The ‘transactional–relational–developmental’ model for early-career physicians’ postgraduate education in psychological contract theory

BACKGROUND: Existing competency frameworks with high international recognition often lack a theoretical basis for explaining the implicit expectations between organisations and individuals as well as intrinsic motivation. This study aims to construct a competency model for early-career physicians based on psychological contract theory to provide insights for further postgraduate education. METHODS: A mixed-methods approach was adopted. A literature analysis, expert consultation and presurvey were implemented to develop a 16-item questionnaire. Exploratory factor analysis (EFA) was used to explore the model structure; 305 valid questionnaires were analysed, and confirmatory factor analysis (CFA) was employed for cross-validation. RESULTS: Exploratory factor analysis revealed three factors, with a cumulative variance explanation rate of 69.987%. Confirmatory factor analysis indicated good model fit (χ2/df = 1.967, CFI = 0.995, RMSEA = 0.056). The three factors, which loaded 14 items, were labelled according to the classic three-dimensional structure of psychological contracts: transactional, relational and developmental. DISCUSSION: This study successfully developed and validated a three-dimensional competency model on the basis of psychological contract theory, achieving innovative theoretical integration. The model also offers hospital administrators actionable strategies to cultivate transactional, relational and developmental factors among early-career physicians, such as enhancing innovation incentives, expanding multidisciplinary team (MDT) programs and establishing redesigned evaluation systems.