Thriving in Medical Practice

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In the mid-2000s, the construct of workplace engagement had been visible in the literature for over a decade, with no consensus on its measurement. The benefits of increasing engagement were consistently reported however measures were developed and used across different contexts, with potential underlying differences due to context remaining unaddressed. The first aim of this thesis was to investigate existing engagement measures and their comparative relevance across two contexts: business and medical. The medical context was chosen for detailed investigation because of the importance of engagement-related factors such as burnout in medical professions, and because of the lack of empirical research on engagement in this context. The second aim of the thesis was to develop an engagement measure specifically for use in medical settings. The third aim of the thesis was to explore the relationships between engagement and related constructs of interest in the literature. In the first, Pilot Study 1, items said to measure engagement were identified. In Study 2, the measures were tested for their perceived relevance to engagement with 217 business and 192 medical respondents. Results demonstrate engagement may be differentially viewed and defined in these contexts. In Study 3, data were drawn from public hospitals across New South Wales, Australia, from 392 nurses and 154 doctors. The first known measure for engagement in medical contexts was developed, a higher order construct including job satisfaction, dedication and focused time use, consistent with a consensus on engagement occurring later in the literature. A path model was developed assessing related constructs not found in other engagement models, climate, empowerment, intrinsic motivation and emotional exhaustion. The model consolidates findings and provides further evidence of differences in the way engagement operates in business and medical contexts. Engagement in medical contexts is an important aspect of current research due to a global healthcare crisis.