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European Journal of Innovation Management

Do nurses display innovative work behavior when their values match with
hospitals’ values?
Bilal Afsar, Sadia Cheema, Bilal Bin Saeed,
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Bilal Afsar, Sadia Cheema, Bilal Bin Saeed, (2017) "Do nurses display innovative work behavior when
their values match with hospitals’ values?", European Journal of Innovation Management, https://
doi.org/10.1108/EJIM-01-2017-0007
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Nurses
Do nurses display innovative display IWB
work behavior when their values
match with hospitals’ values?
Bilal Afsar
Department of Management Sciences, Hazara University, Mansehra, Pakistan
Received 27 January 2017
Sadia Cheema Revised 25 April 2017
Accepted 10 May 2017
National College of Business Administration & Economics, Multan, Pakistan, and
Bilal Bin Saeed
Department of Management Sciences,
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COMSATS Institute of Information Technology, Abbottabad, Pakistan

Abstract
Purpose – The purpose of this paper is to draw on organizational psychology, innovation and knowledge
management literatures to investigate the impact of a nurse’s person-organization (P-O) fit on his/her
innovative work behavior (IWB). Furthermore, in order to understand the psychological mechanisms
surrounding this relationship, the authors examine the mediating role of psychological empowerment and the
moderating role of knowledge sharing behavior.
Design/methodology/approach – Data were collected from 441 nurses and 73 doctors through structured
questionnaires from four public sector hospitals in Thailand.
Findings – Results of the study indicate that nurse’s P-O fit is positively related to both self (nurse) and
doctor’s ratings of innovative behaviors and that psychological empowerment mediates this relationship.
These results imply that a nurse’s perception of value congruence impacts his/her perception about feeling of
empowerment, which in turn helps in engaging him/her into acts of innovativeness more often. The results
also show that the relationship between P-O fit and IWB is stronger among nurses who frequently share their
best practices and mistakes with co-workers.
Originality/value – Employee involvement in innovative work is of crucial importance for organization’s
competitiveness, especially in the nursing profession. The compatibility between personal and organizational
values is a vital ingredient of our personal, social and professional worlds. Although research has identified
some antecedents of nurses’ IWB, it is unclear how P-O fit influence nurses’ IWB. Nurses with stronger value
congruence when empowered psychologically may respond more effectively to display IWBs in current
dynamic and challenging public health care work environments.
Keywords Innovation, Knowledge sharing, Work psychology
Paper type Research paper

Introduction
Innovation plays a critical role in today’s highly competitive and technologically advanced
world. Successful companies create competitive advantage in the marketplace through
individuals’ innovations (Chen and Chen, 2012). Hospitals are dependent on the knowledge,
the creativity and the innovative engagement of their nursing personnel (Brown et al., 2006;
Chang and Liu, 2008). Innovative work behavior (IWB) of nurses, who are close to patients,
is necessary if they are to be active participants in reaching organizational aims and, in a
wider context, the aims of health care (Chang and Liu, 2008; Knol and Van Linge, 2009).
Therefore, it is important to gain insight into the antecedents of IWB of nurses (Knol and
Van Linge, 2009). IWB refers to the intentional generation, promotion and realization of new
ideas within a work role, work group or organization, in order to benefit role performance,
the group or the organization (Scott and Bruce, 1994). Employees with IWB can quickly and
appropriately respond to customers, propose new ideas and create new products. European Journal of Innovation
Management
The health care system is facing huge challenges with its retiring workforce, increasing © Emerald Publishing Limited
1460-1060
number of elderly patients, and cost-efficiency demands, combined with expectations of DOI 10.1108/EJIM-01-2017-0007
EJIM high-quality care that exploits all the latest advances in technology and related knowledge
(Länsisalmi et al., 2006; Thakur et al., 2012). Motivating nurses to engage in IWB and
share their knowledge with co-workers have increasingly attracted scholarly attention
(e.g. Länsisalmi et al., 2006; Varkey et al., 2008). Hospital management recognizes the
importance of promoting creativity and innovative intent among their nurses through
different psychological processes affecting nurses’ inclination toward innovation
(Berg et al., 1994; Doane, 2002; Lane, 2005). Innovations in the delivery of health care
services can result in more convenient, more-effective and less-expensive treatments for
today’s time-stressed and increasingly empowered health care consumers and these
superior services are primarily provided by the nurse practitioners (Herzlinger, 2006). In a
systematic review of literature, Länsisalmi et al. (2006) found that strong leadership, shared
and clear objectives, task orientation, participative safety, reflective team practices, active
internal marketing, correct timing, motivation and participation of personnel, lack of stress,
and sufficient resources (financial, instrumental and personal), all seem to be positively
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related to innovation in health care organizations. However, how compatibility between a


person’s and his/her organizational values is related to IWB needs further investigation.
Person-organization fit has been found effective in increasing many positive behavioral and
attitudinal outcomes (Kristof-Brown et al., 2005); and researchers view it as a good strategy for
organizations to innovate and remain competitive. An employee initiates innovative ideas,
builds social support and advocate their implementations with support from the organization,
both tangible and intangible (e.g. culture and climate of innovation, perceived empowerment)
support. Without this support, employees’ innovation may stagnate. While most of the
previous research has investigated the influence of organizational characteristics on employees’
innovation (e.g. Camelo-Ordaz et al., 2011; Kristof-Brown et al., 2005), little work has taken the
employee’s psychological characteristics in consideration. This is an important issue because
individuals may respond differently to a context (Afsar et al., 2015), and it is premature to
assume that all employees of an organization would demonstrate the same behavior to the
organizational characteristics. Therefore, it is of great interest to investigate the impact of
the fit between an employee’s and organization’s characteristics on his/her IWB.
Drawing from organizational psychology, innovation and knowledge management
perspectives, the objectives of this paper are threefold. First, we examine how the fit
between an employee’s and his/her organization’s characteristics impacts the employee’s
IWB. Person-organization (P-O) fit theory seems to be an interesting area in explaining
employee’s innovation performance because it suggests that individuals and organizations
are attracted to each other on the basis of their characteristics. Employees’ IWB refers to the
development of novel and useful ideas as well as implementing and commercializing
these ideas so that they may become a part of the organizational processes (De Jong and
Den Hartog, 2010). The lack of systematic attention to the impact of P-O fit on employee’s
IWB is especially surprising given that ideas are useless unless used and that
employee’s innovation, particularly in knowledge-intensive contexts.
Second, in order to understand the psychological mechanisms through which P-O fit
impacts the IWB, we argue that the P-O fit and IWB relationship is mediated by the nurse’s
psychological empowerment (i.e. P-O fit has a positive impact on psychological empowerment
that, in turn, has a positive impact on employee’s IWB). Third, we examine the role that
knowledge sharing behavior (KSB) plays in moderating the relationship between P-O fit and
IWB. Fong et al. (2011) mentioned knowledge sharing among many HR practices that may
impact employee outcomes through P-O fit but did not test them empirically. Knowledge
sharing is based on perception of a positive social interaction culture and obligation to
reciprocate (Chang and Hsu, 2015). The positive association between P-O fit and IWB holds
for employees who show high level of KSB, because knowledge sharing is subject
to socialization and frequent interaction with each other. By offering extensive knowledge,
employees entail improved friendly relationships, and adapt to the social dynamics of the Nurses
workplace. The expected associations (perception of positive exchange relationships) and display IWB
expected contributions (perception of contribution to organizational performance) by showing
positive attitude towards knowledge sharing engenders intrinsic motivation and feelings of
trust (Afsar et al., 2015), make them more responsive to their situations (Hoffman et al., 2011),
and thus more creative.
The major contributions of this paper are fourfold. First, unlike most of previous
research that investigates the impact of organizational characteristics on employees
(e.g. Afsar et al., 2015; Hoffman et al., 2011), this study is among the few attempts to directly
theorize and test the impact of the fit between both the employee’s characteristics and the
organization’s characteristics on employees’ IWB. It, therefore, contributes to and extends
both P-O fit and the IWB literatures. Second, this research further explains the
psychological mechanism through which the fit between employee and organization
impacts the IWB. Third, this study sheds light on the importance of moderating role of KSB
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in explaining the relationship between P-O fit and IWB. Organizations need to develop a
culture of knowledge sharing if they want to maximize the benefits from employees’ IWB.
Fourth, this paper also contributes to the HR practices, in that organizations need to pay
extra attention in the hiring process. In order to increase the benefits of employees’ IWBs,
HR management needs to make sure that the employees’ and the organizations’ values,
purposes and principles are matched.

Research model and hypotheses


The relationship between P-O fit and IWB
P-O fit is defined as a general match of an individual’s values, knowledge, skills, abilities and
personality with the overall organization (Cable and Judge, 1996). A meta-analysis of P-O fit
literature by Verquer et al. (2003) found that P-O fit affects work attitudes of employees and
increases organizational identification, commitment and organization citizenship behavior
(OCB). They also found that P-O fit resulted in positive work outcomes and employees
performed well in their jobs. Previous research explored the effects of organizational
commitment and OCB on individual innovativeness and found that greater commitment
and OCBs lead to higher levels of individual innovation (Camelo-Ordaz et al., 2011;
Dorenbosch et al., 2005). P-O fit is strongly related to these outcomes suggesting that P-O fit
is likely to increase individual’s IWB.
P-O fit is strongly related to positive work outcomes suggesting that P-O fit is likely to
increase individual’s IWB. Afsar et al. (2015) reported that employee engagement correlates
positively with IWB; higher P-O fit results in greater employee engagement due to strong
social ties; therefore, high P-O fit will increase employee’s IWB. It is assumed that individuals
with high P-O fit engage in extra-role behaviors more often (Camelo-Ordaz et al., 2011).
As IWBs are discretionary behaviors (Ramamoorthy et al., 2005), and P-O fit positively
impacts discretionary behaviors (Vilela et al., 2008), therefore:
H1. There is a significant positive relationship between P-O fit and IWB of nurses.

The mediating role of psychological empowerment


There are a number of ways in which an individual’s empowerment can be viewed,
depending upon the nature of relationships to be studied. Some researchers viewed
empowerment from structural and social perspective, which focused upon increasing
individual decision-making power (e.g. Laschinger et al., 2001; Spreitzer, 1996). Others
emphasized on the cognitive or psychological perspectives of empowerment, which are
related to individual perceptions about power in the organization and the psychological
EJIM states (e.g. Thomas and Velthouse, 1990; Spreitzer et al., 1999). The current study focuses on
employee’s cognitive or psychological perspectives of empowerment.
Thomas and Velthouse (1990) and Spreitzer (1995) described psychological empowerment
as a motivational construct having four cognitions: meaning, competence, impact and
self-determination. Meaning is the value an individual place on a work role based on his/her
ideals or standards. Competence is the feeling of self-efficacy or effort-performance
expectancy which drives one to believe about his/her capability to perform activities with skill.
Impact is the degree to which an individual can influence organizational outcomes; while
self-determination is autonomy in initiation of work behaviors and making decisions about
work. In this research, psychological empowerment is conceptualized as an individual’s active,
rather than a passive, orientation to a work role with a desire to shape organizational contexts,
processes and work environments (Spreitzer, 1995, 1996). This active orientation increases
autonomy and task motivation (Thomas and Velthouse, 1990), which may increase the
likelihood of them engaging in IWB. When employees are empowered in organizations, they
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find worth and meaning in their work roles ( Jung et al., 2003), show increased inspiration and
upward influence (Spreitzer et al., 1999), and are more likely to be motivated intrinsically to
have an impact on the organization, which in turn promotes task accomplishment and
creativity-related outcomes ( Jung and Sosik, 2002).
Previous studies also showed that empowered employees were more effective in getting
their work done and contributing to organizational productivity goals (Laschinger and
Wong, 1999; Sigler and Pearson, 2000) and also demonstrated better performance in nursing
practice (Manojlovich, 2005). The possible mediation effect of psychological empowerment
in the relationship between P-O fit and IWB is based on the importance of psychological
empowerment in predicting employee creativity. As creativity is an essential element of
IWB, it is likely that psychological empowerment may impact IWB of employees.
Psychological empowerment positively influences creative process engagement and
organizational innovation (Pieterse et al., 2010), and freedom to engage in “trial and error”
(Ramamoorthy et al., 2005). The process of generating and implementing innovative ideas
involves trial and error. Empowered employees feel they have skills, abilities, capabilities,
self-worth and confidence to influence their work contexts more meaningfully by adding
value and purpose.
Conger and Kanungo (1988) suggested that psychological empowerment stimulates
change, and IWBs are change oriented by definition. Most generally, psychological
empowerment increases intrinsic task motivation, individual flexibility, autonomy and
self-determination over job execution making individuals less constrained about rule-bound
aspects and allow them to contribute to innovative behaviors (Ryan and Deci, 2000). Such an
employee is also more likely to take risks with higher levels of creative outcomes and energy
to perform, explore new cognitive pathways and be playful with ideas (Amabile et al., 1996).
Therefore, we may argue that psychological empowerment positively affects employee’s
IWB. P-O theory emphasizes the role of psychological empowerment as a central
mechanism to build positive work-related outcomes of employees (Gregory et al., 2010).
Employees who have better P-O fits are expected to possess greater sense of impact on
organizational systems. This impact influences important behaviors and attitudes toward
work roles such as intrinsic motivation, creativity and innovation, through enhancements to
their psychological empowerment (Gregory et al., 2010; Seibert et al., 2011).
Based on above discussion, it is likely that P-O fit positively affects innovative behavior
of an individual, only if the individual is empowered psychologically and control is given to
him/her in order to perform different activities related to job. Gregory et al. (2010) suggested
that individuals with authority and empowerment understand work contexts to shape
organizational processes effectively. Employees with a better fit understand environmental
demands and supplies and their own values and abilities, creating a work environment
suitable to their organizational schemas and expectations, which advocates that P-O Nurses
fit leads to the cognitions of empowerment and, consequently, creative behaviors display IWB
(Pieterse et al., 2010). Such psychological mechanisms will impact whether or not an
employee engages in IWBs, adequately creates and implement new and innovative ideas.
Therefore, we propose that:
H2. Psychological empowerment mediates the relationship between P-O fit and IWB; the
P-O fit has a positive impact on nurse psychological empowerment that, in turn, has
a positive impact on the nurse’s IWB.

The moderating role of KSB


Davenport and Prusak (1998) defined knowledge sharing as a process that involves
exchange of knowledge among individuals, groups and organization. According to Connelly
and Kevin Kelloway (2003), KSB is “a set of behaviors that involve the exchange of
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information or assistance to other which contains an element of reciprocity”. Knowledge


sharing comprises a set of shared understandings that provide employees with access to
relevant information and that enable them to build and use knowledge networks within
organizations (Hoegl et al., 2003). Kessel et al. (2012) proposed that knowledge sharing
research has limited empirical basis and lacks the depth in human and organizational
factors that affect employee’s initiatives. Managers create avenues for knowledge sharing
by supporting open communication processes and interaction among people which sparks
idea generation. When employees share knowledge frequently, they are likely to strengthen
the effect of P-O fit on IWB because of open and transparent communication with
co-workers, and greater variety of socialization processes leading to higher compatibility
between commensurate individual and organizational characteristics. Conversely, if
employees do not share knowledge quite often, their social ties get weaker and
communication becomes less open, making it hard to gain social support for ideas. It is
highly probable that the relative effect of a person characteristic (knowledge sharing)
on situation characteristic (organizational innovation) is stronger because people changed
and influenced their situations more than their situations changed and influenced them
(Kessel et al., 2012); personal and situational characteristics interact to predict behavior;
people who share knowledge frequently homogenizes with situational characteristics of
innovation and engage strongly in IWB.
Meurier et al. (1997) find that the most important reason for mistakes in the hospital is a
lack of knowledge and experience. Numerous studies indicate that knowledge sharing is
essential, because it enables organizations to reduce redundant learning efforts
(Kankanhalli et al., 2005; Scarbrough, 2003; Thakur et al., 2012). Knowledge sharing can
provide the right vehicle for transferring needed knowledge through different means
suitable to each group of receivers, including patients ( Jabr, 2007). Sometimes individuals
learn and gain knowledge by storytelling and reflective dialogue; such situational learning
is thought to enhance performance, particularly in knowledge-intensive organizations
(Kessel et al., 2012). Individual shows willingness to share knowledge when he/she has
personal cognition in a social environment, and a belief that he/she would receive intrinsic
benefits such as social recognition, shared norms and purpose or better alignment
with organizational values (Kankanhalli et al., 2005), facilitating creative behaviors
(Kessel et al., 2012). Kankanhalli et al. (2005) argued that frequent engagement into KSB
increased the ability of an individual to develop strong inter-relationships, social ties,
shared norms and identity. Such employees trust their supervisors and colleagues and are
more satisfied with their jobs (Connelly and Kevin Kelloway, 2003). This environment of
mutual trust, shared norms and social integration encourages individuals to propose new
concepts and gain support through strong social ties to implement novel concepts.
EJIM Several authors have recognized how initiation and implementation of new ideas is
typically too complex for a single individual, and requires instead a persistent coordination
with others (e.g. Afsar et al., 2015; De Jong and Den Hartog, 2010; Thakur et al., 2012).
Such coordination becomes significantly easier when individuals eagerly show willingness
to share knowledge. It entails friendly relationships with others and obligation to
reciprocate (Wang and Noe, 2010). Employees judge and match their capabilities with
expected contributions they have to make to attain high performance. As such, individuals
might develop greater expectations that their knowledge sharing can be more effective, once
they get connected to a larger network of acquaintances (Afsar et al., 2015). Accordingly, the
higher the propensity to share knowledge, the higher is the impact of P-O fit on promotion
and implementation of a new idea.
Frequent sharing of knowledge helps employees to socialize the idea with colleagues and
to attract their attentions on its advantages; and then translate the new idea into a workable
solution by convincing others to implement (Wang and Noe, 2010). High level of
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socialization leads to greater compatibility between individual values and organizational


values. Therefore, we posit that P-O fit encourages individuals with greater propensity to
share knowledge to engage in innovative behaviors. On the basis of above arguments, the
following hypothesis is proposed:
H3. Nurse’s KSB moderates the relationship between P-O fit and IWB, the higher the
KSB, the stronger the relationship between P-O fit and IWB.

Research methods
Sample and data collection
This research studied the relationships among employee’s P-O fit, psychological
empowerment, KSB and IWB. A cross-sectional design was employed in the study.
Power analysis was calculated to estimate the minimum samples needed to obtain
statistically significant results. A total of 800 full-time public health nurses were initially
approached and convenience sampling strategy was used, with a minimum sample size of
155 ( p ¼ 0.05, power ¼ 0.80, effect size ¼ 0.15) (Cohen, 1988). We selected four public sector
hospitals in Thailand. These hospitals were rated as the top four in medical services and
technological advancements. Data were collected from September to November 2015, using
a questionnaire that consisted of 33 items. Based on feedback from a pilot study (n ¼ 7),
small adaptations were made in the layout, while some instructions were clarified. Several
techniques to increase response rate were adopted, e.g. a cover letter, a stamped addressed
return envelope, drawing attention to the study in the in-house newsletters and via
executives, and follow-up reminders.
A total of 160 doctors (40 in each hospital) and 800 nurses (200 in each hospital) were
administered a questionnaire. Data were collected from multiple hospitals to better
understand the studied constructs and doctors were also involved to rate IWB of the nurses
so that biasness could be minimized. The permission from the concerned authorities of these
hospitals was taken prior to the distribution of the survey. We utilized services of four
research assistants who went to the hospitals and gave questionnaires to the respondents.
The measures of psychological empowerment, KSB, P-O fit and self-rated IWB were filled
by the nurses. Doctors were asked to rate the IWBs of their subordinate nurses.
Of the 800 surveys distributed to nurses, 527 surveys were returned with a response rate
of 66 percent. Of those 527 surveys, matching surveys (a doctor rated a nurse who had also
turned in a survey) were returned from 441 individuals. A total of 73 out of 160 doctors rated
IWB of their nurses thus usable matched data consisted of six nurses’ ratings per doctor, on
average. We used the full-information maximum likelihood method for missing data
treatment, which is a more robust technique than list-wise deletion, pairwise deletion, mean
replacement or multiple imputation methods (Bollen and Curran, 2006). All models were Nurses
rerun using the cases with no missing values, to ensure that our treatment of missing data display IWB
did not adversely impact our findings. The results remained unchanged. The average age of
nurses was 32.3 years with a standard deviation of 4.94 whereas the average age of doctors
was 35.6 years. The average tenure of nurses with the hospital was 4.58 years with a
standard deviation of 3.22 years. Approximately 79 percent of the sample consisted of
females (Figure 1).

Measurement
All constructs were measured on a five-point Likert scale.

P-O fit
The perceived P-O fit scale was adopted from Cable and Judge (1996) with three items.
The reliability of the scale was found to be 0.89.
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Psychological empowerment
The 12-item empowerment at work scale, developed by Spreitzer (1995), using the four
cognitive aspects of empowerment (meaning, competence, self-determination and impact)
was used in this study. The items were averaged to form a scale with a reliability of 0.81.

IWB
The ten-item scale measuring IWB (e.g. “The nurse pays attention to issues that are no part
of his/her daily work”) used the studies by De Jong and Den Hartog (2010). To remove
biasness, both self-assessment and doctor assessment of IWB were taken. The items were
averaged to form a scale with a reliability of 0.84.

KSB
The eight-item scale in the KSB (e.g. “As soon as I get to know a best practice, I immediately
share it with my work-team,” “I have no problems sharing my past mistakes with
colleagues”) was adopted from study of Mura et al. (2013). They represent the extent to
which a professional individual shares his/her best practices or mistakes with co-workers.

Data analysis and results


Confirmatory factor analysis (CFA)
To ensure that there was sufficient discriminant validity among constructs, we conducted a
CFA with P-O fit, KSB, psychological empowerment and IWB. We then evaluated model fit
according to various fit indicators including the χ2 goodness-of-fit test, non-normed fit index

Knowledge Sharing Behavior

Person-Organization Fit Innovative Work Behavior

Psychological Empowerment Figure 1.


Theoretical framework
Direct effect Moderating effect
EJIM (NNFI), comparative fit index (CFI) and root mean square error of approximation (RMSEA).
Hu and Bentler (1999) suggest that a value close to 0.95 is reflective of good fit for NNFI and
CFI, and RMSEA values close to 0.06 indicate reasonable model fit. According to Table I, the
test result of adaptability were χ2 ¼ 774.06, χ2/df ¼ 2.66, NNFI ¼ 0.93, CFI ¼ 0.92 and
RMSEA ¼ 0.072, indicating that the model achieved an acceptable standard.

Descriptive analyses
Table I presents means, standard deviations and correlations among the study variables.
As expected, P-O fit is significantly correlated with psychological empowerment, and IWB
(r ¼ 0.37, p o0.001; r ¼ 0.64, p o0.01), respectively. Psychological empowerment is also
significantly correlated with IWB (r ¼ 0.68, p o0.01). Sharing best practices is positively
correlated with P-O fit, and IWB (r ¼ 0.28, p o0.01; r ¼ 0.45, p o0.01), respectively. Finally,
sharing mistakes is also positively correlated with P-O fit, and IWB (r ¼ 0.21, p o0.001;
r ¼ 0.41, p o0.01), respectively.
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The structural model


In order to evaluate the degree of within-group interdependence in our data, we proceeded to
calculate the ICCs and design effects for all the variables in our model. None of the variables
had a significant ICC (all ICCs were lower than 0.08) or a design effect larger than 1.6. These
results indicate that there was no significant group-level variance in the variables. In other
words, even if nurses were nested in groups, their group membership did not count for
significant variance in the variables and thus did not need to be controlled for by multilevel
modeling. In such a case, single-level analysis is recommended by researchers (Cohen, 1988).
Therefore, we relied on single-level structural equation modeling (SEM) as the main method
to test our model. Specifically, we used covariance-based SEM (Qureshi and Compeau, 2009),
which is a second-generation multivariate analytic technique that simultaneously estimates
measurement and structural models. SEM can incorporate measurement error, assess
overall model fit and permit simultaneous estimation of multiple associations (Preacher
et al., 2007). We followed Anderson and Gerbing’s (1988) two-step analytical strategy to test
our hypothesized model. First, a measurement model was performed to test the construct
validity of the constructs. Second, a series of nested structural models were conducted to
estimate the fit of the hypothesized model to the data. We then assessed the significance of
the path estimates to test the hypotheses.
To examine the hypothesized relationships among P-O fit, KSB, psychological
empowerment and IWB, this study utilized simultaneous maximum-likelihood-estimation
procedures. According to Table II, the model achieved a satisfactory level of goodness-of-fit
in predicting the variance of P-O fit (56 percent) and IWB (44 percent). As expected, P-O
fit and psychological empowerment are two powerful predictors of IWB (the coefficients
were 0.73 and 0.58). The effect of P-O fit on IWB was significant ( β ¼ 0.28, p o0.05),

Scale Inter-correlations
Variable Mean SD 1 2 3 4 5

1. Person-organization fit 3.55 0.56 1


2. Psychological empowerment 3.99 0.32 0.37** 1
3. Sharing best practices 4.01 0.22 0.28* 0.15 1
4. Sharing mistakes 3.52 0.53 0.21** 0.15 0.11 1
Table I. 5. IWB 4.12 0.38 0.64* 0.68* 0.45* 0.41* 1
Descriptive analyses Notes: *po 0.01; **p o0.001
Coefficient t-value
Nurses
display IWB
Dependent variable: psychological empowerment
R2 0.47
P-O fit 0.61 5.91*
Dependent variable: IWB
R2 0.75
P-O fit 0.73 6.84*
Psychological empowerment 0.58 6.11*
Goodness-of-fit statistics
χ2 (p-value) 469.8
df 291
GFI 0.94 Table II.
Structural equation
NNFI 0.97
models of P-O fit,
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RMSR 0.042 psychological


RMSEA 0.041 empowerment, and
(90% CI) (0.046-0.072) innovative work
Note: *po 0.05 behavior

supporting H1. The increased R2 value (0.28, from 0.47 to 0.75 for IWB) resulting from
adding psychological empowerment in the equation is significantly large.
According to Table III, positive and significant relationships existed between P-O fit and
psychological empowerment (P-O fit→PE ¼ 0.41, po0.05), and psychological empowerment
and IWB (PE→IWB ¼ 0.46, po0.001). The study found that psychological empowerment
was a partial mediator between P-O fit and IWB. In addition, P-O fit positively influenced IWB
( β ¼ 0.27, po0.01). When indirect effect of psychological empowerment was included in the
equation, the positive impact of P-O fit on IWB 0.1287(0.33 × 0.39), reduced than the direct
impact (0.1287o0.27). The study thus validated H2 that psychological empowerment was the
partial mediation variable between P-O fit and IWB.
The third hypothesis posits the moderating role of KSB on IWB through P-O fit. Initially, a
regression of IWB with both control variables and independent variables was conducted. We
mean-centered the scores of the P-O fit, psychological empowerment, sharing best practices
and sharing mistakes to minimize the threat of multicollinearity. To test H3, we entered the
main effect of P-O fit as well as the interaction effects (P-O fit × SBP) on doctor-rated IWB.
A significant β coefficient for each interaction term (P-O fit × SBP, P-O fit × SM) or values of
the incremental F-statistic indicated that the moderator variable (sharing best practices and
sharing mistakes) acts as a moderator. We first entered control variables and then the main
effects of P-O fit, sharing best practices, and sharing mistakes were entered along with the
control variables. In last step, the interaction effects of sharing best practices and sharing
mistakes with P-O fit were entered along with the control variables and the direct effects of
sharing best practices, sharing mistakes and P-O fit. (Table IV)

Standardized path coefficients (t-value)


Direct effects model Full mediation model Partial mediation model

P-O fit → IWB 0.28 (2.82*) 0.27 (2.91**)


P-O fit → PE 0.41 (3.93*) 0.33 (4.57**)
PE → IWB 0.46 (3.48***) 0.39 (4.06***) Table III.
Notes: P-O fit represents person-organization fit; PE represents psychological empowerment; IWB Results of multilevel
represents innovative work behavior. *p o0.05; **p o 0.01; ***p o 0.001 path analysis
EJIM Step 1 Step 2 Step 3
Variables β t-value β t-value β t-value

Controls
Age 0.35 2.07 0.53 2.22 0.53 2.28
Job tenure 0.49 3.91* 0.44 3.60** 0.44 3.67**
Gender 0.41 2.80* 0.41 2.74* 0.41 2.76***
Industry type 0.29 6.05 0.28 5.30 0.28 5.32
Main effects
P-O fit 0.46 8.18** 0.46 6.25**
Sharing best practices 0.28 4.59*** 0.35 4.44***
Sharing mistakes 0.34 2.47** 0.24 2.40**
Interactions
P-O fit × SBP 0.43 3.59**
PO fit × SM
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0.36 6.01***
R2 0.35 0.53 0.76
F 16.87* 29.1** 45.05**
Table IV.
Hierarchical ΔR2 0.18 0.23
moderated regression ΔF 12.23** 15.95**
analysis (dependent Notes: SBP represents sharing best practices; SM represents sharing mistakes. *p o 0.05; **p o 0.01;
variable ¼ IWB) ***p o 0.001

When the control variables were entered, job tenure and gender were related positively and
significantly to IWB (t ¼ 3.91, po0.01 and t ¼ 2.80, po0.05), respectively. Step 2 provided a
significant increase in variance explained over Step 1 (ΔR2 ¼ 0.18; ΔF ¼ 12.23, po0.01) for
IWB. Both sharing best practices and sharing mistakes were positively and significantly related
to IWB (t ¼ 4.44, po0.001 and t ¼ 2.40, po0.01). Step 3 provided a significant increase in
variance explained over Step 2 (ΔR2 ¼ 0.23; ΔF ¼ 15.95, po0.01). Hence, H3 was supported.

Discussion
The current study examined the relationship between P-O fit and IWB through mediating
role of psychological empowerment and moderating role of KSB. This study suggested three
important conclusions. First, we found a positive link between P-O fit and IWB. While the
direct relationships between P-O fit and nurse creativity and contextual performance have
been tested in the literature (e.g. Afsar et al., 2015; Vilela et al., 2008), we extend this notion
by finding that nurses with higher P-O fit exhibit higher levels of IWB.
Second, a nurse’s psychological empowerment perceptions mediated the relationship
between P-O fit and IWB. We improve upon Gregory et al.’s (2010) work by testing
psychological empowerment as a mediator between P-O fit and IWB relationship.
Their work explored the mediating role of psychological empowerment on the relationship
between P-O fit and in-role performance and job satisfaction of nurses. Our results
indicated that nurse’s perceptions of value congruence positively influenced the way
he/she felt about work environment, and then these feelings of empowerment persuaded
him/her to engage in IWB. Specifically, this research is among the first to examine the
mediating role of psychological empowerment, thereby shedding light on the mechanism
by which P-O fit impacts IWB. Third, nurses’ KSB moderated the relationship between
P-O fit and IWB displayed by nurses. Our results suggested that differences in nurse
levels of innovative behavior may be explained in part by the differences in his/her
attitude to share knowledge with colleagues. These findings are crucial because
continuous innovation ensures sustained competitive advantage and the best way to
innovate is by engaging nurses into IWBs.
Theoretical implications Nurses
Our findings help to deeply understand the drivers of IWB among nurses through focus on display IWB
empowerment and KSB. Our results suggest that, a better match between, on the one hand,
the knowledge, skills and abilities of nurses and, on the other hand, the organization’s
demands, expectations, goals and targets stimulates intellectual abilities of nurses
and inspires them to create opportunities to significantly impact their work roles, thus
leading to higher levels of IWB. Nurses’ fit perceptions positively influenced IWB, as
previous studies empirically tested positive correlations between P-O fit and citizenship
behaviors (e.g. Afsar et al., 2015; Seibert et al., 2011).
Our results implied that differences in nurse levels of IWB may be explained in part by
the differences in his/her perceptions of psychological empowerment. Individuals with
higher level of P-O fit developed perceptions that they were capable to perform work
activities, had significant autonomy over behaviors and work contexts and could
influence and make a difference at workplace. These perceptions of empowerment make
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individuals to think in terms of reciprocation. The power and autonomy given to them by
co-workers and organization is to be reciprocated by them in the form of positive
behaviors because everyone has high expectations of them. One such positive behavior
they often engage in is IWB.
The motivation behind individuals’ knowledge sharing is that patterns of knowledge
exchange lead to organizational improvements and then it helps individuals to draw
personal benefits and connects them more strongly with their colleagues (norm of
reciprocity). The distinction between sharing best practices and mistakes is relatively new
in the literature since only an empirical study by Afsar et al. (2015) has found that both
contents of KSB have positive impact on IWB. This study showed that these two
dimensions of KSB moderated P-O fit-IWB linkage.
By sharing best practices and mistakes, the individual gains social obligations and
support which fosters social ties. Individual perceive knowledge sharing as an improvement
process and expect to gain long-term benefits. As better value congruence between
individual and organization leads to strong social ties, perception to gain long-term benefits,
and creation of goodwill, the results showed that P-O fit perceptions affect nurse’s IWB
more strongly when they readily share knowledge with co-workers. Our study collected P-O
fit, psychological empowerment, KSB and IWB ratings from multiple industries and
different departments within the same firm, increasing better understanding of the
relationships among the studied constructs.

Practical implications
Our results showed that when nurses fit better with the organizations’ values, they tend to
share their knowledge and devote extra efforts beyond their job descriptions to promote and
implement new ideas. To contribute to the level of fit of nurses who are already working in
the organization, top management can arrange organizational socialization practices such
as frequent company social gatherings and training programs (Kristof-Brown et al., 2005).
The doctors should communicate regularly with their nurses about the latest developments
in the organization, expectations from individuals and values of organization. This study
confirmed that nurses are more likely to engage in IWB if they feel their values have
stronger compatibility with their respective hospitals’ values.
Hospitals should empower nurses by giving increased responsibility and autonomy to
take actions. When nurses have greater feeling of control over work environment and
internal locus of control, they become less alienated at work and thus more creative.
Empowered individuals feel significant and their talents and aspirations match the value
system encouraging them to invest mental energies positively. Nurse’s feeling of
responsibility and ownership about work activities causes self-assertion which enables
EJIM them to carry out initiatives. Managers should make individuals feel that they have ability,
capacity and control to do the job. Doctors should persuade nurses to share knowledge by
trusting and supporting them. By placing greater emphasis on a nurse’s sense of
competence, trust, choice, control, meaningfulness, fearless environment for creativity,
organizations can foster nurse propensity toward IWB.

Limitations and recommendations


The current study in not without limitations. First, we were unable to establish causality
due to the cross-sectional nature of data. We could not examine whether empowered
employee causes more innovativeness in his/her behavior or willingness to innovate
results in greater psychological empowerment. Second, we relied on a questionnaire
study and convenience samples. Although convenience samples were used and data
were collected from one country, the emergence of similar results across studies helps
reduce concerns of limited generalizability and future research is needed to replicate
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results across Western cultures (e.g. North America, Western Europe), work contexts and
study designs.

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Corresponding author
Bilal Afsar can be contacted at: afsarbilalait@gmail.com

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