Promises in psychological contract drive commitment for clinicians

Julia Ellershaw, Peter Steane*, John McWilliams, Yvon Dufour

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose - Job satisfaction, mental health and organisational commitment are important for clinician retention. Psychological contracts, organisational justice and negative affectivity (NA) have been linked with these outcomes but there is limited research examining these concepts in combination, particularly for clinicians. The aim of this paper is to examine the relationships between psychological contract breach, organisational justice and NA, on the outcomes of organisational commitment, psychological distress and job satisfaction, in a medical context. Design/methodology/approach - Surveys were distributed to Australian hospital clinicians through their internal mail and 81 completed surveys were returned (response rate = 24 per cent). Findings - Multiple regression analyses revealed that organisational commitment was related to NA, psychological contract obligation and the interaction between psychological contract breach and distributive justice. Psychological distress was related to NA and procedural justice. Job satisfaction was related to the interaction between psychological contract breach and informational justice, however, the overall model for job satisfaction was not significant. Practical implications - By implementing innovative social exchange processes, healthcare organisations can ensure distributive justice is maintained in the culture in event of contract breach, and by so doing build safety mechanisms into sustaining commitment from clinicians. Originality/value - This paper contributes to the literature on clinical governance in managing the psychological contract to sustain commitment from clinical staff. The findings provide new insights into the factors effecting employee outcomes for clinicians.

Original languageEnglish
Article number17110972
Pages (from-to)153-165
Number of pages13
JournalClinical Governance
Issue number2
Publication statusPublished - 2014
Externally publishedYes


  • Job satisfaction
  • Management of clinical performance
  • Mental health
  • Organisational commitment
  • Psychological contract


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