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• Volume 13, Issue 5
• Assessing the efficacy of a job rotation for improving occupational physical and psychosocial work environment, musculoskeletal health, social equality, production quality and resilience at a commercial laundromat: protocol for a longitudinal case study
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• http://orcid.org/0000-0003-2939-0236 Jennie A. Jackson 1 ,
• Marianne Sund 2 ,
• Griztko Barlari Lobos 2 ,
• Lars Melin 2 ,
• Svend Erik Mathiassen 1
• 1 Department of Occupational Health Sciences and Psychology , University of Gävle , Gavle , Sweden
• 2 Elis Textil Service AB , Ockelbo , Sweden
• Correspondence to Dr Jennie A. Jackson; jennie.jackson{at}hig.se

Introduction Job rotation is a work organisation strategy used to reduce work-related exposures and musculoskeletal complaints, yet evidence for the efficacy of the approach is weak. Mismatch between job rotation and company needs, lack of full implementation, lack of exposure variation in included tasks and failure to assess variation may underlie inconclusive research findings to date. The study aims to develop a job rotation with company stakeholders, perform a process evaluation of the implementation, and determine the extent to which the intervention improves the physical and psychosocial work environment, indicators of health, gender and social equality among workers and production quality and resilience.

Methods and analysis Approximately 60 production workers at a Swedish commercial laundromat will be recruited. Physical and psychosocial work environment conditions, health, productivity and gender and social equality will be assessed pre and post intervention, using surveys, accelerometers, heart rate, electromyography and focus groups. A task-based exposure matrix will be constructed, and exposure variation estimated at the level of the individual worker pre and post intervention. An implementation process evaluation will be conducted. Job rotation efficacy will be assessed in terms of improvement in work environment conditions, health, gender and social inequality, and production quality and resilience. This study will provide novel information on the effects of the job rotation on physical and psychosocial work environment conditions, production quality and rate, health and gender and social inequality among blue-collar workers in a highly multicultural workplace.

Ethics and dissemination The study received approval from the Swedish Ethical Review Authority (reference number 2019-00228). The results of the project will be shared directly with the employees, managers and union representatives from the participating company, other relevant labour market stakeholders and with researchers at national and international conferences and via scientific publication.

Trial registration number The study is preregistered with the Open Science Framework ( https://osf.io/zmdc8/ ).

• OCCUPATIONAL & INDUSTRIAL MEDICINE
• HEALTH ECONOMICS
• Musculoskeletal disorders

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/ .

https://doi.org/10.1136/bmjopen-2022-067633

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Strengths and limitations of this study

Cocreation participative intervention and study design.

Assessment of job rotation intervention effects on physical and psychosocial work environment conditions, health, production quality and resilience with consideration to gender and social equality.

Process evaluation of the intervention implementation.

Consideration of inequality both from a male–female (gender) and a place of birth (ethnicity).

Case study based on a limited number of workers at a single work site.

Introduction

Job rotation is an organisation-level strategy that involves alternating workers between tasks that, ideally, differ in physical and psychosocial demands. In the field of ergonomics, job rotation has predominantly been used with the aim of reducing work-related exposures and musculoskeletal complaints; however, the current evidence has been described as weak 1 or inconclusive 2 regarding the efficacy of job rotation to prevent musculoskeletal disorders (MSDs). Recent work has even suggested that job rotation can increase the overall risk of workplace injury. 3

The efficacy of a job rotation is theoretically dependent on the extent to which the tasks included in the rotation differ, and thus the extent to which more variation can be introduced in the jobs of individual workers rather than appearing between workers. 4 Quantification of exposure variation is therefore required before and after job rotation to determine whether the intervention succeeded in altering exposure patterns. Mixed study results to date regarding the effects of job rotation on health outcomes may be the result of a lack of objective assessment of exposure variation both before and after intervention. In Leider’s 2015 systematic review of evidence of the effects of job rotation on musculoskeletal complaints, only 4 of the 16 studies quantified aspects of both exposure and MSD health outcomes, and none of the studies assessed exposure variation. 5–8

Consideration of psychosocial factors is also paramount when considering the complex relationships between work organisation, work environment and health (including MSDs) 9–13 ( figure 1 ). Similar to physical exposures, job rotation is generally undertaken to improve psychosocial conditions. While positive correlations have been shown for higher worker job satisfaction ratings, 1 there is inconclusive evidence to date for the effects of job rotation on other psychosocial risk factors, for example, job control 14 or health outcomes, including work absence or sick leave. 1 Again, mixed study results to date may be the result of low-quality study designs and the lack of assessment of exposure and outcome variables before and after intervention.

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Conceptual model illustrating overlapping interests of production and ergonomics. Proposed interactions are shown in arrows between rationalisation (job rotation, in the current study) and work environment factors (shown in rectangles), and health and productivity outcomes (shown in ovals). MSDs, musculoskeletal disorders. Model adapted from Winkel and Westgaard 11 and Rolander et al . 12

The conceptual model used in this study is given in figure 1 and illustrates the interconnection of ergonomic and production factors and outcomes which warrant consideration when making changes in work organisation. Rationalisation is defined here as comprising changes made to ‘ maximise productivity, quality and efficiency under the prevailing conditions of, among other things legislation, education level of available work force and culture’. 11 In addition to potential ergonomic gains, job rotation has been shown to improve employee skill/competence, productivity, quality, 15 16 decrease worker turnover 15 and improve organisational flexibility. 16 Thus, job rotation is per se a rationalisation. At the time this paper was written, we were unable to find any studies that had simultaneously and quantitatively addressed the effects of a job rotation on the interrelated ergonomics and production factors and outcomes outlined in figure 1 . The job rotation will be designed according to the Goldilocks Work approach 17 18 to distribute physical and mental loads during productive work to improve worker health and, to the extent possible, capacity. The job rotation will aim to distribute tasks with higher physical and/or mental demands across workers, and to schedule work to facilitate recovery by interspacing higher demand tasks with lower demand tasks.

Inconclusive findings in previous job rotation studies may also be the result of a mismatch between specific company needs and the implemented job rotation. 19 20 To improve intervention efficiency, a participatory approach has been called for in which interventions are cocreated by researchers together with relevant company stakeholders, such as, management, health and safety, union, and production representatives. 21 22 Cocreation can also increase knowledge within an organisation regarding the problem(s) to be targeted by an intervention and how the intervention will address the problem(s). This can enhance readiness for change, which is a necessity for successful intervention implementation. 23 24 Cocreated programme logic (COP) is a participatory approach that begins with a set of outcomes identified by stakeholders, around which a specific intervention is subsequently designed. 25 COP is also a tool for defining, through negotiation between stakeholders and researchers, the outcomes to be measured and the optimal time points for the measurements. COP has proved successful in developing study aims and design and in improving readiness for change, intervention contextual fit and implementation efficacy. 23

Insufficient process evaluation of the intervention implementation, including failure to fully implement the intervention, 26 has also been identified as a common weakness in prior job rotation studies. 27 Consideration of how job rotation has been implemented in subpopulations of workers may prove salient in fully understanding the implementation and in the effects of an intervention, but to date has been sparse. Findings from a job rotation intervention study at a grocery store found work tasks deemed the worst by employees were excluded from the intervention and subsequently allotted to a group of female workers who were, thus, not included in the job rotation. 28 This example is in line with the findings of a 2013 review report prepared for the Swedish Work Environment Authority, finding that task allocation within jobs was gendered, where female workers tended to be given more monotonous and repetitive tasks than male workers. 29 Further, there is a broad consensus in the literature that women receive less on-the-job training than men, including initial on-the-job training, 30 which positions women to be assigned fewer tasks and possibly to be excluded for job rotation initiatives comprising tasks requiring more than basic training or competences. Foreign-born employees have also been shown to receive less on-the-job training than native born employees. 31 Consideration of job rotation design and implementation within a social context may therefore be crucial. The many limitations of previous studies and the lack of research simultaneously considering aspects of social inequality in task assignment, job rotation and health demonstrate the need for further research that considers the effects of job rotation from a wide range of perspectives.

The aim of this study is to develop a job rotation intervention at a commercial laundromat in concert with company stakeholders using COP, evaluate the process implementation of the job rotation intervention and determine the extent to which the intervention can improve the physical and psychosocial work environment and indicators of health, advance gender and social equality among workers and increase production quality and resilience without negatively affecting production rates.

The specific aims of the study are to:

Describe the cocreation programme logic process used to develop the intervention and study design.

Provide a process evaluation for the implementation, including assessment of readiness for change and the extent to which the intervention was implemented.

Determine the extent to which the job rotation intervention increased exposure variation and lead to changes in physical and mental work environment factors and indicators of health.

Evaluate social and gender inequality in work organisation, working conditions and health before, during and after the job rotation intervention.

Assess the impact of the job rotation on production rate, quality and resilience.

Methods and analysis

The study will be performed at a commercial laundromat employing approximately 60 full-time workers in laundry handling tasks. The study resulted from contact initiated by the study site: a commercial laundromat in Sweden. The laundromat management and union saw room for improvement in physical and psychosocial working conditions and issues of equality and were interested in implementing a job rotation, but sought help to successfully make the change. We began by establishing a steering committee of eight people that comprised company management (LM and GBL), production workers, health and safety and union representatives (MS) and researchers (JJ and SM) to jointly develop the study.

After extensive negotiations, the steering committee arrived at a cocreated study design that included (1) development of an innovative job rotation intervention via cocreation with company stakeholders, (2) evaluation of the implementation of the job rotation intervention and (3) assessment of the efficacy of the job rotation intervention using a pre–post intervention case study design. Methods for all three aspects of the study are presented below.

Development of the job rotation intervention using COP

The job rotation intervention was cocreated in a collaboration between management (GBL), union representatives (MS) and researchers (JJ) and was guided by the Goldilocks Work approach principals 17 18 to find a health-promoting balance in both physical and mental work exposures. To better understand laundry processing tasks, one researcher (JJ) shadowed workers performing each task and, to the extent possible, spent 15–45 min performing each task. Company representatives and the researcher worked together to rate the physical and mental load (heavy/light) and the degree of repetitiveness (monotonous/variable) of each task. Led by the research team, company representatives grouped tasks into different proficiency levels, starting with a base group of tasks that they believed all workers could and should learn and then moving onto tasks that required increased knowledge of production flow and task-specific training. Five hierarchical levels of tasks were created, namely: (1) basic tasks (which all workers could perform), (2) driers and small machines, (3) order picking and packing for hotel and medical customers, (4) order picking and packing of work clothes and (5) steering production flow.

The laundromat is physically divided into two sides—the sorting side, where bags of dirty laundry are received, emptied onto conveyor belts and goods are sorted by colour and item prior to washing, and the processing side of the laundromat, where clean goods are dried, pressed, folded and packed. In general, rotation from sorting to processing is not typically done within a day, as a shower is required before moving from sorting to processing. Base tasks were identified on both the sorting and processing sides, and so full-day rotation plans were established for each side to accommodate the hygiene requirements.

To meet company goals for improved language proficiency, social and gender equality and integration, the job rotation was based on teams comprising 3–6 workers that rotated as a unit. Teams were created to include at least one man and one woman, one native Swede, ideally not more than one person with the same mother tongue and a mix of seniority levels in the competencies required for the tasks assigned to the team. A total of 10 job rotation teams were formed; 5 of which performed basic tasks. Of these, four teams were assigned both sorting work and processing work, while one base group was assigned only processing work. Job training was required for nearly all workers to be able to perform all tasks assigned under the job rotation intervention. The company aimed to, in parallel, develop a new salary structure that would match the new proficiency ‘steps’ and competencies with employee wages. The company expected that the new work and wage structure would make for a more transparent development and promotion path, including making it easier for employees to understand and express interest in career advancement plans.

Implementation process and outcome evaluation

To assess the implementation process, semistructured focus group interviews with each job rotation team and individual interviews with management will be conducted at three time points: immediately prior to the start of the job rotation intervention and at 6-week and 12-month follow-up. Data collected immediately prior to the job rotation intervention will be used to assess worker readiness for change and worker impressions of their new working schedules. Individual interviews with managers from this time point will be used to assess readiness to lead change. At 6-week follow-up, group interviews will be used to document the extent to which the job rotation intervention has been implemented during the initial phase and self-reported ability of workers to complete all assigned tasks. At 12-month follow-up, group interviews with each team will be used to document the progress and extent of implementation achieved. Individual interviews with management will be used to assess the company’s perspective and experience of the implementation process and the extent of success. Together, the interviews will capture facilitators and barriers to the implementation process and will document additional changes occurring during the follow-up period that were unrelated to the intervention, but which may have affected the way in which work was performed.

Interview data will be transcribed and analysed thematically, 32 guided by research aim 2 to assess readiness for change and the extent of intervention implementation.

Assessment of job rotation intervention efficacy via pre–post study design

Using COP 25 as earlier outlined, outcome metrics were established by the researchers in concert with the company steering committee using an iterative procedure based on identifying desired changes that could directly be tied to the job rotation intervention. The study scientific testing protocol was then developed (JJ and SM) and presented to the steering committee who completed a risk analysis prior to the protocol being approved.

Study design overview

The workers will be followed for approximately 12 months, with measurements occurring prior to, during and 8–12 months following the job rotation intervention implementation ( figure 2 ). Baseline physical and psychosocial working conditions will be documented using (1) a questionnaire to assess the physical and psychosocial environments, (2) technical measurements to assess posture, heart rate (HR) and muscle activity levels during work and (3) semistructured interviews to assess readiness for change. Initial response to the intervention will be assessed 6 weeks post implementation via semistructured focus group interviews. At follow-up, physical and psychosocial working conditions will be reassessed using the baseline measurement protocol, and a final set of semistructured focus group interviews will be conducted to document production and working environment changes that occurred during the follow-up period but were unrelated to the job rotation intervention. 33 Production rate and quality will be assessed weekly throughout the study period, using data collected by the company.

Study design.

Study population

Permanent and contract workers currently employed in laundry handling tasks at the laundromat will be invited to participate in the study; the exact number of participants and inclusion criteria will vary by measurement type and research question, as outlined below. For the questionnaire, we will aim for a response rate of 70% (n=35). For both technical measurement protocols, we will collect data from all interested participants and will aim for a minimum of 20 participants, which corresponds to approximately 30% of the total worker group. Focus groups interviews will be conducted with each team and will include all team members who elect to participate.

Approximately half of the employees are foreign born with varying levels of Swedish language proficiency, and there is a wide range in education levels across all employees. To ensure workers are informed, understand participation is voluntary and understand what participation entails, we will present all aspects of the research project in person to all employees using slides relying primarily on graphical displays of information, and we will provide live demonstration of technical measurement methods.

All production employees will be invited to participate in the study. Baseline survey response rates were 97% (n=58), which suggests a strong likelihood for obtaining ample data for this case study throughout the follow-up period. Focus on developing and maintaining a strong relationship with the company has been present since study inception.

Pre and post job rotation measurements

Questionnaire.

A custom questionnaire comprised of modules from well-established, validated and documented questionnaires and modules adapted from questionnaires previously used in our research group to assess other occupational groups, but adjusted to specifically capture information about the commercial laundromat environment. 34 35 The modules in our questionnaire consider: personal and demographic parameters (9 questions), employment status and working hours (7 questions), specific work tasks currently performed and time spent per task over a week (6 questions), physical and mental demands of each work task and the overall job (4 questions with Borg category-ratio (CR) 10 response scale 36 ), self-rated work ability (4 questions), workload, fatigue and recovery (short Swedish Occupational Fatigue Inventory (SOFI) Questionnaire, 37 38 14 questions); musculoskeletal pain (Standardised Nordic Questionnaire, 39 4 questions), job satisfaction (2 questions) and the psychosocial work environment (selected Copenhagen Psychosocial Questionnaire (COPSOQ) modules, 40 79 questions).

All employees will be invited to complete the questionnaire. The language and education level of the respondents was a focus during the development of all questionnaire modules, and substantial efforts were made to simplify language and response options in all custom modules. Where appropriate, a colour bar, ranging from green to red, was added to help participants understand the value (positive/neutral/negative) of the response options ( figure 3A ). We also added a colour bar to each COPSOQ question, which helped to highlight that the response scales vary (positive to negative or negative to positive) by question ( figure 3B ).

Examples of survey questions showing colour bar used to assist in understanding the value of response options. (A) A custom module question and (B) A Copenhagen Psychosocial Questionnaire question.

To further assist employees, a workplace language course will be given 1 month prior to introducing the questionnaire for the 24 employees deemed to have the lowest language proficiency. As part of the course, a Swedish language teacher will review the questionnaire and teach employees how to respond to the different types of questions (short answer, multiple choice and CR-10 response scale). Lessons will be provided during working hours for groups of eight employees at a time, be 1 hour in duration, and occur two times a week. In addition, all employees will be provided with a copy of the questionnaire 1 week in advance of the data collection.

Questionnaires will be completed during paid working hours in small groups (6–8 employees) sitting in the same room as a researcher. We will provide help as needed and encourage workers to join a group with other workers sharing the same mother tongue. Mobile phones and translation/dictionary apps will be permitted and encouraged. Workers will also be permitted to answer the survey at home if desired. The on-site researcher will have trained in giving consistent explanations. The same researcher will be present on all occasions.

Technical measurements

Pre implementation, technical data collection will be conducted to assess postures and HR over 5 consecutive days, and then to assess muscle activity levels during individual work tasks. All full-time permanent and contract employees working day shifts will be invited to participate in one or both technical data collections.

Post implementation, we will evaluate any work tasks that have changed and any new work tasks that have been introduced.

Posture and HR assessment

Working postures, HR and HR variability will be assessed continuously over 5 consecutive working days. Postures will be assessed using wireless triaxial accelerometers (Axivity, Newcastle upon Tyne, UK) affixed to the skin using double-sided toupee tape (between the device and the skin) and breathable medical tape (over top of the device). Upper arm elevation will be recorded using units mounted according to ‘LT INC’ location 41 : upper edge of the device aligned with the insertion of the deltoid muscle into the humerus, long axis aligned with the humerus. Trunk elevation angle will be recorded using a unit placed on the sternum with the top edge of the unit at the level of the sternoclavicular notch, and the long axis of the unit aligned with the line of gravity. A final accelerometer unit will be placed on the right thigh (long axis aligned with the femur) and will be used to determine activities (sit/stand/walk/run) during the 5 working days.

During the same 5-day period, participants will also wear a BodyGuard HR monitor (Firstbeat Technologies Oy, Finland) comprising two electrodes (Ambu, Denmark) positioned according to Firstbeat recommendations, a wireless logger (attached to the electrode positioned directly below the right clavicle) and a wire joining the two electrodes.

To permit task-level analysis of posture and HR, workers will record the specific tasks and times at which each task was performed over the 5-day period in a daily logbook. A researcher will briefly meet each worker individually once a day during the 5-day period. Placement and alignment of all accelerometer units will be verified and tape changed, as necessary, depending on worker discomfort and tape adhesion, and calibration exercises will be performed according to Jackson et al . 41 The researcher will also confirm that the participant has been completing the work task log and responding to the fatigue assessment questions.

Muscle activity assessment

Muscle activity will be assessed using electromyography (EMG) recorded continuously during one working bout of approximately 2 hours, and during the adjacent coffee break (15 min) or lunch break (30 min). During a work bout, workers typically perform one task, but may perform two or more tasks. EMG will be recorded bilaterally from the trapezius (Tr EMG) and forearm (FA EMG) muscles using a portable logger and EMG sensors from Biometrics (Newport, UK). At each recording site, the skin will be shaved and cleaned with alcohol prior to applying a disposable electrode (Ambu, Denmark). A single ground electrode (Ambu, Denmark) will be positioned atop a prominent thoracic vertebra (usually C7). Tr EMG electrodes will be positioned 2 cm lateral to the midpoint between C7 and the acromion process and aligned along the direction of the muscle fibres. 42 Bilaterally, a ‘through the forearm’ assessment of FA EMG will be made, as described by Takala and Toivonen, 43 using electrodes placed just lateral to the muscle bellies of the flexor digitorum superficialis and extensor digitorum communis muscles. Given the physical nature of the laundry handling work tasks, the tight spaces through which workers are often required to navigate, and the heavy machinery involved in the work, care will be made to ensure the EMG recording equipment is securely attached to the participant and that the cables will not interfere with their work.

A rest file and three repeats of muscle-specific reference contractions will be collected to permit normalisation. For the trapezius muscles, a submaximal reference voluntary exertion (RVE) normalisation will be employed according to Mathiassen et al . 42 RVE trials will be 15 s in duration 44 , 45 interspaced by 30 s of rest. For the forearm, a maximum voluntary exertion (MVE) pinch grip normalisation task will be employed. Subjects will gradually increase their pinch grip on a pinch dynamometer over 3 s, until reaching and holding their MVE for 3 s before gently ramping down their exertion. MVE trials will be approximately 7 s in duration interspaced by 60 s of rest

A researcher will follow workers during the EMG recording period to document the times and tasks performed. Workers will also be videotaped during the EMG recording period to provide additional assistance in dividing the full EMG recording into component tasks.

Focus group interviews

Semistructured focus group interviews will be conducted with each job rotation team and with individual managers at three time points and analysed as outlined in the ‘Implementation process and outcome evaluation’ section above. Information regarding facilitators and barriers to the intervention and additional changes occurring during the follow-up period will be used to give additional context to the survey and technical measurement data.

Company data

The laundromat will track and provide weekly data on production rate (total tonnes laundered), quality, worker sick days, days off for workers to care for sick children, accidents, injuries and worker turnover from baseline until the end of the follow-up period.

Data processing and statistical analysis

Most previous studies documenting working conditions and occupational physical exposures via questionnaires and technical measurements have data analyses based on standard statistical methods, including a priori power calculations. Such methods assume that participants represent, in theory, the total population of all workers in similar settings. In our study, results consider a specific workplace and its 60 participant workers and not all workers employed in all commercial laundromats. We accept this notion in the research project and acknowledge it by adjusting basic descriptive statistics, such as SDs, by a finite population correction term. 35 In terms of the finite population correction, the anticipated number of technical measurement participants corresponds to approximately 30% of the total worker population.

To estimate a study size necessary to obtain sufficient power for assessing significant differences requires information regarding the relevant and interesting effect sizes; however, these data are not currently available for most of our quantitative variables. Further, information regarding the variance of the variables is also required but, again, these data are not currently available. Accordingly, in this case study of a single laundromat, we will aim to document changes according to our pre–post design.

Differences pre to post job rotation in work task allocation, psychosocial work environment conditions (including COPSOQ dimension) and self-reported health will be analysed, including consideration of confounders such as age, geographical location, marital status, family situation and other socioeconomic factors ultimately included in the questionnaires. Change scores will be calculated between baseline and follow-up for all COPSOQ dimensions.

The extent to which factors differed between men and women and between Swedish-born and foreign-born employees will, to the extent possible, be considered using a stratification approach.

The Firstbeat SPORTS uploader (V.1.0; Firstbeat Technologies) will be used for uploading and visually identified artefacts will be removed. Average HR during work, non-work and sleep will be calculated using a custom MATLAB script. Relative aerobic workload will be calculated in a previously developed custom MATLAB script and will be based on the HR reserve (HRR), which is a well-established estimate of the body’s workload and the body’s workload relative to individual fitness.

The accelerometry data will be processed using a custom-made MATLAB programme to determine the time spent sitting, standing, walking, in light physical activity and in moderate to vigorous physical activity during both working and non-working hours. Trunk and upper arm elevation data will be calibrated 41 to angles calculated using an in-house custom MATLAB programme.

Accelerometry and HR data will be determined for each individual work task using the log book kept by workers. For each task, HR variables calculated will include HR intensity (relative aerobic workload, measured in terms of % HRR), time at different intensity levels, and HR variability, and postural variables, mean angle, time in neutral and minute-to-minute variance of angle. 46 Tasks where worker HR reaches or exceeds 60% HRR will be deemed sufficiently high-intensity for potentially generating increases in physical capacity. 47

Post collection, EMG signals will be Butterworth filtered (30 Hz high pass) for minimisation of ECG contamination 48 , offset corrected and root mean square converted (100 ms moving window), then quadratically rest adjusted. All files will be visually inspected to ensure good data quality. The mean amplitude across a stable 10 s period from each of the three RVE trials will be calculated and the mean of the three trials will be used to normalise the subject’s Tr-EMG data. The largest 0.5 s mean EMG value will be determined across each MVE, and the largest single MVE will be used to normalise the subject’s FA-EMG

EMG data from the approximately 2-hour work bout will be partitioned, if necessary, to individual work tasks using the time log kept by the researcher during data collection and, when necessary, assisted by the time stamp in the video data. For each task, the following muscle activity variables will be calculated using a custom-made MATLAB programme: mean, peak, time at rest, minute-to-minute variance and sustained low-level muscle activity (SULMA) periods. 49

A task-based exposure matrix will be constructed comprising the posture and muscle activity variables, as outlined above. Using the log book data, individual exposure profiles will be constructed by estimating exposure variation for each day using an approach similar to the job variance ratios described by Barbieri et al . 46 Weekly variation will be assessed at the individual level by the mean variation across days and the between-days variance across the 5 days.

Pre–post changes in individual estimates of daily and weekly exposure variation will be assessed using repeated measures analysis of Variance (ANOVA) analyses and, in cases where multiple variables reflect similar properties of exposure, using multivariate ANOVA (MANOVA) analyses. ANOVA analyses will include a correction for the effects of multiple comparisons.

Interview data

To the extent possible, differences in experiences of the job rotation will be considered between male and female employees and Swedish-born and foreign-born employees. Management interview data will be primarily used to assist in interpreting and understanding survey and technical data findings including changes occurring during the follow-up that could have influenced work organisation or work environment unrelated to the intervention. 33

In interpreting focus group interviews, Acker’s theory of inequality regimes will be used as a framework for assessing how inequalities are produced and reproduced. 50 Acker’s theory comprises both organisational and individual levels and states that inequality regimes exist in all organisations and can be defined as ‘loosely interrelated practices, processes, actions and meanings’ that create power orders from intersections of gender and ethnicity within the organisation. 50

Patient and public involvement

No patient involved.

Registration

The study is preregistered with the Open Science Framework ( https://osf.io/zmdc8/ ).

Ethics and dissemination

The study received approval from the Swedish Ethical Review Authority (reference number 2019-00228). Written informed consent will be obtained for each data collection method, namely: accelerometry and HR monitoring, EMG, survey and focus group interview participation.

The results of the project will be shared directly with the Elis employees and managers at the participating laundromat, the worker’s union (IF Metall) and the central Swedish and Global Elis concerns via presentations and summary reports. Research results will also be disseminated via publication in international, peer-reviewed, open-access scientific journals and presentation at international scientific conferences.

Strengths and Limitations

The major novel contributions of this study to the literature are (1) the broad scope of the evaluation of the job rotation intervention, including consideration of the effects of the rationalisation on work environment conditions, health and production quality and resilience with consideration to gender and social equality and (2) the inclusion of a process evaluation of the intervention implementation.

The consideration of inequality both from a male–female (gender) and a place of birth (ethnicity) perspective is in line with intersectionality theory 51 and further reflects the reality of modern immigration. It also reflects the Swedish government’s latest Work Environment Strategy, which prioritises increased efforts towards sustainability with the goal of all employees (regardless of sex or place of birth) having a work environment that makes them able to, capable of and willing to work until official retirement age. 52

The primary limitation of this longitudinal case study is the limited number of workers, and the inclusion of a single work site, which will limit the generalisability of the results. Still, we anticipate that our findings on the impact of job rotation on physical and psychosocial work conditions, health and equality will be immediately useful for other laundromats in the global Elis concern. Further, we anticipate findings regarding social equality to be relevant for other commercial laundromats and small-sized and medium-sized production-based industries with high employee diversity. The study is also limited by the lack of information required to perform power calculations a priori (ie, knowledge of the relevant/interesting effect sizes and size of variance for most of the quantitative variables). On completion of this study, these data will be available to guide future studies.

Ethics statements

Patient consent for publication.

Not applicable.

Acknowledgments

The authors wish to thank the production workers at the Elis laundromat in Ockelbo Sweden for generously welcoming the research team and embarking on this journey together with genuine enthusiasm.

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Contributors JJ and SM conceptualised the project. All coauthors (JJ, MS, GBL, LM and SM) participated in the cocreation process in which the study design and intervention were developed with JJ leading the process. All authors made substantial contributions to the development of the research study aims. JJ, MS and GBL developed the job rotation. JJ and SM developed the research study design. JJ collected pilot data to assess task exposure variation. All authors approve the submitted version and agree to be personally accountable for their contributions. All authors read and approved the final manuscript.

Funding This work was supported by the Swedish Research Council for Health, Working Life and Welfare (Forte) grant number 2009-1761.

Competing interests None declared.

Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

Provenance and peer review Not commissioned; externally peer reviewed.

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SYSTEMATIC REVIEW article

More hype than substance a meta-analysis on job and task rotation.

• Department of Psychology, Bielefeld University, Bielefeld, Germany

Although there exist numerous publications on job and task rotation from various disciplines, there is no consistent evidence of their effectiveness. Drawing on theories from industrial and organizational psychology, knowledge management, ergonomics, and management science, we meta-analytically investigated relationships between job/task rotation and employee attitudes, learning and development, psychological and physical health, and organizational performance. Due to a conceptual overlap and frequent confusion of terminology, we analyzed the design of the rotation (job rotation vs. task rotation) as a possible moderator. The three-level meta-analysis on 56 studies ( N = 284,086) showed that rotation was significantly associated with job satisfaction ( r = 0.27), organizational commitment ( r = 0.16), career success ( r = 0.31), labor flexibility ( r = 0.32), general psychological health ( r = 0.20), stress/burnout ( r = −0.13), individual performance ( r = 0.13), and productivity ( r = 0.13). Positive relationships between rotation and physical health could only be found when rotation was compared to high-intensity work. Task rotation yielded stronger relationships with attitudinal outcomes, job rotation with learning and development, psychological health, and organizational performance outcomes. Further moderator analyses showed that individualism decreased relationships between task rotation and attitudes, and correlations with organizational performance and physical health were stronger for subjective measures. The findings indicate that many expectations toward job and task rotation are not fully supported.

Introduction

Job and task rotation describe techniques where employees shift periodically and in a planned manner between a range of jobs or tasks within an organization ( He et al., 2016 ; Jones and James, 2018 ). The first, rather unsystematic appearance of the term job rotation dates back to the 1940s and 1950s, when work design methods started to counteract the simplification, specialization, and repetitiveness that dominated the Tayloristic work design of the early twentieth century ( Tucker, 1942 ; Morris, 1956 ). Since then, rotation has oftentimes been recommended in textbooks and practitioner literature in the fields of industrial and organizational (I/O) psychology (e.g., Jex and Britt, 2014 ), organizational behavior (e.g., Robbins and Judge, 2017 ), human resources management (e.g., Armstrong and Taylor, 2017 ), and engineering (e.g., Kutz, 2014 ). Despite its widespread use, a closer look at the literature reveals that the label job rotation is not used in a consistent way. It describes the rotation either between different jobs ( Hsieh and Chao, 2004 ; Mohsan et al., 2012 ), between different tasks ( Weichel et al., 2010 ; Jeon et al., 2016 ), or both ( Colombo et al., 2007 ; Kim et al., 2016 ). Although job and task rotation are conceptually similar, this impreciseness in terminology could lead to false conclusions. Overall, there are more than 800 publications on job and task rotation from all over the world, and the number of articles as well as citations has been steadily growing ( Posthuma et al., 2013 ; Web of Science, 2021 ). In the CRANET survey of 2014/15, more than 50% of U.S. organizations reported that they practiced job rotation ( Cranet, 2017 ). They anticipate multiple advantages from rotation: employees with greater satisfaction and motivation due to a reduction of monotony; more skill development due to a greater variety of stimulating work environments; a healthier workforce due to a decrease in monotony and muscle fatigue; and an increase in organizational performance due to greater labor flexibility and a stronger stimulation of organizational learning. Existing studies seem to support these expectations at first glance. In jobs with rotation, they found, for example, greater motivation ( r = 0.44; Muramatsu et al., 1982 ; where necessary, values are converted to correlation coefficient r for easier comparison) and labor flexibility ( r = 0.57; Sawhney, 2013 ), decreased mental fatigue ( r = −0.32, Jones and James, 2018 ), a lower incidence of carpal tunnel syndrome ( r = −0.23; Roquelaure et al., 1997 ), and increased process innovation performance ( r = 0.21; Pini and Santangelo, 2005 ). However, some studies also reported contradicting significant results for motivation ( r = −0.17; Mohsan et al., 2012 ), employee adaptability ( r = −0.41; Zhu et al., 2013 ), employee energy ( r = −0.09; Luger et al., 2016 ) , incidence of upper-extremity musculoskeletal disorders ( r = 0.07; Roquelaure et al., 2009 ), and innovation performance ( r = −0.11; Song et al., 2010 ). Thus, despite much interest in job and task rotation from a variety of disciplines and from researchers and practitioners alike, there are still questions left unanswered: Does rotation really provide the benefits that organizations expect? Is the interchanging use of the terms job rotation and task rotation justified, or are there differential effects for the interventions? How does the study context affect relationships between rotation and beneficial outcomes? In this manuscript, we present a meta-analytic integration of the relationships between rotation and beneficial outcomes and aim to provide answers to these questions. The participants of the included studies were either employees affected by rotation, managers reporting about rotation in their organization, or student samples in experimental settings. Our aim was to compare great levels of rotation with small levels of rotation (e.g., many job changes vs. few job changes, rotation vs. no rotation) and their relationship with a variety of outcomes (e.g., job satisfaction, career success, stress and burnout, musculoskeletal complaints, and speed of product development). We used the PRISMA reporting guidelines (see Supplementary Material , Supplementary Table 8 , for PRISMA checklist).

This manuscript makes several contributions to the literature. First, this is the first meta-analysis and most comprehensive integration of outcomes of job and task rotation. So far, there have been only narrative reviews (e.g., Leider et al., 2015 ; Padula et al., 2017 ), and also, these are almost exclusively focused on physical health criteria, such as musculoskeletal complaints or physical strain. Narrative reviews have the limitations that they do not consider measurement error in primary studies, and particular studies might be overweighted or underweighted such that conclusions can be misleading ( Schmidt and Hunter, 2015 ). Moreover, the existing reviews mostly do not cover outcomes from the fields of I/O psychology and management science (e.g., employee development or performance). Second, our meta-analysis contributes to theoretical knowledge about the mechanisms of rotation. We use the interdisciplinary approach to work design of Campion and Thayer (1985) as a guide for possible outcomes of rotation, and complement it with other theories and models from multiple disciplines to explain why rotation might have beneficial effects and under which conditions these effects might increase or decrease. As potential moderating factors, we point out context-related differences regarding the societal culture, investigate differences due to the work intensity in the non-rotation condition, and show to what extent the design of the rotation has an impact on the relationship between rotation and possible beneficial effects. By doing that, we acknowledge conceptual differences between job rotation and task rotation that have been neglected by some previous studies. Third, the meta-analysis provides relevant information for practitioners. The results can give guidance to managers who need to know about the effects of rotation, as well as potential differences between job and task rotation, when considering its implementation. In conclusion, the purpose of this manuscript is to help in understanding the effects of job and task rotation, explain when and where rotation works, and make transparent those areas where we are still lacking knowledge.

Conceptual Overview of Job Rotation and Task Rotation

Job rotation refers to a lateral transfer of employees within an organization without a change in salary or hierarchy ( Campion et al., 1994 ). It most commonly describes a change between different functions, departments, or units ( Dinis and Fronteira, 2015 ; Le Meunier-Fitzhugh and Massey, 2019 ). Task rotation also includes a move between job tasks, but on a smaller scale. More specifically, it refers to the alternation between tasks within a job that can require different skills and responsibilities but is not associated with a change to a different function or department ( Jeon et al., 2016 ; Jones and James, 2018 ). In the past, job and task rotation have not been strictly separated. Some authors defined job rotation as a change between jobs or tasks (e.g., Kim et al., 2016 ; Comper et al., 2017 ). Others used the label job rotation but actually measured a change of job tasks (e.g., Bao et al., 2016 ). Then again others used the term task rotation to refer to a transfer between functions (e.g., Tsai and Huang, 2020 ).

The fact that there are no prevailing definitions of job and task rotation could be attributed to the fact that both interventions are based on a change of work settings, and that making a distinction between tasks and jobs is often difficult. Yet, in comparison to task rotation, job rotation refers to more severe job changes. Thus, it probably requires more initial training and a longer time to adjust to the new job, and is more likely to be associated with a change in work environment, colleagues, or supervisors. Additionally, it is likely that job rotation indicates a longer time interval between rotations than task rotation. These arguments are supported by Eriksson and Ortega's (2006) employee learning hypothesis of job rotation. They argued that interfunctional job rotation could be a way to prepare employees for management positions, whereas intrafunctional rotations (i.e., task rotations) are primarily aimed at being able to reallocate employees across different tasks. They also stated that this latter rotation was only efficient when employees already had experience in the tasks and thus did not need much initial training.

Both job rotation and task rotation describe workplace interventions aimed at improving outcomes for employees and the organization. Since research on rotation stems from various disciplines, its outcomes are also multifaceted. In their historical overview of work design research, Parker et al. (2017) identified the interdisciplinary approach of Campion and Thayer (1985) as the starting point of integrative perspectives of work design. Campion and Thayer analyzed work design characteristics from the four disciplines of organizational psychology, human factors, ergonomics, and industrial engineering, and showed that the disciplines are typically aimed at different goals, namely positive employee attitudes (e.g., job satisfaction), reliability (e.g., reduced stress), physical well-being (e.g., few health complaints), and efficiency (e.g., reduced idle time), respectively. To address the multidisciplinarity of rotation research, we investigated in our meta-analysis the relationships between rotation and employee attitudes, psychological health (which Campion and Thayer subsumed under reliability), physical health, organizational performance (which is a broader concept than Campion and Thayer's efficiency), and employee learning and development. Although this last outcome was not a work design goal in Campion and Thayer's approach, more recent publications emphasize its importance in work design research and theory ( Parker, 2014 , 2017 ). In the following, we will outline in more detail the theoretical background of attitudinal, developmental, psychological and physical health-related, and organizational outcomes of rotation.

Rotation and Employee Attitudes

One of the most influential theories of psychological work design, the job characteristics model of Hackman and Oldham (1976) , explains why rotation may result in more positive employee attitudes. The authors stated that the five job characteristics of skill variety, task identity, task significance, autonomy, and feedback affect job-related outcomes, such as motivation and satisfaction. The job characteristics model has been complemented by Morgeson and Humphrey (2006) and Humphrey et al. (2007) . The authors added knowledge characteristics, social characteristics, and characteristics of the work context. In their meta-analysis ( Humphrey et al., 2007 ), they found evidence for this extended model.

While there already exists cumulative knowledge on single work characteristics (meta-analyses by Fried and Ferris, 1987 ; Humphrey et al., 2007 ), there is a unique combination of characteristics that distinguishes jobs with rotation from jobs without rotation. On the one hand, it is likely that the rotation between tasks or jobs increases the perceived variety of tasks, requires a greater variety of skills, and in some cases makes a job more holistic because the tasks or jobs add up to a complete cycle of a work process. Humphrey et al. (2007) found in their meta-analysis positive relationships between these characteristics (task variety, skill variety, and task identity) and positive employee attitudes, such as job satisfaction, internal work motivation, job involvement, and organizational commitment. We assumed that a job that provides a combination of these characteristics, as we expect to be the case in jobs with rotation, is also associated with positive employee attitudes.

On the other hand, jobs with rotation might decrease the experience of autonomy regarding the scheduling of work tasks because employees might be required to follow a fixed rotation roster. In their meta-analysis, Humphrey et al. (2007) investigated the relationships between autonomy and job satisfaction (there were not enough primary studies to investigate other outcomes). They found only significant associations between job satisfaction and other types of autonomy (e.g., work methods autonomy), but not between job satisfaction and work scheduling autonomy. Hence, even a fixed rotation schedule should not affect the positive relationship between rotation and employee attitudes.

Hypothesis 1 : Rotation is positively associated with the employee attitudes (a) job satisfaction, (b) work motivation, (c) job involvement, and (d) organizational commitment.

Rotation and Learning and Development

A more recent expansion of the job characteristics model—the work design growth model—was proposed by Parker (2017) . This model states that the way work is designed also influences several short-term (e.g., a change in cognition or skills) and long-term learning and development outcomes (e.g., an increase in intellectual flexibility), which had been neglected in previous work design models. Applied to an employment with job or task rotation, it is conceivable that the greater levels of task variety and task identity enhance learning because employees are introduced to new knowledge domains and gain a broader perspective of organizational processes. This notion is supported by a study with 5,800 working participants by Weststar (2009) . Here, a change in skill level required to perform a job and a change in work techniques and equipment (both core features of jobs with rotation) were significantly associated with an increase in employees seeking advice from someone knowledgeable with the intention of developing their job skills. Additionally, Antonioli and Della Torre (2016) found in their study of 118 small and medium enterprises that the adoption of job rotation was negatively associated with formal training. The authors interpreted this finding to mean that the investigated companies may adopt job rotation as a substitute for formal learning approaches.

Another explanation is that rotation facilitates the creation of tacit knowledge. Tacit knowledge refers to knowledge that is acquired through experience because it cannot be explicitly verbalized ( Nonaka and Takeuchi, 1995 ). When employees rotate between jobs or tasks, it is more likely that they share their tacit knowledge and learn from each other because they might have more contact with colleagues from other disciplines ( Kane et al., 2005 ). This knowledge acquisition in a variety of jobs or tasks allows employers to deploy their workers more flexibly.

Lastly, the meta-analysis by Humphrey et al. (2007) indicates that rotation might facilitate not only competence development but also career development because they found positive relationships between several rotation-specific work characteristics (i.e., task variety, skill variety, and task identity) and satisfaction with promotion. Thus, we proposed the following hypothesis.

Hypothesis 2 : Rotation is positively associated with the employee development indicators (a) competence development, (b) career success, and (c) labor flexibility.

Rotation and Psychological Health

According to an integrative model of psychologically healthy workplaces, employee well-being can be ensured by reducing negative demands and stressors and promoting organizational resources ( Kelloway and Day, 2005 ). Thus, the model suggests changing the objective working conditions, as opposed to addressing individual perceptions and attitudes ( Hurrell, 2005 ).

It can be argued that rotation benefits psychological health because it reduces the job stressors repetitiveness and imbalanced workload. In a review about boredom at work, Loukidou et al. (2009) found that repetitive and monotonous jobs were associated with, for example, psychological distress, depression, and feelings of hostility. Consequently, there are many simulation studies that aim to find an algorithm for job rotation scheduling that diminishes employee boredom (e.g., Bhadury and Radovilsky, 2006 ; Azizi et al., 2010 ). Additionally, it is possible that employees' psychological health is positively affected by rotation because the workload is more balanced than in jobs with a single activity, which improves physical health (as described in the following section). Previous studies found a high correlation between physical and psychological health (e.g., Bonzini et al., 2015 ).

Besides the reduction of these stressors, rotation also provides certain resources. Warr (1999) summarized ten potential environmental determinants of well-being, two of them being variety and opportunities for skill use. As described above, these are assumed to be provided by jobs with rotation. Sevastos et al. (1992) found significant associations between the well-being factors of anxiety-contentment and depression-enthusiasm and the job characteristics of skill variety and task identity. We proposed the following hypothesis.

Hypothesis 3 : Rotation is (a) positively associated with general psychological health, and (b) negatively associated with stress and burnout.

Rotation and Physical Health

A model developed by Westgaard and Winkel (1996) , based on a review of guidelines for occupational musculoskeletal load, explains why rotation can have an effect on a wide variety of health-related outcomes. The authors state that environmental exposure at work leads to individual reactions in the body, which then cause acute physiological and psychological responses, such as fatigue, change in heart rate, and (dis)comfort. Ultimately, these lead to improved or impaired musculoskeletal health. One important environmental exposure in the workplace proved to be repetitive or monotonous work ( Andersen et al., 2002 ). Increased repetitiveness means that one particular body region is continuously stressed, and the affected internal structures have little opportunity to recover ( Luger et al., 2014 ). As a relief, employees could either have more rest breaks or change between tasks that stress different body regions, and thus engage in task rotation ( Luger et al., 2014 ).

Previous literature reviews on the effects of task rotation on physical health found ambiguous results. On the one hand, reviews about task rotation and shoulder fatigue ( Luger et al., 2014 ), muscular activity variability ( Rodriguez and Barrero, 2017 ), or work-related musculoskeletal disorders and sick leave ( Padula et al., 2017 ) reported (weak) positive effects of task rotation on physical health. On the other hand, reviews about task rotation and musculoskeletal complaints and physical workload ( Leider et al., 2015 ) or upper limb muscle fatigue ( Santos et al., 2016 ) found inconsistent effects across studies. The authors discussed several explanations: First, the overall effect of rotation might have been canceled out because employees who normally performed high-intensity work benefitted from rotation, whereas employees who normally perform low-intensity work experienced a disadvantage due to the introduction of rotation ( Luger et al., 2014 ; Leider et al., 2015 ). Second, it is possible that the tasks within a rotation cycle did not stress different body regions so that the expected beneficial effects could not unfold. Leider et al. (2015) described, for example, a study where the employees had to work above shoulder level and do repetitive hand movements for an extended time both before and after the introduction of rotation. Mathiassen (2006) noted that there are currently no appropriate metrics to determine the diversity of exposed body regions.

To account for the previous ambiguous results, we assumed the following hypothesis.

Hypothesis 4 : The associations between rotation and physical health outcomes are moderated by the work intensity of the reference group. If the reference group performs high-intensity work, there is a (a) positive association with general physical health, and a negative association with (b) musculoskeletal complaints and (c) physical workload. If the reference group performs low-intensity work, there is a (d) negative association with general physical health, and a positive association with (e) musculoskeletal complaints and (f) physical workload.

Rotation and Organizational Performance

We drew on resource-based theory to explain why job and task rotation may affect organizational performance. The theory states that the major determinant of an organization's success is its internal resources, one of them being human capital resources (e.g., experience of managers and workers; Barney, 1991 ; Barney et al., 2011 ). Ensuing from human capital resources in resource-based theory, there are two explanatory approaches for the effect of rotation on organizational performance: workforce flexibility and organizational learning.

First, workforce flexibility ensues from rotation because, as described above, rotation fosters employee development, and thus proficiency in a variety of jobs and tasks. This labor flexibility helps to avoid bottlenecks, reduce idle time, and achieve a shorter lead time. All of these contribute to an enhanced financial performance of the organization ( Bhattacharya et al., 2005 ; Beltrán-Martín et al., 2008 ). Additionally, the work characteristics of task variety and task identity have also been found to be positively related to individual, subjective performance ( Humphrey et al., 2007 ).

Second, organizations can use rotation as a method to convert individual resources (i.e., employee knowledge and skills) into organizational knowledge, a process called organizational learning ( Maier et al., 2001 ; Basten and Haamann, 2018 ). This process reduces employee turnover and is critical to an organization's innovative capabilities, which, in turn, should translate into organizational performance ( Egan et al., 2004 ; Jiménez-Jiménez and Sanz-Valle, 2011 ). One important component of organizational learning theories is the transfer of knowledge among employees ( Nonaka, 1994 ; Argote, 2013 ). This knowledge sharing should be facilitated by rotation activities: Studies on cross-functional teams found that job rotation was associated with increased communication between functions, more involvement in cross-functional activities, and more congruent goals across functions ( Hauptman and Hirji, 1999 ; Xie et al., 2003 ). Thus, rotation enables a tighter network within the organization ( Jansen et al., 2005 ). These factors can contribute to faster processes, such as product development, greater productivity, and increased innovative capabilities. Thus, we proposed the following hypothesis.

Hypothesis 5 : Rotation is positively associated with the organizational performance indicators (a) individual performance, (b), productivity, (c) speed of product development, (d) innovativeness, and (e) financial performance, and negatively associated with (f) turnover (intention).

Potential Moderators of Rotation Outcomes

As described above, previous studies have often confused task rotation with job rotation (or vice versa). Thus, it is possible that ambiguous results from primary studies can be explained by the concrete design of a rotation intervention, which is either a job rotation or a task rotation. Based on the theoretical arguments presented above, one can assume that for some outcomes, the relationships with rotation are stronger for job rotation than for task rotation and conversely for other outcomes. As regards employee attitudes, we expected stronger relationships for task rotation than for job rotation. Task rotation implies a more frequent change between activities so that the perceived task variety and skill variety, which are both associated with positive employee attitudes, should be greater ( Humphrey et al., 2007 ). Additionally, job rotation is often associated with a change to a different workplace, which can result in a lack of social support because employees will have new colleagues. Meta-analytic results indicate that a lack of social support is associated with less positive employee attitudes ( Humphrey et al., 2007 ). In the case of learning and development, it is likely that employees gain a broader perspective from job rotation than from task rotation because they experience more diverse work environments. These are more likely to stimulate learning and growth ( Parker, 2017 ). Based on our reasoning for psychological health, the relationship should be stronger for task rotation than for job rotation. As described above, task rotation is more likely to provide the resource of variety, which was found to be related to less depression and anxiety ( Sevastos et al., 1992 ). Additionally, task rotation is potentially more suitable to reduce the stressor of an imbalanced workload, which should indirectly affect psychological health ( Bonzini et al., 2015 ). With regard to physical health, we expected stronger relationships with task rotation than with job rotation (when compared to high-intensity work) because the recovery of specific strained body parts can be best achieved when the alternation between work activities occurs quite frequently ( Mathiassen, 2006 ). Regarding organizational performance, we believed that job rotation would result in stronger relationships because it more often includes a change to another department. This contributes firstly to a broader picture of the organization and consequently more workforce flexibility ( Parker, 2017 ), and secondly to organizational learning because it encourages more interdepartmental knowledge sharing ( Hauptman and Hirji, 1999 ). We proposed the following hypothesis.

Hypothesis 6 : The relationship between rotation and (a) employee attitudes, (b) learning and development, (c) psychological health, (d) physical health, and (e) organizational performance is moderated by the concrete design of the rotation (job rotation vs. task rotation).

As another potential moderator, we investigated the context of the primary studies. As Johns (2006) pointed out, it is important to always interpret study results in the light of situational factors that might affect the occurrence of behavior and the relationship between variables. We expected that the collectivism/individualism of the societal culture would have an influence on the relationship between rotation and attitudes. In individualistic cultures, people tend to view themselves as independent individuals. Employees are thus more likely to strive for individual goals and pursue individual interests. In contrast, employees from collectivistic cultures see themselves as part of a collective (e.g., their organization), are motivated by the collective's norms, and are willing to give the collective's goals a higher priority than their own ( Triandis, 1995 ). Task rotation could be more strongly related to positive employee attitudes in collectivistic cultures because it puts an emphasis on the collective's goal by diminishing job specialization and making employees more interchangeable ( Fægri et al., 2010 ). Employees from individualistic cultures, however, might feel that their individual contributions at work cannot be identified in the context of task rotation, which might result in less positive employee attitudes. In regard to the adoption of job rotation it is likely that it is more beneficial for employee attitudes in individualistic cultures than in collectivistic cultures. Job rotation helps employees broaden their skill set and gain a deeper understanding of business operations ( Eriksson and Ortega, 2006 ). As this could ultimately be beneficial for their individual career advancement, the possibility of participating in job rotation might be perceived as a privilege, which results in more favorable attitudes. These individual-oriented goals are theorized to be less relevant for employees from collectivistic cultures ( Triandis, 1995 ).

Hypothesis 7 : The individualism/collectivism value of the societal culture moderates the relationship between rotation and employee attitudes, based on the concrete design of the rotation. As the societal culture becomes more individualistic, the positive relationships will (a) decrease in the case of task rotation and (b) increase in the case of job rotation.

In addition to the theoretically derived potential moderators, we also addressed a practically relevant aspect that could affect the relationships between rotation and its outcomes: We investigated whether there were any differences depending on whether the outcome was measured subjectively or objectively. Especially from an organization's point of view, objective success indicators are highly relevant because they are believed to be the most accurate representation of the real world and therefore guide future strategic decisions ( Andrews et al., 2006 ). Although often used interchangeably, meta-analytic studies suggest that subjective and objective organizational performance measures are only weakly correlated (e.g., Bommer et al., 1995 ).

Research Question : Are there any differences in the strength of the relationship between rotation and its outcomes based on whether the outcome was measured subjectively or objectively?

The data underlying the present meta-analysis are openly available in Open Science Framework (OSF 1 ).

Literature Search and Inclusion Criteria

We conducted a variety of search strategies to identify empirical studies published before February 2021. First, we conducted a search in the online databases PsycINFO, PSYNDEX, Education Source, Web of Science, EconLit, and Medline using the search term “ job rotation” OR “task rotation.” Second, we conducted a manual search of all conference programs that were available online of the Society for Industrial and Organizational Psychology (1998–2020), Academy of Management (1954–2020), European Association of Work and Organizational Psychology (2007–2019), and International Ergonomics Association (2015–2018) conferences. Third, we manually searched major journals from the fields of I/O psychology, management, health, and ergonomics, including the Journal of Organizational Behavior, Journal of Applied Psychology, Personnel Psychology, Organization Science, Journal of Occupational Health Psychology, Applied Ergonomics, Health Psychology , and Work & Stress . Fourth, we examined the reference lists from previous literature reviews on job rotation and pertinent topics (e.g., Leider et al., 2015 ; Padula et al., 2017 ; Basten and Haamann, 2018 ). Lastly, we conducted a manual search of the reference lists of all included articles. In an effort to obtain more gray literature, we complemented these search strategies with further approaches. More specifically, we posted a call for unpublished data in the Calls and Announcements section on the website of the Society for Industrial and Organizational Psychology 2 and via the mailing list of the German Psychological Society. As the European Association for Work and Organizational Psychology does not have a mailing list or announcements section on their website, we shared our call for unpublished data in the corresponding LinkedIn group. 3 Additionally, we contacted all authors of primary studies that we had identified thus far and asked whether they had further unpublished data that we could include.

We included all studies that reported a sample size and an effect size, or enough information to calculate it, and examined a unique sample that had not been included in this meta-analysis already. In line with past meta-analyses, we only included outcomes of job and task rotation when they were represented in at least three independent samples (cf., Berry et al., 2007 ; Eby et al., 2008 ; Kleine et al., 2019 ). We included experimental studies, quasi-experimental studies, and correlational studies in all languages. In studies in a language other than English, German, or French, we retrieved the relevant information using Google Translate. 4 Due to the recommendation by Roth et al. (2018) , we excluded studies that only reported regression weights and where we could not obtain zero-order correlations from the authors.

Coding Procedures

For the coding of the included studies, we compiled a manual that described the coding procedure, including all relevant coding decisions. The first author coded all studies, and another I/O psychologist familiar with the coding procedure coded a randomly selected 30% of the studies. We assessed the interrater agreement for categorical variables with Cohen's kappa, and the interrater reliability for continuous variables with intraclass coefficients (ICC 2,1) after all studies were coded. The kappa coefficients ranged from 0.76 (level of operationalization) to 1 (e.g., nationality), and the ICC from 0.99 (mean age) to 1 (e.g., sample size). Overall, these analyses showed good to very good interrater agreement and reliability. The discrepancies among the coders were then resolved by discussion between the coders, and the first author re-evaluated the coding decisions of the single-handedly coded studies based on the aspects that were discussed most frequently.

The effect size metric was the correlation coefficient Pearson's r . We coded either r directly, another effect size that could be converted to r (e.g., odds ratio for the incidence of low back pain), or the necessary information to calculate an effect size that could be converted to r (e.g., means and standard deviations). For the conversion, we used formulae by Borenstein et al. (2009) . We included studies with a between-subjects design as well as those with a within-subjects design. Borenstein et al. (2009) argue that it is legitimate to combine studies with different designs as long as they aim to answer the same question. When studies used a within-subjects design, we first calculated Cohen's d using the formula provided by Cheung (2015a) , which accounts for the dependency between pre- and post-values by including the intercorrelation, and then converted it to r . When studies used two independent groups with repeated measures, we used the formula provided by Lipsey and Wilson (2001) . In two cases ( Kuijer et al., 2005 ; Comper et al., 2017 ), we could not obtain the intercorrelation for the within-person values, so we only coded the between-person effect size for the post-values.

Coding of Methodological Factors and Study Characteristics

Publication status of the study was coded as a dummy variable (peer-reviewed publication vs. unpublished). For the study design, we coded whether rotation and the corresponding outcome were assessed concurrently or if the outcome was assessed after rotation. Thus, the binary variable had the two categories cross-sectional and time-lagged. Other design factors that we coded were the study setting (laboratory vs. field) and whether the study used a within- or between-subjects design. A within-subjects design meant that participants of the primary study were their own control group because they were assessed before and after the rotation intervention. A between-subjects design meant that participants with and without rotation (or with varying degrees of rotation) were compared with each other. Additionally, we coded the study rigor using an ordinal variable with the categories experiment (greatest rigor), quasi-experimental study, and correlational study (lowest rigor). As there were only few studies with an experimental or quasi-experimental design, we later combined these categories in our calculations.

Coding of Outcomes

For some outcomes, we decided to create synthetic construct groupings because primary studies reported very similar, conceptually overlapping constructs. We analyzed the operationalizations of each construct and logically combined semantically similar constructs. A table with all synthetic constructs and the underlying operationalizations can be found in the Supplementary Table 1 .

Coding of Moderators

In terms of the concrete design of the rotation, we created a categorical variable with the groups job rotation, task rotation, and both. The coding was based on the measurement of rotation (not on the definition the primary authors provided). An example description that indicated job rotation is “any change in job title or department that did not coincide with an increase in salary” ( Campion et al., 1994 , p. 1525), an example that indicated task rotation is “a dichotomous question asking whether an employee's job involves rotating tasks between the employee and colleagues” ( Avgoustaki, 2016 , p. 663), and an example of both is “do operators rotate across jobs or tasks on the line?” ( Colombo et al., 2007 , p. 1045). To investigate the relationships between rotation and physical health outcomes, we coded whether the control group performed tasks with a higher work intensity or lower work intensity. For the cultural moderator, we used the dimension individualism/collectivism by Hofstede (2001) . Every study that provided information on the country of data collection was assigned the individualism/collectivism index for this country. The values ranged from 1 to 100, with higher scores indicating greater levels of individualism. To address our research question, we also coded whether the outcome measure was a subjective (e.g., a self-rating questionnaire) or an objective (e.g., company data) measure.

Meta-Analytic Procedure

Most of our included studies reported more than one effect size. These effect sizes are usually dependent, which is why traditional meta-analytic procedures (e.g., Schmidt and Hunter, 2015 ) require the meta-analyst to include only a single effect size per study. Common strategies to accomplish this are, for example, calculating composites or selecting one effect size per sample. These strategies, however, result in an underestimation of heterogeneity and a loss of information ( Cheung and Chan, 2004 ; Cheung, 2014 ). Hence, we decided to perform a three-level meta-analysis, which accounts for dependencies of effect sizes ( Van den Noortgate et al., 2013 ; Cheung, 2015a ).

Traditional meta-analytic procedures can be regarded as two-level models, with participants at Level 1 and studies at Level 2. That means that effect sizes vary due to two types of variance: sampling variance and between-study variance. With the use of a three-level model, it is possible to consider a third source of variance: within-study variance, which can result, for example, from the use of several measures for the same criterion, or from the measurement of various criteria in one study. The resulting three levels were participants at Level 1, effect sizes within studies at Level 2, and studies at Level 3.

We calculated the sampling variance of the effect sizes (Level 1 variance) using formulae provided by Cheung (2015a , Chapter 3) and Borenstein et al. (2009 , Chapter 7). To calculate the mean effect sizes across studies ( r ) and the heterogeneity of effect sizes τ 2 within studies (Level 2) and between studies (Level 3), we used the metaSEM package (Version 1.2.5; Cheung, 2015b ) for R (Version 4.0.1; R Core Team, 2020 ). The package calculates significance ( p -values) and 95% confidence intervals based on Wald approximations ( Z ).

Study Characteristics

Our literature search yielded 803 hits (excluding duplicates). After excluding studies according to our predefined criteria, the analyses are based on a total of 56 studies, 253 effect sizes, and 284,086 participants, reported in 56 articles (see Figure 1 for a flow chart depicting reasons for article exclusions). An overview of all included studies with the investigated constructs, operationalizations, and the respective effect sizes can be found in Supplementary Table 9 .

Figure 1 . Flow chart with reasons for article exclusions.

Overall, 53 articles were peer-reviewed publications and three were unpublished studies (one working paper, one news article without peer review, and one unpublished data set). The primary studies were carried out between 1982 and 2020. We could not include any earlier articles because these were either not empirical studies or they were qualitative and thus did not report an effect size. Most studies were conducted in Europe ( k = 24), followed by North America and Asia (both k = 13), mixed samples ( k = 3), South America, Australia, and Africa (all k =1). On average, the samples had a mean age of 34.73 years ( SD = 6.30; Min = 22; Max = 42) and were 47.64% female. The majority of the samples were employees ( k = 37), followed by managers ( k = 16), and students ( k = 3). Most studies had a correlational design ( k = 46), eight studies were experiments, and two studies used a quasi-experimental design.

Relationships Between Rotation and Employee-Related and Organizational Outcomes

To test the relationships between rotation and employee-related and organizational outcomes, we computed a mixed-effects three-level meta-analysis that included the type of outcome as a covariate (see Table 1 ). As all outcomes were included in this analysis, we reverse-coded the effect sizes of those outcomes that indicate a negative effect: stress and burnout, musculoskeletal complaints, physical workload, and turnover (intention). Thus, positive values in these outcomes indicate a reduced level of the respective outcome. The results showed significant correlations between rotation and job satisfaction ( r = 0.27, p < 0.001), organizational commitment ( r = 0.16, p = 0.02), career success ( r = 0.31, p = 0.002), labor flexibility ( r = 0.32, p = 0.004), general psychological health ( r = 0.20, p = 0.01), stress and burnout ( r = 0.13, p = 0.02), individual performance ( r = 0.13, p = 0.02), and productivity ( r = 0.13, p = 0.02). These correlations exceed in magnitude between 27 and 75% of effect sizes reported in the human resources and organizational behavior literatures ( Paterson et al., 2016 ). Thus, the results supported our Hypotheses 1a, 1d, 2b, 2c, 3a, 3b, 5a, and 5b. They did not support our Hypotheses 1b (work motivation), 1c (job involvement), 2a (competence development), 5c (speed of product development), 5d (innovativeness), 5e (financial performance), and 5f (turnover).

Table 1 . Relationships between job and task rotation and outcomes.

Regarding the relationships between rotation and physical health, we had not assumed a general positive or negative relationship. Instead, we expected differences due to the work intensity of the reference group. Most studies did not specify which tasks were performed by the reference group, or work intensity was similar in the rotation and the non-rotation condition. Also, there was only one study that reported a comparison between rotation and high work intensity and investigated an effect of job rotation on general physical health ( Han et al., 2020 , r = 0.17). Thus, we could not test Hypotheses 4a and 4d. To test the other hypotheses on physical health, we investigated the subsample of rotation vs. low work intensity and the subsample of rotation vs. high work intensity (see Table 2 ). In line with our hypotheses, when the reference group performed high-intensity work, there were negative relationships between rotation and musculoskeletal complaints ( r = −0.38, p = 0.003) and physical workload ( r = −0.32, p = 0.01). These results support Hypotheses 4b and 4c. When the reference group performed low-intensity work, there were positive relationships between rotation and musculoskeletal complaints ( r = 0.16, p = 0.06) and physical workload ( r = 0.20, p = 0.07), but they were smaller and non-significant. Thus, Hypotheses 4e and 4f could not be supported.

Table 2 . Relationships between job and task rotation and physical health outcomes subdivided according to work intensity of reference group.

Differences Between Job Rotation and Task Rotation

To investigate whether the concrete design of the rotation affected the relationships between rotation and employee attitudes, learning and development, psychological health, physical health, and organizational performance, we conducted analyses for each outcome category and included the intervention (job rotation vs. task rotation) as a covariate. There was only one study with one effect size that investigated the relationship between job rotation and physical health outcomes. Therefore, we could not test Hypothesis 6d. The results for the other outcome categories are presented in Table 3 . As we investigated the overall outcome categories, we again used the reverse-coded effect sizes for stress and burnout and turnover (intention). As expected, the relationship between rotation and employee attitudes was stronger in the case of task rotation ( r = 0.10, p = 0.03) than in the case of job rotation ( r = −0.00, p = 0.97). The difference was, however, non-significant ( r Diff = 0.11, p = 0.23). Also as expected, the relationship between rotation and learning and development was stronger when the intervention was job rotation ( r = 0.21, p = 0.10) than when it was task rotation ( r = 0.09, p = 0.48). Again, the difference was non-significant ( r Diff = −0.12, p = 0.51). Contrary to our expectations, the relationship between rotation and psychological health was stronger for job rotation ( r = 0.20, p = 0.005) than for task rotation ( r = 0.14, p = 0.01). This difference was also not significant ( r Diff = −0.05, p = 0.54). Lastly, in line with our expectations, the relationship between rotation and organizational performance was stronger in the case of job rotation ( r = 0.12, p = 0.002) than in the case of task rotation ( r = 0.03, p = 0.26). This difference was also not significant ( r Diff = −0.09, p = 0.07). In conclusion, the results indicated slight differences between job rotation and task rotation, which were mostly in line with our expectations. As none of these differences were statistically significant, we had to reject Hypotheses 6a–c and 6e.

Table 3 . Results of moderated meta-analysis that compares job rotation with task rotation for different outcome categories.

Differences Due to Societal Culture

To examine whether collectivism/individualism affected the relationship between rotation and employee attitudes, depending on the concrete design of the rotation, we created subsamples for task rotation and job rotation and added the collectivism/individualism value as a continuous covariate in both subsamples. In the task rotation subsample, with greater levels of individualism, the relationship between rotation and attitudes decreased significantly ( B = −0.004, p = 0.003). Thus, the results supported Hypothesis 7a. In the job rotation subsample, with greater levels of individualism, the relationship between rotation and attitudes increased, however not significantly ( B = 0.00, p = 0.80). Thus, the results did not support Hypothesis 7b.

Differences Between Subjective and Objective Outcome Measures

To investigate whether there were differences between subjective and objective outcome measures, we conducted analyses for each outcome category and included the measurement type (subjective vs. objective) as a covariate. The only outcome categories that contained any objective outcome measures were physical health and organizational performance. As we had found that the work intensity of the reference group affected the results, we excluded effect sizes that compared rotation to low-intensity work in this analysis. The results (see Table 4 ) showed that for both outcome categories, the relationship between rotation and subjective outcome measures was stronger (physical health: r = 0.21, p < 0.001; organizational performance: r = 0.18, p < 0.001) than between rotation and objective outcome measures (physical health: r = 0.07, p = 0.23; organizational performance: r = 0.01, p = 0.88). The difference was significant in both cases (physical health: r Diff = −0.14, p < 0.001; organizational performance: r Diff = −0.19, p < 0.001).

Table 4 . Results of moderated meta-analysis that compares subjective with objective outcome measures for different outcome categories.

Methodological Factors and Influential Studies

Where possible, we examined whether methodological factors of primary studies affected the relationships between rotation and the superordinate outcome categories (see Supplementary Material , Supplementary Tables 2–6 , for detailed results). For all outcome categories, there were no significant differences between correlational and (quasi-)experimental studies, laboratory and field studies, and studies with a within- and between-subjects design. The comparison of cross-sectional with time-lagged studies showed significant differences for learning and development outcomes ( r Diff = 0.43, p = 0.01) and for physical health outcomes ( r Diff = −0.20, p = 0.05). The relationship between rotation and learning and development was stronger in cross-sectional studies, the relationship between rotation and physical health was stronger in time-lagged studies.

To determine whether single studies with very large sample sizes might have skewed the results of the meta-analysis, we conducted a sensitivity analysis. More specifically, we computed the relationships between rotation and the outcomes without the studies of Avgoustaki (2016 ; n = 29,537), Bouville and Alis (2014 ; n = 24,486), Kampkötter et al. (2016 ; n 1 = 90,321; n 2 = 91,987), and Ollo-Lopez et al. (2010 ; n = 12,056). The results showed that the exclusion of these studies affected the effect sizes only marginally ( Supplementary Table 7 ).

Ambiguous results from previous studies required a quantitative integration to assess an average relationship between job and task rotation and the beneficial outcomes that organizations expect and textbooks assert. Based on theories and models from multiple disciplines, we had assumed that rotation was positively associated with various employee attitudes, learning and development outcomes, psychological health, and organizational performance. The results supported our assumptions regarding the positive relationships between rotation and job satisfaction, organizational commitment, career success, labor flexibility, general psychological health, individual performance, productivity, and less stress and burnout. We could, however, not find significant evidence for positive relationships between rotation and work motivation, job involvement, competence development, speed of product development, innovativeness, financial performance, and reduced turnover (intention).

Regarding the relationships between rotation and physical health outcomes, we had expected positive relationships between rotation and physical health when the reference group performed high-intensity work, and negative relationships when the reference group performed low-intensity work. The results indeed showed that rotation was associated with reduced musculoskeletal complaints and physical workload when compared to high-intensity work. When compared to low-intensity work, there were positive, yet non-significant, relationships with musculoskeletal complaints and physical workload. There were not enough studies to investigate the associations between rotation and general physical health.

A comparison of job and task rotation revealed that, as expected, task rotation resulted in stronger correlations with attitudes, whereas job rotation had stronger correlations with learning and development and organizational performance. Contrary to our expectations, job rotation was also more strongly correlated with psychological health outcomes. In each case, the difference between job rotation and task rotation was not significant, although the absolute values of the correlation coefficients differed greatly in most cases. For example, when compared to averaged effect sizes in the human resources and organizational behavior literatures ( Paterson et al., 2016 ), the association between job rotation and learning and development exceeds in magnitude 50% of effect sizes, whereas the association between task rotation and learning and development exceeds only about 17%. There were not enough primary studies on relationships between job rotation and physical health so that we could not test our assumptions for this outcome category.

Lastly, as expected, we found that as the societal culture of the primary studies becomes more individualistic, the relationship between task rotation and employee attitudes decreases. We had also assumed the opposite for job rotation but could not find evidence for this assumption. We had thought that job rotation could be more beneficial for individual-oriented goals, such as career advancement, and therefore result in more favorable attitudes. However, it is possible that these individual-oriented goals are only relevant in the more distant future so that they do not affect more direct attitudinal responses.

The results of our exploratory research question showed that there were significant differences between subjectively and objectively measured outcomes. The association between rotation and physical health and organizational performance—the only outcome categories with enough objectively measured outcomes—was stronger when the outcomes were measured subjectively.

Theoretical Implications

We aimed to explain the expected relationships between rotation and employee attitudes, learning and development, psychological and physical health, and organizational performance with the help of theories and models from the respective disciplines. Based on the results of the comparison of job rotation and task rotation, we could draw initial conclusions on the appropriateness of our theoretical arguments for the investigated outcomes.

Based on the job characteristics model ( Hackman and Oldham, 1976 ), we had assumed that a positive association between rotation and employee attitudes could be explained by the fact that jobs with rotation usually provide certain work characteristics (e.g., task variety). These should be more prominent in task rotation than in job rotation because task rotation usually happens more frequently. Also, job rotation should be more likely to reduce the work characteristic of social support, as it usually involves a change to a different workplace. Hence, we assumed that if the association between attitudes and task rotation was stronger than between attitudes and job rotation, this would be a first indicator that the job characteristics model provided an appropriate explanation of the relationship between rotation and attitudes. The results supported this assumption.

In regard to learning and development, we drew on the work design growth model ( Parker, 2017 ) and expected rotation to be beneficial because it broadened the employees' skills and perspectives. We believed that job rotation provided more diverse work environments than task rotation and thus more diverse perspectives that could stimulate learning and growth. The comparison of job and task rotation showed that there was indeed a stronger correlation between learning and job rotation. This finding can be regarded as a first confirmation that the work design growth model is an appropriate explanation for the relationship between rotation and learning and development.

Based on the integrative model of psychologically healthy workplaces of Kelloway and Day (2005) , we had assumed that rotation improved psychological health because it reduces negative demands and stressors and promotes organizational resources. We had expected that task rotation would be more suitable than job rotation to provide resources, such as variety and opportunity for skill use, and reduce demands, such as an imbalanced workload. The results, however, indicated slightly stronger relationships between job rotation and psychological health. One explanation could be that in some cases, task rotation could be perceived as stressful because the workflow is interrupted. Fletcher et al. (2018) found, for instance, a positive relationship between workflow interruptions and psychological stress reactions.

Drawing on a model by Westgaard and Winkel (1996) , we had expected a beneficial effect of rotation on physical health because rotation between activities that stress different body regions provides opportunities to recover. However, previous literature reviews (e.g., Leider et al., 2015 ; Padula et al., 2017 ) had found only weak or ambiguous relationships between rotation and physical health. Our results provide an explanation for these results: There is only a beneficial health effect of rotation when it is compared to high-intensity work. Thus, the model by Westgaard and Winkel (1996) is a fitting explanation for the relationship between rotation and physical health, as long as the rotation introduces more light-intensity work.

Lastly, based on resource-based theory ( Barney, 1991 ; Barney et al., 2011 ), we expected rotation to be associated with organizational performance because it promotes workforce flexibility and organizational learning. Analogously to our expectations regarding learning and development, we believed that job rotation would yield stronger effects than task rotation. The results supported this assumption and therefore give a first indication that the resource-based theory provides a suitable explanation for the relationship between rotation and organizational performance.

Practical Implications

The prevailing view of job and task rotation is that they provide a variety of advantages for organizations and employees. More than half of U.S. organizations practice job rotation ( Cranet, 2017 ) and many textbooks recommend rotation as a work design technique. The results from this meta-analysis give reason to reconsider the unrestricted recommendation of rotation. First, although the relationships between rotation and its outcomes were positive on average, many correlations were non-significant and small. Thus, organizations planning to implement rotation should be aware that the intervention might not improve the targeted outcomes very much. On the basis of the existing primary studies, organizations can only expect great associations between rotation and job satisfaction, career success, labor flexibility, and general psychological health.

Second, depending on the desired outcome, organizations should also bear in mind that the concrete design of the rotation can potentially influence the relationship between rotation and its outcomes. More specifically, the results of our meta-analysis indicate that task rotation seems to be more suitable than job rotation when the desired outcomes are improved employee attitudes. Job rotation, however, should be preferred when the goal is an increase in employee learning and development, improved psychological health, or an increase in organizational performance. In addition, practitioners should carefully analyze future primary studies to determine whether they report on job or task rotation so that they can draw correct conclusions from these studies.

Third, with regard to physical health and organizational performance, organizations should be aware that subjectively measured outcomes were more strongly related to rotation. This is critical because the actual, objectively measurable benefit is highly relevant for these outcomes. It is probably a waste of resources to adopt a work design method that only improves the perceived innovativeness, individual performance, or physical workload. In comparison to that, the perceived stress or satisfaction in a workplace are measures where the subjective assessment might provide appropriate information.

Limitations and Directions for Future Research

We believe that our meta-analysis provides important insights into the effects of job and task rotation. However, there are also some limitations. To begin with, the relatively small number of studies for some of the analyses prevents us from drawing wide generalizations. However, compared with alternative techniques of study aggregation (e.g., vote counting or narrative reviews), which are usually dependent on subjective and sometimes untransparent decisions, the meta-analytic integration of studies provides the advantage of a quantification of the average effect. Valentine et al. (2010) therefore came to the conclusion that a meta-analysis already provides added value when it is based on as few as two studies. Furthermore, by using a three-level meta-analysis, we included as much information as possible from each primary study.

A further limitation is that we could include only a relatively small number of unpublished primary studies. This is problematic because the results from the included studies might differ from the results of the overall research that has potentially been done on the effects of job and task rotation. The reason for a possible difference lies in publication bias, which describes the tendency that significant results and results that support the authors' hypotheses are more likely to be published ( Rothstein et al., 2005 ). Thus, the averaged effect sizes reported in this meta-analysis might have been lower if we would have been able to include more unpublished data. On the other hand, a meta-meta-analysis of 83 meta-analyses published in Psychological Bulletin has found only weak evidence for publication bias and an overestimation of effect sizes in psychological meta-analyses ( van Aert et al., 2019 ).

Additionally, most included primary studies had a cross-sectional, correlational design. This could be regarded as a limitation because these studies do not allow for conclusions to be drawn about causality. To find out more about the direction of the effect and to rule out alternative explanations, we recommend that further research with (quasi-)experimental designs be carried out.

Another limitation was that our moderator analyses were limited by the information provided in the primary studies. This meant that there were some moderators that we could not investigate. For instance, we were interested in whether the perceived similarity of tasks or jobs would moderate the relationships between rotation and beneficial outcomes. We believed that a greater similarity would weaken the relationships because it would result in less variety, provide less diverse stimuli from the work environment, could be perceived as more repetitive, and might not leave enough opportunity for muscle recovery.

Another group of moderators that might further explain heterogeneity can be derived from self-determination theory ( Deci et al., 2017 ). The theory claims that every individual has basic human needs (i.e., the needs for autonomy, competence, and relatedness), which, when satisfied, result in internal motivation and consequently lead to psychological well-being and enhanced performance ( Deci et al., 2017 ). The design of job and task rotation might satisfy these needs in some cases more than in others. One could, for instance, assume that having a say during the implementation of rotation strengthens its relationship with employee-related outcomes because this would satisfy the need for autonomy. In general, greater work autonomy is associated with more positive attitudes, greater job performance, and reduced stress and burnout ( Humphrey et al., 2007 ). In order for job and task rotation to satisfy the need for competence, it might be necessary for the rotation to involve activities that require a diverse set of skills. Lastly, it might be possible that the rotation between workstations with varying colleagues is more beneficial than a rotation with limited potential for interaction because the latter alternative does not satisfy the need for relatedness. Studies that investigated job rotation between different functions in an organization found, for example, that the rotation was associated with more interdepartmental communication and cross-functional activities ( Hauptman and Hirji, 1999 ).

Job and task rotation have been a research topic in several disciplines for many years. This meta-analysis is the first to provide a quantitative estimate of the relationships between these work design methods and their expected outcomes, point to moderating factors, and clarify the differences between job rotation and task rotation. Our results showed that rotation was generally positively related to a variety of outcomes. However, many relationships were only small and non-significant. Positive relationships between rotation and physical health could only be found when rotation was compared to high-intensity work. A comparison of job and task rotation revealed that task rotation yielded stronger relationships with attitudinal outcomes, whereas job rotation had stronger relationships with development, psychological health, and organizational performance outcomes. Individualism led to weaker relationships between task rotation and attitudes, and relationships between rotation and physical health as well as organizational performance were stronger for subjective outcome measures. In conclusion, this meta-analysis enriches our understanding of job and task rotation because we showed that these two methods should not be confused, and that many expectations toward rotation cannot yet be empirically supported.

Data Availability Statement

Publicly available datasets were analyzed in this study. This data can be found at: Open Science Framework, https://osf.io/xtrkn/ .

Author Contributions

LM and GM contributed to the conception and design of the meta-analysis, contributed to the manuscript revision, read, and approved the submitted version. LM conducted the literature search, coding of studies, performed the statistical analyses, and wrote the manuscript.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

We thank all researchers providing information about study details. We also thank Katharina D. Schlicher for coding part of the primary studies to determine interrater agreement. We acknowledge the financial support of the German Research Foundation (DFG) and the Open Access Publication Fund of Bielefeld University for the article processing charge.

Supplementary Material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.633530/full#supplementary-material

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2. ^ https://www.siop.org/Career-Center/Calls-and-Announcements

3. ^ https://www.linkedin.com/groups/1999015/

4. ^ https://translate.google.com

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Keywords: job rotation, task rotation, attitudes, health, organizational performance, meta-analysis, work design

Citation: Mlekus L and Maier GW (2021) More Hype Than Substance? A Meta-Analysis on Job and Task Rotation. Front. Psychol. 12:633530. doi: 10.3389/fpsyg.2021.633530

Received: 25 November 2020; Accepted: 04 March 2021; Published: 25 March 2021.

Reviewed by:

Copyright © 2021 Mlekus and Maier. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Lisa Mlekus, lisa.mlekus@uni-bielefeld.de

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

GeNeDis 2020 pp 159–168 Cite as

The Job Rotation of Nursing Staff and Its Effects on Nurses’ Satisfaction and Occupational Engagement

• Charalampos Platis 8 ,
• Christina Ilonidou 9 ,
• Pantelis Stergiannis 10 ,
• Antonios Ganas 11 &
• George Intas 12  
• Conference paper
• First Online: 01 January 2022

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4 Citations

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1337))

Introduction: Job rotation in nursing staff involves moving workers from one department to another to increase their qualities in all areas.

Aim: Investigating the effects of job rotation of nursing staff on employee satisfaction and occupational engagement.

Methodology: A total of 211 nurses took part in the study. A structured questionnaire with closed-ended questions was used to collect the data. The questions used were based on previous research tools. The data analysis was performed with the SPSS statistical package v.24.0.

Results: Τhe results regarding the correlation of job rotation, job satisfaction, and occupational engagement show that job rotation is positively related to occupational engagement and job satisfaction of nurses. The overall attitude of nursing staff toward job rotation is neutral, and they express moderate to neutral professional satisfaction, moderate degree of vigor and absorption, and moderate-to-high degree of dedication. Regarding the correlation of job rotation, job satisfaction, and occupational engagement with the demographic characteristics of nurses, it was found that the gender and years of work of nurses are not the factors that affect job satisfaction, occupational engagement, and job rotation. On the contrary, it was found that the age of nurses is a factor that only affects their work satisfaction, nursing education is a factor that only affects nurses’ occupational engagement, and job position is a factor that affects nurses’ occupational engagement and job rotation.

Conclusions: The results highlight the importance of job rotation of nursing staff in their professional satisfaction and occupational engagement.

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Effects of job rotation and role stress among nurses on job satisfaction and organizational commitment

• Wen-Hsien Ho 1 ,
• Ching Sheng Chang 1 ,
• Ying-Ling Shih 2 &
• Rong-Da Liang 3  

BMC Health Services Research volume  9 , Article number:  8 ( 2009 ) Cite this article

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The motivation for this study was to investigate how role stress among nurses could affect their job satisfaction and organizational commitment, and whether the job rotation system might encourage nurses to understand, relate to and share the vision of the organization, consequently increasing their job satisfaction and stimulating them to willingly remain in their jobs and commit themselves to the organization. Despite the fact that there have been plenty of studies on job satisfaction, none was specifically addressed to integrate the relational model of job rotation, role stress, job satisfaction, and organizational commitment among nurses.

With top managerial hospital administration's consent, questionnaires were only distributed to those nurses who had had job rotation experience. 650 copies of the questionnaire in two large and influential hospitals in southern Taiwan were distributed, among which 532 valid copies were retrieved with a response rate of 81.8%. Finally, the SPSS 11.0 and LISREL 8.54 (Linear Structural Relationship Model) statistical software packages were used for data analysis and processing.

According to the nurses' views, the findings are as follows: (1) job rotation among nurses could have an effect on their job satisfaction; (2) job rotation could have an effect on organizational commitment; (3) job satisfaction could have a positive effect on organizational commitment; (4) role stress among nurses could have a negative effect on their job satisfaction; and (5) role stress could have a negative effect on their organizational commitment.

As a practical and excellent strategy for manpower utilization, a hospital could promote the benefits of job rotation to both individuals and the hospital while implementing job rotation periodically and fairly. And when a medical organization attempts to enhance nurses' commitment to the organization, the findings suggest that reduction of role ambiguity in role stress has the best effect on enhancing nurses' organizational commitment. The ultimate goal is to increase nurses' job satisfaction and encourage them to stay in their career. This would avoid the vicious circle of high turnover, which is wasteful of the organization's valuable human resources.

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Job rotation inspires nurses to achieve higher performance, allowing continuous growth at work, extended knowledge and skill, and increasing clinic patient care-taking quality. Scholars have all proposed that job rotation may help employees to acquire multiple capabilities and expand vision, and that it can be an approach to reduce job burnout [ 1 – 3 ]. But emotional pressure often occurs in the work environment where interpersonal interactions are highly involved [ 4 – 6 ]. Especially, the nurses working at hospitals not only implement independent and professional nursing activities in accordance with doctors' advice, but take responsibility for any immediate threat to patients' lives as well. Thus, the importance of nurses is undeniable, and the influence of nurses' qualities and capabilities on medical care quality can never be ignored [ 7 , 8 ]. Therefore, the primary concern of the practical field of medical care is to exhaustively recognize how role stress among nurses could affect their job satisfaction and organizational commitment, and effectively utilize the job rotation system to enhance and develop nurses' job satisfaction and organizational commitment, in order to promote competitive advantages.

Literature Review and Research Hypotheses

Job rotation.

Job rotation is also called cross-training, meaning an employee of a unit or department can learn diversified job skills during a specific period of time; it is also regarded as a practical approach to enrich and expand job assignments [ 9 ]. Therefore, job rotation is also planned on-the-job training for cultivating future candidates of management by transferring a management trainee from one department to another to increase his or her understanding and credentials in all aspects [ 3 ]. In addition, job rotation is also regarded as a method of job design that, on top of allowing employees to learn job skills from different departments, eliminates employee fatigue caused by tedious job assignments by changing such assignments; the challenge of these new assignments can encourage an employee's enthusiasm once again, and improve employee morale to increase output [ 10 , 11 ]. When implementing job rotation, the quality of an individual's work experience should be focused on, instead of quantity. Organizations should arrange the next rotation plan according to each employee's learning capability and adjustment time [ 12 ]. Therefore, high frequency of job rotation may not be better; factors such as employee's background, learning status, and job familiarity should be taken into consideration for frequency of job rotation.

The definition of job rotation here refers to a professional job cross training plan that helps employees expand their job territory while broadening their working experience and skills, stimulating their working spirit and cultivating their interpersonal relationships by shifting medical personnel to different departments or units of the same department. In reality, job rotation means neither job promotion nor paid adjustment. The structure of this study was based on one rotation as the only variable. The task was mainly to obtain the opinions and inclinations of nursing personnel toward job rotation. The purpose is to discuss hospital nursing personnel's comments and opinions on the implementation of job rotation.

Role stress

[ 4 , 5 ] suggested that a role is the manifestation of behavior appropriate to an individual's position. In an organization, an individual's role stress refers to "the stress formed by the combined expectations of an individual's behavior from all circles." While facing role stress, an individual may produce unfavorable behavior to an organization, such as performance reduction, job burnout, and resignation, which deserve to be taken seriously. In the role theory, [ 13 ] divided role stress into two types: role conflict and role ambiguity. [ 14 ] further separated "role overload" from role conflict, so that there are three types of role stress, which are role ambiguity, role conflict, and role overload [ 15 ]. [ 16 ], on the other hand, asserted that role stress is composed of five constructs, including role ambiguity, role overload, role conflict, role incongruity, and role incompetence or role over-qualification. This study adopts the viewpoint of role ambiguity, role conflict, and role overload as the three types of role stress.

Job satisfaction

[ 17 ] believed job satisfaction is a positive or negative attitude that an employee has toward his or her job or some specific aspects of the job, and is an internal state of mind of an individual. [ 18 ] pointed out it is a feeling or affection held by a member of an occupation system; if the feeling is positive or the response is active, then the member is satisfied, and vice versa. [ 19 ] proposed that job satisfaction is an employee's feeling about his or her work environment, which includes the job itself, supervisor, work group, organization, and life. [ 20 , 21 ] suggested that the level of job satisfaction depends on the difference between what a person actually gains from his or her job and what he or she expects. [ 22 ] proposed that job satisfaction is the level in which an employee likes or dislikes his or her job. [ 23 ] also pointed out that job satisfaction is an employee's feeling about his or her job and is a general attitude derived from an evaluation of all aspects in a job.

Organizational commitment

[ 24 , 25 ] indicated that organizational commitment is an individual's willingness to dedicate efforts and loyalty to an organization. The commitment to a job is because an individual believes the cost of leaving an organization is so high, that it is difficult for the individual to leave after consideration of the investment and sacrifice made to the organization [ 26 , 27 ]. Psychological commitment proposed by [ 28 ] is also called normative commitment. [ 29 ] explained that this type of organizational commitment means the members of an organization have active and highly positive inclination toward the organization, and such inclination includes identification with an organization's goals and values, dedication to a job, and loyalty to an organization. [ 30 , 31 ] described the process of the forming of organizational commitment with investment and dedication that an individual shall develop a relatively deep identification with an organization after such individual has invested in the organization at a relatively high level, and a forced commitment to the organization is consequently formed. [ 32 , 33 ] pointed out that basically organizational commitment is a structural phenomenon of a transaction between an individual and an organization, and its non-transferable investment result shall increase as time goes on; members are reluctant to leave the organization because of the salary, status, position, and friendship among colleagues.

Relationships among job rotation, job satisfaction, and organizational commitment

In regard to the relationship between job satisfaction and organizational commitment, [ 34 – 36 ] pointed out in their study of job satisfaction and organizational commitment that the two have significant positive correlation [ 37 , 38 ]. [ 10 , 39 , 19 ] proposed that job rotation has the advantage of increasing job satisfaction. [ 12 , 40 ] also believed implementing job rotation has the advantage of increasing organizational commitment in the aspect of employees' career and emotion. From the above statements, the following hypotheses are formed:

Hypothesis 1: Nurses' job rotation has a positive influence on job satisfaction .

Hypothesis 2: Nurses' job rotation has a positive influence on organizational commitment .

Hypothesis 3: Nurses' job satisfaction has a positive influence on organizational commitment .

Relationships among role stress, job satisfaction, and organizational commitment

The results of the research of [ 24 , 41 ] showed that there is a significant negative correlation between role stress and organizational commitment, and role conflict, role ambiguity, and role overload have the most remarkable influence in the construct of role stress [ 42 , 5 ]. In regard to the relationship between role stress and job satisfaction, [ 15 , 5 ] found that the tension at work caused by role ambiguity, role conflict, and role overload has a significant negative correlation with job satisfaction. From the above statement, the following hypotheses are formed:

Hypothesis 4: Nurses' role stress has a negative influence on job satisfaction .

Hypothesis 5: Nurses' role stress has a negative influence on organizational commitment .

Research Framework (Model)

Our conclusion from the motivation, purpose, and literature review is that nurses' job rotation has a positive influence on job satisfaction and organizational commitment, nurses' job satisfaction has a positive influence on organizational commitment, and role stress among nurses has a negative influence on their job satisfaction and organizational commitment. Therefore, in this study, job rotation and role stress among nurses are independent variables, and organizational commitment is a dependent variable, while job satisfaction is the mediating variable, in order to discuss the correlation among all the variables. The overall research framework is shown as Figure 1 .

Conceptual framework of the relationship among job rotation, job satisfaction, organizational commitment, and role stress .

Research Subject and Sampling Method

There are two reasons for the job rotation of nurses: 1. The planned rotation: for example, in compliance with the promotion of nurses in basic units or training of associate head nurses; 2. Non-planned rotation: for instance, large-scale temporary transfer of personnel to different sections and offices in a unit (due to support for other units, dismissal, leave of absence and so on). Generally, the period for the first type of rotation is a half year and for the second type is about three months.

In order to survey a diverse and representative sample of RNs, nursing staff in two large and influential hospitals (each was a teaching hospital and medical center, and each had more than 1200 sickbeds) in southern Taiwan were surveyed. We first visited the management supervisors at the hospitals in person to acquire approval. Volunteer supervisors of nurses were asked to post on bulletin boards at their respective units a notice for recruiting volunteer nurses who would participate in the anonymous questionnaire. The response period was limited to two months. A seminar was delivered to the supervisors of the nurses to explain the details, and an introductory letter was attached to the questionnaire to explain the motivation of this study and guarantee the respondents' confidentiality. Anyone who was also interested in learning about the result of this study was able to request a copy through the contact address provided in the questionnaire. 650 copies of the questionnaire were only distributed (Medical Center A: 340 copies; Medical Center B: 310 copies) to those nurses who had had job rotation experience, and 550 were collected between October 2006 and December 2006, among which 18 were rejected due to incomplete answers. 532 valid copies were collected (Medical Center A: 273 copies; Medical Center B: 259 copies), and the valid response rate was 81.8%.

Study Tools

The following is the explanation of the questionnaire which comprised questions already developed in foreign studies and modified to serve the study purposes. First, dimensions of questionnaire forms were obtained from the literature and used to compile questionnaires. Second, the dimensions were slightly modified to create initial questionnaires based on the research purposes and industry features. Third, tests were repeatedly administered to three academic professors in the industry, and to two medical specialists and five nurses with experience of job rotation; a pilot run of the questionnaire was administered to 38 nurses. Thirty-two valid questionnaire forms meeting the acceptable standard of more than thirty recommended by [ 43 ] were collected, and the analytical results indicated that all factor loadings were greater than 0.7, and all Cronbach's α values exceeded 0.7, therefore, none of the items were deleted [ 43 ]. Finally, the questionnaire was officially released. Deserving of special attention is that, the questionnaire employed did not allow the measurement of job rotation levels, and thus, cannot establish whether participants experienced job rotation or not.

The questionnaire employed a 5-point Likert scale from 1, for "strongly disagree" to 5, for "strongly agree." Table 1 summarizes constructs and variables, including operational definitions for all variables. Questionnaires were examined for reliability and validity as follows:

Reliability analysis: Principal component factor analysis was used to extract major contributing factors, and varimax of the orthogonal rotation was performed to maximize the differences in factor loading carried by every common factor after the rotation to help recognize common factors. Thus, as Table 2 illustrates, the analytical results indicated that factor loadings were 0.79 to 0.92 meeting the acceptable standard of more than 0.7, and all Cronbach's α values exceeded 0.7 [ 43 , 44 ].

Construct convergent validity (confirmatory factor analysis): The confirmatory factor analysis could gain higher recognition than expert content validity [ 43 ], and the results for all dimensions were listed in Table 3 . All of the adequacy indicators met the acceptable standard recommended by [ 43 ]. Parameter (λ) between each latent variable and manifest variable were estimated to determine the significance of the estimated parameter (λ) in order to evaluate convergent validity. Thus, as Table 4 shows, the t values for the factor loading of all measurement items reached the level of significance (p < 0.01), no single factor included only one question, and the composite reliability values for all constructs were greater than 0.6, which demonstrated satisfactory convergent validity [ 45 , 43 ].

Data Analysis Method

Finally, the SPSS 11.0 and LISREL 8.54 (Linear Structural Relationship Model) statistical software packages were used for data analysis and processing, as follows:

Descriptive statistical analysis: To see the characteristics of samples.

Structural Equation Modeling (SEM): According to [ 46 ], structural equation modeling allows not only the determination of relationship extent between variables, but also the examination of chain of cause and effect. This means that results do not merely show empirical relationships between variables when defining the practical situation. For this reason, this study chose structural equation modeling to test hypotheses. This study also used several indices, including Chi-square ratio (< 3), goodness of fit index (GFI > .9), adjusted goodness of fit index (AGFI > .8), normal fit index (NFI > .9) and root mean square of standardized residual (RMSR < .08) to evaluate overall model fitness.

Ethical Considerations

The study had been verbally approved by each institution's ethics committee before the research started and before the supervisors were approached. Nursing staff supervisors were asked to post a notice requesting volunteers for the anonymous questionnaire on bulletin boards at their respective units. The nurse supervisor made the questionnaires available for volunteer nurses to fill out anonymously on site; respondent nurses could ask questions directly to the supervisor, and the supervisors collected even those questionnaires not filled out on site. The response period was limited to two months. The authors invited all nursing supervisors to a seminar to explain the details of the study, and an introduction letter was attached to the questionnaire to explain the purpose of the study and to ensure respondent confidentiality. The questionnaire provided contact information so that respondents could later inquire about the results of the study.

Characteristics of Samples

The demographic data revealed that 48.1% of participants were under 30, and 57.7% were unmarried. Subjects with less than junior college education comprised 44.2% of the study population. The employment data revealed that 30.3% had between three and six years of work experience. 93.8% were not currently in management positions and 50.8% were currently working in hospital wards (see Table 5 ).

The Relationships among Nurses' Job Rotation, Role Stress, Job Satisfaction, and Organizational Commitment

The Linear Structural Relationship Model was employed to examine the relationships among nurses' job rotation, role stress, job satisfaction, and organizational commitment [ 45 , 46 ]. Hypotheses 1 to 5 in this study were demonstrated to be significant, as in Figure 2 . Nurses' job rotation had a positive influence on job satisfaction (γ 11 = 0.51) and organizational commitment (γ 21 = 0.46). Nurses' job satisfaction (β 21 = 0.63) had a positive influence on organizational commitment. Nurses' role stress had a negative influence on job satisfaction (γ 12 = -0.52) and organizational commitment (γ 22 = -0.79). Figure 2 shows the SEM of this study and Table 6 shows the model fit goodness of the structural equation modeling. In short, it can be concluded that the research model is applicable for the data.

Structural Equation Modeling (SEM) of the relationship among job rotation, job satisfaction, organizational commitment, and role stress . ( Note . * represents p < .01)

Conclusions and implications

According to the nurses' views, there are five major results in this study: (1) job rotation among nurses could have an effect on their job satisfaction; (2) job rotation could have an effect on organizational commitment; (3) job satisfaction could have a positive effect on organizational commitment; (4) role stress among nurses could have a negative effect on their job satisfaction; and (5) role stress could have a negative effect on their organizational commitment. The implications are discussed, as follows:

Academic implications

Cases in which past researchers' viewpoints corresponded to the results of this study that job satisfaction has positive effects on nurses' organizational commitment [ 34 , 37 ]. Our findings also support the statement that job rotation could have an effect on nurses' job satisfaction and organizational commitment. This agrees with the assertions of previous relevant studies [ 12 , 40 ].

The results support that role stress exercises obviously negative influences on organizational commitment, this inference is in accordance with the assertions of certain scholars in the past [ 47 , 48 , 5 ]. The findings of this study also reveal that role stress exercises obviously negative influences on job satisfaction indicating that role stress among nurses negatively influences their job satisfaction. It is in accordance with the assertions of relevant studies in the past [ 49 – 51 ].

Practical implications

Due to the fact that hospitals depend on nurses' work to operate and it takes tremendous time and effort to train nurses' talent, retaining excellent nurses and stimulating them to do their best to serve hospitals and take on future challenges are crucial issues for hospitals to stay competitive in today's environment. As a practical and excellent strategy for manpower utilization, a hospital could promote the benefits of job rotation to both individuals and the hospital while implementing job rotation periodically and fairly. The ultimate goal is to increase nurses' job satisfaction and encourage them to stay at their work. This would avoid the vicious circle of high turnover which is wasteful of the organization's valuable human resources.

The findings of this study reveal that role stress among nurses exercises negative influences on both job satisfaction and organizational commitment. The parameter estimates of the correlation show that the negative influence that role stress among nurses has on organizational commitment (-0.79) is greater than that on job satisfaction (-0.52). Therefore, when a medical organization attempts to enhance nurses' commitment to the organization, the findings suggest that reduction of role ambiguity (with a path coefficient of 0.82) in role stress has the best effect on enhancing nurses' organizational commitment.

Avian Influenza (AI) has caused hundreds of deaths in Europe. The hospital system of Taiwan, standing in the first line of prevention and treatment, has to effectively employ the experience of SARS in order to tackle the new serious challenge of AI. Though Taiwan is not an epidemic area of AI, it is important for us to be well prepared to confront it, given that prevention is more important than treatment. It is essential that we try our best to build up an efficiently preventive system for AI and other serious infectious diseases. This study aims to investigate what is most important and critical in the preventive system. More specifically, what are the priorities in such a preventive system, especially under a limited condition of budgets and human resources?

Research Limitations

The findings of this study should be considered in view of the following limitations.

This study merely investigated the correlation between perception of job rotation, role stress, job satisfaction, and organizational commitment in a population of nurses. Factors influencing organizational commitment such as the nature of employment, work environment, work experience and management style, await further study.

This study examined a population of nurses in a single country and should be generalized cautiously to other populations. However, given the context of the study, the survey results exhibited adequate validity and reliability.

The primary research instrument in the study was the questionnaire, which has a certain degree of validity and reliability. However, the results of the voluntary survey would have been subject to numerous factors which could cause variations in the results, such as defensiveness, pretending, personal emotion and other attitudes.

This study examined only one time period, which would not reveal factors which have long-term effects. A multiple time period approach is suggested for follow-up study. Analyzing multiple periods of data would achieve more complete and objective statistical data.

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Dept. of Medical Information Management, College of Health Science, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan

Wen-Hsien Ho & Ching Sheng Chang

Dept. of Nursing & Nutrition Support Team, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan

Ying-Ling Shih

Dept. of Marketing and Logistics Management, National Penghu University, Taiwan

Rong-Da Liang

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The following indicated the contributions of each author in this study: WHH conceived of the study, and participated in its design and coordination; CSC participated in the design of the study and performed the statistical analysis & FG, conceived of the study, and participated in its design and coordination; YLS conceived of the study, and participated in its design and coordination; and RDL conceived of the study, and participated in its design and coordination. All authors read and approved the final manuscript.

Wen-Hsien Ho, Ching Sheng Chang contributed equally to this work.

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Ho, WH., Chang, C.S., Shih, YL. et al. Effects of job rotation and role stress among nurses on job satisfaction and organizational commitment. BMC Health Serv Res 9 , 8 (2009). https://doi.org/10.1186/1472-6963-9-8

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Received : 01 August 2007

Accepted : 12 January 2009

Published : 12 January 2009

DOI : https://doi.org/10.1186/1472-6963-9-8

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