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LODJ
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Received 27 October 2021
Revised 15 January 2022
1 May 2022
21 June 2022
Accepted 9 July 2022
The relationship between
emotional intelligence,
transformational leadership, and
performance: a test of the
mediating role of job satisfaction
Joather Alwali
Independent Researcher, Abu Dhabi, United Arab Emirates, and
Wafaa Alwali
University of Derby, Derby, UK
Abstract
Purpose – This paper examines the effect of job satisfaction on job performance among physicians in Iraq’s
public hospitals. It also determines the mediating role of job satisfaction on the relationship between emotional
intelligence and job performance. It further unveils the mediating role of job satisfaction on the nexus between
transformational leadership and job performance. As physicians form the bulk of health-care professionals,
their performance at work is crucial in determining patient satisfaction regarding care quality.
Design/methodology/approach – A quantitative approach with structural equation modelling via partial
least squares (PLS-SEM) and bootstrapping estimation was used to test the hypotheses developed. A total of
157 responses were utilized in the data analysis.
Findings – Evidence from the study indicates that job satisfaction has a positive relationship with job
performance. The study also provides evidence that job satisfaction plays a positive mediating role in the
relationship between emotional intelligence and job performance. Similarly, job satisfaction has a positive
mediating effect on the nexus between transformational leadership and job performance among physicians in
Iraq’s public hospitals.
Originality/value – To the best of the authors’ knowledge, this is the first study to investigate the relationship
between physician job satisfaction and job performance in Iraqi public hospitals. Studies using Eastern
samples are scarce, so the findings of this study will add to the body of knowledge from a cross-cultural
standpoint.
Keywords Emotional intelligence, Transformational leadership, Job satisfaction, Job performance
Paper type Research paper
Leadership & Organization
Development Journal
Vol. 43 No. 6, 2022
pp. 928-952
© Emerald Publishing Limited
0143-7739
DOI 10.1108/LODJ-10-2021-0486
1. Introduction
The importance of job performance among physicians in public hospitals cannot be
overemphasized since the provision of basic public health services as well as the delivering of
quality patient care necessitates attitudes toward practice, knowledge and skills (Li et al.,
2017; Hou et al., 2020). For instance, the current form and delivery of health care is a timeconsuming and labor-intensive service (Nasurdin et al., 2020). Hence, the attitudes, knowledge
and skills of the physicians are critical components of their job performance in the healthcare
industry. It has been asserted that the healthcare industry represents one of the economy’s
most labor-intensive service sectors (Ozcan et al., 1996). Specifically, public hospitals in Iraq
provide free or low-cost health care to the Iraqi people. This care is heavily subsidized by the
government. Patients who use public hospitals are disproportionately low-income and
government employees. The provision of quality healthcare services to the people depends on
the job performance of the physicians in the hospitals. Thus, it is important to determine the
factors that drive physicians’ job performance in public hospitals.
The human resource management (HRM) functions in healthcare organizations and
health systems have become increasingly important, as fundamental issues of
administration and organizational behavior (such as job satisfaction, emotional
intelligence, transformational leadership and job performance) have emerged. For
instance, job satisfaction is considered as one of the factors that drives job performance.
Robbins (2006) stated that though awards and achievements are important, job satisfaction
is a common behaviour in work performance. Furnham et al. (2009) defined job satisfaction
as the degree to which employees were happy with their jobs. The two concepts are often
discussed together since a person could be satisfied at work because there is a factor or
condition that motivates him or her. In other words, job satisfaction is linked to job
performance because employees who are happier at their jobs tend to be more effective and
productive at their jobs. Furthermore, employees who are satisfied with their jobs are less
likely to leave (Chen, 2006).
According to Top et al. (2015), in order to provide insights into the quality of care and
performance outcomes in hospitals, researchers should examine the employee levels of job
satisfaction and job performance, as well as the effects of such factors on employee
motivation, productivity and effectiveness. Job satisfaction is often considered as an attitude
indicator that shows how much people enjoy their jobs, and it is positively connected with
employee’s health and performance (Spector, 1997). For several physicians, job satisfaction
depends on their positive relationships with staff and colleagues, control over vacation time,
adequate resources, and clinical autonomy (Williams et al., 2003). The primary source of job
stress for physicians is probably increased in workload while the consequences of
dissatisfaction are increased physician turnover, decreased continuity of patients care,
increased medical system costs as well as increased patient dissatisfaction (Murray et al.,
2001). Therefore, job satisfaction could have influence on the physician’s job performance
(Platis et al., 2015) since higher job satisfaction is related to better doctor-patient relationship
(Deng et al., 2018), lower burnout (Natasha et al., 2015) and lower job turnover (Deng et al.,
2018; Brawley and Pury, 2016).
Besides, it is fundamental to examine the employee’s perceptions of their hospital
administration within the context of emotional intelligence, and how the latter influences job
performance. Healthcare organizations’ HRM policies and practices should foster work
environment that promote emotional intelligence to generate positive effects on creativity,
motivation, employees’ cooperation, job performance and organization’s effectiveness. As
management studies undergo an “affective revolution,” emotional intelligence has emerged
as a critical predictor of important organizational outcomes. The fact that emotions are a part
of the workplace is well-known, but research into them is limited (Bande et al., 2015; Sony and
Mekoth, 2016). According to Ashforth and Humphrey (1995), emotions are an important part
of organizational life, and managing them effectively can lead to happier employees. Despite
the controversy surrounding the use of emotional intelligence in the workplace, it has been
reported that emotional intelligence has positive outcomes such as a decrease in turnover
intention (Tett and Meyer, 1993), an increase in organisational citizenship behaviours
(Fassina et al., 2008), a higher level of organisational commitment (Meyer et al., 2002), as well
as an increase in job performance (Iaffaldano and Muchinsky, 1985). Empirically, some
studies have argued that employees with a higher emotional intelligence perform better than
employees with a lower emotional intelligence partly because they are more satisfied with
their jobs, which results in improved performance (Alonderiene and Majauskaite, 2016;
Brunetto et al., 2012; Li et al., 2018; Wong and Law, 2002). Moreover, Akkoc et al. (2022) noted
that emotional labour has a positive effect on life satisfaction albeit the effect varies with the
level of affective commitment. They emphasized the need to understand and transform the
surface emotional setting that can cause emotional conflict in order to enhance a
satisfactory life.
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satisfaction
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Apart from the direct relationship between emotional intelligence and job performance,
there could be a dynamic relationship between emotional intelligence and job satisfaction.
The empirical outcomes from some studies showed that job satisfaction has a positive
relationship with behavior, attitude and health (Winton, 2021). Improvements in employee job
satisfaction offer a productive way to help generate positive attitudes and behaviors among
employees, as organisations are constantly seeking new ways to improve shareholder value.
Hence, job satisfaction could mediate the relationship between emotional intelligence and job
performance in the health sector. Wong and Law (2002) posited that emotional intelligence is
positively associated with both job satisfaction and job performance while Brunetto et al.
(2012) noted that emotional intelligence promotes job satisfaction, organisational
commitment and employee’s engagement. Moreover, Javed et al. (2020) noted a significant
relationship between emotional intelligence and job satisfaction while Winton (2021)
confirmed that improvement in emotional intelligence will increase the level of job
satisfaction.
Furthermore, another factor that could drive job performance is leadership style. The
extensive research on the relationship between leadership styles and workplace performance
nowadays, focuses on transformational and transactional leadership styles (Advani and
Abbas, 2015). Essentially, a system of changing and transforming people is considered as
transformational leadership (Hall et al., 2002). Some previous studies have indicated that
transformational leadership has the capacity to improve employee’s performance (Al-Amin,
2017; Mangkunegara and Huddin, 2016; Manzoor et al., 2019). Besides, Arun et al. (2020) found
a positive relationship between paternalistic leadership and organizational performance
albeit organizational culture (i.e. cultural tightness/looseness) has insignificant moderating
role on the efficacy of leadership on organizational performance. Essentially,
transformational leaders with idealized influence can create employee’s trust and respect,
express confidence in the organization’s vision, as well as emphasize the critical nature of a
shared understanding of the organization’s mission (Yukl, 2013). These characteristics
motivate subordinates to work diligently and creatively. By fostering an environment of
collaboration and teamwork, leaders can motivate followers to perform at a high level. They
shape the vision, inspire optimistic commitment to it, and foster an environment conducive to
innovation. For example, Iraq is confronted with rapidly changing challenges that necessitate
exceptional leadership (Al-Husseini et al., 2019). The country is investing heavily in human
resource development. The educational policy of the country is to re-organize the educational
system and to connect education to the country’s national development plans, with a
particular emphasis on scientific, professional, and technical studies (Sikhi, 2008).
Besides, transformational leadership and job satisfaction could have significant
relationship, as job satisfaction is critical for local government institutions to provide
services to meet citizens’ ever-growing and sometimes conflicting needs in rural areas or local
level of governance. This is because contented employees are more productive than their
dissatisfied counterparts (Riketta, 2008). Hence, numerous studies have examined the impact
of leadership behaviors (transformational and transactional) on job satisfaction, and majority
of these studies have reported a positive impact (Alonderiene and Majauskaite, 2016; Mickson
et al., 2021). Given the dynamic relationship between transformational leadership and job
satisfaction on the one hand, and between transformational leadership and job performance
on the other, job satisfaction could mediate the relationship between transformational
leadership and job performance. This issue has not been thoroughly examined especially
among physicians in public hospitals in developing countries.
Therefore, the specific objectives of this research are to: (1) examine the effect of job
satisfaction on job performance among physicians in Iraq’s public hospitals; (2) determine the
mediating role of job satisfaction on the relationship between emotional intelligence and job
performance among physicians in Iraq’s public hospitals; (3) unveil the mediating role of job
satisfaction on the nexus between transformational leadership and job performance among
physicians in Iraq’s public hospitals.
Our study makes some contributions to the extant literature. First, our study reveals the
relationship between job satisfaction and job performance among physicians in Iraq’s public
hospitals, unlike most previous studies that typically focused on western or affluent cultures.
Besides, our analysis enables us to account for the relationship between emotional
intelligence and job performance as well as the relationship between transformational
leadership and job performance in single framework. The literature on the relationship
between job satisfaction and job performance is extensive, as numerous studies have found a
strong link between one’s attitude toward his/her job (job satisfaction) and job performance
(Judge et al., 2001). Our research extends the extant literature by integrating emotional
intelligence and transformational leadership in the framework.
Second, our study represents a novel idea that unveils the mediating role of job
satisfaction on the relationship between emotional intelligence and job performance among
physicians in Iraq’s public hospitals. Given the dynamic relationship between emotional
intelligence and job performance on the one hand, and the nexus between emotional
intelligence and job satisfaction on the other, job satisfaction could mediate the relationship
between emotional intelligence and job performance. This issue has not been thoroughly
explored in the empirical literature especially in developing countries. Most previous studies
on emotional intelligence are conducted in western and affluent cultures. Henrich et al. (2010)
and Sony and Mekoth (2016) emphasized the importance of using non-western samples in
research, particularly when the focus of the study is the nature of humans. Consequently, our
research was carried out in Iraq, which is a society that is distinct from western societies.
Emotional intelligence has been proposed as a significant predictor of job satisfaction since
employees with a high level of emotional intelligence are more likely to be satisfied with their
jobs compared to their peers with low level of emotional intelligence (Petrides, 2001; Petrides
and Furnham, 2006). As a result, job satisfaction could act as a mediator between physicians’
emotional intelligence and job performance.
Third, our study also contributes to the extant literature by unveiling the mediating role of
job satisfaction on the relationship between transformational leadership and job performance
among physicians in Iraq’s public hospitals. Transformational leaders have a profound effect
on their employees’ cognition and behavior patterns (Lord et al., 2017). As a result, we can
reasonably hypothesize that job satisfaction (achievement, motivations and coping styles)
may have a significant impact on the relationship between transformational leadership and
job performance. Numerous studies have been conducted over the last century to investigate
the relationship between work-related motivations and job performance (Cerasoli et al., 2014)
and to demonstrate that achievement, motivations, benefit work life and outcomes (Suarezlvarez et al., 2013). Meanwhile, leadership in medical settings has effect on health worker
motivations (Musinguzi et al., 2018). Transformational leadership that serves a greater
purpose motivates public health staff to efficiently perform their work (Ree and Wiig, 2020),
and their motivations alter their behavioral styles and productivity (Ree and Wiig, 2020;
Judson et al., 2015). Despite the mounting evidence of transformational leadership’s beneficial
effects in public health settings, the underlying mechanisms remain poorly defined. As a
result, managers continue to emphasize the importance of transformational leadership.
However, a more precise and effective method of leadership has yet to be discovered. By
omitting possible processes of cognitive and behavioral changes in physicians, the practical
implications of the research are limited, and the issue of causality remains unresolved.
To gain a better understanding of transformational leadership’s application in Iraq’s public
hospitals, the current study examines the relationship between transformational leadership,
job performance, and the mediating effect of job satisfaction in Iraq’s public hospitals.
The mediating
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2. Literature review and hypotheses
2.1 Job satisfaction and job performance
Job satisfaction refers to people’s attitudes toward their jobs and various aspects of them. It
establishes the degree to which people value and appreciate their jobs. It is a result of a
combination of physiological, psychological and environmental factors. Job satisfaction is
typically viewed as an attitude indicator that shows how much people enjoy their jobs, and it
is positively associated with employee’s health and performance (Spector, 1997). Reliable
measures of physicians’ job satisfaction aid the explanation of physicians’ behavior in
clinical, economic and organizational domains. They could also enhance the redesign of
medical workplaces to better meet the needs of physicians and patients (Konrad et al., 1999).
Conversely, the consequences of job dissatisfaction include increased physicians’ turnover,
decreased continuity of care for patients, increased medical system costs, and increased
patient dissatisfaction (Murray et al., 2001).
Theoretically, the relationship between job satisfaction and job performance can be
described by the theory of equity, which emphasizes the balance between the inputs and
outputs of the employees in a workplace (see Adams and Freedman, 1976). The inputs are
considered as the effort, time, tolerance, loyalty, flexibility, personal sacrifice, enthusiasm,
skills as well as trust in superiors. The employees’ outputs include the salary, benefits, job
security, sense of achievement, as well as reputation and praise. Adams and Freedman (1976)
noted that an employee can be dissatisfied when his/her input is not appropriately rewarded
compared to other individuals doing similar work. Hence, the employee’s inputs and outputs
should be balanced. Consequently, since the physicians receive outputs for the inputs they
invest in public hospitals, a study on the nexus between job satisfaction and job performance
is fundamental to enable the hospitals to understand the need to enhance physicians job
satisfaction in order to boost their job performance. It will also inspire the hospitals
management (particularly the departmental heads) to raise the level of physicians’ job
satisfaction. The job satisfaction of several physicians depends on the positive relationships
with colleagues, adequate resources, control over vacation time, as well as clinical autonomy
(Williams et al., 2003).
Empirically, some studies have examined the effect of job satisfaction on job performance
and concluded that job satisfaction and job performance have a strong positive relationship
(e.g. Shooshtarian et al., 2013; Fu and Deshpande, 2014; Javed et al., 2015). For instance, Judge
et al. (2001) reported a positive relationship between job satisfaction and job performance.
According to Grunfeld et al. (2005), the primary sources of job satisfaction for Canadian
oncology physicians were patient care and contact while increased workloads were identified
as significant sources of job stress. Judge et al. (2017) analyzed the relationship between job
attitudes, job satisfaction and job affect in a century of continuity and change. They noted
that the literature on job attitudes has experienced significant improvement in the use of
methods and theory as a basis for providing insights into work psychology. Recent research
has emphasized the critical role of job satisfaction in influencing different aspects of job
performance. For example, Yousef (2017) examined employee’s commitment and satisfaction
in relation to organizational change. Similarly, other researchers have examined job
satisfaction as a significant construct in recent years (Alessandri et al., 2017; Gul et al., 2018;
Huo and Boxall, 2018). Job satisfaction may have effect on how well a physician performs in
his or her job (Platis et al., 2015). Higher job satisfaction has been linked to lower burnout
(Natasha et al., 2015), and lower job turnover (Brawley and Pury, 2016). Deng et al. (2018)
stressed the need to improve the doctor-patient relationship, balance work and family life in
order to boost job satisfaction and job performance. Hou et al. (2020) noted that psychological
resilience and job satisfaction are significant predictors of job performance while Nasurdin
et al. (2020) reported that job satisfaction has a positive connection with high-performance
work practice (e.g. participation, compensation, training) and job performance. Mickson et al.
(2021) also emphasized the need to improve job satisfaction through the appropriate
leadership styles while Winton (2021) stressed emotions’ management to facilitate job
satisfaction. However, no research has been conducted in Iraq to determine whether job
satisfaction has an impact on physician job performance. Hence, we hypothesized the
following:
The mediating
role of job
satisfaction
H1. Job satisfaction is positively associated with job performance.
933
2.2 Emotional intelligence and job performance
The human resource management’s policies and practices in healthcare organizations should
foster work environment that promote emotional intelligence in order to enhance employees’
creativity, motivation, co-operation and job performance. The “affective revolution” in
management studies has necessitated the emergence of emotional intelligence as a critical
predictor of important organizational outcomes since emotions are considered a part of the
workplace or organizational life (Bande et al., 2015; Sony and Mekoth, 2016).
Theoretically, the relationship between emotional intelligence and job performance can be
explained by the mutualism model of general intelligence, which opines that “intelligence is
based on the underlying cognitive processes” (Van Der Maas et al., 2006). It states that the
mutual beneficial relationships between these processes enhance the growth of other
processes associated with this intelligence (Van Der Maas et al., 2006). Essentially, the
positive connection between processes could be direct or indirect (via other processes). These
mutual relationships have been explained in previous studies for different cognitive
processes (Gibson, 1986; Van Der Maas et al., 2006). According to the mutualism model,
certain cognitive processes mutually affect one another within certain environmental
circumstances. Van Der Maas et al. (2006) noted that cognitive processes are viewed in a
general sense (together with abilities), and that the mutual relationships between these
cognitive abilities are not confined to only intellectual intelligence but are also applicable to
emotional and social intelligence. Commenting on the relationship between emotional
intelligence and job satisfaction, some studies have argued that managers who possess high
emotional intelligence can boost the employees job performance since they can effectively
manage employees’ emotions that stimulate greater resilience, creativity, and performance
(Fredrickson, 2003; Sy et al., 2006). Besides, managers who possess high emotional
intelligence could be more proficient at fostering greater positive interactions between
employees which are capable of intensifying better coordination, cooperation, organizational
behaviours, and job performance (Barsade, 2002; Sy et al., 2005; Wong and Law, 2002).
Furthermore, some scholars have theorized that job performance can be enhanced by the
ability of employees to utilize emotions to promote performance (George and Brief, 1996).
Both negative and positive emotions can be used by employees to their benefits in order to
boost performance. Specifically, positive emotions (e.g. enthusiasm or excitement) can inspire
employees to complete their task, offer greater customer service, as well as assist the
organization. On the other hand, negative emotions (e.g. anxiety) can inhibit or enhance the
ability of employees to focus on their assignments. Employees who possess greater emotional
intelligence could be more skilful in fostering greater productive interactions that can
promote job performance (Wong and Law, 2002). Some studies have also stressed the need to
manage emotions effectively to ensure happier employees (Ashforth and Humphrey, 1995),
decrease in turnover intention (Tett and Meyer, 1993), greater level of organisational
commitment (Meyer et al., 2002), and increase in job performance (Iaffaldano and Muchinsky,
1985). Besides, employees with greater emotional intelligence can perform their works
effectively relative to employees with lower emotional intelligence (Alonderiene and
Majauskaite, 2016; Brunetto et al., 2012). Essentially, Wong and Law (2002) noted that
emotional intelligence has a positive influence on job performance while Li et al. (2018)
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showed that emotional intelligence is a significant predictor of job performance. Similar
empirical outcomes have been reported in some studies (Brunetto et al., 2012; Javed et al., 2020;
Winton, 2021). Based on the foregoing discussion, our study proposes the following
hypothesis:
H2. Emotional intelligence is positively associated with job performance.
934
2.3 Transformational leadership and job performance
Nowadays, the extensive research on the relationship between leadership styles and
workplace performance focuses on transformational and transactional leadership styles
(Advani and Abbas, 2015). Transformational leaders with idealized influence can establish
employee’s trust and respect, express confidence in the organization’s vision, as well as
emphasize the critical nature of a shared understanding of the organization’s mission (Yukl,
2013). Hall et al. (2002) summarized the four factors to transformational leadership as
idealized influence, inspirational motivation, intellectual stimulation and individual
consideration. Leaders can motivate followers to perform effectively by creating an
environment of collaboration and teamwork where subordinates can work diligently and
creatively. Transformational leaders can shape the vision, inspire optimistic commitment to
it, and foster an environment conducive to innovation.
Transformational leadership theory began with the ideas of Burns (1978) and Bass (1985)
who asserted that transformational leaders motivate the subordinates to create leadership
perceptions with novel perspectives due to intellectual stimulations. Leaders can create
perceptions since they are people who have the capacity to support or inspire the
subordinates with personalized consideration via charisma and motivation (Bass, 1985). In
contrast, transactional leadership gives priority to supervising, assigning, organizing,
monitoring and controlling each employee’s performance. Leaders that operate transactional
leadership styles are interested in monitoring subordinates’ jobs, rewarding outstanding
workers, and providing punishment or warnings to subordinates who stray from the
predetermined goals. Several theories have been identified to explain the nexus between
leadership style and job performance (Vigoda-Gadot, 2007). Transformational leadership has
the capacity to boost job satisfaction because it can provide tasks, intellectual motivation and
sense of responsibility. Essentially, leaders who adopt transformational leadership style can
encourage their workers to have greater accountability and autonomy, which ultimately
enhance workers’ sense of accomplishment and job satisfaction (Long et al., 2014). Under
transformational leadership, the workers can optimally explore themselves, thereby raising
their job performance level. Besides, the workers can have the opportunity to enhance their
job satisfaction factors (such as increase in skills, salary, promotion opportunities, etc.)
Transformational leaders who understand workers’ thoughts are better trainers, and possess
the capacity to relate the workers’ objectives with the organizational goals (Horwitz
et al., 2008).
Some previous studies have noted that transformation leadership has a positive influence
on employees’ job satisfaction, productivity and performance (Al-Amin, 2017; Mangkunegara
and Huddin, 2016; Manzoor et al., 2019). Specifically, Mangkunegara and Huddin (2016)
investigated the effect of transformational leadership on job satisfaction and job
performance, and the results showed that transformational leadership has a positive
influence on employees’ job performance. Besides, transformational leadership qualities
(especially individualized considerations) have significant relationship with optimum
employees’ performance (Long et al., 2014). By adopting the appropriate leadership style
(e.g. transformational leadership style), managers can have significant influence on
employees’ commitment, efficiency, productivity as well as job contentment. Al-Amin
(2017) noted that transformational leadership has a positive influence on employee’s
performance while Buil et al. (2019) reported a positive connection between transformational
leadership and job performance. Manzoor et al. (2019) also stressed the importance of
transformational leadership in promoting job performance. Mickson et al. (2021) also
emphasized the role of transformational leadership in enhancing job outcomes. Based on the
discussion above, we develop the following hypothesis:
The mediating
role of job
satisfaction
H3. Transformational leadership is positively associated with job performance.
935
2.4 Job satisfaction as a mediator
Based on the relationships between physicians’ emotional intelligence, job satisfaction, and
job performance, we expect that job satisfaction will act as a mediator on the impact of
physicians’ emotional intelligence on job performance. This is consistent with the findings of
Li et al. (2018), who discovered an indirect positive relationship between physicians’
emotional intelligence and job performance via job satisfaction. They argued that physicians
with a higher emotional intelligence perform better than physicians with a lower emotional
intelligence partly because they are more satisfied with their jobs, which results in improved
performance. Furthermore, there is evidence that job satisfaction plays a mediating role in the
relationship between physicians’ emotional intelligence and performance-related variables
(Alonderiene and Majauskaite, 2016). Wong and Law (2002) and Brunetto et al. (2012) found
that physicians’ emotional intelligence positively predicted job satisfaction, which in turn,
promoted employee engagement. On the basis of the existing literature, we propose in the
current study that job satisfaction acts as a mediator on the relationship between physicians’
emotional intelligence and job performance. A review of the literature on emotional
intelligence in healthcare settings established that emotional intelligence has a broad
application in medicine, encompassing domains such as interpersonal skills and
communication, patient care, professionalism, medical knowledge, and practice-based
learning and improvement (Arora et al., 2010). As a result, there has been an increasing call for
incorporating emotional intelligence development into medical education (Arora et al., 2010;
Lewis et al., 2005; Pilkington et al., 2012). Hence, the following hypothesis is proposed:
H4. Job satisfaction mediates the relationship between emotional intelligence and job
performance.
Employees’ interest in completing their assigned tasks increases when they are satisfied with
their jobs (Mangkunegara and Huddin, 2016; Mujkic et al., 2014). Besides, Rezvani et al. (2016)
found that when employees are satisfied with their job, they are more likely to perform better,
make better decisions, and solve problems. As a result, satisfied employees at work usually
perform better (Rezvani et al., 2016). Leadership, on the other hand, is a management function
that focuses on public relations, people and techniques to motivate employees to achieve
higher levels of performance and organizational success (Voon et al., 2011; Mangkunegara
and Huddin, 2016). In order to achieve job satisfaction, effective leadership is crucial.
According to several studies conducted in various countries, transformational leadership has
a positive correlation with job satisfaction, which leads to higher employee performance and
organizational success (Berson and Linton, 2005; Seo et al., 2004). Idealized influence,
inspirational motivation, intellectual stimulation, and empowerment are all characteristics of
transformational leadership (Shaw et al., 2018). Transformational leaders in medical settings
generally inspire public health workers to share the sacred mission, stimulate their
intelligence, and provide personalized care (Fischer, 2016; Pearson, 2020). Employees
(particularly those with high need for leadership) are more likely to engage in work and
perform better when leaders demonstrated a greater capacity for transformational leadership
(Breevaart et al., 2016). Public health leadership can help with the professional development of
the public health workforce. The cognition and behavior patterns of their employees are
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profoundly influenced by transformational leaders (Lord et al., 2017). As a result,
achievement, motivation and coping styles may have a significant impact on the
relationship between transformational leadership and performance. Based on the
discussion above, the following hypothesis is proposed:
H5. Job satisfaction mediates the relationship between transformational leadership and
job performance (see Figure 1).
936
3. Methodology
3.1 Procedure and sample
A questionnaire survey was used to collect data from employees working in Iraq’s public
hospitals. The justification for choosing the survey method is because it allows us to collect a
large quantity of data within a short time (Al Wali et al., 2022b). Unlike other data collection
techniques, the survey method is extensive because it can provide different information about
the population or sample. Moreover, the survey method is less costly relative to other
techniques. Another justification for using the survey method is that the method is flexible
since it can be administered in various modes such as face-to-face, email, online, telephone,
etc. The survey method is also dependable because its’ anonymity allows the respondents to
provide valid, honest, as well as unambiguous responses (Al Wali et al., 2022a). Prior to
conducting the survey, two medical professionals working in public hospitals in Iraq and two
academic professionals working in universities reviewed the questionnaire for wording,
content, and question ambiguity issues. The professionals suggested a few minor changes to
the questionnaire.
We collected data from full-time healthcare professionals (physicians) recording their
opinions on emotional intelligence, transformational leadership, job satisfaction, and job
performance using a convenience sampling technique. Data was collected from seven public
hospitals in Baghdad, Iraq, between June and July 2021 (Baghdad Teaching Hospital, Al
Kindi General Teaching Hospital, Al Yarmuk General Teaching Hospital, Al Nuaman
General Hospital, Al Qadisiya General Hospital, Al Karkh General Hospital, and Ibn Sina
Hospital). The questionnaires were administered to the physicians who had direct interaction
with the patients (e.g. in emergency and OPD). Public hospitals were chosen for this study
because they receive a high volume of patients seeking free medical treatment. A total of 157
responses were utilized in the data analysis.
This study employs the Structural Equation Model (SEM) through Partial Least Squares
(PLS-SEM) to ascertain the relationship between the variables. The justification for choosing
the PLS-SEM relative to other techniques (e.g. Covariance-Based Structural Equation Model)
is that our research model seeks to predict and explain the variance in fundamental target
constructs (Chin, 2010; Al Wali et al., 2022b). The PLS-SEM is appropriate for a study that
seeks to predict important target constructs or seeks to identify fundamental driver
construct. Moreover, the PLS-SEM is appropriate for exploratory research or a research that
extends an existing structural theory. Also, the relationships examined in our study are still
in the early stages of theoretical development, which opens the door to the exploration of
Emotional Intelligence
Job Satisfaction
Figure 1.
Conceptual framework
Transformational
Leadership
Job Performance
novel ideas in future research (Al Wali et al., 2022a). Besides, the structural model is capable of
revealing the relative effects of exogenous variables on endogenous variables (Richter et al.,
2016). Table 1 shows the profile of respondents.
3.2 Measures
In this study, items were adapted from previously well-established and published studies.
All items were scored on a 5-point Likert scale ranging from “1” “strongly disagree” to “5”
“strongly agree”.
3.2.1 Emotional intelligence. This variable was determined through the use of sixteen
items adapted from Wong and Law (2002). “I usually have a good sense of why I have certain
feelings,” and “I can always tell my friends’ emotions based on their behaviour.” Although the
scale was developed in 2002, it has been widely used in recent studies (Acosta-Prado and
Zarate-Torres, 2019; Di et al., 2020), and its validity has been confirmed in a variety of
different countries and markets (Acosta-Prado and Zarate-Torres, 2019; Iliceto and Fino,
2017). For these reasons, it was included as a component of the research instrument in this
study. In this study, the Cronbach alpha value for emotional intelligence was 0.968.
3.2.2 Transformational leadership. The seven items from Carless et al. (2000) were used to
assess the participants. For example, “My leader encourages me to think about problems in
new ways and to question assumptions,” and “My leader treats us as individuals, supports,
and encourages our development,”. According to this study, the Cronbach alpha for
transformational leadership was 0.957.
3.2.3 Job satisfaction. The six-item scale used in this study provides a one-dimensional
measure of overall job satisfaction (Agho et al., 1992). In this study, the Cronbach alpha for job
satisfaction was 0.894, which is very high.
3.2.4 Job performance. This variable was measured by using five items adapted from
Williams and Anderson (1991). Sample items include “I adequately complete assigned
duties”, “I meet the formal performance requirements of the job”. Cronbach alpha for this
measure was 0.923 in this study.
The mediating
role of job
satisfaction
937
3.3 Common method bias
The data for this study were collected from a single source through the use of a selfadministered questionnaire. As a result, it has the potential to introduce the possibility of
Demographic variable
Categories
N
%
Gender
Male
Female
Bachelors
Masters
Doctors
20–30 years
31–40 years
41–50 years
Over 50 years
Less than 1 year
1–5 years
6–10 years
11–15 years
More than 15 years
Single
Married
101
56
42
64
51
26
42
52
37
15
36
33
46
27
43
114
64.3
35.7
26.8
40.8
32.5
16.6
26.8
33.1
23.6
9.6
22.9
21
29.3
17.2
27.4
72.6
Education
Age
Experience
Marital status
Table 1.
Profile of respondents
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common method variance (CMV) into the data. Because of this, both procedural and statistical
methods were used in this study to address the common method bias that was observed
(Schwarz et al., 2017). The data set was subjected to Harmon’s single factor analysis in order
to determine the presence of common method bias. According to the findings, the first factor
explains 28% of the variance, indicating that common method bias had no effect on the
current study’s findings (Babin et al., 2016).
3.4 Analysis strategy
For analyzing the data in this study, we used Smart PLS version 3.2.7 to examine both the
measurement and structural model.
3.4.1 Measurement model assessment. The measurement model was evaluated in order to
determine the validity and reliability of the measurement items (see Table 2). In the first step,
the loadings, average variance extracted (AVE), and composite reliability (CR) are evaluated
to ensure the measurement model’s convergent validity. According to Hair et al. (2021), each
item should have a loading of at least 0.5 to be considered valid. Furthermore, they
recommended that items with loadings of less than 0.50 be removed. However, as shown in
Table 2, loadings for items with a value of less than 0.5 have been removed from this study.
The descriptive statistics reported in Table 3 indicate small variations among the
variables. For instance, the mean values of job performance, job satisfaction, emotional
Constructs
Items
Factors loading
Emotional intelligence
EI1
EI2
EI3
EI4
EI5
EI6
EI7
EI8
EI9
EI10
EI11
EI14
EI15
EI16
TL2
TL3
TL4
TL5
TL6
TL7
JS1
JS2
JS3
JS4
JS5
JS6
JP1
JP2
JP3
JP4
JP5
0.833
0.924
0.886
0.825
0.802
0.893
0.845
0.906
0.895
0.853
0.808
0.721
0.738
0.735
0.889
0.914
0.932
0.929
0.887
0.885
0.671
0.811
0.908
0.875
0.804
0.780
0.776
0.863
0.888
0.921
0.914
Transformational leadership
Job satisfaction
Job performance
Table 2.
Factors loading
No of items deleted
EI12, EI13
TL1
None
None
intelligence, and transformational leadership were 0.871, 0.808, 0.831, and 0.905, respectively.
The corresponding standard deviations indicate that the variables are quite dispersed around
their means (averages).
Additionally, we examined CR values and AVE scores to evaluate the measurement model
(Hair et al., 2017). For advanced research, CR values of between 0.7 and 0.9 are considered
satisfactory (Hair et al., 2011). The CR values for all constructs (see Table 4) ranged from 0.920
to 0.970, which is greater than the recommended value (Hair et al., 2021; Henseler et al., 2009).
Finally, convergent validity was determined using the AVE scores. Acceptable AVE scores
are 0.5 or greater (Al Wali et al., 2022b; Hair et al., 2011). The findings indicate that all
constructs had AVE scores greater than 0.5, which met the minimum threshold suggested by
some authors (Hair et al., 2021), as shown in Table 4.
Next, this study assessed HTMT (Henseler et al., 2015) to confirm the discriminant validity
for the measurement model. Henseler et al. (2015) suggest an HTMT value of less than 0.9 is
acceptable. As shown in Table 5, the values of HTMT were all lower than the criterion of 0.90.
Therefore, it suggests that respondents in this study believed and understood that all the
constructs used in this study were distinct from each other in practical terms. However, it can
be concluded that both the convergent and discriminant validity of the measurement model
were confirmed in this study (Table 5).
3.4.2 Structural model assessment. All hypotheses that include both direct and indirect
effects can be tested simultaneously using the PLS-SEM (Hair et al., 2021). Figure 2 illustrates
Construct
N
Min.
Max.
Mean
S.D.
JP
JS
EI
The mediating
role of job
satisfaction
939
TL
Job performance (JP)
157
1
5
0.871
0.029 1
Job satisfaction (JS)
157
1
5
0.808
0.036 0.682 1
Emotional intelligence (EI)
157
1
5
0.831
0.526 0.721 0.595 1
Transformational leadership (TL) 157
1
5
0.905
0.020 0.257 0.346 0.144
1
Table 3.
Note(s): Emotional Intelligence (EI), Job Performance (JP), Job Satisfaction (JS), Transformational
Descriptive statistics
Leadership (TL)
and correlation matrix
Constructs
Cronbach’s
alpha
Composite
reliability
Average variance
extracted
(AVE)
0.968
0.957
0.894
0.923
0.970
0.965
0.920
0.942
0.698
0.821
0.659
0.764
Emotional intelligence
Transformational leadership
Job satisfaction
Job performance
Constructs
Emotional intelligence
Job performance
Job satisfaction
Transformational
leadership
Emotional
intelligence
Job
performance
0.711
0.581
0.126
0.736
0.262
Job
satisfaction
0.373
Table 4.
Composite reliability,
average variance
extracted (AVE)
Transformational
leadership
Table 5.
Discriminant validity
Heterotrait-Monotrait
ratio (HTMT) criterion
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940
Figure 2.
Structural model
a structural model. Regarding the first hypothesis, the findings reported in Table 6 show that
job satisfaction is significantly and positively related to job performance (t-statistic 5 5.882,
p-value 5 0.000), thereby supporting hypothesis H1. The results also indicate that emotional
intelligence is significantly and positively related to job performance (t-statistic 5 7.939,
p-value 5 0.000), thereby supporting hypothesis H2. However, there is no evidence to support
hypothesis H3 since transformational leadership is not significantly and positively related to
job performance (t-statistic 5 0.910, p-value 0.363).
We used Preacher and Hayes’s (2008) method to assess mediating effects. The
bootstrapping technique is used to determine the significance of mediation relationships
using this method (indirect effects). For mediating relationships, t-values greater than the
critical value of 1.96 were considered significant. Additionally, indirect effects established the
existence of mediating effects in the absence of a “0” value between confidence intervals, as
Preacher and Hayes (2008) suggested. The results of the mediating effects reported in Table 6
revealed that job satisfaction mediates the relationship between emotional intelligence and
Hypothesis relationship
Std
error
t-value
Job satisfaction → job performance
0.359
0.061
5.882
Emotional intelligence → job
0.503
0.063
7.939
performance
H3 Transformational leadership → job
0.056
0.062
0.910
performance
H4 Emotional intelligence → job
0.198
0.043
4.626
satisfaction → job performance
H5 Transformational leadership → job
0.096
0.026
3.693
satisfaction → job performance
Note(s): p < 0.05 (based on one-tailed test with 5.000 bootstrapping)
H1
H2
Table 6.
Result of
structural model
Original
sample
95% CI
LL
95% CI
UL
p-value
0.173
0.388
0.364
0.603
0.000
0.000
0.051
0.155
0.363
0.136
0.274
0.000
0.054
0.142
0.000
job performance (t-statistic 5 4.696, p-value 5 0.000), implying that hypothesis H4 is
supported. Finally, the results also show that job satisfaction mediates the relationship
between transformational leadership and job performance (t-statistic 5 4.625,
p-value 5 0.05). Therefore, hypothesis H5 is supported.
4. Discussion
This study seeks to investigate the association between job satisfaction and job performance
among physicians in public hospitals in Iraq. It also examines the mediating role of job
satisfaction on the relationship between emotional intelligence and job performance as well as
the mediating role of job satisfaction on the nexus between transformational leadership and
job performance. This study focuses on a particular sector of health professionals who play a
central role in the health system. Furthermore, it investigates the relationships between these
variables in this population at a time of particular need and vulnerability such as the global
health crisis caused by the COVID-19 pandemic (World Health Organization, 2020).
The information for this study was gathered from physicians working in Iraqi public
hospitals during the peak period of the pandemic (second wave) in Iraq, which occurred
between June and late July 2021. These circumstances afforded us the opportunity to provide
better insights into the relationship between these variables and physicians’ job performance.
Besides, we can design future research programmes aimed at improving the physicians’
performance in this sector. Unfortunately, the crisis triggered by COVID-19 is not yet under
control, either in Iraq or around the world, and it is necessary to understand how different
variables that influence the job performance of physicians are related in the context of a
pandemic.
The research was conducted in response to repeated requests for information on how the
various components of a transformational leadership style influence various workplace
behaviors and attitudes (Yammarino, 1990; Yammarino and Bass, 1990). According to
existing research, the components of a transformational leadership style have similar effects
on various work outcomes, leading to the transformational leadership style being
conceptualized as a global construct. This research also discovered that organizational
leaders should align their leadership behaviors with individual followers’ identity and
orientation differences. As a result, the organization will be able to get the most out of its
employees’ assigned tasks, improve their job and life satisfaction, and reduce their desire to
leave. For example, a leader who wants his followers to believe in him and have a strong sense
of mission should use idealized influence to be a role model in moral and workplace ethics.
From the first hypothesis, our study shows that job satisfaction has a significant and
positive influence on the job performance of physicians in public hospitals in Iraq. This
positive and significant relationship indicates that the more employees are satisfied with their
jobs, the more likely they are to perform well at work. The effect of job satisfaction on job
performance is supported by some previous studies in various fields or industries. For
instance, Maaitah et al. (2018) and Tsai et al. (2010) reported that job satisfaction is positively
correlated with job performance. Bakan et al. (2014) also confirmed that job satisfaction has a
positive impact on job performance and job commitment among academic staff in Turkey.
Using data from a study of non-executive workers in the Kalutara district of Sri Lanka, Perera
and Weerakkody (2016) discovered a positive relationship between job satisfaction and their
performance.
The results of the second hypothesis show that emotional intelligence is significantly and
positively related to job performance among the physicians in Iraq public hospitals. This
implies that employees with greater emotional intelligence can perform their works
effectively relative to employees with lower emotional intelligence (see Alonderiene and
Majauskaite, 2016; Brunetto et al., 2012). This empirical outcome is consistent with some
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satisfaction
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previous studies (e.g. Li et al., 2018; Javed et al., 2020; Wong and Law, 2002) who posited that
emotional intelligence is a significant and positive determinant of job performance.
The results of the third hypothesis indicate that transformational leadership has no
significant relationship with job performance among the physicians in Iraq public hospitals.
This implies that transformational leadership cannot predict physicians’ performance. This
empirical outcome is consistent with Brewer et al. (2016) who reported that transformational
leadership has insignificant relationship with intent to stay and job satisfaction of nurses
albeit it has small direct positive impact on organizational commitment. Though
transformational leadership can be seen in medical settings in Iraq, our study found no
evidence to show that it can positively influence physicians job performance in public
hospitals. The low level or degree of transformational leadership in Iraq public hospitals
could possibly be responsible for the insignificant relationship between transformational
leadership and physicians job performance. For instance, some studies have argued that
transformation leadership (as a fundamental factor in the workplace) can only stimulate job
performance if it engenders employee’s creativity, innovation and job satisfaction (Cheung
and Wong, 2011; Miao and Cao, 2019; Vecchio et al., 2008). Besides, transformational
leadership can contribute to employees’ job performance and quality improvement if it
reduces attrition, enhances employees’ retention and creates a positive work environment for
employees (Brewer et al., 2016; Boamah et al., 2018). In this regard, it may be necessary to
strengthen medical leadership (especially transformational leadership) in Iraq public
hospitals in order to promote the physicians’ personal development and performance.
The results of the fourth hypothesis show that job satisfaction has a significant mediating
role on the relationship between emotional intelligence and job performance of physicians in
Iraqi public hospitals. In this case, job satisfaction becomes an important factor to consider in
an effort to improve employee performance. Job satisfaction is a powerful motivator that can
influence the relationship between emotional intelligence and performance (Chin and Yusof,
2017; Schlaegel et al., 2020). Physicians are expected to have good acceptance and emotional
control over how they deal with changes by optimizing the aspects of job satisfaction.
According to the fifth hypothesis, job satisfaction mediates the relationship between
transformational leadership and job performance. Job satisfaction is extremely important in
transformational leadership because it has a direct impact on employee performance.
Theoretically, transformational leadership could play a role in improving the performance of
physicians by increasing their level of job satisfaction (Paracha et al., 2012; Risambessy et al.,
2012; Elgelal and Noermijati, 2015). These previous studies showed that job satisfaction
mediates the relationship between transformational leadership and employee performance
albeit it has no significant mediating role on the nexus between transactional leadership and
employee performance.
4.1 Theoretical implications
This study makes some contributions to the theoretical literature by integrating the literature
on the nexus between job satisfaction and job performance, emotional intelligence and job
performance, as well as transformational leadership and job performance in single framework.
It emphasizes the fundamental roles of job satisfaction and emotional intelligence in promoting
job performance in the health sector albeit transformational leadership has tenuous effect. It
indicates that employees with high job satisfaction are likely to perform well in their jobs
relative to employee with low job satisfaction. Besides, the job performance of employees with
high emotional intelligence is greater than the job performance of employee with low emotional
intelligence. Apart from the direct effects, this study indicates that job satisfaction has a
significant mediating role on the relationship between emotional intelligence and job
performance. This finding reveals important theoretical clues that emotional intelligence as a
personal capability may influence job performance not only directly but also indirectly through
its positive effect on job satisfaction. This further emphasizes the value of emotional intelligence
in the workplace. Essentially, emotional intelligence probably influences physicians’ emotional
labor strategies and job satisfaction which ultimately affects their job satisfaction.
Though the direct impact of transformational leadership on job performance is tenuous,
there is robust evidence that job satisfaction enhances the impact of transformational
leadership on job performance. Precisely, job satisfaction has a significant mediating role on
the relationship between transformational leadership and job performance. Hence,
organizations that want to strengthen the relationship between transformational
leadership and job performance should promote employee’s job satisfaction. Employees
who work with transformation leaders can improve their job performance if they have greater
job satisfaction. The causal mediation analysis in this study confirms that job satisfaction
mediates the relationship between emotional intelligence and job performance as well as the
nexus between transformational leadership and job performance among physicians in public
hospitals. In other words, job satisfaction should be considered when investigating the
impacts of emotional intelligence and transformational leadership on physicians’ job
performance. Therefore, this research extends the social cognitive theory and social exchange
theory [1].
4.2 Practical implication
The study’s findings have some intriguing and practical implications for hospital-based
medical professionals. To begin with, it demonstrates that physicians’ emotional intelligence
can contribute significantly to job performance in the workplace. Earlier research has
established that emotional intelligence can be enhanced through targeted training (e.g. Nelis
et al., 2009, 2011). Thus, it is suggested that public hospital administrators and policymakers
recognize its significance and incorporate it into physician training programs. Second, from a
managerial standpoint, physician leadership positions should be filled with physicians who
exhibit transformational leadership characteristics. This is important because these
leadership characteristics have a positive relationship with employee’s job satisfaction
especially when accompanied with job satisfaction. For physicians who lack these
characteristics, it is critical to develop organizational practices that foster respect and
support equitable treatment. Regardless of individual styles, it may be beneficial for public
hospitals to engage actively in training their physicians to develop transformational qualities
and skills and to instill them in their interactions with subordinates. Third, transformational
leadership must be incorporated into physician recruitment, promotion, and training in
healthcare settings. Particularly in healthcare, leadership development would benefit from
combining training and coaching approaches based on the transformational leadership
concept (Braun et al., 2009). In general, our findings suggest that the healthcare sector can
serve as a model for other organizations (in the for-profit and not-for-profit sectors) by
demonstrating the impact of a culture which is shaped by transformational leadership
and trust.
5. Conclusion
The results of the current study confirm that the objectives were achieved. The first
objective of this study was to examine the association between job satisfaction and job
performance. The finding showed that job satisfaction has a significant positive
relationship with job performance. The second objective was to determine the
relationship between emotional intelligence and job performance. The findings indicate
that emotional intelligence is significantly and positively related to job performance. The
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third objective sought to ascertain the nexus between transformational leadership and job
performance, and the findings reveal that transformational leadership has no significant
relationship with job performance. The fourth objective was to test the mediating role of job
satisfaction on the relationship between emotional intelligence and job performance. The
results indicate that job satisfaction mediates the effect of emotional intelligence on job
performance. These findings significantly lend support to the mediating role of job
satisfaction in emotional intelligence on job performance. The final objective was to
determine the mediating effect of job satisfaction on the relationship between
transformational leadership and job performance. The findings show that job
satisfaction mediates the relationship between transformational leadership and job
performance. This study has some theoretical and practical implications. Theoretically, it
integrates the literature on the nexus between job satisfaction and job performance,
emotional intelligence and job performance, as well as transformational leadership and job
performance in single framework. By unveiling the mediating role of job satisfaction on the
relationship between emotional intelligence and job performance as well as between
transformational leadership and job performance, this study has extended the theoretical
literature. It indicates that employees who have high job satisfaction, emotional intelligence
and transformational leaders are likely to perform their job effectively relative to employees
who have low job satisfaction and emotional intelligence. Hence, this study extends the
social cognitive theory and social exchange theory. Practically, this study emphasizes that
job satisfaction is a significant determinant of job performance among physicians in public
hospitals. It also plays a favorable mediating role on the effects of emotional intelligence
and transformational leadership on job performance in public hospitals. Therefore, public
hospitals should create the enabling environment that promotes job satisfaction among
physicians in order to attain optimal job performance. This study also demonstrates that
physicians’ emotional intelligence can contribute significantly to job satisfaction.
Therefore, public hospital administrators and policymakers should recognize the
significance of emotional intelligence and incorporate it into physician training
programs. Moreover, the leadership of physicians should be filled with people who
exhibit transformational leadership characteristics in order to develop organizational
practices that foster respect and support equitable treatment. Public hospitals should
actively engage in the training of physicians to develop the requisite transformational
qualities and skills that will enhance their interactions with subordinates.
Transformational leadership should be incorporated into physicians’ recruitment,
promotion, and training in healthcare settings.
6. Limitations and future research
Every study arguably has limitations, which emphasizes the importance of additional
research. To begin with, this study focuses exclusively on the health sector. Hence, future
research may extend its findings to other service sectors, such as banking and the hotel
industry. Second, this study’s data collection occurred in a single session. The data collected
in future research can be collected in two waves. Time one could be devoted to emotional
intelligence and transformational leadership while time two could be devoted to job
performance and satisfaction. Finally, because the results of this study were obtained during
a pandemic, their generalizability to other contexts should be exercised with caution. Despite
its limitations, this research data sheds light on a critical issue, such as the impact of
emotional intelligence and transformational leadership on physician performance.
Additionally, the data reflects these relationships during a period of extraordinary crisis in
Iraq, as they were collected during the country’s peak of the COVID-19 pandemic. We believe
that these data provide an excellent opportunity to investigate this critical issue for
physicians, the health system, and society in a setting as unique and difficult to study as a
pandemic’s peak. We hope that the data presented here can assist physicians in ensuring
their performance in future situations.
Note
1. The social cognitive theory stresses the importance of cognition in the interplay between the self,
behavior and the environment. It posits that human functioning is influenced by “people’s judgments
of their capabilities to organize and execute courses of action required to attain designated types of
performances” (Bandura, 1986, p. 391). On the other hand, the social exchange theory is “a general
sociological theory concerned with understanding the exchange of resources between individuals
and groups in an interaction situation” (Ap, 1992, p. 668). Social exchange theory is based on the idea
that the relationship between two individuals is formed through a process of cost-benefit analysis.
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Corresponding author
Joather Alwali can be contacted at: joather12@gmail.com
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