Job autonomy and career development satisfaction among healthcare professionals: the moderating role of organizational identification

BackgroundUnder China’s Healthy China strategy and the high-quality development agenda for public hospitals, healthcare professionals’ career development satisfaction has become critical for service quality and workforce stability. However, most existing studies adopt linear frameworks and fail to capture the nonlinear moderating mechanisms between job autonomy and organizational identification, particularly within the institutional context of Chinese public hospitals.MethodsIntegrating role boundary theory, conservation of resources theory, social exchange theory, and self-determination theory, this study develops an analytical framework to examine how organizational identification moderates the relationship between job autonomy and career development satisfaction. A survey of 398 healthcare professionals from public hospitals was conducted. Multiple linear regression was used to test the main and moderating effects, while quadratic terms were incorporated to examine potential nonlinear relationships. In addition, random forest modeling was applied to assess variable importance and explore complex nonlinear patterns among the study variables.ResultsJob autonomy had a significant positive effect on career development satisfaction and emerged as the strongest predictor. Organizational identification significantly moderated the relationship between job autonomy and career development satisfaction in a nonlinear manner: under low job autonomy, high organizational identification had a compensatory effect; under high job autonomy, it showed an inhibitory effect. Random forest results corroborated the regression findings, confirming the critical role of job autonomy and its interaction with organizational identification.ConclusionBy identifying the nonlinear moderating role of organizational identification, this study advances understanding of career development satisfaction among healthcare professionals. The combined use of regression and random forest analyses captures both linear and nonlinear relationships. Practically, hospitals should adopt differentiated management strategies by strengthening organizational support for employees with low job autonomy while avoiding excessive conformity pressures on highly autonomous staff, thereby enhancing career development satisfaction and workforce stability.