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Introduction
At present, the issues of professional development and professionalization of representatives of socionomic professions, the distinctive feature of which is serving other people, are relevant and practically significant. These professions include, first of all, professions of the "Man-to-man" type, which have rather high risks of developing professional personality deformations. In our study, focused on the search for factors that determine the characteristics of the professional development of representatives of socionomic professions, the emphasis was placed on the profession of a doctor and nursing staff.
Problems of professional growth of medical workers, their professional development and professional career have their enduring importance in connection with the development and improvement of the medical care system in any society (Kudelina & Killyakova, 2018). The search for factors that determine the career orientations of medical workers, the motives of their professional activities and professional development, is, first of all, of practical importance, which is associated with the need to develop comprehensive programs aimed at stimulating the professional growth of medical workers and optimizing the human resources of medical organizations.
One of these factors can be considered the type of organizational culture of the organization where the professional activities of medical workers are carried out. This is evidenced by partial studies carried out on small research samples, but convincingly proving the existence of a relationship between the type of organizational culture of the organization and the motives of the labor activity of its employees (Romanov, 2001; Peters & Waterman, 2014; Bonkalo & Kadiev, 2016; Vereshchagina & Olkhova, 2019; Bonkalo, et al., 2021).
The concept of "organizational culture" is widely used to refer to the totality of those behavioral models that have developed in a particular organization and the system of values shared by its employees (Isopeskul, 2012). It is complex and includes the style of management (Romanova, 2015; Bonkalo, et al., 2021), the nature of communications (Yusina, 2015), features of conflict resolution and attitude towards employees (Shane, 2012). Researchers note that a developed or positive organizational culture makes it possible to form a system of values that unites the personnel of an organization (Lipatov, 1997); acts as a factor of stability in crisis conditions; ensures competitiveness (Romanova, 2001) and performance efficiency.
In health care, the problem of organizational culture is also of paramount importance (Manerova, 2011; Bodrova & Kizyan, 2019; Tsiring, 2020), including the connection with the need to support the professional growth of medical workers (Reshetnikov, 2015) and the management of their business career (Gabrielyan & Chernyshev, 2013; Guskova & Malyasova, 2014; Mikhailov, et al., 2020).
In the process of theoretical analysis, it was concluded that the type of organizational culture of a medical organization is one of the dominant factors in the views of medical workers about an ideal and competitive doctor, as well as the specifics of managing a medical organization determine the career orientations of medical personnel. This conclusion requires empirical verification, as a result of which an empirical study was carried out, the purpose of which was to study the peculiarities of the influence of the type of organizational culture of medical organizations on the career orientations of medical workers.
Materials and methods
The research sample consisted of 7364 medical workers with professional experience in a particular organization from 1 to 25 years. The average age of the respondents was 41,6 years. In total, 98 medical organizations in Moscow and the Moscow region, St. Petersburg and the Leningrad region were examined.
The study used a complex of psychodiagnostic techniques that allows us to study the prevailing type of organizational culture of medical organizations (R. Harrison's questionnaire, adapted by Lipatov (1997), the preferences of medical workers in building their professional career (the ideas about a competitive medical worker (semantic differential - 16 opposite personality characteristics).
After the first series of empirical research carried out using the R. Harrison questionnaire, four research groups were formed, each of which consisted of medical organizations with a predominance of one of the four types of organizational culture. The predominant type of organizational culture was determined on the basis of the arithmetic mean obtained by the organization due to the characteristics of all medical personnel (filling out a blank questionnaire).
Statistical analysis of empirical data was carried out by calculating the frequency and percentage distributions, arithmetic mean, standard deviation, as well as comparative (using Student's t-test - in this case, the conclusion about the correctness of using the criterion was made on the basis of the Livy test) and correlation analyzes.
Results and discussion
The results were obtained, presented in Figure 1. The largest number of organizations (28,57%) were attributed by us to an undefined type of organizational culture. The perception by medical workers of the real organizational culture of such organizations is extremely contradictory, as evidenced by the absence of statistically significant differences between the indicators of various types of organizational culture, diagnosed using the chosen methodology.
Fig. 1 - Percentage distribution of medical organizations by the prevailing type of their organizational culture.
24,49% of organizations are characterized by the predominance of a culture of role in them (the average indicators on this scale are in the range of very high values); 18,37% - culture of power; 17,35% - the culture of the problem and only 11,22% - the culture of the individual.
Features of career orientations of medical workers
In the course of the study, there were revealed reliably significant differences between groups of medical workers who carry out their professional activities in organizations with a predominance of different types of organizational culture, in terms of their career orientations (Fig. 2).
Significant differences were also revealed in pairwise comparison. While the majority of healthcare workers in organizations with a predominant culture of power are characterized by an orientation towards autonomy (33,6) and the integration of lifestyles (38,3), in those medical organizations where a culture of personality prevails, many employees strive to achieve professional competence (38,9) or oriented towards serving people (42,6). It was in these indications that statistically significant differences were revealed at a high level of significance (p <0,001).
Health professionals' perceptions of a competitive personality
The results of the study of the views of medical workers about a competitive personality, presented in Table 1, confirmed the preliminary conclusions drawn.
Table 1 - Results of a study of the views of medical workers in organizations with different types of organizational structure about a competitive personality.
| Specifications competitiveness | Culture of power | Culture task | Role culture | Personality culture |
|---|---|---|---|---|
| Professionalism | 6,5 ± 0,7 | 8,6 ± 0,9 | 5,4 ± 0,6 | 9,2 ± 1,0 |
| A responsibility | 4,8 ± 0,5 | 9,4 ± 1,0 | 8,4 ± 0,9 | 7,7 ± 0,8 |
| Labor discipline | 2,4 ± 0,3 | 5,6 ± 0,6 | 8,8 ± 0,9 | 6,4 ± 0,5 |
| Creativity, initiative | 2,6 ± 0,3 | 9,6 ± 1,1 | 1,2 ± 0,2 | 6,8 ± 0,7 |
| Ability to adapt | 6,8 ± 0,7 | 1,7 ± 0,2 | 2,6 ± 0,3 | 4,2 ± 0,4 |
| Operability | 7,0 ± 0,7 | 8,0 ± 0,8 | 8,2 ± 0,8 | 8,8 ± 0,9 |
| Diligence | 5,8 ± 0,6 | 3,8 ± 0,4 | 9,2 ± 1,0 | 4,6 ± 0,5 |
| Careerism | 9,2 ± 1,0 | 1,8 ± 0,2 | 5,6 ± 0,6 | 2,8 ± 0,3 |
| Honesty | 1,8 ± 0,3 | 4,6 ± 0,5 | 5,2 ± 0,6 | 7,0 ± 0,7 |
| Persistence | 6,6 ± 0,7 | 5,6 ± 0,6 | 4,8 ± 0,5 | 8,2 ± 0,9 |
| Enterprise | 8,2 ± 0,9 | 4,2 ± 0,4 | 1,4 ± 0,2 | 3,6 ± 0,4 |
| Self confidence | 7,2 ± 0,8 | 7,6 ± 0,8 | 3,6 ± 0,4 | 7,4 ± 0,8 |
| Unscrupulousness | 7,4 ± 0,8 | 1,2 ± 0,2 | 1,4 ± 0,2 | 1,2 ± 0,2 |
| Lack of morality | 5,2 ± 0,5 | 1,4 ± 0,2 | 2,6 ± 0,3 | 1,2 ± 0,2 |
| Purposefulness | 8,4 ± 0,8 | 7,9 ± 0,9 | 6,4 ± 0,7 | 8,8 ± 0,9 |
| Courage, risk appetite | 4,4 ± 0,5 | 7,6 ± 0,8 | 1,2 ± 0,2 | 6,8 ± 0,7 |
Pairwise comparison of the indicators revealed allows us to identify reliably significant differences in the views of medical workers about a competitive personality, that is, about actually those career orientations that, in their view, should be among medical personnel of organizations.
So, for example, there were reliably significant differences between the ideas of medical workers carrying out their professional activities in organizations with a predominant type of organizational culture "Culture of Power" and the views of doctors working in organizations building relationships of the "Culture of Personality" type about the need for successful career development of professionalism (t = 4,32, p <0,001), responsibility (t = 3,66, p <0,001), labor discipline (t = 5,02, p <0,001) and almost all characteristics.
For workers whose professional activities are carried out in power-oriented organizations, a competitive doctor is associated with an enterprising, self-confident, but completely unprincipled person. Important for them is also such a personality characteristic as careerism (1 rank in ideas).
Reliably significant differences were also recorded in the perceptions of careerism as a necessary quality of a competitive doctor, career-oriented, in organizations characterized by such types of organizational culture as “Culture of the task” and “Culture of power” (t = 7,12, p <0,001). Self-confidence, in the minds of healthcare professionals working in a Role Culture type of organization, is not essential to advancement and career development. The majority of medical workers who carry out their professional activities in organizations where this type of organizational culture prevails, such as "Personal culture", believe that a competitive medical worker is, first of all, a professional in his field (rank 1,2), a person with a high the level of working capacity (2,4 rank), dedication (3,6), perseverance (3,9) in combination with hard work (4,2) and goodwill (5,8).
Thus, as a result of the study, it was revealed that the views of medical workers about the qualities of a competitive specialist are largely subjective and determined by the type of organizational culture of the organization where his professional activity takes place.
The relationship between the career orientations of healthcare workers and the competitiveness of their personality.
At the final stage of the study, correlation analyzes were carried out, which made it possible to establish the presence of reliable links between the type of organizational culture of a medical organization and the career orientations of medical personnel working in them (Table 2).
The predominance of a culture of power in the organization is positively correlated with the orientation of health workers towards autonomy (r = 0,330, p <0,01) and integration of lifestyles (r = 0,531, p <0,001) and negatively - service (r = - 0,339, p <0,01) and professionalism (r = - 0,223, p <0,05).
Table 2 - The relationship between indicators of the prevailing type of organizational culture of medical organizations and the characteristics of career orientations of medical workers.
| Career orientations | Culture of power | Culture task | Role culture | Personality culture |
|---|---|---|---|---|
| Professional competence | - 0,223 | 0,334 | - 0,139 | 0,377 |
| Management | 0,012 | 0,172 | - 0,042 | 0,111 |
| Autonomy | 0,330 | 0,056 | - 0,081 | 0,129 |
| Stability of work | 0,133 | - 0,099 | 0,133 | - 0,084 |
| Residence stability | 0,121 | - 0,158 | 0,141 | - 0,173 |
| Service | - 0,339 | 0,181 | - 0,154 | 0,621 |
| Call | - 0,034 | - 0,043 | 0,088 | 0,055 |
| Integration of lifestyles | 0,531 | - 0,002 | - 0,001 | 0,016 |
| Entrepreneurship | - 0,077 | 0,071 | - 0,165 | 0,136 |
The predominance in the organization of the culture of the task determines.
The results of the study allow us to say that the type of organizational culture of a medical organization largely determines the views of medical workers about a competitive personality as a representative of medical professions and determines the orientation in their careers. The empirical data are largely consistent with the data of other studies carried out on the example of organizations in different fields of activity: educational (Tsiring, 2020), commercial (Peters & Waterman, 2014), business organizations (Bodrova & Kizyan, 2019), public service (Romanov, 2001), industrial organizations (Guskova & Malyasova, 2014).
The study confirmed the relationship between the type of organizational culture of a medical organization and the motives of the professional activity of its employees.
In organizations with a dominant “task culture” type, successful healthcare workers in their professional careers are focused mainly on professional competence and management.
In organizations characterized by such a type of organizational culture as “culture of power”, there is a natural relationship between indicators of the level of development of such a career orientation as stability in work, combined with the motive “relationship with the boss” and the idea of a competitive person as a person capable of “to establish a relationship with everyone".
In organizations with a dominant culture of personality, authoritative health professionals are mostly service-oriented, while in organizations with a culture of role, they are oriented towards entrepreneurship and independence.
Conclusions
The results of the study concretize and deepen the scientific understanding of what type of organizational culture of a medical organization has a positive impact on the professional and personal development of medical workers, on their professional growth and professional career. Personality orientation, its development, the deliberative nature of the management of a medical organization, a joint search for solutions to emerging problems in combination with an individual approach to each medical worker, in accordance with his individual psychological and typological characteristics - all this contributes to the development of employees of medical organizations aspiring to serving and fulfilling one's professional duty in the name of other people and the requirements of socionomic professions.
To support the professional career of representatives of socionomic professions, it is necessary to develop and implement special programs aimed at forming the organizational culture of the organization, its orientation towards the development of the personality of each employee.
