Relational dimensions, motivation and knowledge-sharing in healthcare: a perspective from relational models theory
| Author | Negar Monazam Tabrizi |
| DOI | http://doi.org/10.1177/00208523211029128 |
| Published date | 01 March 2023 |
| Date | 01 March 2023 |
| Subject Matter | Articles |
Relational dimensions,
motivation and knowledge-
sharing in healthcare: a
perspective from relational
models theory
Negar Monazam Tabrizi
Global Development Institute, The University of Manchester,
UK
Abstract
This study investigates the relational dimensions that shape clinicians’intentionality and
motivation for knowledge-sharing. Qualit ative data was collected from 40 clinicians in
two hospitals, and relational models theory was used to investigate the impact of differ-
ent relational models (communal-sharing, authority-ranking, equality-matching and mar-
ket-pricing) on clinicians’intentionality and motivation to engage in knowledge and
learning. While communal-sharing and expert-based authority–ranking relationships
predominantly encourage intra-professional knowledge-sharing, equality-matching
encourages inter-professional knowledge-sharing. This implies that while the idea is to
work together to improve public service quality, each actor has their own interests
and is motivated to share knowledge for different collective and/or personal reasons/
agendas. In the public sector, formal authority-ranking and market-pricing are the
main driving forces of coordination of actions and knowledge flow, through the medium
of money and trade. Despite this, power games and a lack of support from those in posi-
tions of authority and ignorance of potential conflicts of interest, as well as extrinsic
motivators, hamper knowledge-sharing, all of which threaten patient safety.
Points for practitioners
In pursuit of public service improvement, a focus on fostering an organizational culture
that promotes collective behaviour, especially among those in authority, is crucial, given
Corresponding author:
Negar Monazam Tabrizi, The University of Manchester, Global Development Institute, Oxford Road,
Manchester M13 9PL, UK.
Email: negar.monazamtabrizi@manchester.ac.uk
Article
International
Review of
Administrative
Sciences
International Review of Administrative
Sciences
2023, Vol. 89(1) 221–238
© The Author(s) 2021
Article reuse guidelines:
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DOI: 10.1177/00208523211029128
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that their lack of support retards knowledge-sharing. For effective knowledge-sharing,
both intrinsic and extrinsic motivators are equally important depending on the relational
model.
Keywords
healthcare, intentionality and motivation, knowledge-sharing, public service delivery,
relational models theory
Introduction
As in all fields of professional practice, there is growing interest in stimulating
knowledge-sharing practices in healthcare organizations. The aim is to exploit and lever-
age knowledge to reduce the costs of medical errors caused by a knowledge gap and to
improve the quality of healthcare services (Currie et al., 2008; Waring et al., 2013).
Medical knowledge-sharing, however, needs careful integration of expertise from
several interdisciplinary areas. In this context, high levels of interaction and cooperation
are required (El Morr and Subercaze, 2010) where intentionality and motivation condi-
tion such cooperative behaviour (Nahapiet et al., 2005).
This realization has shifted the focus of literature from the technical side of
knowledge-sharing to social relationships and their role in guiding knowledge-sharing
behaviour (e.g. Bate and Robert, 2002; Tagliaventi and Mattarelli, 2006; Tasselli,
2015). However, current relational research has left a significant gap in our understanding
of the differences in relational contexts/models and the way they shape clinicians’inten-
tionality and motivation. Relational models theory (RMT) (Fiske, 1992) suggests that
there are four relational models (i.e. communal-sharing, authority-ranking, equality-
matching and market-pricing) that determine the way people interact with others. Boer
et al. (2011) then argue that intentionality and motivation to share knowledge are
shaped by the relational models in which they are embedded.
In discussions of relationality, dominated by communities of practice (CoP) and
social networks theories, there is an emphasis on the collective and altruistic elements
in clinicians’intentionality and motivation. RMT moves us beyond this limited view of
intentionality and motivation, which produced inconclusive empirical results on the
effectiveness of knowledge-sharing within healthcare networks (Ferlie et al., 2012).
In contrast, RMT helps to better understand the various ways in which different rela-
tional models affect knowledge-sharing, with a view to illuminating better motivational
strategies based on the underlying relational model(s). However, there has so far been
little detail on relational models in healthcare. We know little about how different rela-
tional models shape clinicians’intentionality and motivation for knowledge-sharing, or
about which relational models most encourage clinicians to participate in knowledge-
sharing. This paper therefore aims to provide a detailed analysis of clinicians’
knowledge-sharing behaviour by applying RMT in two National Healthcare Service
(NHS) Trusts in England.
222 International Review of Administrative Sciences 89(1)
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