Electronic word of mouth (eWOM) has become increasingly important for the tourism industry. However, existing studies tend to overlook tourists' eWOM sharing behavior, especially on different platforms. This paper aims to explore the antecedents of distinct eWOM behaviors on social media platforms and integrated tourism websites. Thirty tourists with rich travel experience were invited to attend in-depth interviews. Tourists' emotions, eWOM motivations, and platform features were explored by coding. Based on dramaturgical theory and task-technology fit theory, we discovered the ways that platform features fit with tourists' eWOM motivations, which provide important implications for destination and platform management.

PurposeOnline trust is a key factor for successful online transactions. To some extent, online health consultation can be considered an online transaction. Owing to the unique physician–patient relationship, patients' choice of physicians within an online health consultation setting may not only be based on rational judgments but also considerably affected by their feelings. Hence, the purpose of this study was to explore which physicians' attributes affect patients' cognitive and affective trust in physicians, as well as how these two variables and their association affect patients' willingness to choose.Design/methodology/approachBased on the broad conceptual framework of online trust, this paper proposed a set of hypotheses that were tested through analyzing survey data using structural equation modeling techniques.FindingsResults showed that physicians' ability had a significant positive influence on patients' cognitive trust in the physician; physicians' integrity and benevolence had a significant positive influence on patients' affective trust in the physician; cognitive and affective trust had a significant positive impact on patients' willingness to choose and there were significant positive interactions between affective and cognitive trust.Originality/valueThis study theoretically enriches the generic model of online trust. From the practical perspective, it will provide physicians working in online health consultation platforms and relevant practitioners with baseline information on the topic and advice for decision-making toward service enhancement and clientele improvements.

PurposeThe significance of physician-user interaction has been widely acknowledged in offline and online healthcare consultation. However, limited attempts have been made to explore the influence of physician-user interaction on users' perceived service quality (PSQ) in the mobile context. Based on the literature on physician-user interaction and media synchronicity theory, this study proposes a theoretical model where the interactive factors common across the offline, online and mobile context, i.e. physicians' informational support and emotional support, the interactive factors unique in the mobile context, i.e. physicians' response speed and voice service, and the interaction between the two categories of interactive factors predict users' PSQ in mobile consultation.Design/methodology/approachThis study collects consultation records between 25,225 users and 738 physicians from a leading Chinese mobile consultation application, and employs linear regression to verify the proposed theoretical model.FindingsPhysicians' informational, emotional support, response speed and voice service are found to have significant positive impacts on users' PSQ. Besides, physicians' response speed strengthens the positive impacts of physicians' informational and emotional support on users' PSQ, while physicians' voice service weakens the positive link between physicians' informational support on users' PSQ.Originality/valueThis study contributes to the antecedents for users' PSQ in mobile consultation by identifying unique interactive factors in the mobile context, and highlighting the individual and interaction effects of different physician-user interactive factors. Besides, this study employs novel methods, which leverages text classification and text pattern recognition to more accurately depict physicians' online behaviors based on objective communication records.

This study aims to understand the underlying reasons for poor doctor-patient relationships (DPR). While extant studies on antecedents of poor DPR mainly focus on the offline context and often adopt the patients' perspective, this work focuses on the mobile context and take both doctors' and mobile consultation users' perspectives into consideration. To fulfill this purpose, we first construct a theoretical framework based on the Computer-Mediated Communication (CMC) literature. Then we coded 592 doctor-user communication records to validate and elaborate the proposed theoretical model. This work reveals that characteristics of mobile technologies pose potential challenges on both doctors' and patients' information providing, informative interpreting, and relationship maintaining behaviors, resulting in 10 and 6 types of inappropriate behaviors of doctors and users, respectively, that trigger poor DPR in the mobile context. The findings enrich the research on online DPR and provide insights for improving DPR in the mobile context. Extant research on mobile healthcare service is emerging, but studies that aim at uncovering the underlying reasons for poor DPRs in the mobile context are still lacking. The majority of previous research tends to focus on the positive experience brought about by mobile healthcare services, such as user satisfaction [10] and the adoption or continuous usage of mobile technology [3,11]. However, the experience of dissatisfied participants is largely ignored. The negative experience is also worth noting because understanding the complaints guide practitioners to improve service quality [8]. Although a few studies have paid attention to the dissatisfying experience of mobile healthcare services, they tend to interpret the experience only from the perspective of users [8,12]. While these studies are insightful, a single perspective from users is not adequate, because they missed the perception of doctors which is considered quite different from that of users [13,14].These two literature gaps (namely lacking studies on dissatisfying experience of mobile healthcare services and lacking dual perspectives from both users and doctors) might partly be attributed to the mainstream research method in the healthcare field. Most studies rely on questionnaires and interviews to collect subjective ratings about mobile healthcare services, such as Akter et al. (2013) [15], Deng et al. (2015) [16], and Wu et al. (2018) [17]. The collected responses are usually inaccurate since respondents are rating events that happened at an earlier time. Besides, it is difficult to match responses from doctors and patients via questionnaires.This work aims to uncover the underlying reasons for poor DPR from dual perspectives of both doctors and users in mobile medical consultation service. To achieve our goals, we first reviewed the literature on Computer-Mediated Communication (hereafter, CMC) in search of theoretical accounts for the poor DPR in the mobile context. The CMC literature focuses on the influence of the fe...

During technology transitions, incumbents are frequently faced with the ambidextrous challenge of exploiting existing capabilities and exploring new ones. While extant studies focus on radical changes in the product domain, we notice radical changes can happen in both product and market domains. Pioneering studies indicate that cross-functional ambidexterity addresses this challenge at the business-unit level by juxtaposing exploration and exploitation across different functional domains (particularly in product and market domains) and that complementary assets address this challenge at the organizational level. However, how efforts at two levels can be combined to build cross-functional ambidexterity and what roles complementary assets play remain unclear. Therefore, this study conducts an in-depth case study of Huawei Mobile, which managed to achieve superior performance during a technology transition that triggers radical changes in both product and market domains. We find that multi-level synergies contribute to the transition process. Specifically, cross-functional ambidexterity is constructed by prioritizing exploration in the product domain ahead of that in the market domain, and that it generates learning, brand and channel extension, matching, and brand alliance benefits at the business-unit level. Complementary assets help to reduce the uncertainty of exploration and resolve functional conflicts at the organizational level.

Background: Medical education is a demanding lifelong learning process, which includes three tightly connected stages: college education, post-graduate education, and continuous education. Residency, the first several years after a college education, is a pivotal time in the development of a qualified doctor. Additionally, residents are the main force that undertakes much of the clinical work in hospitals. Therefore, guaranteeing and improving residents' clinical skills and abilities through the standardized training of resident physicians (STRP) is important. However, compared with other hospitals in the Zhejiang Province, the STRP assessment results of residents in our hospital were not satisfactory in recent years. Therefore, the objective of this study was to find the problems causing the unsatisfactory performance and identify the role of the “Plan-Do-Check-Action” (PDCA) plan in providing a valuable framework for future training.Methods: Relevant studies of STRP in China and abroad were investigated by the literature review. According to published data by the Health Commision of Zhejiang Province, we collected the STRP assessment rsults of a total number of 12,036 residents. The inclusion cretria of these residents include: (1) 3rd-year residents. (2) taking STRP in the Zhejiang Province during 2016–2018 or 2017–2019. (3) the first time taking the clinical practice ability examination (CPAE) in 2018 or 2019. The results of 634 3rd-year residents from The Second Affiliated Hospital of Zhejiang University (SAHZU) were provided by the Department of Medical Education and were analyzed in depth. Three hundred and eight residents from SAHZU received normal training and took the CPAE in 2018, whereas 326 residets received PDCA and took the CPAE in 2019. PDCA is a program designed to improve the performance of residency in SAHZU. It includes the formulation and implementation of specific training plans, the check of effects, and continuous improvements. There was no change in the STRP assessment in these 2 years and the indicator of performance in the STRP assessment was the first pass rate (FPR). Statistical analyses were performed using Pearson's chi-squared test, Yates-corrected chi-square test, or Fisher's exact test (SPSS Statistics, version 25). A P-value of < 0.05 was considered significant.Results: A total number of 6,180 and 5,856 examinees in the Zhejiang Province took the clinical practice ability examination in 2018 and 2019, respectively. In 2018, a total of 308 residents from 20 departments of the SAHZU took the STRP assessment. In 2019, a total of 326 residents from 22 departments of the SAHZU underwent the PDCA plan and took the STRP assessment. Compared with the results in 2018, the average FPR in the Zhejiang Province increased by 2.92% from 87.87 to 90.79% (P < 0.001). The FPR of the SAHZU increased by 7.88% from 85.06 to 92.94% (P = 0.001). In the SAHZU, the FPRs of the Department of Emergency and Department of Anesthesiology improved 34.51% (P = 0.024) and 20.36% (P = 0.004), respectively. There were no significant differences between the performances in the 2 years of the other 20 departments. There were improved results in the “Clinical Thinking and Decision-Making” and “Operation of Basic Skills” assessment stations with increases of 3.01% (P = 0.002) and 3.94% (P = 0.002), respectively. No statistically significant differences in the FPRs of the other six stations were found. The performances in all the stations in the final tests were better than in the stimulation tests (P < 0.001).Conclusions: Although our sample size was relatively small, our results showed a small success of the PDCA plan in improving the quality of the STRP, especially for the residents in the Departments of Emergency and Anesthesiology. The PDCA plan also contributed to enhancing residents' abilities in the “Clinical Thinking and Decision-Making” and “Operation of Basic Skills” stations. Taken together, the PDCA plan may provide a practical framework for developing future training plans.

BACKGROUND: As the digital economy evolving as a nation-level strategy of China, firm decision-makers have shown increased interest in implementing digital transformation. However, they lack strategic guidance towards the realization of digital transformation. OBJECTIVE: This study aims to provide a holistic and comprehensive understanding of the status quo of Chinese firms' digital transformation. METHODS: We fulfill this task by combining qualitative and quantitative methods. First, a conceptual model and an associated survey tool are developed based on an in-depth literature review and field practitioners' opinions. The status quo of digital transformation is decomposed into 5 dimensions. Second, empirical survey data collected from 282 Chinese firms are analyzed and interpreted both in general and across industry types and ownerships. RESULTS: We find that the majority of Chinese firms reach a consensus on the strategic importance of digital transformation and agree on the importance of technological and human resources. In general, firms in the information technology sector scored higher in all five dimensions compared with firms in the manufacturing sector, and private-owned firms scored higher in all five dimensions than state-owned firms. CONCLUSIONS: This pilot study set a basis for the development of a maturity model of digital transformation and offers practical insights for Chinese firms to initiate and implement digital transformation projects.

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