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   Table of Contents      
Year : 2017  |  Volume : 22  |  Issue : 2  |  Page : 128-134

Comparison of the perceptions of managers and nursing staff toward performance appraisal

1 Student Research Centre, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
2 Asistant Professor, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
3 Assistant Professor, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

Date of Web Publication9-May-2017

Correspondence Address:
Marzieh Adel Mehraban
Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijnmr.IJNMR_142_15

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Background: Performance appraisal is an essential component of health care organizations for the improvement in quality of patients' care. Awareness of managers' and employees' perception of performance appraisal can lead to improved performance appraisal quality. The purpose of this study was to compare the perception of performance appraisal among managers and nursing staff of hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. Materials and Methods: This descriptive-analytical and cross-sectional study was conducted among 75 managers and 313 nurses in 2014. The participants were selected through a two-stage quota-random sampling. Data were collected using two researcher-made questionnaires (nursing managers and nurses' questionnaires). Data were analyzed using descriptive and statistical tests using the Software Package for the Social Sciences software. Results: The mean score of managers' and nurses' perception of the current performance appraisal was 56.8 (14.2) and 51.4 (14.5), respectively. A significant difference was observed between managers' and nurses' perception of performance appraisal (P = 0.004). The participants' perception was examined in terms of performance appraisal method, the consequences of performance appraisal, and the necessity of performance appraisal. In general, perception of managers was more positive than employees. Conclusions: The evaluation of the perception of nurses revealed deficiencies in the process of performance appraisal. Moreover, managers had a more positive perception than employees toward the current pattern of performance appraisal. The results of this study can be effective on the decisions of authorities in this field.

Keywords: Performance appraisal, nurse managers, nursing staff, Iran

How to cite this article:
Moradi T, Mehraban MA, Moeini M. Comparison of the perceptions of managers and nursing staff toward performance appraisal. Iranian J Nursing Midwifery Res 2017;22:128-34

How to cite this URL:
Moradi T, Mehraban MA, Moeini M. Comparison of the perceptions of managers and nursing staff toward performance appraisal. Iranian J Nursing Midwifery Res [serial online] 2017 [cited 2023 Mar 21];22:128-34. Available from: https://www.ijnmrjournal.net/text.asp?2017/22/2/128/205956

  Introduction Top

Performance appraisal is a formal process in organizations that, based on objective tasks with mental elements, compares performance and expected performance.[1] Performance appraisal can include many organizational processes such as performance measurement, objective formation, and reward management. Performance appraisal analyzes the achievements and shortcomings of employees and estimates whether they deserve training or promotion in the future.[2] Since the early days of the formation of management, the effort to improve performance has been a sacrosanct principle, which enters new areas every day.[3] The improvement in the efficiency and effectiveness of staff, as the most important organizational assets, is possible through their performance appraisal.[4] Thus, one of the main duties of managers in order to achieve organizational goals and promote the quality of services is the effective evaluation of employees.[5]

Given the importance and sensitivity of the nursing profession, due to their important role in promoting public health, and in order to continue this role, the existence of exact techniques to measure the performance of nurses is essential.[6] Nursing managers in hospitals, compared with other employees, have an important role in the progress and performance of the organization and improvement in the quality of their services.[7] What is certain is that the effectiveness of nursing managers' performance in hospitals, the quality of care provided to the patients, the satisfaction of the patients and their families, and the satisfaction of nurses can be evaluated. Their actions are deemed effective when these criteria are acceptable. In other words, achieving these objectives in nursing management is not possible unless the nursing staff performance appraisal, as one of the fundamental measures of managers to achieve the abovementioned goals, is correctly implemented. There is one problem in this case and that is the lack of a common understanding of performance appraisal among managers and nurses. Emamzadeh Ghasemi et al. reported this lack of consistency in the understanding of managers and nurses, dissatisfaction of nurses with the performance appraisal method, and the lack of measurable and objective criteria in the evaluation.[5]

It can be noted that employees' understanding of the performance appraisal procedures has a significant positive correlation with performance and organizational commitment.[2] On the other hand, researchers found that, to achieve an effective performance appraisal system, paying attention to employees' perceptions of the impartiality of the performance appraisal system and their reactions to this system are as important as the scores given by the assessor because the belief of partiality of the evaluation and dissatisfaction results in the failure of the evaluation system.[8] Therefore, for the success of any organization, attention to its employees' perceptions is important. According to Akhtar and Khattak, a major challenge in the performance appraisal system is its maximum acceptance among employees. Their study showed that, in general, an evaluation system can obtain a high level of acceptance and employee satisfaction through an efficient appeal procedure, combined purpose, and employee participation in its design.[9] The results of the study by Riham Mahmoud [10] showed that there was an agreement between managers and employees regarding the importance of performance appraisal. However, there were differences among them regarding fairness of the scores, resolution of the tools, and the actual use of results.[11]

Research carried out in Iran in the field of performance appraisal have shown that the current system of nurses' performance appraisal does not have the required objectivity, has general and nonspecialized criteria, and there is little concordance between its criteria and the realities of the administrative system. One of the main reasons for the failure of the performance appraisal system was reported to be its lack of appropriate implementation due to the appraisers' lack of knowledge of the execution methods.[11] The results of another study showed that the main drawback of the performance appraisal system of hospital staff was its incorrect implementation due to a lack of manager training.[12] Thus, the employees' satisfaction with the new evaluation system was low.[12] Nikpeyma et al. stated that, based on research related to the evaluation of nurses, its structure and performance does not have the required effectiveness.[8] Some of these problems are related to organizational structure whereas some others are related to structure, process, and the results of the performance appraisal system.[8]

Reviewing the perception of managers and employees and bringing the perception of these two groups closer together could increase the effectiveness of the performance appraisal as a tool to help improve performance.[13] Given the role of managers and nursing staff, as the two main elements in evaluating nursing performance, this descriptive analytical study was conducted to compare the perception of managers and nursing staff toward performance appraisal in the hospitals of Isfahan University of Medical Sciences, Iran.

  Materials and Methods Top

This descriptive-analytical study was conducted in 2014. The study population consisted of all the managers and nursing staff who worked at 11 hospitals affiliated to the Isfahan University of Medical Sciences and were evaluated at least once during their service. The sample size was calculated to be a minimum of 384 individuals. The number of participants was determined for each hospital through quota sampling, and then, the required number of participants in each hospital was randomly selected. The researcher prepared a list of the hospitals affiliated to Isfahan University of Medical Sciences, and then, according to the number of managers and nursing staff of each center, the required sample size was determined (the number of nurses per facility was divided by the total number of the nurses of all the centers and multiplied by the sample size). In each center, a list of managers and nursing staff of that center was obtained from the human resources department, and based on the number of managers and nursing staff, the number of the participants to fit each group was determined using sample software (S-Plus version 6.2, Insightful Corporation, Seattle, WA, USA) via random sampling method. It should be noted that, in certain centers, due to lack of cooperation of managers and nursing staff, the required number of samples was not obtained which was compensated by other centers.

After obtaining written consent forms from the participants in the study, 388 questionnaires were collected. The desired data were collected through two questionnaires (staff and nursing managers). These questionnaires reviewed the participants' perception in three dimensions, namely, performance appraisal method (12 questions), the need for performance appraisal (2 questions), and the outcomes of performance appraisal (8 questions). The responses were collected using a Likert scale; the perceptions of agree and completely agree were considered as positive perceptions, and disagree and completely disagree were considered as negative perceptions.[3] The validity of the questionnaires was confirmed through content review, consultation with experts, and by reviewing previous studies. Questionnaire reliability was calculated using Cronbach's alpha (Cronbach's alpha coefficient of managers' questionnaire was 0.86 and that of the nursing staff questionnaire was 0.94). Data were analyzed using frequency distribution test, independent t-test, and one-way analysis of variance using the Statistical Package for the Social Sciences software (version 16, SPSS Inc., Chicago, IL, USA).

Ethical considerations

The Research Ethics Committee accreditation number 393480 was obtained from the Research Deputy of Isfahan University of Medical Sciences. To conduct this study, an informed written consent was obtained from each participant, and the participants were assured of the confidentiality of information obtained from them.

  Results Top

In total, 313 nursing staff participated in this study. Results showed that the mean and standard deviation of nursing staff work experience was 8.76 ± 5.92 years. In addition, 75 nursing managers were studied, and the mean and standard deviation of their work experience was 18.8 ± 5.5 years, with management experience of 9.5 ± 7.3 years. [Table 1] shows the demographic characteristics of the participants in the managers and nursing staff groups.
Table 1: Demographic characteristics of nursing staff and nursing managers

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According to the findings of [Table 2], a majority of the managers had a positive perspective toward the studied dimensions. More than half of the nursing staff had a positive perspective toward dimensions of the outcomes and the need for performance appraisal. However, less than half of the nursing staff had a positive view toward the method of performance appraisal. The details of the respondents' opinions regarding their perception toward the current performance appraisal are presented in [Table 3].
Table 2: Nurses' and managers' perceptions toward performance appraisal

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Table 3: Nurse and managers' perceptions of performance appraisal

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The mean score of nursing managers' perception of the current performance appraisal was 56.8 ± 14.2 (maximum score of 88 and a minimum score of 25), and the nursing staff was 51.4 ± 14.5 (maximum score of 88 and a minimum score of 6). Independent t-test showed that this difference was significant (t = 2.89) (P = 0.004). In other words, managers had a more positive perception, compared to the nursing staff, toward the current performance appraisal condition.

  Discussion Top

It is believed that performance appraisal is an effective tool in human resource management. Moreover, through its appropriate implementation, not only are the goals and missions of the organization are achieved with satisfaction but the welfare of employees and the community are also promoted.[14] Knowledge regarding the different perspectives in this area could resolve the issues related to performance appraisal. This study showed that managers had a more positive attitude toward performance appraisal. It can be deduced that because the managers pursued the policies of the organization and they were often involved in planning and performance appraisal, they were more satisfied with performance appraisal implementation. The findings of Chuluunkhuu confirmed this result.[15] The study by Keramati et al. in the Department of Education, also showed that the managers, compared to the staff, had a more positive attitude toward aims, methods, content, criteria, and standards, as well as the competency of the evaluators and the use of evaluation results.[13] The results of a previously reported study showed that top-ranking corporate staff and evaluators, compared with the evaluated staff, have a better perception toward the performance appraisal system because they have more knowledge and experience regarding the performance appraisal system.[16]

In this study, the perception of the managers and nursing staff regarding the three dimensions of outcomes, methods, and the necessity of evaluating performance were examined, and the findings are presented in the following section.

Dimension of the necessity of evaluating performance

In management, evaluation is important, necessary, and continuous. The managers review the performance of the employees, progress of the program, effectiveness of the resources and facilities, organizational performance, and the achievement of their objectives through this performance evaluation.[14] It was found that 85.3% of the staff and 93.3% of the nursing managers believed that evaluation of staff performance was essential. This showed that almost all of the participants stressed the importance of performance appraisal. However, the next option which was related to the time spent on performance appraisal showed that individuals felt that there was wasting of time in the evaluation, which should be noted. This perception might be due to the unused results of the assessment. The majority of managers also felt that there was a wasting of time in performance appraisal. In this context, Torabi and Setodeh stated that 69.32% of the staff had a positive view regarding the need to conduct an annual evaluation.[4] In the study by Ghamari Zare et al., 83.5% of the nursing staff stated that performance appraisal was essential.[17]

Dimension of performance appraisal method

An organization might apply a developed performance appraisal system, however, if this system is not accepted and supported by the staff, its effectiveness will be limited.[18] In the present study, the majority of the managers and only less than half of the staff had a positive perspective toward the current performance appraisal method. In the study by Jahangiri, more than 67% of employees of Ardebil University of Medical Sciences, Iran, were not satisfied with the performance appraisal method.[19] The results of the study by Torabi and Setodeh showed that only 41.34% of the staff had a positive view regarding the implementation method of the current performance appraisal.[4]

Less than half of the nursing staff stated that the performance appraisal criteria were not determined for them at the beginning of every year, while the personnel must exactly know what is expected from them and how much of the activity is considered optimum. Therefore, at the beginning of their work, their duties and standards of care should be explained to them.[20] Marquis and Huston have pointed out that, for an evaluation system to be effective, employees must be aware of their duties and standards.[21]

Although the actual assessment results are important in the evaluation, the results of this study showed that almost half of the managers and nurses believed that the results of the evaluation did not show their actual performance; the rest of the participants were against this statement or had no opinion. If the results do not show the actual performance of employees, the management's plans for reform based on the evaluation results will be futile.

The results of this study showed that 42.6% of the managers and 36% of the nursing staff supported the conducting of a final interview session of the evaluation period to obtain feedback on the evaluation. This indicated that, although regular and consistent feedback on employee performance, if it strengthens the staff, utilizes their maximum power and results in their maximum participation in the organization is of great value, less than half of the participants supported the feedback sessions.[22] The findings of Ansari Tabar et al. showed that 12.6% of the staff stated that upon completion of the evaluation, the officials sat and talked with them at the end of the interview sessions.[12] In the study by Torabi and Setodeh, only 13.35% of the staff were interviewed in this regard.[4] Nikpeyma et al. found that nurses believed that, due to the lack of suitable feedback on the evaluation results and identification of the strengths and weaknesses of the subsequent performance, the importance of the evaluation had decreased and individuals have become indifferent to it.[8]

Dimension of the consequences of performance appraisal

The mean score of the managers' and nursing staff's perception of the consequences of performance appraisal was positive. In a more detailed examination of the items discussed in this dimension, it was observed that the ultimate objective of the evaluation was to promote staff performance and job motivation.[23] The results of the present study showed that there was a significant difference in the motivation of managers and nurses after performance appraisal. Less than half of the nurses (47.9%) had adequate motivation after the performance appraisal. The study by Hamidi et al. also showed that the results of performance appraisal had little impact on motivation.[24] However, studies have shown that the negative attitudes of nurses toward evaluation played a role in the reduction of motivation and lack of improvement in their performance.[6]

  Conclusion Top

Performance appraisal is an importance process in an organization to ensure that the organization achieves its goals. Furthermore, consideration of the perceptions of evaluators and those being evaluated was effective in the improvement of the efficiency of the performance appraisal system. Based on the results of this study, managers have a more positive perception, compared to the nursing staff, regarding the current performance appraisal; this difference in perception is more pronounced in the method of the performance appraisal. Therefore, it is suggested that, in the process of performance appraisal, more attention should be paid to the performance appraisal method and its problems should be resolved.


Our sincere appreciation goes to the managers and nursing staff participating in the study, officials of the School of Nursing and Midwifery and teaching hospitals of Isfahan University of Medical Sciences, and all those who assisted in this study.

Financial support and sponsorship

Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

Conflicts of interest

There are no conflicts of interest.

  References Top

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Torabi A, Setodeh S. Employees 'Attiude the Annual Performance Evaluation of Faculties Affiliated to Ahvaz University of Medical Sciences in 2007, Iran. Journal of Health Administration 2010;12.  Back to cited text no. 4
Emamzadeh Ghasemi H, Vanaky Z, Dehghan Nayeri N, Salehi T, Salsali M, Faghihzadeh S. Management by Objective approach in nursing performance appraisal and its impact on quality of nursing. Hayat 2007;13:5-15.  Back to cited text no. 5
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Keramati M, Gorbani S, Lazemi M, Bardbar A, Javid KH. The difference of opinion about the existing system of evaluation performance system for teachers. Journal of Educational Research. Islamic Azad University Bojnoord 2007;11.  Back to cited text no. 13
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  [Table 1], [Table 2], [Table 3]

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