Keywords

Healthcare Sector, Training & Development, Job Satisfaction.

Introduction

India has recorded progress in the field of social, technological, political and economical aspects, after its independence. Progress is also seen in the medical field. Training and development is related with how to develop positive attitude towards their work in employees. Correcting and enhancing their working style. It also focuses on enhancing behavioural skills in employees, improving their interpersonal skills. Employee Development refers to the programs, prepared by management for the middle level or senior level employees. These programs are for overall personality development for the employees. Need Analysis of Training Program is done to know the actual need for training in the organization. It is done on 3 levels: a) Organizational Analysis b) Task Analysis c) Person Analysis:

Job Satisfaction

A very important and Employee attitude is Job satisfaction. It describes a positive feeling about the job. A person having high level of job satisfaction shows positive feeling and having low level of job satisfaction have negative feeling towards his work.

Profile of the Gwalior & Chambal Division

Gwalior and Chambal Divisions are administrative subdivisions of Madhya Pradesh consisting 9% & 6% of state population respectively. Ashoknagar, Datia, Guna, Gwalior, and Shivpuri come under Gwalior division. Chambal Division consists of the three districts namely Morena, Bhind and Sheopur

Literature Review

Sharma et al. (2020) concluded that working in emergency area, ICU etc. creates stressful work environment in hospitals and this is one of the reasons of dissatisfaction among nurses. Their study also concluded that nurses with higher qualification were more dissatisfied. Nurses in early phases of their service were more dissatisfied.

NimaSajai (2020) found job insecurity as the most important factor which hinders job satisfaction among the nurses.

Taamneh et al. (2018) argued that any enterprise can gain a competitive advantage by using superior HR practices, which includes staffing, culture management, performance management, training and development.

Shah et al. (2018) studied the job satisfaction level of married and unmarried male lecturers of plus two level schools, on 60 male lecturers (30 married and 30 unmarried). Random sampling method was used for collecting the sample, and used a 52 items scale for job satisfaction with 8 dimensions, developed by Meera dixit. Statistical techniques used in the study were mean, S.D. and t-test. They found that there is significant difference between, composite score, intrinsic aspect of the job, Salary, Promotional Avenues and Service Conditions of job with respect to job satisfaction. Every lecture has different level of job satisfaction w.r.t. the above mentioned variables. But they have found no difference for level of job satisfaction between physical facilities, Institutional Plans, Policies and authorities.

Albrecht et al. (2015) suggests training and development as the efforts of any organization to improve the skill set of their employees.

Jiang et al. (2012) also discussed that training and development is the effort and strategy of any organization efforts which improves the skills, abilities and knowledge of employees.

Kabene et al. (2006) discussed about Human Resource Management in healthcare in global context. The study aimed to find a relationship to show the healthcare system in global context and importance to show the healthcare system in global context. It was Secondary data based study. It was shown that proper management of Human Resource is critical in providing quality of healthcare.

Gould-Williams (2003) attempted to understand effect of HRM-practices and Job-satisfaction in local Govt organizations in UK. It was found that job-satisfaction was associated with, commitment, workplace and perceived organizational performance, effort, trust.

Pareek (2002) stressed on purpose and planning for Training. Purpose should be very clear and the place must be decided well in advance, it may be “on the job training” or “off the job training”. Right choice of place makes training more effective and it should be given on right time. Training is helpful to improve a person’s skill at a task.

Kydd (1990) identified five common HRM practices which are associated with innovation, mentioned in previous studies. The study was based on secondary data and literature review. The common HRM practices identified were: Performance Appraisal, Career Management, Reward system, Training and Recruitment.

David & Stephen (1989) studied about Training & Development and defined it as an experience of learning, which leads to make a relatively permanent change in individual, and his/ her ability for performing the job is increased.

Noe et al. (2010) studied about influence of attitude of trainees on the effectiveness of training. These are very much related with each other. The Research focused on the level of minimum ability of learning program content. They analysed the motivational and situational factors from OB, describing how trainee’s attributes and attitudes are influential on the effectiveness of training.

Oatey (1970) argued about the importance of training. Training helps in the development of employees mentally, socially and intellectually. Development is very important for creating an engaged and happy workforce which is helpful in increasing productivity level.

Material and Methods

Problem Statement

Health is very important for any individual, society or nation. Hospitals are the organizations which take care of the health of the people. Any organization can run effectively when the employees working there are able to work in an effective and efficient way. The services provided by the nurses in the hospitals are very important. It is very important to know the level of Job satisfaction of the nurses and how they are being trained to deliver their work effectively. There are so many factors which influence the job satisfaction of any employee. The present study is done to know the effect of training and development provided to the nurses on their job satisfaction.

Research Question

1) Is there any difference between Training and development of private sector hospitals and public sector hospitals of Gwalior and Chambal Region?

2) Is there any difference between level of Job Satisfaction in private sector hospitals and public sector hospitals of Gwalior and Chambal Region?

3) Does Training and Development give any impact on Job Satisfaction of Gwalior and Chambal Region?

Hypothesis

H01 There is no significant difference between Training and Development of Private and Public Hospitals

H11 There is significant difference between Training and Development of Private and Public Hospitals

H02 There is no significant difference between Job itself of Private and Public Hospitals

Research question

H12 There is significant difference between Job itself of Private and Public Hospitals

H03 There is no significant impact of Training and Development on Job Satisfaction:

a) in private sector hospital b) in public sector

H13 There is significant impact of Training and Development on Job Satisfaction:

a) in private sector hospital b) in public sector

Research Design

Explanatory research design was adopted due to the nature of the study. An Exploratory research can be conducted when the problem is not identified and studied clearly, while descriptive research is used to describe the characteristics of the population.

Instrumentation

The survey questionnaire instruments were used to achieve the objective of the study. A self structured questionnaire based on previous researches, prepared by the researcher was distributed to the nurses of private and public sector hospitals in the target area. A five-point Likert scale was prepared having separate questions for Training & Development and Job Satisfaction. Minnesota satisfaction questionnaire.

• Data Type: Both Primary and Secondary data was used for the study.

• Sample Design: Non Probability – Purposive Sampling method was used for sample design.

• Data Collection: After getting permission from the concerned authorities and the HR Managers, the questionnaire was distributed to the nurses and data was collected.

• Dependent Variable: Job Satisfaction

• Independent Variables: Training and Development

Objectives of the Study

1. To study the Training& Development practices in Hospitals of Gwalior & Chambal Region.

2. To compare the level of job-satisfaction among employees in Public and Private sector Hospitals.

3. To assess the impact of Training & development practices on job-satisfaction level of employees in Public and Private sector Hospitals

Results and Discussion

The demographic distribution of the sample population is shown in the following table:

In order to test the hypothesis, collected data was analyzed through t-test in SPSS. Group t-test was performed to know the significant difference between the training and development of Private and public sector hospitals, as well to know the difference between the factors job satisfaction in private and public sector hospitals. An Independent sample t test is also performed in order to compare the mean difference between training and development and job satisfaction in both types of hospitals. Following Table 1 show the results of t-test:

Table 1 Result of T-Test: Training & Development and Job Satisfaction for Nurses
Variables	Mean Value : Private Sector Hospitals (Doctors)	Mean Value : Public Sector Hospitals (Doctors)	Significant Value	Result	Hypothesis Accepted/Rejected
Training & Development	14.5439	14.3152	0.026	Significant difference	Hypothesis Rejected
Teamwork and Trust	10.0292	12.4457	0.000	Significant difference	Hypothesis Rejected
Salary	10.8129	9.1087	0.000	Significant difference	Hypothesis Rejected
Employment Security	16.7427	14.5217	0.000	Significant difference	Hypothesis Rejected
Relationship with supervisor and co-workers	7.1988	7.3261	0.676	No Significant difference	Hypothesis Accepted
Job itself	7.4971	7.0761	0.152	No Significant difference	Hypothesis Accepted

Region and Nature of Job for Nurses of Public Hospitals of Gwalior and Chambal region. In both types of hospitals, nurses get similar kind of jobs.

The mean score of Training and Development of Nurses working in private sector hospitals is 14.5439 and the mean score of Training and Development of Nurses working in public sector hospitals is 14.3152. Both have the value greater than 3. This shows that both Private and Public Sector Hospitals are following HRM Practices for Training and Development for Nurses. The independent sample t-test shows that the significant value comes to 0.026, which is less than .05. Therefore, the null hypotheses is not accepted, and concluded that there is no significant difference between Training and Development for Nurses of both types of hospitals. The mean score of Team Work of Nurses are 12.2164 and 10.6739 in private and public hospitals respectively, both are greater than 3. This shows that there is trust on team members in both the sectors. The significant value comes to .000 in the Independent t-test. Therefore, the null hypotheses is not accepted, and concluded that there is significant difference between Teamwork for Nurses of both types of hospitals. The mean score of Salary of Nurses are 10.8129 and 9.1087 in private and public sector hospitals respectively. Both are greater than 3. The significant value comes to .000 in the independent t-test. Therefore, the null hypotheses is not accepted, and concluded that there is significant difference between salaries for Nurses of both types of hospitals. The mean score of Employment Security of Nurses are 16.7427 and 14.5217 in private and public hospitals respectively. Both are greater than 3. This shows that both Private and Public Sector Hospitals provides employment security for nurses. The significant value comes to 0.000 in the independent test. Therefore, the null hypotheses is not accepted, and concluded that there is significant difference between Employment Security for Nurses of both types of hospitals. The mean score of “Relationship with supervisor and co-workers” of Nurses working in private sector hospitals is 7.1988 and the mean score of “Relationship with supervisor and co-workers” of Nurses working in public sector hospitals is 7.3261. The independent sample t-test shows that the significant value comes to 0.676, which is greater than 0.05. Therefore, the null hypotheses is accepted, and concluded that there is no significant difference between “Relationship with supervisor and co-workers” for Nurses of both types of hospitals. The mean score of “Job itself (Nature of Job)” of Nurses are 7.4971 and 7.0761 respectively in private and public sector hospitals. The significant value comes to 0.152, in the independent test, which is greater than .05. Therefore, the null hypotheses is accepted, and concluded that there is no significant difference between Nature of Job for Nurses of Private and public sector Hospitals of Gwalior and Chambal.

In order to know the impact of Training & Development on Job Satisfaction, regression analysis was performed on the collected data. Following Table 2 shows the results of regression analysis.

Table 2 Model Summary (Private Hospitals)
Model		R	R Square	Adjusted R Square	Std. Error of the Estimate	Change Statistics					Durbin-Watson
						R Square Change	F Change	df1	df2	Sig. F Change
dimension0	1	0.469a	0.220	0.216	5.01865	0.220	47.709	1	170	0.000	1.592

In the above Table 3, the value of Adjusted R Square is 0.216, which implies, that 21.6 percent of the variations in Job Satisfaction are explained by Training and development factor in Private Hospitals.

Table 3 Regression Results for Private Hospitals
Model	Unstandardized Coefficients		Standardized Coefficients	T	Sig.	95.0% Confidence Interval for B
	B	Std. Error	Beta			Lower Bound	Upper Bound
(Constant)	13.992	1.437		9.738	0.000	11.156	16.828
Training and Development	0.564	0.082	0.469	6.907	0.000	0.403	0.725

In the above Tables 4 & 5, the value of Adjusted R Square is 0.468, which implies, that 46.8 percent of the variations in Job Satisfaction are explained by Training and Development factor in Public Hospitals.

Table 4 Model Summary (Public Hospitals)
Model		R	R Square	Adjusted R Square	Std. Error of the Estimate	Change Statistics					Durbin-Watson
						R Square Change	F Change	df1	df2	Sig. F Change
dimension0	1	0.688a	0.474	0.468	5.89680	0.474	74.778	1	91	0.000	1.312

Table 5 Regression Results for (Public Hospitals)
Model		Unstandardized Coefficients		Standardized Coefficients	T	Sig.	95.0% Confidence Interval for B
		B	Std. Error	Beta			Lower Bound	Upper Bound
1	(Constant)	41.992	3.204		13.106	0.000	35.619	48.365
	Training & Development	3.680	0.426	0.688	8.647	0.000	2.834	4.527

In the above Table 6 it is observed that the impact of Training and Development on Job Satisfaction is high, 0.468 in Public sector Hospitals, as compared to Private Hospitals which is 0.216. This means there is a high impact of Training and Development in Public sector hospitals in comparison to Private sector hospitals of Gwalior and Chambal region.

Table 6 Comparative Analysis of Public and Private Sector Hospitals
Type of hospital	Significant value	Beta value	Adjusted R square value
Private Sector Hospitals	0.000	0.469	0.216
Public sector Hospitals	0.000	0.688	0.468

Conclusion

Study was done in the hospitals of Gwalior and Chambal Region. After taking permission from the competent authorities in various hospitals, questionnaire was distributed to the nurses in the hospitals. Responses were also collected through schedulers. SPSS 18.0 was used to analyse the data.

Training and Development is very important HRM practice for hospitals; according to this study it gives positive and high impact on Job satisfaction. β value of training and development in public hospitals is 0.469 and for private hospitals is 0.688 is observed in this study. It was found in the study that both private and public hospitals have implemented the Training and development program, but there is a significant difference between Training & development program in both types of hospitals. In public hospitals training programs are arranged by MP Govt, and group of nurses are nominated by the CMOs of Hospitals to attend such kind of Training Program. But in Private Sector hospitals, very few hospitals focus towards Training and development programs. They arrange in- house lectures on daily basis, some arrange it on monthly basis also. It was also observed that training needs are not identified properly in both kinds of hospitals. In public sector hospitals, nurses are sent to attend the training program according to their availability. Very few of them find it beneficial.

Teamwork and trust amongst the team members are different in both types of hospitals. Salary structure for nurses in both the hospitals is different. The nurses in public sector hospitals feel high level of Employment Security as compared to the nurses of private sector hospitals. In both types of hospitals nurses were not satisfied with the relationship with their supervisors. In both sectors, similar kinds of responses towards their nature of job were received from the nursing staffs. In both sectors nurses feel it a very tiring and thankless job.

Significance of the Study

Training and Development give impact on Job Satisfaction. If training needs are identified and fulfilled properly and regularly the employees learn new things to develop their skills that will enhance their job satisfaction. Training and development programs improves the sense of employment security, gives enhanced level of trust leading to improved teamwork. Well trained employees can get better salary, which will motivate them to give better performance. Trained employees can get variety of job which impacts their nature of job and prevent from monotonous job. Employment security, trust, teamwork, organizational support all these are components of Job satisfaction. Training and development is also a component of organizational support which is perceived by any employee before joining, and Organizational support is an important factor of Job Satisfaction. It can be concluded that a well planned and well designed training program gives a satisfied and motivated workforce, which is required for effective and efficient practice of hospitals.

Suggestions

The findings of this study can be a roadmap for policymakers especially in hospitals of India.

Very few private sector hospitals in Gwalior Chambal region are providing Training and Development programs. Training and development programmes should be frequently organized and it should be ensured that each and every nurse gets a chance to attend these training programs.

Training needs should be identified in a proper manner, especially in public sector hospitals of Gwalior and Chambal region. Nurses should be sent to the training programs according to their training needs rather than the availability of nurses. Salary of employees should be such that it is commensurate with the experience and competence of the employees

References

1. Albrecht, S.L., Bakker, A.B., Gruman, J.A., Macey, W.H., & Saks, A.M. (2015). Employee engagement, human resource management practices and competitive advantage. Journal of Organizational Effectiveness: People and Performance , 2(1), 7-35.
2. David, A., & Cenezo, D. (1989). Personnel/Human resource management. New Delhi: Prentice-Hall of India.
3. Gould-Williams, J. (2003). The importance of HR practices and workplace trust in achieving superior performance: a study of public-sector organizations. International journal of human resource management, 14(1), 28-54.
4. Jiang, K., Lepak, D.P., Han, K., Hong, Y., Kim, A., & Winkler, A.L. (2012). Clarifying the construct of human resource systems: Relating human resource management to employee performance. Human Resource Management Review, 22(2), 73-85.
5. Kabene, S.M., Orchard, C., Howard, J.M., Soriano, M.A., & Leduc, R. (2006). The importance of human resources management in health care: a global context. Human Resources for Health, 4(1), 20.
6. Kydd, C.T., & Oppenheim, L. (1990). Using human resource management to enhance competitiveness: Lessons from four excellent companies. Human Resource Management, 29(2), 145-166.
7. NimaSajai, X.S.B. (2020). Comparative study to assess the level of job satisfaction among the nursing professionals working in certain hospitals & academic institutions at asir region, kingdom of Saudi Arabia. International Journal of Advanced Science and Technology , 29(7), 4800-4813.
8. Noe, R., Hollenbeck, J., Gerhart, B., & Wright, P. (2010). Fundamentals of human resource management.
9. Oatey, M. (1970). The economics of training with respect to the firm. British Journal of Industrial Relations, 8(1), 1-21.
10. Pareek, U. (2002). Training instruments in HRD and OD.
11. Shah, H.S.A., & Khan, M.A. (2018). Leadership effectiveness in relation with job satisfaction. International Journal of Advanced Multidisciplinary Scientific Research , 1(5), 50-57.
12. Sharma, A., Kaushal, V., Pandey, N., Arora, P., Thiyagarajan, A., & Bhattacharya, S. (2020). Assessment of job satisfaction among nursing officers working at a tertiary care hospital in Northern India. CHRISMED Journal of Health and Research, 7(1), 35-41.
13. Taamneh, A., Alsaad, A.K., & Elrehail, H. (2018). HRM practices and the multifaceted nature of organization performance. EuroMed Journal of Business , 13(3), 315-334.