Determinants of Clinical Instructor Service Quality in Healthcare Education: The Roles of Knowledge Management, Professional Commitment, Work Motivation, and Interpersonal Communication

Abstract

This study investigates the structural determinants of Clinical Instructor (CI) service quality in Indonesian healthcare education through an integrated mixed-methods design grounded in the POP-SDM (Pemodelan dan Optimasi Penguatan Sumber Daya Manajemen) framework. The research model positions knowledge management (X1) as the exogenous variable, professional commitment (X2), work motivation (X3), and interpersonal communication (X4) as intervening variables, and CI service quality (Y) as the endogenous variable. Employing a sequential exploratory design, qualitative inquiry (12 informants across 30 healthcare clinics in Bekasi City) was first used to identify and validate the causal constellation, followed by quantitative path analysis with a sample of 144 clinical instructors drawn via proportional random sampling. Instruments were based on SERVQUAL (service quality), and validated theoretical frameworks for each independent variable, all measured on five-point Likert scales. Data were analyzed using SPSS v.29 with prerequisite tests for normality, homogeneity, linearity, multicollinearity, and heteroscedasticity. Results confirmed ten significant hypotheses: all four variables exert direct positive effects on CI service quality—interpersonal communication (β = 0.234), work motivation (β = 0.212), knowledge management (β = 0.208), and professional commitment (β = 0.195). Knowledge management exerts strong direct effects on all three intervening variables: interpersonal communication (β = 0.771), work motivation (β = 0.737), and professional commitment (β = 0.655). Three significant indirect paths from knowledge management to service quality were confirmed via Sobel test, with interpersonal communication yielding the strongest indirect effect (β = 0.163), followed by work motivation (β = 0.144) and professional commitment (β = 0.136). However, all three intervening variables function as partial rather than full mediators, since direct effects exceed indirect effects. SITOREM analysis identified 18 priority indicators for improvement across all variables. Findings provide a validated causal model with actionable optimization recommendations for clinical education policy and practice in Indonesia.