Research On The Mechanism Of Intrinsic Motivation Among "Reserved Talents" In Prefecture-level Tertiary Public Hospitals

Prefecture-level public hospitals are in the “sandwich layer” under the \ current policy environment.The “reserved talents” are the middle level talents of the hospital.They have strong personal development expectations,but there are also many instability factors in the population.For the hospitals,the “reserved talents” is an important human resource reservoir,which determines the direction of future hospital medical capacity.The motivation and retention of “reserved talents” deserves our attention.Performance appraisal is an important management tool.Job autonomy is the trait that played a high role in “reserved talents”.The intrinsic motivation theory is an extension of the traditional motivation theory,mainly focusing on the non-salary incentives.Our study combined performance appraisal orientation,intrinsic motivation and job autonomy with job involvement as the outcome variable,aiming to verify the mediating effect of intrinsic motivation in the “reserved talents”,and provide a theoretical model and data support for stabilizing the talents for municipal-level public hospitals.Objective: The aims of the study was to 1.Describe the demographic patterns of “reserved talents” in prefecture-level public hospitals and the related issues about personal career development;2.Analyze the influencing factors of performance appraisal orientation,job autonomy,intrinsic motivation and job involvement;3.Analyze the path model among above four constructs,and construct a structural equation model with the intrinsic motivation as a mediator;4.Comparative analysis of two specific path of prefecture-level public hospitals;5.Propose suggestions to further motivate “reserved talents” in municipal-level public hospitals and to stabilize the talents team.Methods: The research data is derived from the survey data of the Jiangsu Provincial Graduate Research Innovation Program “Research on the Motivation Mechanism of “Reserved Talents” in Jiangsu Province and Prefecture-level Public Hospitals”,which is a cross-sectional study,using convenient sampling methods to select one hospital in Nanjing and two hospitals in Wuxi,Jiangsu Province.The study investigated 294 “reserved talents” with officially issued documents,including doctors,nurses and administrators in various departments of the hospital.The questionnaire included demographic patterns and job-related attributes of the staffs;it also included four scales: job autonomy,performance appraisal orientation,intrinsic motivation,and job involvement.The study used descriptive statistical analysis of demographic characteristics and job attributes,and one-way ANOVA to explore four latent variables.Multivariable regression model was applied to analyze the path coefficients for each dimension of each scale,and structural equation modeling and Sobel test was used to verify the mediating effect of intrinsic motivation among “reserved talents” of job autonomy and job involvement,performance appraisal orientation and job involvement respectively.The study mainly used SPSS25.0 for descriptive statistical analysis,single factor analysis,correlation analysis,multiple linear regression analysis,reliability analysis,principal component analysis and Sobel test.Structural model analysis was performed by AMOS 17.0.Results: In the single factor analysis,the older,the higher professional title is,the more training times was obtained;The higher the hospital attaches importance to training,and the more career development opportunities,the higher level with the intrinsic motivation and job involvement.For the evaluation performance appraisal orientation,the scores of the 40 to 45-year-old group are the highest;the more training times are better than the less training times.Talents who are satisfactory with the salary were higher than the dissatisfied group.Comparing to less attention to the training,more attention to training would get higher scores.Regarding the development performance appraisal,getting more trainings had higher scores than those who receive less and general trainings.Those who think that the hospital attaches great importance to training had higher scores than those who think hospital pay general attention to trainings;in general,the less career development opportunities,the lower the development performance appraisal scores.For job autonomy,the 35 to 40 year old group compared to the 40 to 45 year old group,talents who has never received training compared to frequent trainings had generally lower scores.The higher the salary satisfaction,the higher the hospital pays more attention to the training,the more career development opportunities,the less work,the higher the job autonomy.In the path analysis model,the standardized path coefficient of intrinsic motivation to job involvement was 0.446,and the standardized path coefficient of performance appraisal orientation to intrinsic motivation was 0.205.The intrinsic motivation played a full mediating role between performance appraisal orientation and job involvement.The total effect size was 0.032.The standardized path coefficient of job autonomy to intrinsic motivation was 0.329,and the standardized path coefficient of job autonomy to job involvement was 0.244.The intrinsic motivation plays a partial mediating role between job autonomy and job involvement.The total effect size is 0.391.Conclusions: The expectation for higher salary among “reserved talents” has not been met.For hospitals,salary motivation was still an unmet factor.Among the “reserved talents”,improving their salary can still improve the job involvement.Neither development performance appraisal or evaluation performance appraisal has no direct impact on the job involvement but was fully mediated by intrinsic motivation.The direct impact effect was very limited.The Sobel test results showed that performance appraisal methods should focus on the development orientation,which paid more attention to the evaluation for the future development,potential progress and innovation ability of the “reserved talents”.Job autonomy was a very important antecedent variable.Hospital leaders should decentralize and believe that “reserved talents” can play an active role in hospital medical activities.Appropriate competition between the department was conducive to the promotion of management measures,when the leaders can recognize that the unique role of the job autonomy in the motivation.The characteristics of the “reserved talents” determined the strong demand for personal development.When the responsibility of the organization exceeds the individual’s tolerance,such policies were not advisable.