|Year : 2011 | Volume
| Issue : 2 | Page : 91-96
A preliminary study to measure and develop job satisfaction scale for medical teachers
Kavita Bhatnagar1, Kalpana Srivastava2, Amarjit Singh3, SL Jadav4
1 Department of Ophthalmology, Pad Dr. D. Y. Patil Medical College, Pimpri, Pune, India
2 Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
3 Dean and Chairman, MET Cell, Pad Dr. D. Y. Patil Medical College, Pimpri, Pune, India
4 Department of Community Medicine, MET Cell, Pad Dr. D. Y. Patil Medical College, Pimpri, Pune, India
|Date of Web Publication||16-Oct-2012|
B4/21, Brahma Aangan,Off Salunke Vihar Road, Kondhwa, Pune - 411048, Maharashtra
Source of Support: Dr. D. Y. Patil Vidyapeeth, Pune., Conflict of Interest: None
| Abstract|| |
Background: Job satisfaction of medical teachers has an impact on quality of medical education and patient care. In this background, the study was planned to develop scale and measure job satisfaction status of medical teachers. Materials and Methods: To generate items pertaining to the scale of job satisfaction, closed-ended and open-ended questionnaires were administered to medical professionals. The job satisfaction questionnaire was developed and rated on Likert type of rating scale. Both quantitative and qualitative methods were used to ascertain job satisfaction among 245 health science faculty of an autonomous educational institution. Factor loading was calculated and final items with strong factor loading were selected. Data were statistically evaluated. Results: Average job satisfaction score was 53.97 on a scale of 1-100. The Cronbach's alpha reliability coefficient was 0.918 for entire set of items. There was statistically significant difference in job satisfaction level across different age groups (P 0.0358) showing a U-shaped pattern and fresh entrants versus reemployed faculty (P 0.0188), former showing lower satisfaction. Opportunity for self-development was biggest satisfier, followed by work, opportunity for promotion, and job security. Factors contributing toward job dissatisfaction were poor utilization of skills, poor promotional prospects, inadequate pay and allowances, work conditions, and work atmosphere. Conclusion: Tertiary care teaching hospitals in autonomous educational institutions need to build infrastructure and create opportunities for their medical professional. Job satisfaction of young entrants needs to be raised further by improving their work environment. This will pave the way for effective delivery of health care.
Keywords: Health science, job satisfaction, medical, teachers
|How to cite this article:|
Bhatnagar K, Srivastava K, Singh A, Jadav S L. A preliminary study to measure and develop job satisfaction scale for medical teachers. Ind Psychiatry J 2011;20:91-6
Job satisfaction is defined as the positive personal perception toward work or work experiences.  It has been variously linked with increased productivity/performance  and negatively with absenteeism and turnover in an organization.  In a teaching hospital, where doctors are playing dual role of teaching and patient care, this may have wider ramifications. The discontent of faculties may get translated into their academic output and may influence the morale and attitudes of medical students to the profession.  At the same time, poor job satisfaction of these physicians will adversely affect patient care. The question at hand is to evaluate the motivation level of the doctors or other health care professionals who hold the health of the public in their hands and shape the attitudes and aptitudes of the budding generations. Based on the proposed report of MCI undergraduate education working group 2010, the most significant challenge for regulatory bodies has been to balance the need for more medical colleges with the maintenance of quality standards.  In this regard, the job satisfaction of medical teachers is perhaps not getting its due attention. Job satisfaction is very important but very less studied issue.  More work needs to be done to link the perceptions of individual faculties with the organizational context in which they work and with the wider political, economic, and social context of medical education reforms. As a component of development of quality system in our organization, we undertook this study to construct "Job Satisfaction Profile" of teaching faculty of all tertiary care health science institutions of a private autonomous educational university and to evaluate their level of satisfaction and to describe variables related to their job satisfaction.
Construct of job satisfaction: Theoretically, the model, which was taken as a background for the development of the scale, is "Job satisfaction and its modeling among township health care employees: a quantitative study in poor rural China." The construct is based on factors as given below:
Professional practice environment; personal attitudinal factors; organizational factors of social support; job competency; welfare measures; job reward; motivation and work enthusiasm.
The framework of our research is shown in [Figure 1].
|Figure 1: Research framework of job satisfaction among health science faculty|
Click here to view
| Materials and Methods|| |
The study was conducted between July 2010 and February 2011 using an English language, self-administered anonymous questionnaire. Initially, items comprising four domains were extracted with the help of in-house group discussion and brain storming of health care professionals. The scale was subsequently administered to 25 experts for further generation and expert validation of items. Finally, 245 questionnaires were distributed to various colleges, out of which 163 were received back, at a response rate of 66.53%. The faculty members included professors, associate professors lecturers (all having postgraduate degrees), and tutors (having MBBS degree or diploma in their respective specialty), working in health science institutions (i.e., medical, dental, homeopathic, and ayurvedic colleges). We promised keeping secrets of personal information of all the subjects. Therefore, this study did not harm the ethics of subjects.
The questionnaire was designed after detailed discussions with a group of hospital administrators, doctors, and sociologists and subjected to a pilot trial and expert validation. It contained six components:
- Personal factors of educational level and sociodemographic characteristics, consisting questions regarding age, sex, qualifications, teaching experience, designation, and occupational history
- Continuing education credits in academics and nonacademic achievements
- Perceived competence as per job requirement
- Job satisfaction-related questions consisting of statements related to personal attitudinal factors
- Job satisfaction-related questions consisting of statements related to organizational factors of social support
- Job satisfaction-related questions consisting of statements related to professional practice environment to which the participants were required to indicate their agreement or disagreement by responding in the affirmative or negative.
It is measured on a 5-point Likert scale from 1 (extremely dissatisfied) to 5 (extremely satisfied) [Table 1]. Besides, job satisfaction questionnaire and qualitative data were also elicited using open-ended elicited questions on their perception regarding factors contributing to job satisfaction/job dissatisfaction.
Participants were informed about the study objectives and procedures, and the purpose for which data was being collected. Confidentiality of data was assured.
|Table 1: Variables involved in each principal factor and their factor loadings|
Click here to view
The completed forms were analyzed using SPSS package and epi-Info.
Standard 5-point likert-type scale
Staff satisfaction is typically rated on a 5-point Likert scale from 1 (extremely dissatisfied to 5 (extremely satisfied). And the standard satisfaction scale ranging from 1 to 5 were converted into 0 to 100 scales using a formula as given below.
AdjSS = 100 × (stdSS-1)/(5-1)
Where "adjSS" and "stdSS" are "adjusted satisfaction score" and "standard satisfaction score," respectively.
With the new scoring meth0od, job satisfaction fell into five categories: "extremely dissatisfied" (adjSS: 10-29), "dissatisfied" (30-49), "generally satisfied or not" (50-69), "satisfied" (70-89), and "extremely satisfied" (90-100). 
Exploratory factor analysis
Exploratory factor analysis (EFA) was performed to identify common factors that can cover all aspects of job satisfaction of the respondants by using principal component analysis and equamox rotation. Based on scree plot seven common factors were than variables having more than one (compo) were excluded. Also variables that did not have strong loading (eigenvalue <0.44) were also excluded. Finally, variables with strong loading were taken for analysis. Seven factors with cumulative initial eigenvalue being 88.86% were extracted after analysis.
| Results|| |
KMO and Barlett's test
It shows adequate sample size with Kaiser-Meyer-Olkin measure of sampling adequacy of 0.855.
Statistics was based on all cases with valid data for all variables in the procedure. User-defined missing values were treated as missing. Out of 162 cases, 154 (95.1%) cases were valid and 8 (4.9%) were excluded. The Cronbach's alpha reliability coefficient was 0.918 for entire 33 set of items.
In this study, 162 health science professionals, including 84 (47.85%) females and 78 (51.53%) men working as teaching faculty in health science colleges including medical, dental, ayurvedic, and college of homeopathy, took part in the investigation. The response rate for medical college was 82%, homeopathy 80%, dental college 53.68%, and 40% for Ayurvedic College. The Cronbach's alpha reliability coefficient was 0.937 for entire set of items. The respondents were divided into five age groups as shown in [Table 2]. Maximum response was from the teachers aged 25-35 followed by 36-45 years age group.
|Table 2: Demographic characteristics associated with faculty job satisfaction|
Click here to view
Common factors of job satisfaction
Based on scree plot, seven components were identified with initial Eigenvalue of 1. All the variables were loaded onto these seven components [Table 1]. All variables showed high loadings (Eigenvalue >0.400).The final rotated matrix was taken for analysis. The first factor related to professional practice environment included nine items; the second factor concerning personal attitudinal factors involved eight items; the third factor regarding organizational factors of social support had six items; the forth factor about job competency consisted of two items; the fifth factor relating to welfare measures contained three items; the sixth factor about job reward included three items; and the seventh factor concerning motivation and work enthusiasm contained four items.
Job satisfaction scores
The scores of job satisfaction of all the subjects are listed in [Table 3]. Arithmetic mean of job satisfaction score of all the health science faculties was 53.97 equivalent to "generally satisfied or not" on Likert scale. The average job satisfaction score of medical college faculty was 58.59; suggesting job satisfaction was higher among medical college faculty when compared with the health science faculties taken together (P 0.0010). Scores reflecting personal attitudinal factors, professional practice environment, and job competency were highest, with their arithmetic means being 72.879, 62.39, and 63.58, respectively. Welfare measures and job reward were lowest, with corresponding average score being 39.74 and 46.4.
Demographic characteristics associated with faculty job satisfaction
There is statistically significant difference in job satisfaction level across various health science colleges (P 0.0010) and across different age groups (P 0.0358) as shown in [Table 2]. Overall satisfaction level is highest for medical college followed by Homeopathy College among all health science faculties. Satisfaction level is low in <35 years and >65 years age group, it is higher for 36-45 years and 56-65 years of age, and is in between for 46-55 years of age. Married people were more satisfied than unmarried with a P value of 0.0073, which is statistically significant. There is statistically significant difference in job satisfaction level based on occupational history (P 0.0188). There is no statistically significant difference in the satisfaction level among the faculty based on their, sex, years of service, profession of spouse, or designation although the level of overall satisfaction is lower among associate professors.
As qualitative data [Table 4] was also elicited from a randomly selected group in our institution using open-ended questions on respondent's perception regarding factors contributing to job satisfaction/dissatisfaction, majority (90.5%) opined that most important factor contributing toward job satisfaction was opportunity for self-development. Other factors were work itself (70.6%), opportunity for promotion (70%), and job security (50%) in that order. Factors contributing toward job dissatisfaction were poor utilization of skills (80.7%), poor promotional prospects (79.2%), inadequate pay and allowances (78%), work conditions and atmosphere (77%), organization policy and administration (68.8%), and inadequate redressal of grievances (60.5%).
|Table: 4: Factors mentioned by academician-clinicians as contributing toward job satisfaction and job|
Click here to view
| Discussion|| |
The government of India recognizes Health for All as a national goal and expects medical training to produce capable "Physicians of First Contact" toward meeting this goal. However, the Indian health care and medical education is facing systems and standards challenges.  The changing scenario in health manpower, rapid advances in medical technology, changing modalities of therapeutic practice and growing health awareness among clients, demand for a holistic approach toward job satisfaction, and motivation of clinicians working in academic institutions. 
According to previous reports, job satisfaction is associated with a wide array of factors, including organizational factors such as job reward and work conditions and personal factors like sense of work achievements and work enthusiasm. ,, In our study, EFA was conducted and seven common factors were identified, which covered virtually all job satisfaction-related factors, such as professional practice environment, personal attitudinal factors, organizational factors of social support, job competency, welfare measures, job reward, motivation, and work enthusiasm. As compared with JDI that contains five domains (work, compensation, promotion opportunities, superiors, and coworkers)  our self-designed questionnaire was more comprehensive. Our study showed that the job satisfaction model in this study was more reliable (the Cronbach's alpha reliability coefficient was 0.918). Our study provides a good starting point for further development of standard scale for measuring job satisfaction of health science faculties in teaching institutions in India.
In the study, we found that the mean score of job satisfaction of health science faculties was 53.97, which was at "generally satisfied or not" level on Likert's scale. We also found that most faculties considered their job of importance. What they felt most dissatisfied with were work rewards (i.e., welfare, pay, and promotion opportunity), working conditions, and sense of work achievements.  Herzberg believed that pay, work conditions, job security, and relation with colleagues are essential factors that dictate job satisfaction.  Moreover, failure to meet the demands of employees in these regards will lead to complaints. Moreover, job satisfaction was found to be inversely related with turnover of employees,  i.e., poor job satisfaction is linked to high turnover.  If most employees, especially backbone ones, in any tertiary care hospital intend to quit, the result will be disastrous.
Personal factors, such as age, gender, marital status, and spouse being professional or not, also have impact on job satisfaction. According to previous reports, females tend to be more satisfied with their job than males,  and a U-shaped relation was observed between age and job satisfaction.  Our results were consistent with these findings.
Midcareer professionals in our series were the least satisfied with their job. However, these caregivers are the main force of the institution and care more about their work environment and professional development. Therefore, policy makers should address their demands and concerns to bring their talents into full play.
At present, it is necessary to design a well-tailored job satisfaction instrument for health care professionals in India. This study is a preliminary effort to achieve this goal. Compared with the JDI instrument,  which has 14 items, and the JSS instrument , that consists of 10 items, our self-designed questionnaire is relatively more comprehensive but more complicated and time consuming which may pose problem with busy medical professionals. Additionally, because the sample size of our study was comparatively small, studies of large cohorts need to be conducted to further revise and perfect this questionnaire.
The response rate (66.53%) in our study was lower than that (90.5) reported by Liu et al,  Yin et al (81.2%)  by Nicholas et al. (75%),  and Magne et al. (73%)  This could be because people do not have faith that something positive would come out of this study.
There are still some limitations with the research. This investigation had no baseline data for comparison. Further studies with greater sample size are required toward extrapolation of our findings.
There is no study available on medical professional in terms with the standard measure to evaluate the same. The questionnaire developed out of the work is a good tool to be used in the medical scenario with adequate reliability and validity. The present study is unique as this has been done on health care providers and has yielded some significant findings. Job satisfaction is a multidimensional phenomenon with a number of factors operating simultaneously. Job satisfaction level across different age groups (P 0.0358) showed a U-shaped pattern and fresh entrants showed lower satisfaction when compare with reemployed faculty (P 0.0188). Tertiary care teaching hospitals in autonomous educational institutions need to build infrastructure and create opportunities for their faculties. To enhance their job satisfaction, authorities should take measures to improve work conditions, raise work rewards, and pay more attention to the professional development of their employees. Fixed criteria based and transparent promotion policy should be developed. Further, in this connection, personal audit on a regular basis may be considered. Second line of leadership should be developed where full time junior capable faculties are considered.
| References|| |
|1.||Howard M. Deconstructing job satisfaction: Separating evaluations, beliefs and affective experiences. Hum Resour Manage Rev 2002;12:174. |
|2.||Ostroff C. ′The relationship between satisfaction, attitudes and performance: an organizational level analysis′. J ApplPsychol 1992;32:963-74. |
|3.||Robbins S. Organizational Behavior. 9 th ed.New Delhi: Prentice Hall of India; 1998. p. 78. |
|4.||Madan N. Job Satisfaction among Doctors in a Tertiary Care Teaching Hospital. JK Science 2008;10:81-3. |
|5.||Medical Council of India. Proposed, Under Graduate Medical Education, Undergraduate Education Working Group 2010. Available from: http://www.bvnmedicol.org/uploaded_files/ug medical-education.pdf. [Last accessed on 2011 Mar 12]. |
|6.||Liu JA, Wang Q, Lu ZX. Job satisafction and its modeling among township health center employees: a quantitative study in poor rural China. BMC Serv Res 2010;10:115. Available from: http://www.biomedcentral.com/1472-663/10/115. [Last accessed on |
|7.||Bhatnagar K, Srivastava K, Deshmukh S, BasannarDR. Job Satisfaction among Clinicians in Private Medical College: An Explorative Study. Ind Psychiatry J 2008;17:111-6. |
|8.||Naidu R, Newton JT, Ayers K. A comparison of career satisfaction amongst dental health care professionals across three health care systems: Comparison of data from the United Kingdom, New Zealand and Trinidad and Tobago. BMC Health Serv Res 2006,6:32. |
|9.||Kivimäki M, Vanhala A, Pentti J, Länsisalmi H, Virtanen M, Elovainio M, et al. Team climate, intention to leave and turnover among hospital employees: prospective cohort study. BMC Health Serv Res 2007,7:170. |
|10.||Geneau R, Lehoux P, Pineault R, Lamarche PA. Primary care practice a la carte among GPs: using organizational diversity to increase job satisfaction. FamPract 2007;24:138-44. |
|11.||Castle NG, Degenholtz H, Rosen J. Determinants of staff job satisfaction of caregivers in two nursing homes in Pennsylvania. BMC Health Serv Res 2006;6:60. |
|12.||Herzberg FI, Mausner B, Synderman B. The motivation to work. 2 nd ed. NewYork: John Wiley; 2007. |
|13.||Pathman DE, Konrad TR, Williams ES, Scheckler WE, Linzer M, Douglas J. Physician job satisfaction, dissatisfaction, and turnover. J FamPract 2002;51:593. |
|14.||Parsons SK, Simmons WP, Penn K, Furlough M. Determinants of satisfaction and turnover among nursing assistants: The results of a statewide survey. J GerontolNurs 2003;29:51-8. |
|15.||French F, Ikenwilo D, Scott A. What influences the job satisfaction of staff and associate specialist hospital doctors? Health Serv Manage Res 2007;20:153-61. |
|16.||Kwangho JM, Jae M, Sung DH. Do age, gender, and sector affect job satisfaction? Results from the Korean labor and income panel data. Review Publ Personnel Admin 2007;27:125-46. |
|17.||Nylenna M, Gulbrandsen P, Førde R, Aasland OG.Unhappy doctors? A longitudinal study of life and job satisfaction among Norwegian doctors 1994-2002. BMC Health Serv Res2005;5:44. |
|18.||Warr P, Cook J, Wall T. Scales for the measurement of some work attitudes and aspects of psychological well-being. J OccupPsychol 1979;52:129-48. |
|19.||Yin W, Wang K, Fu H. Research on the scope of job satisfaction and stability of community health workers. Chinese J Hosp Admin 2003;6:351-5. (in chinese) |
[Table 1], [Table 2], [Table 3], [Table 4]