SelfWriter 8 | - Freelance Writer
Oct 31, 2019 | #1
I'll suggest some ideas based on what I think would be meaningful in the context of other recent literature. If you like one of the ideas below, I'll write a few pages of Lit Review so we can refine our focus even more. Your topic interested me because of its importance; quality of care improves when there is a high level of interpersonal collaboration among health care professionals (Martin,Ummenhofer, Manser, & Spirig, 2010; Kalisch, Lee, & Rochman, 2010; Mohr, Burgess, & Young, 2008 ). Also, interpersonal relationships and support from colleagues is one of the most important factors in determining job satisfaction among nurses. In turn, nurse job satisfaction is positively correlated to patient satisfaction (Kutney-Lee, McHugh, Sloane, Cimiotti, et al, 2009). We can benefit a lot of people if we design a project that can lead to improved methods of overcoming barriers to collaboration or enhancing it in some way.
We could look for correlations between Work Locus of Control (LOC) (Spector, 1988) and the quality of collaboration between nursing professionals and physicians. Research has already established that people with internal LOC express more job satisfaction and excel at problem solving, coping with difficulty, and more (Ng, Sorenson, & Eby, 2006), so it can be expected that meaningful relationships will exist between LOC and the quality of nurse-physician collaboration. In a similar study, Tillman, Smith, and Tillman (2010) used quantitative methods to search for relationships between LOC and other important variables such as satisfaction with work, pay, opportunities for promotion, supervision, and so forth, because they wanted to contribute to scholarly discourse about the best ways to use LOC as theoretical construct for organizational psychology. We could do the same with a focus on this specific relationship between nurses and physicians. So, that's one quantitative option for you, maybe using the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (JSATPNC) and also the 16-item Work Locus of Control Scale designed by Paul Spector (1988).
The research questions could be about the strength of relationships between several variables measured by the two data collection instruments.
However, at this point in the discourse it might be better to use a qualitative method to generate new theory by identifying an important concept for overcoming barriers to collaboration, because we already know collaboration is both imperfect and important, so it's not helpful to keep observing relationships between them, etc. It's better to find real insight through qualitative research and then perhaps in a followup study someone will use quantitative methods to lean more about the themes that emerge in analysis of qualitative and quantitative data from nurses and physicians asked to respond to one meaningful question.
Herzberg's (1959) two Factor theory is based on Maslow's hierarchy of needs. People can't take interest in the higher needs until the lower ones are satisfied. Some needs among workers can be met with extrinsic motivation and others can be met with intrinsic motivation. A need for sufficient pay and safe working conditions must be met in order for people to have intrinsic motivation. Intrinsic motivation leads to improved effort and better outcomes. Research shows that extrinsic motivation (pay, safe working conditions, benefits) is more important before all those needs are met, but after extrinsic needs are met the type of motivation that is most important is intrinsic motivation (opportunity to make a difference, opportunity to advance through performance).
Interestingly, some researchers treat the quality of interpersonal relationships as one of the extrinsic motivators that are necessary in order for people to have any job satisfaction at all. It could even be argued that potential for intrinsic motivation is limited until people reach a certain level of quality in their collaboration with colleagues. There is a threshold that can be crossed in the satisfaction of a healthcare professionals' extrinsic motivation after which it becomes easier to achieve the advantages of intrinsic motivation (Ismail & El Nakkache, 2014), and in light of this insight from research, we might ask nurses and physicians to reply to items on a Likert rating scale. That would enable us to quantify subjective data so it can be expressed numerically.
Example:
Please indicate the extent to which you agree with the following statements.
To each statement, they would reply: strongly agree, agree, neutral, disagree, or strongly disagree.
I would need to write the statements based on concepts that emerge in the review of literature about nurse-patient collaboration.
**For this option, I don't yet have a sense of what the research question might be, but we could accomplish a lot by getting their responses to several statements.
This subject would make a great qualitative project, especially since you have access to RN's who can give some data. We could make it simple and very meaningful by asking only one open-ended question. The rate of response would be high because it's only one question, and the whole study will be poignant in its simplicity. In fact, we can still use several research questions but it would be great to present the paper as though it really is about one essential question. I wonder what comes to mind for you, when I ask, What is the most useful question we could ask nurses and physicians about their collaboration?
My first idea is to approach it from the perspective of Kurt Lewin's famous (1947) change theory. We would complete the first step for using his model: Identify driving and restraining forces. We could ask nurses and physicians to describe the circumstances that drive them to collaborate more with one another, and we could ask them to describe the barriers that stand in the way. By doing that, we can identify the most important aspects of their professional relationship where leaders/administrators can direct initiatives for improving collaboration.
It's not even necessary to conduct interviews, because the question could be distributed online online and we'd use textual analysis or grounded theory to identify themes in their responses and relate those themes to one another. It would result in a 'core category' that represents the most prominent theme in their responses.
The research questions might be:
1. What are the driving forces that promote increased collaboration between nurses and physicians?
2. What are the restraining forces that prevent increased collaboration between nurses and physicians?
You can choose any of these, or suggest different ideas, and then the next step will be for me to review some relevant, recent literature and write some pages for the Introduction of Lit Review.
While I do that, I'll discover all the most recent research findings, and maybe some of them will contradict less recent findings or raise questions, etc., so after I write some pages I'll be better able to refine one of these topics and really nail down the best research questions to use.
After that, the research design can be informed by the research questions.
I look forward to hearing from you!
Simon (References below)
REFERENCES
Herzberg, F. (1973). Work and the nature of man. Cleveland, Ohio: World Publishing.
Herzberg, F. (1987). One More Time: How do you motivate employees? Harvard Business Review, 46 (1), 53-62.
Herzberg, F., Mausner, B, & Snyderman, B (1959). The motivation to work (2nd ed.).New York: John Wiley.
Ismail, H., & El Nakkache, L. (2014). Extrinsic and Intrinsic Job Factors: Motivation and Satisfaction in a Developing Arab Country - the Case of Lebanon. Journal of Applied Management and Entrepreneurship, 19(1), 66.
Kalisch, B. J., Lee, H., & Rochman, M. (2010). Nursing staff teamwork and job satisfaction. Journal of Nursing Management, 18, 938-947.
Kutney-Lee, Matthew D. McHugh, Douglas M. Sloane, Jeannie P. Cimiotti, Linda Flynn, Donna Felber Neff, and Linda H. Aiken. (2009). Nursing: a key to patient satisfaction. Health Affiliated, 28(4), 669-677.
Lewin, K. (1947). Frontiers in group dynamics. Human Relations , 1947, 1, 5-40.
Martin, J. S., Ummenhofer, W., Manser, T., & Spirig, R. (2010). Interprofessional collaboration among nurses and physicians: Making a difference in patient outcome. Swiss Medical Weekly, 140, 1-12.
Mohr, D. C., Burgess, J. F., & Young, G. J. (2008). The influence of teamwork culture on physician and nurse resignation rates in hospitals. Health Services Management Research, 21, 23-31.
Ng, T. W., Sorenson, K. L., & Eby, L. T. (2006). Locus of control at work: A meta-analysis. Journal of Organizational Behavior, 27(8), 1057-1087.
Spector. (1988). The Work Locus of Control Scale.
Identify relationships between Level of Collaboration and Work Locus of Control (LOC)
We could look for correlations between Work Locus of Control (LOC) (Spector, 1988) and the quality of collaboration between nursing professionals and physicians. Research has already established that people with internal LOC express more job satisfaction and excel at problem solving, coping with difficulty, and more (Ng, Sorenson, & Eby, 2006), so it can be expected that meaningful relationships will exist between LOC and the quality of nurse-physician collaboration. In a similar study, Tillman, Smith, and Tillman (2010) used quantitative methods to search for relationships between LOC and other important variables such as satisfaction with work, pay, opportunities for promotion, supervision, and so forth, because they wanted to contribute to scholarly discourse about the best ways to use LOC as theoretical construct for organizational psychology. We could do the same with a focus on this specific relationship between nurses and physicians. So, that's one quantitative option for you, maybe using the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (JSATPNC) and also the 16-item Work Locus of Control Scale designed by Paul Spector (1988).The research questions could be about the strength of relationships between several variables measured by the two data collection instruments.
However, at this point in the discourse it might be better to use a qualitative method to generate new theory by identifying an important concept for overcoming barriers to collaboration, because we already know collaboration is both imperfect and important, so it's not helpful to keep observing relationships between them, etc. It's better to find real insight through qualitative research and then perhaps in a followup study someone will use quantitative methods to lean more about the themes that emerge in analysis of qualitative and quantitative data from nurses and physicians asked to respond to one meaningful question.
Nurse-Physician Collaboration and Herzberg's (1959) Two-Factor Theory
Herzberg's (1959) two Factor theory is based on Maslow's hierarchy of needs. People can't take interest in the higher needs until the lower ones are satisfied. Some needs among workers can be met with extrinsic motivation and others can be met with intrinsic motivation. A need for sufficient pay and safe working conditions must be met in order for people to have intrinsic motivation. Intrinsic motivation leads to improved effort and better outcomes. Research shows that extrinsic motivation (pay, safe working conditions, benefits) is more important before all those needs are met, but after extrinsic needs are met the type of motivation that is most important is intrinsic motivation (opportunity to make a difference, opportunity to advance through performance).
Interestingly, some researchers treat the quality of interpersonal relationships as one of the extrinsic motivators that are necessary in order for people to have any job satisfaction at all. It could even be argued that potential for intrinsic motivation is limited until people reach a certain level of quality in their collaboration with colleagues. There is a threshold that can be crossed in the satisfaction of a healthcare professionals' extrinsic motivation after which it becomes easier to achieve the advantages of intrinsic motivation (Ismail & El Nakkache, 2014), and in light of this insight from research, we might ask nurses and physicians to reply to items on a Likert rating scale. That would enable us to quantify subjective data so it can be expressed numerically.
Example:
Please indicate the extent to which you agree with the following statements.
To each statement, they would reply: strongly agree, agree, neutral, disagree, or strongly disagree.
I would need to write the statements based on concepts that emerge in the review of literature about nurse-patient collaboration.
**For this option, I don't yet have a sense of what the research question might be, but we could accomplish a lot by getting their responses to several statements.
Use grounded theory to identify the most important driving and restraining forces that affect efforts to increase the level of collaboration.
This subject would make a great qualitative project, especially since you have access to RN's who can give some data. We could make it simple and very meaningful by asking only one open-ended question. The rate of response would be high because it's only one question, and the whole study will be poignant in its simplicity. In fact, we can still use several research questions but it would be great to present the paper as though it really is about one essential question. I wonder what comes to mind for you, when I ask, What is the most useful question we could ask nurses and physicians about their collaboration?
My first idea is to approach it from the perspective of Kurt Lewin's famous (1947) change theory. We would complete the first step for using his model: Identify driving and restraining forces. We could ask nurses and physicians to describe the circumstances that drive them to collaborate more with one another, and we could ask them to describe the barriers that stand in the way. By doing that, we can identify the most important aspects of their professional relationship where leaders/administrators can direct initiatives for improving collaboration.
It's not even necessary to conduct interviews, because the question could be distributed online online and we'd use textual analysis or grounded theory to identify themes in their responses and relate those themes to one another. It would result in a 'core category' that represents the most prominent theme in their responses.
The research questions might be:
1. What are the driving forces that promote increased collaboration between nurses and physicians?
2. What are the restraining forces that prevent increased collaboration between nurses and physicians?
You can choose any of these, or suggest different ideas, and then the next step will be for me to review some relevant, recent literature and write some pages for the Introduction of Lit Review.
While I do that, I'll discover all the most recent research findings, and maybe some of them will contradict less recent findings or raise questions, etc., so after I write some pages I'll be better able to refine one of these topics and really nail down the best research questions to use.
After that, the research design can be informed by the research questions.
I look forward to hearing from you!
Simon (References below)
REFERENCES
Herzberg, F. (1973). Work and the nature of man. Cleveland, Ohio: World Publishing.
Herzberg, F. (1987). One More Time: How do you motivate employees? Harvard Business Review, 46 (1), 53-62.
Herzberg, F., Mausner, B, & Snyderman, B (1959). The motivation to work (2nd ed.).New York: John Wiley.
Ismail, H., & El Nakkache, L. (2014). Extrinsic and Intrinsic Job Factors: Motivation and Satisfaction in a Developing Arab Country - the Case of Lebanon. Journal of Applied Management and Entrepreneurship, 19(1), 66.
Kalisch, B. J., Lee, H., & Rochman, M. (2010). Nursing staff teamwork and job satisfaction. Journal of Nursing Management, 18, 938-947.
Kutney-Lee, Matthew D. McHugh, Douglas M. Sloane, Jeannie P. Cimiotti, Linda Flynn, Donna Felber Neff, and Linda H. Aiken. (2009). Nursing: a key to patient satisfaction. Health Affiliated, 28(4), 669-677.
Lewin, K. (1947). Frontiers in group dynamics. Human Relations , 1947, 1, 5-40.
Martin, J. S., Ummenhofer, W., Manser, T., & Spirig, R. (2010). Interprofessional collaboration among nurses and physicians: Making a difference in patient outcome. Swiss Medical Weekly, 140, 1-12.
Mohr, D. C., Burgess, J. F., & Young, G. J. (2008). The influence of teamwork culture on physician and nurse resignation rates in hospitals. Health Services Management Research, 21, 23-31.
Ng, T. W., Sorenson, K. L., & Eby, L. T. (2006). Locus of control at work: A meta-analysis. Journal of Organizational Behavior, 27(8), 1057-1087.
Spector. (1988). The Work Locus of Control Scale.