|ORIGINAL RESEARCH PAPER
|Year : 2008 | Volume
| Issue : 2 | Page : 100
Medical Laboratory Sciences Graduates: Are They Satisfied at Work?
N Al-Enezi1, MA Shah2, RI Chowdhury2, A Ahmad3
1 Ministry of Health, Sulaibekhat, Kuwait
2 Department of Health Information Administration, Kuwait University, Sulaibekhat, Kuwait
3 Al-Amiri Hospital, Ministry of Health, Kuwait
|Date of Submission||11-Aug-2007|
|Date of Acceptance||11-May-2008|
|Date of Web Publication||20-Aug-2008|
PO Box 31470-Sulaibekhat, 90805
Source of Support: None, Conflict of Interest: None
Objective:In this study, the overall job satisfaction of medical laboratory scientist graduates of one Kuwaiti University was examined in relation to the environment and organizational features of their places of employment.
Materials and Methods:A questionnaire was distributed to 105 graduates of the Medical Laboratory Sciences (MLS) Department, Faculty of Allied Health Sciences, Kuwait University from the years 1982 to 2001 who are currently working in Ministry of Health hospitals. Of those, 85 questionnaires were returned and this was a response rate of 80 percent.
Results:Fifty-six percent of respondents were satisfied overall with their jobs, but 44% were not satisfied. Overall job satisfaction was found to be associated with having the opportunity of applying their academic knowledge and laboratory skills to their work when job conditions were conducive to the work and there was collegiality in the laboratory. Reporting to only one supervisor also showed a positive relationship with overall job satisfaction. In contrast, perceptions of unhealthy working conditions, where employees tended to be a hindrance to another employee, were associated with lower overall job satisfaction. Forty-nine percent of all respondents reported that they were not satisfied with organizational practice, 44% were not satisfied with the work environment, and 39% were not satisfied with their autonomy and freedom to work.
Conclusion:A high percentage of laboratory technologists were not satisfied overall with their jobs or with specific aspects of their jobs. Particularly important in this respect were whether technologists felt that their work appropriately used their knowledge, feelings of technical competency, work related rules/procedures, and presence of unhealthy competition. These issues of health worker dissatisfaction need to be addressed by the health authority managers responsible for these services and by academics who train MLS workers.
Keywords: Medical laboratory scientists, professional recognition, job satisfaction
|How to cite this article:|
Al-Enezi N, Shah M A, Chowdhury R I, Ahmad A. Medical Laboratory Sciences Graduates: Are They Satisfied at Work?. Educ Health 2008;21:100
The work in clinical laboratory sciences, also called medical laboratory sciences (MLS) and medical laboratory technology (MLT), combines the challenges and rewards of medicine with laboratory science that is a foundation for an effective diagnostic laboratory service. This laboratory service plays a crucial role in the detection, diagnosis, and treatment of disease. Medical laboratory scientists therefore view their work, qualities, and characteristics as being on par with those of other healthcare professions, like medicine, as was defined by Abraham Flexner (1991). But, unlike medical doctors, they are not universally recognized as a profession within the healthcare sector (Koylarz, 1998). Mishoe et al.(1993) reported that among students who chose careers in engineering, medicine, and pharmacy, a large percentage regarded those in allied health science professions as having a relatively lower social status. This is particularly true in Kuwait where the professional status of those working in the field of allied health sciences is yet to be duly recognized (Onuoha & Abdulla, 1991). This was repeatedly found among high school graduates during the yearly Kuwait University Education Fair held to attract students to study allied health science subjects. This dearth of professional recognition is bound to cause frustration among the MLS professionals, lower their job satisfaction and ultimately adversely effect the quality of the laboratory investigation component of the healthcare provided to patients (Brayfield & Crockett, 1995; Gvazdinskas & Maffetone, 1995).
Recruitment and retention of graduates from MLS programs remain a common challenge for clinical laboratory managers (Lundh, 1999; Blau et al., 2005; Stuart & Otz, 2007). Laboratory managers often experience loss of highly skilled, competent and experienced employees as these workers pursue alternative ‘attractive’ areas of employment (Bernice & Teixeira, 2002). It is well established that dissatisfaction with one’s job is often at the root of high employee turnover (Lucas et al., 1993; Stagnitti et al., 2006; Blau et al., 2006), whereas a satisfied employee generally stays longer in a particular job (Schmidt-Hoffman & Radius, 1995). Spencer (1982) found an association between the sense of work accomplishment and career satisfaction. If the medical laboratory scientists' perception of their profession is different from the reality at the work place, this inevitably adversely affects how they feel about the job (Andreasson & Hamrin, 1993). Changing work responsibilities and role expectations have the potential to dramatically change, either positively or negatively, employees’ job satisfaction (Ferguson & Cheyne, 1995; Nelson & Cooper, 1995; Howard & Frink, 1996). Understanding the dynamics of the continuously changing environment of the healthcare delivery system in recent years and its impact on employees’ job satisfaction has important implications for educators and employers. For educators, this understanding is necessary for designing a course curriculum that turns out graduates who are better equipped to find satisfying positions and able to find satisfaction from their work. For employers, understanding the sources of job satisfaction helps them when making decisions about staffing and job design. In addition, educators and hospital laboratory authorities can pool efforts and collaborate to produce graduates who are well informed about all aspects of the employment within the hospital laboratory service and who are prepared to cope with the challenges of present-day working conditions.
To enhance laboratory staff commitment to their profession and the provision of quality healthcare services, the medical laboratory environment should encourage good work and be supportive with regard to working conditions, organizational hierarchy, supervision, interpersonal relations, benefits, flexibility at work and opportunity for career progression (Lunz et al., 1996; Pitt & Sands, 2002). Continuing education is an important and ever increasing need for medical laboratory technologists to help them keep abreast of the advances in the field, attain job satisfaction and provide quality service (Fritsma et al., 1979; Kumaska, 1998; Shah et al., 2001a; Tan et al., 2007). This can best be achieved by cooperative efforts between the teaching institutions and hospital laboratories from the outset of the MLS undergraduate program. The course curriculum can be planned and directed to meet the competency profile recommended for medical laboratory technologists by recognized professional bodies (CSMLS, 2000). At the hospital laboratory end, the academic input from the University academic staff will complement the expertise of laboratory professionals for running specially designed training sessions on chosen areas such as laboratory management updates, new practical skills, clinical advances, and contemporary trends in diagnostic assays.
Background and Aim
In the staffing structure of hospital laboratory service in Kuwait, a clinical biochemistry department, for example, will have one Chief Medical Laboratory Technologist and up to four Senior Medical Laboratory Technologists. With a few exceptions, the Chief Medical Laboratory Technologist’s posts have been occupied by Biochemistry or Microbiology graduates from the Science Faculty of Kuwait University. Only in recent years has the Allied Health Sciences Faculty begun offering a Medical Laboratory Sciences degree program. Since a key criterion for career progression within the hospital laboratory service in Kuwait is job seniority, it is unlikely that in the near future there will be many MLS graduates who are specifically trained for hospital laboratory service in senior laboratory posts. This likely lessens motivation for qualified MLS professionals, dampens their morale, reduces job satisfaction and thereby adversely affects the quality of healthcare.
The first graduate class from the four-year Medical Laboratory Science (MLS) program at the FAHS, Kuwait University, entered the profession in 1982. The curriculum has two major components. The first, comprised of academic and practical skills, is taught within the faculty. The second is hands-on practical experience within rotations in the main subject areas in hospitals during the program’s fourth year. The hospital laboratories are chosen as sites for student training based on staffing levels, laboratory facilities and the standard of service.
The aim of this paper was to analyze the overall job satisfaction, in relation to work environment characteristics, of graduates of the Department of MLS (previously called Department of Medical Laboratory Technology) of the Faculty of Allied Health Sciences, Kuwait University.
Materials and Methods
The study population was comprised of 128 Kuwaiti graduates (1982-2001) from the Medical Laboratory Sciences, FAHS, Kuwait University. Of these, 105 are currently working in the hospital service laboratories under the Ministry of Health. They were contacted and questionnaires were distributed in February and March 2002 Eighty-five questionnaires were returned, for a response rate of 80.1%.
After reviewing the literature in this area and a number of instruments used in other job satisfaction studies (Abu Ajamieh et al., 1996; Shah et al., 2001a), a questionnaire was designed that included questions on specific background characteristics (age, gender, years of experience working in MLS, whether one feels technically competent for the job, whether one feels that their university curriculum prepared them optimally for the job), characteristics of the work environment (remuneration, rules and procedures, participation in decision-making, communication with colleagues and supervisors, opportunities for promotion), and work/role variables (responsible or report to only one supervisor, opportunity for continuing education, effective supervision and control regarding the job). All questions were posed in a closed-ended format, except one in which respondents were asked to provide additional comments. The questionnaire also included seven questions designed to measure the professional and organizational satisfaction of respondents, and one question to measure overall job satisfaction. Responses to the satisfaction items were made on a 5 point Likert scale, with response options ranging from 5 (very satisfied) to 1 (very dissatisfied), with 4 indicating satisfied, 3 neither satisfied nor dissatisfied, and 2 dissatisfied. Due to the small number of cases in each category, these variables were converted into binary variables in which the lowest levels of job satisfaction (highly dissatisfied, dissatisfied, and neither satisfied nor dissatisfied) were re-categorized as “not satisfied”, and the highest two levels (satisfied and highly satisfied) were re-categorized as “satisfied”, as has been done in previous studies (McNeese-Smith, 1995; Abu-Ajemieh et al., 1996; Shah et al., 2001a; Al-Enezi et al., 2003). The questionnaire was pre-tested with ten subjects who were not included in the final sample. Minor but warranted changes were made in the language to improve clarity and comprehension. The anonymity of all respondents was preserved. In keeping with the standard research protocol, necessary permission for data collection was obtained from the Hospital Administration Department of the Kuwait Ministry of Health (MOH).
Descriptive statistics, bivariate analysis and chi-square tests were used to examine the association between independent and dependent variables. Logistic regression analysis was used to identify the factors associated with overall job satisfaction.
The information on background characteristics of the respondents revealed that 8% were male and 92% were female. The average age of respondents was 30 years and their average experience was 7 years in medical laboratory science work.
Responses regarding overall job satisfaction and satisfaction with specific professional and work environment characteristics are shown in Table 1. Fifty-seven percent of respondents were satisfied overall with their jobs. The proportion of respondents satisfied with the overall work environment and organizational practices were 57% and 51%, respectively. Regarding autonomy and freedom to do the work, 61% were satisfied. More than two-thirds of the respondents were satisfied with recognition and appreciation from colleagues, especially their superiors, while 81% were satisfied with the collegiality that they enjoyed at work.
Table 1: Satisfaction with the job overall and with specific professional and work environment characteristics (n=85)
The findings regarding the relationship between work environment characteristics and overall job satisfaction are presented in Table 2. Relationships were found significant for seven variables. Higher overall job satisfaction was reported by respondents who felt that their knowledge was properly utilized at work, they had effective communication with their superiors, their job related rules/procedures were functional/effective, they had opportunities to participate in decision-making and they were responsible to one supervisor. Respondents who felt unhealthy competition among various employees showed lower overall job satisfaction.
Table 2: Work environment characteristics and overall job satisfaction
To know how long respondents planned to remain in their jobs we asked subjects whether they expected to “continue the same job for the next five years” (Table 3). In total, 54% planned to remain in their jobs. Sixty-nine percent of the respondents who planned to continue their job for the next five years were satisfied compared to 35% who did not plan to continue (p<0.01).
Table 3: Respondent’s plan to remain in the job and overall job satisfaction
Logistic regression was employed to determine which characteristics independently correlated with overall job satisfaction. For the multivariate analysis, all variables from Table 2 were included in the logistic regression model (Table 4). Odds of being satisfied were significantly higher for those who felt their knowledge was properly utilized. Awareness of unhealthy competition was negatively related to overall job satisfaction. Overall job satisfaction was also lower for respondents who reported they were technically competent for the job. Respondents who reported to only one supervisor were more likely to be satisfied with their jobs.
Table 4: Logistic regression analysis of overall job satisfaction
In this paper, we analyzed the overall job satisfaction of MLS graduates in relation to the work environment characteristics. Our findings revealed that while over 50% of the respondents were satisfied with their jobs, a significant 44% were not. The literature regarding levels of job satisfaction among health professionals presents a mixed picture. Some published studies have found medical laboratory technologists to be less satisfied on the job than physicians, nurses, and pharmacists (Broski et al., 1982; Shah et al., 2001a; Lyons, 2003), while other studies (Lowstedt, 1989; Harmening et al., 1994; Lundh, 1999) have reported the level of overall job satisfaction among medical laboratory technologists as moderately high (over 75%) to high (up to 95%).
The findings of our study regarding the intention to stay at a job showed that a majority of technologists (66%) who planned to leave their jobs within the next five years were not satisfied. Mobley (1977) and Belcher et al.(2005) reported that low job satisfaction can compromise a person’s intention to stay at a job. Considerations other than job satisfaction may play a part in worker turnover, however. A lack of satisfaction with one’s job lessens the chances of further development of a career and, ultimately, reduces one’s willingness to continue in the same employment (Onuoha & Abdulla, 1991; Oleckno & Blacconiere, 1995; Shah et al., 2001a). Irrespective of the reasons, high staff turnover can adversely affect the quality of laboratory service and, thereby, the healthcare patients receive.
Although bivariate analysis in our study found that overall job satisfaction was significantly related to seven characteristics of the work environment, some of these relationships did not remain significant in multivariate analysis. Multivariate analysis of our findings identified only four work environmental characteristics as significant correlates of job satisfaction. They were: ability to apply educational qualification/scientific knowledge to the work, presence of unhealthy competition between staff within the same institution, respondent’s sense of technical competence for the job, and number of supervisors one reports to. These findings are concordant with those from other studies from Kuwait and abroad (Schmidt-Hoffmann & Radius, 1995; Barnes, 1998; Lundh, 1999; Shah et al., 2001a; Al-Enezi et al., 2003; Shah et al., 2004; Al-Enezi et al., 2007). The utilization of academic knowledge and recognition as a professional enhance self-esteem and were found to be major factors in overall job satisfaction in our study. These findings are consistent with those of several previous studies (Boissoneau & McPherson, 1991; Blazer et al., 1997; Conant & Kleiner, 1998; Shah et al., 2001a). The feeling that one is using one’s academic training might have improved participants’ perception of doing a good job and hence increased job satisfaction. In the framework of the employment considered in this study, unhealthy competition in the workplace and poor prospects of progression in one’s career were adversely related to peoples’ views of their jobs, as has been noted previously (Lundh, 1999; Shah et al., 2001b).
In the present study, self-confidence in one’s professional competence was inversely related to job satisfaction. This negative relationship might be due to the fact that competent technologists would invariably get frustrated when they could not apply their knowledge and previous experience; this they viewed as a barrier to their career progression. Crawford and Gressley (1993) found work performance, career advancement and work environment were predictors of job satisfaction. For example, a lack of opportunity for more challenging work and possibilities for advancement were cited as reasons for leaving one’s field of work (Harmening et al., 1994). This may be avoided through collaborations between academics and hospital personnel to produce graduates more appropriately trained for laboratory service and better informed about it before they make career and job decisions, briefing newly appointed staff on departmental rules and procedures and the reporting hierarchy, offering in-post structured training and professional updated courses, and equal and fair treatment of all staff irrespective of their backgrounds. Respondents in this study who reported to only one supervisor were more satisfied. This might be attributable to more flexibility at work and in making decisions on laboratory activities. A study by the US Department of Health and Human Services (2004) reported that the lack of job autonomy, lack of support, lack of input in decision making, and poor career structure correlated with job satisfaction.
This study’s small sample size limits our ability to conclude that some observed group differences were statistically significant. Also, it would have been useful to have a broader survey instrument encompassing more areas of job satisfaction and including specific questions about the scientific and professional content of courses taken at the university prior to entering hospital service.
Job satisfaction is important for laboratory staff performance, employment retention and the quality of healthcare. Findings from this study suggest that job satisfaction for MLS worker-graduates of the Faculty of Allied Health Sciences of Kuwait University depends, in part, on proper utilization of graduates’ knowledge by hospital managements, providing workers with opportunities for a clinical advancement, controlling unhealthy competition by creating a collaborative work environment, and increasing autonomy, flexibility and variety in the work. This study provides baseline information for future studies addressing larger sample sizes. Findings may help policymakers recognize some of the causes of job dissatisfaction among employees in the hospital laboratory service sector that might be adversely affecting the quality of care. Educators in the field may use these findings to assess whether the goals of their teaching programs have been met and to ascertain ways to improve the preparation of their graduates for the jobs they will assume.
We would like to thank Syed Faisal Habib for his help with the preparation of the manuscript.
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