The impact of role conflict on retention intentions of trainees participating in standardised residency training: A moderated mediation model.

INTRODUCTION: The standardised residency training stage involves high work demands and multiple role pressures, which may threaten the retention of residency trainees. Based on Conservation of Resources theory, either the mediating processes (resource depletion) or the moderating processes (resource compensation) may explain how role-related sources of stress influence the retention intention of residency trainees, although how these processes operate within the structural design of residency training has not been well explored. METHODS: In a cross-sectional survey, 350 residents in standardised residency training at People's Hospital in China were included (response rate 94.1%). Role conflict, burnout, salary satisfaction and retention intention were surveyed. PROCESS Models 4 and 15 with bootstrap confidence intervals were used to examine the mediation and moderation effects. RESULTS: Role conflict was negatively associated with retention intention and was indirectly associated with lower retention intention through burnout; the indirect effect accounted for 26.5% of the total effect. The negative relationship between role conflict and retention intention was stronger at higher levels when the level of salary satisfaction was higher; the negative relationship between burnout and retention intention was less strong and non-significant. CONCLUSION: Structural pressures and modifications in psychological resources correlate with retention intention in standardised residency training with varying patterns at different stress stages. The context-dependent resource of salary satisfaction exhibits both a buffering and a reinforcing effect in the process of stress. The results indicate that, practically, the optimisation of the role structure, reduction of burnout and enhancement of coordination between the compensation and training systems could contribute to the stable functioning of the residency training system and sustainable evolution of the medical workforce.