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Open Access Open Badges Research article

Learning organizations, internal marketing, and organizational commitment in hospitals

Yafang Tsai

Author Affiliations

Department of Health Policy and Management, Chung Shan Medical University, No.110, Sec., Jianguo N. Rd., Taichung City, 40201, Taiwan

Department of Medical Management, Chung Shan Medical University Hospital, No.110, Sec, Jianguo N. Rd, Taichung City, 40201, Taiwan

BMC Health Services Research 2014, 14:152  doi:10.1186/1472-6963-14-152

Published: 4 April 2014



Knowledge capital is becoming more important to healthcare establishments, especially for hospitals that are facing changing societal and industrial patterns. Hospital staff must engage in a process of continual learning to improve their healthcare skills and provide a superior service to their patients. Internal marketing helps hospital administrators to improve the quality of service provided by nursing staff to their patients and allows hospitals to build a learning culture and enhance the organizational commitment of its nursing staff. Our empirical study provides nursing managers with a tool to allow them to initiate a change in the attitudes of nurses towards work, by constructing a new ‘learning organization’ and using effective internal marketing.


A cross-sectional design was employed. Two hundred questionnaires were distributed to nurses working in either a medical centre or a regional hospital in Taichung City, Taiwan, and 114 valid questionnaires were returned (response rate: 57%). The entire process of distribution and returns was completed between 1 October and 31 October 2009. Hypothesis testing was conducted using structural equation modelling.


A significant positive correlation was found between the existence of a ‘learning organization’, internal marketing, and organizational commitment. Internal marketing was a mediator between creating a learning organization and organizational commitment.


Nursing managers may be able to apply the creation of a learning organization to strategies that can strengthen employee organizational commitment. Further, when promoting the creation of a learning organization, managers can coordinate their internal marketing practices to enhance the organizational commitment of nurses.

Nursing management; Learning organization; Internal marketing; Organizational commitment