1.0: Run State-of-the-Art RAG Locally with Ollama Integration and Open Source Models
• Researchers from Cerebras & Neural Magic Introduce Sparse Llama: The First Production LLM based on Llama at 70% Sparsity

RELATED ARTICLES MORE FROM AUTHOR

Researchers from the university of maryland introduce an automatic text privatization framework that fine-tunes a large language model via reinforcement learning, the ai-powered code revolution: bridging traditional and neurosymbolic programming, empowering developers and non-coders alike to build interactive web applications effortlessly, this ai paper from kaust and purdue university presents efficient stochastic methods for large discrete action spaces, enhancing tensor contraction paths using a modified standard greedy algorithm with improved cost function, researchers from the university of maryland introduce an automatic text privatization framework that fine-tunes..., this ai paper from kaust and purdue university presents efficient stochastic methods for large....

• AI Magazine
• Privacy & TC
• Cookie Policy

🐝 🐝 Join the Fastest Growing AI Research Newsletter Read by Researchers from Google + NVIDIA + Meta + Stanford + MIT + Microsoft and many others...

Thank You 🙌

Privacy Overview

McKinsey Global Private Markets Review 2024: Private markets in a slower era

At a glance, macroeconomic challenges continued.

McKinsey Global Private Markets Review 2024: Private markets: A slower era

If 2022 was a tale of two halves, with robust fundraising and deal activity in the first six months followed by a slowdown in the second half, then 2023 might be considered a tale of one whole. Macroeconomic headwinds persisted throughout the year, with rising financing costs, and an uncertain growth outlook taking a toll on private markets. Full-year fundraising continued to decline from 2021’s lofty peak, weighed down by the “denominator effect” that persisted in part due to a less active deal market. Managers largely held onto assets to avoid selling in a lower-multiple environment, fueling an activity-dampening cycle in which distribution-starved limited partners (LPs) reined in new commitments.

About the authors

This article is a summary of a larger report, available as a PDF, that is a collaborative effort by Fredrik Dahlqvist , Alastair Green , Paul Maia, Alexandra Nee , David Quigley , Aditya Sanghvi , Connor Mangan, John Spivey, Rahel Schneider, and Brian Vickery , representing views from McKinsey’s Private Equity & Principal Investors Practice.

Performance in most private asset classes remained below historical averages for a second consecutive year. Decade-long tailwinds from low and falling interest rates and consistently expanding multiples seem to be things of the past. As private market managers look to boost performance in this new era of investing, a deeper focus on revenue growth and margin expansion will be needed now more than ever.

Perspectives on a slower era in private markets

Global fundraising contracted.

Fundraising fell 22 percent across private market asset classes globally to just over $1 trillion, as of year-end reported data—the lowest total since 2017. Fundraising in North America, a rare bright spot in 2022, declined in line with global totals, while in Europe, fundraising proved most resilient, falling just 3 percent. In Asia, fundraising fell precipitously and now sits 72 percent below the region’s 2018 peak.

Despite difficult fundraising conditions, headwinds did not affect all strategies or managers equally. Private equity (PE) buyout strategies posted their best fundraising year ever, and larger managers and vehicles also fared well, continuing the prior year’s trend toward greater fundraising concentration.

The numerator effect persisted

Despite a marked recovery in the denominator—the 1,000 largest US retirement funds grew 7 percent in the year ending September 2023, after falling 14 percent the prior year, for example 1 “U.S. retirement plans recover half of 2022 losses amid no-show recession,” Pensions and Investments , February 12, 2024. —many LPs remain overexposed to private markets relative to their target allocations. LPs started 2023 overweight: according to analysis from CEM Benchmarking, average allocations across PE, infrastructure, and real estate were at or above target allocations as of the beginning of the year. And the numerator grew throughout the year, as a lack of exits and rebounding valuations drove net asset values (NAVs) higher. While not all LPs strictly follow asset allocation targets, our analysis in partnership with global private markets firm StepStone Group suggests that an overallocation of just one percentage point can reduce planned commitments by as much as 10 to 12 percent per year for five years or more.

Despite these headwinds, recent surveys indicate that LPs remain broadly committed to private markets. In fact, the majority plan to maintain or increase allocations over the medium to long term.

Investors fled to known names and larger funds

Fundraising concentration reached its highest level in over a decade, as investors continued to shift new commitments in favor of the largest fund managers. The 25 most successful fundraisers collected 41 percent of aggregate commitments to closed-end funds (with the top five managers accounting for nearly half that total). Closed-end fundraising totals may understate the extent of concentration in the industry overall, as the largest managers also tend to be more successful in raising non-institutional capital.

While the largest funds grew even larger—the largest vehicles on record were raised in buyout, real estate, infrastructure, and private debt in 2023—smaller and newer funds struggled. Fewer than 1,700 funds of less than $1 billion were closed during the year, half as many as closed in 2022 and the fewest of any year since 2012. New manager formation also fell to the lowest level since 2012, with just 651 new firms launched in 2023.

Whether recent fundraising concentration and a spate of M&A activity signals the beginning of oft-rumored consolidation in the private markets remains uncertain, as a similar pattern developed in each of the last two fundraising downturns before giving way to renewed entrepreneurialism among general partners (GPs) and commitment diversification among LPs. Compared with how things played out in the last two downturns, perhaps this movie really is different, or perhaps we’re watching a trilogy reusing a familiar plotline.

Dry powder inventory spiked (again)

Private markets assets under management totaled $13.1 trillion as of June 30, 2023, and have grown nearly 20 percent per annum since 2018. Dry powder reserves—the amount of capital committed but not yet deployed—increased to $3.7 trillion, marking the ninth consecutive year of growth. Dry powder inventory—the amount of capital available to GPs expressed as a multiple of annual deployment—increased for the second consecutive year in PE, as new commitments continued to outpace deal activity. Inventory sat at 1.6 years in 2023, up markedly from the 0.9 years recorded at the end of 2021 but still within the historical range. NAV grew as well, largely driven by the reluctance of managers to exit positions and crystallize returns in a depressed multiple environment.

Private equity strategies diverged

Buyout and venture capital, the two largest PE sub-asset classes, charted wildly different courses over the past 18 months. Buyout notched its highest fundraising year ever in 2023, and its performance improved, with funds posting a (still paltry) 5 percent net internal rate of return through September 30. And although buyout deal volumes declined by 19 percent, 2023 was still the third-most-active year on record. In contrast, venture capital (VC) fundraising declined by nearly 60 percent, equaling its lowest total since 2015, and deal volume fell by 36 percent to the lowest level since 2019. VC funds returned –3 percent through September, posting negative returns for seven consecutive quarters. VC was the fastest-growing—as well as the highest-performing—PE strategy by a significant margin from 2010 to 2022, but investors appear to be reevaluating their approach in the current environment.

Private equity entry multiples contracted

PE buyout entry multiples declined by roughly one turn from 11.9 to 11.0 times EBITDA, slightly outpacing the decline in public market multiples (down from 12.1 to 11.3 times EBITDA), through the first nine months of 2023. For nearly a decade leading up to 2022, managers consistently sold assets into a higher-multiple environment than that in which they had bought those assets, providing a substantial performance tailwind for the industry. Nowhere has this been truer than in technology. After experiencing more than eight turns of multiple expansion from 2009 to 2021 (the most of any sector), technology multiples have declined by nearly three turns in the past two years, 50 percent more than in any other sector. Overall, roughly two-thirds of the total return for buyout deals that were entered in 2010 or later and exited in 2021 or before can be attributed to market multiple expansion and leverage. Now, with falling multiples and higher financing costs, revenue growth and margin expansion are taking center stage for GPs.

Real estate receded

Demand uncertainty, slowing rent growth, and elevated financing costs drove cap rates higher and made price discovery challenging, all of which weighed on deal volume, fundraising, and investment performance. Global closed-end fundraising declined 34 percent year over year, and funds returned −4 percent in the first nine months of the year, losing money for the first time since the 2007–08 global financial crisis. Capital shifted away from core and core-plus strategies as investors sought liquidity via redemptions in open-end vehicles, from which net outflows reached their highest level in at least two decades. Opportunistic strategies benefited from this shift, with investors focusing on capital appreciation over income generation in a market where alternative sources of yield have grown more attractive. Rising interest rates widened bid–ask spreads and impaired deal volume across food groups, including in what were formerly hot sectors: multifamily and industrial.

Private debt pays dividends

Debt again proved to be the most resilient private asset class against a turbulent market backdrop. Fundraising declined just 13 percent, largely driven by lower commitments to direct lending strategies, for which a slower PE deal environment has made capital deployment challenging. The asset class also posted the highest returns among all private asset classes through September 30. Many private debt securities are tied to floating rates, which enhance returns in a rising-rate environment. Thus far, managers appear to have successfully navigated the rising incidence of default and distress exhibited across the broader leveraged-lending market. Although direct lending deal volume declined from 2022, private lenders financed an all-time high 59 percent of leveraged buyout transactions last year and are now expanding into additional strategies to drive the next era of growth.

Infrastructure took a detour

After several years of robust growth and strong performance, infrastructure and natural resources fundraising declined by 53 percent to the lowest total since 2013. Supply-side timing is partially to blame: five of the seven largest infrastructure managers closed a flagship vehicle in 2021 or 2022, and none of those five held a final close last year. As in real estate, investors shied away from core and core-plus investments in a higher-yield environment. Yet there are reasons to believe infrastructure’s growth will bounce back. Limited partners (LPs) surveyed by McKinsey remain bullish on their deployment to the asset class, and at least a dozen vehicles targeting more than $10 billion were actively fundraising as of the end of 2023. Multiple recent acquisitions of large infrastructure GPs by global multi-asset-class managers also indicate marketwide conviction in the asset class’s potential.

Private markets still have work to do on diversity

Private markets firms are slowly improving their representation of females (up two percentage points over the prior year) and ethnic and racial minorities (up one percentage point). On some diversity metrics, including entry-level representation of women, private markets now compare favorably with corporate America. Yet broad-based parity remains elusive and too slow in the making. Ethnic, racial, and gender imbalances are particularly stark across more influential investing roles and senior positions. In fact, McKinsey’s research  reveals that at the current pace, it would take several decades for private markets firms to reach gender parity at senior levels. Increasing representation across all levels will require managers to take fresh approaches to hiring, retention, and promotion.

Artificial intelligence generating excitement

The transformative potential of generative AI was perhaps 2023’s hottest topic (beyond Taylor Swift). Private markets players are excited about the potential for the technology to optimize their approach to thesis generation, deal sourcing, investment due diligence, and portfolio performance, among other areas. While the technology is still nascent and few GPs can boast scaled implementations, pilot programs are already in flight across the industry, particularly within portfolio companies. Adoption seems nearly certain to accelerate throughout 2024.

Private markets in a slower era

If private markets investors entered 2023 hoping for a return to the heady days of 2021, they likely left the year disappointed. Many of the headwinds that emerged in the latter half of 2022 persisted throughout the year, pressuring fundraising, dealmaking, and performance. Inflation moderated somewhat over the course of the year but remained stubbornly elevated by recent historical standards. Interest rates started high and rose higher, increasing the cost of financing. A reinvigorated public equity market recovered most of 2022’s losses but did little to resolve the valuation uncertainty private market investors have faced for the past 18 months.

Within private markets, the denominator effect remained in play, despite the public market recovery, as the numerator continued to expand. An activity-dampening cycle emerged: higher cost of capital and lower multiples limited the ability or willingness of general partners (GPs) to exit positions; fewer exits, coupled with continuing capital calls, pushed LP allocations higher, thereby limiting their ability or willingness to make new commitments. These conditions weighed on managers’ ability to fundraise. Based on data reported as of year-end 2023, private markets fundraising fell 22 percent from the prior year to just over $1 trillion, the largest such drop since 2009 (Exhibit 1).

The impact of the fundraising environment was not felt equally among GPs. Continuing a trend that emerged in 2022, and consistent with prior downturns in fundraising, LPs favored larger vehicles and the scaled GPs that typically manage them. Smaller and newer managers struggled, and the number of sub–$1 billion vehicles and new firm launches each declined to its lowest level in more than a decade.

Despite the decline in fundraising, private markets assets under management (AUM) continued to grow, increasing 12 percent to $13.1 trillion as of June 30, 2023. 2023 fundraising was still the sixth-highest annual haul on record, pushing dry powder higher, while the slowdown in deal making limited distributions.

Investment performance across private market asset classes fell short of historical averages. Private equity (PE) got back in the black but generated the lowest annual performance in the past 15 years, excluding 2022. Closed-end real estate produced negative returns for the first time since 2009, as capitalization (cap) rates expanded across sectors and rent growth dissipated in formerly hot sectors, including multifamily and industrial. The performance of infrastructure funds was less than half of its long-term average and even further below the double-digit returns generated in 2021 and 2022. Private debt was the standout performer (if there was one), outperforming all other private asset classes and illustrating the asset class’s countercyclical appeal.

Private equity down but not out

Higher financing costs, lower multiples, and an uncertain macroeconomic environment created a challenging backdrop for private equity managers in 2023. Fundraising declined for the second year in a row, falling 15 percent to $649 billion, as LPs grappled with the denominator effect and a slowdown in distributions. Managers were on the fundraising trail longer to raise this capital: funds that closed in 2023 were open for a record-high average of 20.1 months, notably longer than 18.7 months in 2022 and 14.1 months in 2018. VC and growth equity strategies led the decline, dropping to their lowest level of cumulative capital raised since 2015. Fundraising in Asia fell for the fourth year of the last five, with the greatest decline in China.

Despite the difficult fundraising context, a subset of strategies and managers prevailed. Buyout managers collectively had their best fundraising year on record, raising more than $400 billion. Fundraising in Europe surged by more than 50 percent, resulting in the region’s biggest haul ever. The largest managers raised an outsized share of the total for a second consecutive year, making 2023 the most concentrated fundraising year of the last decade (Exhibit 2).

Despite the drop in aggregate fundraising, PE assets under management increased 8 percent to $8.2 trillion. Only a small part of this growth was performance driven: PE funds produced a net IRR of just 2.5 percent through September 30, 2023. Buyouts and growth equity generated positive returns, while VC lost money. PE performance, dating back to the beginning of 2022, remains negative, highlighting the difficulty of generating attractive investment returns in a higher interest rate and lower multiple environment. As PE managers devise value creation strategies to improve performance, their focus includes ensuring operating efficiency and profitability of their portfolio companies.

Deal activity volume and count fell sharply, by 21 percent and 24 percent, respectively, which continued the slower pace set in the second half of 2022. Sponsors largely opted to hold assets longer rather than lock in underwhelming returns. While higher financing costs and valuation mismatches weighed on overall deal activity, certain types of M&A gained share. Add-on deals, for example, accounted for a record 46 percent of total buyout deal volume last year.

Real estate recedes

For real estate, 2023 was a year of transition, characterized by a litany of new and familiar challenges. Pandemic-driven demand issues continued, while elevated financing costs, expanding cap rates, and valuation uncertainty weighed on commercial real estate deal volumes, fundraising, and investment performance.

Managers faced one of the toughest fundraising environments in many years. Global closed-end fundraising declined 34 percent to $125 billion. While fundraising challenges were widespread, they were not ubiquitous across strategies. Dollars continued to shift to large, multi-asset class platforms, with the top five managers accounting for 37 percent of aggregate closed-end real estate fundraising. In April, the largest real estate fund ever raised closed on a record $30 billion.

Capital shifted away from core and core-plus strategies as investors sought liquidity through redemptions in open-end vehicles and reduced gross contributions to the lowest level since 2009. Opportunistic strategies benefited from this shift, as investors turned their attention toward capital appreciation over income generation in a market where alternative sources of yield have grown more attractive.

In the United States, for instance, open-end funds, as represented by the National Council of Real Estate Investment Fiduciaries Fund Index—Open-End Equity (NFI-OE), recorded $13 billion in net outflows in 2023, reversing the trend of positive net inflows throughout the 2010s. The negative flows mainly reflected $9 billion in core outflows, with core-plus funds accounting for the remaining outflows, which reversed a 20-year run of net inflows.

As a result, the NAV in US open-end funds fell roughly 16 percent year over year. Meanwhile, global assets under management in closed-end funds reached a new peak of $1.7 trillion as of June 2023, growing 14 percent between June 2022 and June 2023.

Real estate underperformed historical averages in 2023, as previously high-performing multifamily and industrial sectors joined office in producing negative returns caused by slowing demand growth and cap rate expansion. Closed-end funds generated a pooled net IRR of −3.5 percent in the first nine months of 2023, losing money for the first time since the global financial crisis. The lone bright spot among major sectors was hospitality, which—thanks to a rush of postpandemic travel—returned 10.3 percent in 2023. 2 Based on NCREIFs NPI index. Hotels represent 1 percent of total properties in the index. As a whole, the average pooled lifetime net IRRs for closed-end real estate funds from 2011–20 vintages remained around historical levels (9.8 percent).

Global deal volume declined 47 percent in 2023 to reach a ten-year low of $650 billion, driven by widening bid–ask spreads amid valuation uncertainty and higher costs of financing (Exhibit 3). 3 CBRE, Real Capital Analytics Deal flow in the office sector remained depressed, partly as a result of continued uncertainty in the demand for space in a hybrid working world.

During a turbulent year for private markets, private debt was a relative bright spot, topping private markets asset classes in terms of fundraising growth, AUM growth, and performance.

Fundraising for private debt declined just 13 percent year over year, nearly ten percentage points less than the private markets overall. Despite the decline in fundraising, AUM surged 27 percent to $1.7 trillion. And private debt posted the highest investment returns of any private asset class through the first three quarters of 2023.

Private debt’s risk/return characteristics are well suited to the current environment. With interest rates at their highest in more than a decade, current yields in the asset class have grown more attractive on both an absolute and relative basis, particularly if higher rates sustain and put downward pressure on equity returns (Exhibit 4). The built-in security derived from debt’s privileged position in the capital structure, moreover, appeals to investors that are wary of market volatility and valuation uncertainty.

Direct lending continued to be the largest strategy in 2023, with fundraising for the mostly-senior-debt strategy accounting for almost half of the asset class’s total haul (despite declining from the previous year). Separately, mezzanine debt fundraising hit a new high, thanks to the closings of three of the largest funds ever raised in the strategy.

Over the longer term, growth in private debt has largely been driven by institutional investors rotating out of traditional fixed income in favor of private alternatives. Despite this growth in commitments, LPs remain underweight in this asset class relative to their targets. In fact, the allocation gap has only grown wider in recent years, a sharp contrast to other private asset classes, for which LPs’ current allocations exceed their targets on average. According to data from CEM Benchmarking, the private debt allocation gap now stands at 1.4 percent, which means that, in aggregate, investors must commit hundreds of billions in net new capital to the asset class just to reach current targets.

Private debt was not completely immune to the macroeconomic conditions last year, however. Fundraising declined for the second consecutive year and now sits 23 percent below 2021’s peak. Furthermore, though private lenders took share in 2023 from other capital sources, overall deal volumes also declined for the second year in a row. The drop was largely driven by a less active PE deal environment: private debt is predominantly used to finance PE-backed companies, though managers are increasingly diversifying their origination capabilities to include a broad new range of companies and asset types.

Infrastructure and natural resources take a detour

For infrastructure and natural resources fundraising, 2023 was an exceptionally challenging year. Aggregate capital raised declined 53 percent year over year to $82 billion, the lowest annual total since 2013. The size of the drop is particularly surprising in light of infrastructure’s recent momentum. The asset class had set fundraising records in four of the previous five years, and infrastructure is often considered an attractive investment in uncertain markets.

While there is little doubt that the broader fundraising headwinds discussed elsewhere in this report affected infrastructure and natural resources fundraising last year, dynamics specific to the asset class were at play as well. One issue was supply-side timing: nine of the ten largest infrastructure GPs did not close a flagship fund in 2023. Second was the migration of investor dollars away from core and core-plus investments, which have historically accounted for the bulk of infrastructure fundraising, in a higher rate environment.

The asset class had some notable bright spots last year. Fundraising for higher-returning opportunistic strategies more than doubled the prior year’s total (Exhibit 5). AUM grew 18 percent, reaching a new high of $1.5 trillion. Infrastructure funds returned a net IRR of 3.4 percent in 2023; this was below historical averages but still the second-best return among private asset classes. And as was the case in other asset classes, investors concentrated commitments in larger funds and managers in 2023, including in the largest infrastructure fund ever raised.

The outlook for the asset class, moreover, remains positive. Funds targeting a record amount of capital were in the market at year-end, providing a robust foundation for fundraising in 2024 and 2025. A recent spate of infrastructure GP acquisitions signal multi-asset managers’ long-term conviction in the asset class, despite short-term headwinds. Global megatrends like decarbonization and digitization, as well as revolutions in energy and mobility, have spurred new infrastructure investment opportunities around the world, particularly for value-oriented investors that are willing to take on more risk.

Private markets make measured progress in DEI

Diversity, equity, and inclusion (DEI) has become an important part of the fundraising, talent, and investing landscape for private market participants. Encouragingly, incremental progress has been made in recent years, including more diverse talent being brought to entry-level positions, investing roles, and investment committees. The scope of DEI metrics provided to institutional investors during fundraising has also increased in recent years: more than half of PE firms now provide data across investing teams, portfolio company boards, and portfolio company management (versus investment team data only). 4 “ The state of diversity in global private markets: 2023 ,” McKinsey, August 22, 2023.

In 2023, McKinsey surveyed 66 global private markets firms that collectively employ more than 60,000 people for the second annual State of diversity in global private markets report. 5 “ The state of diversity in global private markets: 2023 ,” McKinsey, August 22, 2023. The research offers insight into the representation of women and ethnic and racial minorities in private investing as of year-end 2022. In this chapter, we discuss where the numbers stand and how firms can bring a more diverse set of perspectives to the table.

The statistics indicate signs of modest advancement. Overall representation of women in private markets increased two percentage points to 35 percent, and ethnic and racial minorities increased one percentage point to 30 percent (Exhibit 6). Entry-level positions have nearly reached gender parity, with female representation at 48 percent. The share of women holding C-suite roles globally increased 3 percentage points, while the share of people from ethnic and racial minorities in investment committees increased 9 percentage points. There is growing evidence that external hiring is gradually helping close the diversity gap, especially at senior levels. For example, 33 percent of external hires at the managing director level were ethnic or racial minorities, higher than their existing representation level (19 percent).

Yet, the scope of the challenge remains substantial. Women and minorities continue to be underrepresented in senior positions and investing roles. They also experience uneven rates of progress due to lower promotion and higher attrition rates, particularly at smaller firms. Firms are also navigating an increasingly polarized workplace today, with additional scrutiny and a growing number of lawsuits against corporate diversity and inclusion programs, particularly in the US, which threatens to impact the industry’s pace of progress.

Fredrik Dahlqvist is a senior partner in McKinsey’s Stockholm office; Alastair Green  is a senior partner in the Washington, DC, office, where Paul Maia and Alexandra Nee  are partners; David Quigley  is a senior partner in the New York office, where Connor Mangan is an associate partner and Aditya Sanghvi  is a senior partner; Rahel Schneider is an associate partner in the Bay Area office; John Spivey is a partner in the Charlotte office; and Brian Vickery  is a partner in the Boston office.

The authors wish to thank Jonathan Christy, Louis Dufau, Vaibhav Gujral, Graham Healy-Day, Laura Johnson, Ryan Luby, Tripp Norton, Alastair Rami, Henri Torbey, and Alex Wolkomir for their contributions

The authors would also like to thank CEM Benchmarking and the StepStone Group for their partnership in this year's report.

This article was edited by Arshiya Khullar, an editor in the Gurugram office.

Explore a career with us

Related articles.

CEO alpha: A new approach to generating private equity outperformance

Private equity turns to resiliency strategies for software investments

The state of diversity in global private markets: 2022