Clinical Leadership and Job Performance Among Doctors in Malaysian University Hospitals: A Simulation Study of the Mediating Role of Professional Work Engagement

ABSTRACT: University hospital doctors perform simultaneous responsibilities in patient care, medical education, research and institutional administration. Effective clinical leadership may provide essential professional resources that strengthen doctors’ engagement and performance across these responsibilities. This simulation study demonstrates how Partial Least Squares Structural Equation Modelling can be applied to examine the relationship between clinical leadership, professional work engagement and job performance among doctors in Malaysian university hospitals. A synthetic dataset representing 300 hypothetical doctors from four Malaysian university hospitals was generated using a fixed random seed. Clinical leadership was operationalised through professional support, collaborative culture and clarity of clinical goals. Professional work engagement comprised vigour, dedication and absorption, whereas job performance covered clinical, teaching and research performance. The simulated data were analysed using descriptive statistics, reliability analysis, convergent and discriminant validity assessments, standardised structural-path analysis and non-parametric bootstrapping with 5,000 resamples. All constructs demonstrated acceptable reliability, with Cronbach’s alpha values ranging from 0.822 to 0.925, composite reliability between 0.882 and 0.936, and average variance extracted between 0.552 and 0.685. All HTMT values were below 0.90. Professional support (β = 0.325, p < 0.001), collaborative culture (β = 0.276, p < 0.001), and clarity of clinical goals (β = 0.149, p = 0.006) positively predicted professional work engagement. Clinical leadership (β = 0.251, p < 0.001) and professional work engagement (β = 0.465, p < 0.001) positively predicted job performance. The simulated indirect effect of clinical leadership on job performance through professional work engagement was significant (β = 0.262, 95% CI [0.197, 0.331]). The model explained 33.2% of the variance in professional work engagement and 41.1% of the variance in job performance. The simulation illustrates a theoretically plausible Job Demands-Resources model but does not constitute evidence collected from actual doctors