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Expectancy theory has been used by leaders and managers in all industries to better understand the motivations and choices of employees among various behavior alternatives. In theory, if the desired outcome is offered, each person or a group of employees will shift their behavior to what the manager requires. This behavior may be a greater effort, better performance, or potentially even factors such as improved creativity. This paper explores the fundamentals of Expectancy Theory and applies it to the healthcare sector.
Vrooms Expectancy Theory was proposed in the 1960s as a motivation and management theory popularly utilized in a variety of industries. The theory states that behavior and choices are motivated by anticipated results or consequences. The way that a person behaves is based on the expected result of the chosen behavior. It is an action-outcome estimate, but it is important to note that the behavior is based on the perception that the result will be a valued outcome to the individual. Expectancy theory consists of three components: expectancy, instrumentality, and valence. Expectancy is the persons belief that the effort or action will result in intended performance objectives. Instrumentality is the belief that the individual will receive the desired outcome if the performance expectation is achieved. Finally, valence is the value that a person uniquely places on a particular outcome, which is solely individual (Borghi et al., 2018).
Expectancy theory has found use in healthcare education contexts. Particularly, Shweiki et al. (2015) apply the Expectancy Theory to residency training to determine resident motivation and improve training in this manner. Applying each element of the Expectancy Theory to the education and students, the authors were able to derive their desired outcomes and motivations, which helped instructors to individualize activities and instruction much more effectively leading to appropriate academic rewards. A similar approach can potentially be used in nursing school and other healthcare education contexts, which then helps to identify opportunities for the development of programmatic methods which facilitate student motivation in the educational process.
Expectancy theory is applicable in healthcare work environments as well. Motivation is key to the performance of individuals, as well as a predictor of turnover in the workplace. It is well-known that the healthcare industry has high turnover rates, particularly among nurses, due to high-stress jobs. For managers in healthcare, the objective is to motivate people to join and remain in the workforce while performing up to standard. Using the Expectancy theory, managers should identify outcomes which employees would value in being rewarded. There is an inherent connection between employee competence, behavior, the workplace environment, and success on the job. Motivations for healthcare workers range widely, including autonomy at work, workplace conditions and hours, salary, opportunities for professional development, and management practices/organizational policies. Motivation in itself can be described as effort undertaken at work to achieve a commonly established goal. Managers are interested in performance and intention to leave, but if the worker is motivated achieving said goals brings a feeling of satisfaction, creating a sense of balance between internal and external conditions. Therefore, they are less likely to leave, as commonly described through the metric job satisfaction (Dolea & Adams, n.d.).
The Expectancy theory reflects individual differences in employee motivations. A study by De Simone (2015) found that emotional, cognitive, and instrumental factors play a role in motivating healthcare workers. Instrumental factors such as comfort, extrinsic rewards, organization, and meritocracy were highest. Cognitive factors included training, work autonomy, and professional growth. Meanwhile, emotional factors included cooperation with co-workers, psychological support, and respect. Notably, many of these elements depend on leadership and management. Therefore, leadership goals are to instill the belief that good performance will present valued rewards, potentially having to individualize rewards based on employee preferences.
References
Borghi, J., Lohmann, J., Dale, E., Meheus, F., Goudge, J., Oboirien, K., & Kuwawenaruwa, A. (2017). How to do (or not to do)& Measuring health worker motivation in surveys in low- and middle-income countries. Health Policy and Planning, 33(2), 192203. Web.
De Simone, S. (2015). Expectancy value theory: Motivating healthcare workers. American International Journal of Contemporary Research, 5(2), 19-23. Web.
Dolea, C., & Adams, O. (n.d.). Motivation of health care workers Review of theories and empirical evidence. Cahiers de Socieologie et Demographie Medicale, 45(1), 135-161.
Shweiki, E., Beekley, A., Jenoff, J., Koenig, G., Kaulback, K., Lindenbaum, G., Patel, P., Cohen, M., Weinstein, M., Zubair, M., Rosen, M., & Martin, N. (2015). Applying Expectancy Theory to residency training: proposing opportunities to understand resident motivation and enhance residency training. Advances in Medical Education and Practice, 6, 339-346. Web.
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