Tharmarajah Nagalingam

In hospitals around the globe, there exists a tripartite culture of leadership and performance in their daily operations. Job performance among healthcare workers often depends on hospital organizational culture, psychosocial conditions, and leadership. This study examined how organizational culture mediates the relationship between transformational leadership and job performance in public hospitals in Malaysia. A cross-sectional survey was conducted among 1,187 doctors, nurses, and medical assistants from 11 public hospitals in Malaysia. A validated self-administered questionnaire was used to assess organizational culture, transformational leadership, and job performance among doctors, nurses, and medical assistants in eleven (11) selected public hospitals in Malaysia. These data were collected and analyzed using hierarchical multiple linear regression and partial least squares structural equation modeling. These statistical methods were used to estimate the direct, indirect, and moderating effects on job performance among healthcare workers. Organizational culture, however, showed the strongest direct association with job performance (β = 0.987, p < .001). Transformational leadership was strongly associated with organizational culture (β = 0.869, p < .001) and had a large positive indirect effect on job performance via culture (β = 0.858, p < .001), despite a small negative direct effect (β = −0.224, p = .042). The model explained 64.6% of the variance in job performance. Therefore, Organizational culture is the primary proximal determinant of job performance and the key pathway to transformational leadership. Improving job performance in public hospitals in Malaysia should prioritize leadership development and culture-building.

Background and objectives: Job performance among healthcare workers depends on organisational and psychosocial conditions in hospitals. This study examined how transformational leadership, organisational culture, and workplace harassment jointly shape multidimensional job performance in public hospitals in Malaysia. Methods: A cross-sectional survey was conducted among 1,187 doctors, nurses, and medical assistants from 11 public hospitals. Validated self-administered scales captured transformational leadership, workplace harassment, organisational culture, and job performance. Hierarchical multiple linear regression and partial least squares structural equation modelling were used to estimate the direct, indirect, and moderating effects. Results: Organisational culture showed the strongest direct association with job performance (β = 0.987, p < .001). Transformational leadership was strongly associated with organisational culture (β = 0.869, p < .001) and had a large positive indirect effect on job performance via culture (β = 0.858, p < .001), despite a small negative direct effect (β = −0.224, p = .042). Workplace harassment showed no significant direct or mediated effects in the overall structural model. The model explained 64.6% of the variance in job performance. Conclusion and recommendations: Organisational culture is the main proximal determinant of job performance and the key pathway for transformational leadership. Performance improvement in public hospitals should prioritise leadership development, culture-building, and strong anti-harassment systems.

Introduction: Microtia is a congenital malformation of the auricle that leads to serious functional and psychosocial consequences. Familial factors, such as the types of auricular anomalies present in family members and sex concordance between affected individuals, may provide crucial insights into its etiology. This study aims to examine the association of the types of ear anomalies found in family members and sex concordance between these individuals with the occurrence of microtia. Methods: This case–control study was conducted with 244 respondents, involving 122 patients with congenital microtia in the case group and 122 participants with normal ears in the control group. Structured questionnaires were used to collect data on sex concordance between participants and family members with ear anomalies, as well as the type of auricular anomaly observed in the affected family members. Cross-tabulation and Chi-square analyses were performed to assess the associations between these variables. Results: While family members with ear anomalies were reported more frequently in the microtia group, the difference was not statistically significant ( P = 0.472). Similarly, sex concordance was also not significantly associated with microtia occurrence ( P = 0.743). Conclusion: Neither sex concordance nor the type of auricular anomalies in family members demonstrates a significant relationship with the occurrence of microtia. These findings indicate that, despite the possible contribution of familial factors, microtia most likely results from multifactorial causes that involve both genetic and environmental interactions.