Possible Effects of Performance Appraisal in Municipal Health Service

Abstract

Performance appraisals have generally been conducted to increase the professional learning and development of employees, but are also a tool for management and dissemination of goals, wage agreements and influencing employee in the workplace. The main aim of this thesis is to explore the different effects of individual performance appraisals and group approaches to performance appraisals for health personnel in municipal health services. • What effect do the municipal health services have on individual performance appraisal, and which factors can explain the differences in effect? That is, what are health personnel’s perceptions of job motivation (Article 1), fairness (Article 2), and dyadic relationships and exchanges (Article 3) through the performance appraisals? • Due to the increasing need for knowledge and coordination in the municipal health services and the managers’ wide range of control, can the municipal health services benefit from conducting performance appraisals in groups? (Article 4). The objectives of these two studies are to explore the effects of performance appraisals and employees’ experiences and the use of goal setting, feedback, and active participation in the conversations, as well as focus on academic learning, dyadic relationships, job efforts, and working conditions. The respondents in these studies are health personnel with bachelor’s degrees, and with lower levels of education. Most of them are trained nurses and auxiliary nurses. They work in home care and nursing homes in the municipal health services. About 93 % of the respondents are female. Study 1: The first three articles focus on the employees’ experiences with performance appraisals in the Norwegian Municipal Health Services. The first article focuses on increases or reductions in job motivation, academic learning, and self-assessment related to the use of performance appraisals. The second article attempts to illustrate the employees’ perception of fairness in performance appraisals. Interactional and procedural justices are applicable concepts of justice for performance appraisals in municipal health services. The third article focuses on dyadic relationships and exchanges through performance appraisals and explores the different effects of high and low qualities of relationships and exchanges in the performance appraisals. The article focuses mostly on the manager-subordinate dyadic relationships related to performance appraisals. Questionnaires were distributed to a representative sample of 600 health personnel from 25 municipal health services in Norway, with a response rate of 62 %. Factor analysis and regression analysis were run in SPSS 15. All items were based on valid scales. The analysis in the first article shows that nurses experience a higher degree of job motivation from performance appraisals than auxiliary nurses, and all subordinates experience higher job motivation in performance appraisals than managers. In the discussion, it is argued that useful feedback, active participation, and higher degrees of education are fundamental elements for useful performance appraisals. This means that nurses are generally more satisfied with the feedback and are more participative in performance appraisals than auxiliary nurses, and therefore experience better effects of performance appraisals as a fair communication tool. The findings in the second article show that justice in performance appraisals is perceived differently for different employee groups in municipal health services. This means that nurses are generally more satisfied with the feedback and are more participative in performance appraisals than auxiliary nurses, and nurses, therefore, experience a good effect of performance appraisals as a fair communication tool better than auxiliary nurses do. Auxiliary nurses are given more thorough feedback through performance appraisals than nurses. Employees in nursing homes have higher quality dyadic exchanges in performance appraisals than employees in home care. Employees with follow-up conversations in performance appraisals rate higher quality exchanges than employees without follow-up conversations. The findings in the third article show that employees in nursing homes are more participatory and report higher quality exchanges with the managers in performance appraisals than employees in home care, which is significant. Subordinates report better effect of constructive discussions with higher exchanges in performance appraisals than managers. Auxiliary nurses report a better effect of being satisfied with feedback and exchanges in performance appraisals than nurses, but the auxiliary nurses are also given more thorough feedback from the managers than the nurses. Managers experience better effects of thorough feedback with higher quality dyadic exchanges in performance appraisals than nurses. The second study and the last article in this thesis explore performance appraisals conducted as group discussions and individual conversations. Can performance appraisals be an arena for professional learning in thsuccessful, and several researchers argue for performance appraisals in small groups. The forth article is a fieldwork research trying out performance appraisals in groups and individual conversations. Then, it finds clear similarities and differences between the two implementation methods of performance appraisals. This fieldwork is conducted in one municipality. One part of the municipality conducts performance appraisals in groups and the other part has individual performance appraisals. Questionnaires were distributed to a representative sample of 60 x 3 employees (pre-test, post-test 1 and post-test 2), mostly nurses and auxiliary nurses. The study has a response rate of 85 %. Performance appraisals in groups included three subordinates and their manager. Factor analysis and regression analysis were run in SPSS 16 -17. The findings from the fourth article show that the employees experience more high professional learning in group performance appraisals than in individual conversations. Performance appraisals in a group result in greater participation and work effort than for individual performance appraisals, and better conditions for learning and a higher quality of exchange through performance appraisals than individual conversations. However, employees who have performance appraisals as individual conversations are more satisfied with the performance appraisals than employees who have performance appraisals in groups. All study questions are supported. All in all, the studies suggest that employees in the municipal health services have different experiences of the benefits and effects of performance appraisal, and performance appraisals in groups provide more professional learning to employees.