Linking hospital culture to the training performance of residents: The roles of leader‐member exchange and transactional leadership style

Abstract

Background: Hospital culture is a crucial aspect of residents' training. However, the mechanisms related to stakeholder culture (SC) and teacher-resident interaction remain unclear. The study investigated the relationship between hospital culture and training performance of residents. Also, it explored the mediating effect of teacher-resident exchange and the moderating effect of the teacher's transactional leadership style within a Chinese context. Methods: Based on stakeholder and leadership member exchange theories, we constructed a composite model. Data were collected from 296 residents from five tertiary hospitals in China. Hierarchical moderated regression analyses were used to test the hypotheses. Results: (a) Both the employee-orientation culture (EOC) (β = .14, P ≤ .05) and patient-orientation culture (POC) (β = .47, P ≤ .001) in the hospital were significantly related to residents' training performance. (b) Teacher-resident exchange fully mediated the relationship between EOC and training performance and partially mediated the relationship between POC and training performance. (c) The moderating role of transactional leadership style (TLS) in the relationship between EOC and leadermember exchange (LMX) (β = −.17, P ≤ .05) was negative; it was not significant in the interaction between POC and TLS (β = .06, P > .1). Conclusion:The results suggest that trainers should consider the value of multiple cultures and ensure balance among stakeholders rather than focusing on a single one.Furthermore, a positive interaction improves teacher-student relationship and training performance. Most importantly, educational departments should pay attention to establishing assessment tools, using rewards and incentives in residents' training.

Work-life enablers for job satisfaction in healthcare: moderating role of organization type

“…This can be explained through the LMX theory according to which the dyadic exchange developed between leaders and followers is positively associated with job satisfaction (Epitropaki and Martin, 2005;Fazlollahtabar, et al, 2016;Graen and Uhl-Bien, 1995). In the context of medical resident training, LMX has been addressed as teacher resident exchange that leads to enhanced job satisfaction (Vaughn and Baker, 2004;Deng et al, 2020).…”

A literature review of leadership training and a novel conceptual model of leader-member exchange theory for new dentists

“…A previous study found that applying LMX theory for training of medical resident physicians at a hospital in China under senior doctor teachers suggests that senior doctors should consider multiple cultures and multiple stakeholders in a single context, emphasize positive relationships and utilize incentives in training new medical residents (Deng et al , 2020). Considering the relationship between senior doctor teachers and new resident physicians is also called teacher–resident exchange (TRX) (Deng et al , 2020). Deng et al.…”

“…A previous study found that applying LMX theory for training of medical resident physicians at a hospital in China under senior doctor teachers suggests that senior doctors should consider multiple cultures and multiple stakeholders in a single context, emphasize positive relationships and utilize incentives in training new medical residents (Deng et al, 2020). Considering the relationship between senior doctor teachers and new resident physicians is also called teacher-resident exchange (TRX) (Deng et al, 2020). Deng et al apply stakeholder theory in that "the development of an organization cannot be separated from the involvement of various stakeholders," which means that stakeholder-related problems in TRX must consider relationships with multiple subjects (Deng et al, 2020).…”

“…Considering the relationship between senior doctor teachers and new resident physicians is also called teacher-resident exchange (TRX) (Deng et al, 2020). Deng et al apply stakeholder theory in that "the development of an organization cannot be separated from the involvement of various stakeholders," which means that stakeholder-related problems in TRX must consider relationships with multiple subjects (Deng et al, 2020). A residentoriented culture, which values residents as partners and assets to success, and a patientoriented culture, which puts the benefits of the customer first, were positively related to resident performance (Deng et al, 2020).…”

“…Deng et al apply stakeholder theory in that "the development of an organization cannot be separated from the involvement of various stakeholders," which means that stakeholder-related problems in TRX must consider relationships with multiple subjects (Deng et al, 2020). A residentoriented culture, which values residents as partners and assets to success, and a patientoriented culture, which puts the benefits of the customer first, were positively related to resident performance (Deng et al, 2020). When considering TRX between senior doctors and residents, TRX fully influenced resident training outcomes in resident-oriented culture and partially influenced resident-training outcomes in patient-orientated culture (Deng et al, 2020).…”