The Influence of Training, Job Security, Career Development Opportunities and Performance Appraisal on Turnover Intention among Hospital Employees i

Employee turnover has gained considerable attention from various industries in Malaysia. The main objectiv of this study is to explore potential influence of training, job security, career development opportunities and performance appraisal towards turnover intention among hospital employees in Kuala Lumpur. By identifying significant influences of training, security, career development opportunities and performance appraisal on hospital employees turnover intention, it will help to create awareness to hospital on the importance of those practices in building human capital. There are 274 hospital employees respective hospitals in Kuala Lumpur were selected as samples. The data were collected using five Likert Scale’s self-administered questionnaires. There are two types of data techniques adapted for this research which is descriptive and inferential analysis techniques. Descriptive analysis technique is used to identify the background of respondents in the aspect of age, gender, marital status, years of experience, and qualification. However inferential analysis is used to determine the significant relationship between training, job security, career development opportunities, performance appraisal and turnover intention among hospital employees in Kuala Lumpur. The result of this study shows that there is a strong correlation between training and turnover intention. The results also revealed that there is a weak correlation between performance appraisal, career development opportunities, job security and turnover intention. This study helps to identify factors contributing towards | Volume – 2 | Issue – 1 | Nov-Dec 2017 6470 | www.ijtsrd.com | Volume Journal of Trend in Scientific and Development (IJTSRD) International Open Access Journal

Employee turnover has gained considerable attention from various industries in Malaysia. The main objective of this study is to explore potential influence of training, job security, career development opportunities and performance appraisal towards turnover intention among hospital employees in Kuala Lumpur. By identifying significant influences of training, job security, career development opportunities and performance appraisal on hospital employees turnover intention, it will help to create awareness to hospital on the importance of those practices in building human capital. There are 274 hospital employees from five respective hospitals in Kuala Lumpur were selected as samples. The data were collected using five-point administered questionnaires. There are two types of data techniques adapted for this ferential analysis techniques. Descriptive analysis technique is used to identify the background of respondents in the aspect of age, gender, marital status, years of experience, and qualification. However inferential analysis is used to ificant relationship between training, job security, career development opportunities, performance appraisal and turnover intention among hospital employees in Kuala Lumpur. The result of this study shows that there is a strong correlation between and turnover intention. The results also revealed that there is a weak correlation between performance appraisal, career development opportunities, job security and turnover intention. This study helps to identify factors contributing towards hospital employees turnover intention in Kuala Lumpur and recognise few recommendation to reduce turnover intention.
Keywords: Training; Job Security; Performance; Development

INTRODUCTION
Healthcare services in Malaysia consist of government run public health clinics and hospitals and private medical services are mainly provided by private health clinics or general practices and hospitals. Public sector health services are administered by the Ministry of Health through its central, state and district health offices. Meanwhile, Public health clinics are under the coordination and administration of their respective district health offices. General practices are usually solo practices run by non similarly to private hospitals, they are mainly si urban areas. Both healthcare sectors are still expanding. The Malaysian healthcare sector is set to be transformed from a social service and consumer of wealth to a private sector-driven engine for economic growth. Demand of healthcare is likely to elderly increase in number, consumer awareness of healthcare service grows and access to services improves. Healthcare services in Malaysia consist of governmentics and hospitals and private medical services are mainly provided by private health clinics or general practices and hospitals. Public sector health services are administered by the Ministry of Health through its central, state and district health . Meanwhile, Public health clinics are under the coordination and administration of their respective district health offices. General practices are usually solo practices run by non-specialist doctors and similarly to private hospitals, they are mainly sited in urban areas. Both healthcare sectors are still expanding. The Malaysian healthcare sector is set to be transformed from a social service and consumer of driven engine for economic growth. Demand of healthcare is likely to expand as the elderly increase in number, consumer awareness of healthcare service grows and access to services Turnover intention issue has not been solved which means that until now it still remains as one of the top issue that has been studied and explored more compare to any other Human Resource Management (HRM) phenomenon. However, reason for turnover intention being so important and its influences to employees lead researchers from time to time return to restudying deeper into this matter. Moreover, nearly all of the available researchers on employee turnover is not attempts to address the question of why some workplace experience higher turnover rates than others but rather on understanding the process of which individuals choose to quit or stay ( (2007), found that job security and increasing level of experience will weaken employee's turnover rate. Those employees who have a thought that they do not be in the right place in an organization will shortly leave. For this reason, investigating the relationship between training, job security, career development opportunities, performance appraisal and employee's turnover intentions will be essential for the management since it could lead to actual employee losses.  (Mitchell et.al., 2001). . Eleven HRM practices adopted by Kuo (2004), found that employment security, training and performance appraisal are regarded as three of the main practices for impacting hospital performance. Wheeler, Harris and Harvey (2010) cited that organizations should enhance their business performances through practicing strategic HRM practices as it have the ability in reducing employee's turnover which was also highlighted by Chang & Chen, (2002); Moynihan, Wright & Gardner (2003) in discussions on HRM in recent years. Therefore, this research paper aims to gain better understanding and provide further insights into the role of employee's identification with their organization and how evaluation on training, job security, career development opportunities and performance appraisal affects turnover intention of hospital employees in Kuala Lumpur.

i)
To examine the relationship between training and turnover intention among hospitals employees.
ii) To investigate the relationship of job security towards turnover intention among hospitals employees.
iii) To examine the relationship of career development opportunities and turnover intention among hospitals employees.

iv)
To determine the relationship of performance appraisal towards turnover intention among hospitals employees.

Literature Review
According to Robbins et.al., (2005), turnover is the permanent withdrawal either voluntary or involuntary from an organization. Abassi and Hollman (2000) adding in that employee turnover can be considered as an employee cycle in a particular industry whereby there will be rotation between employment and unemployment situation and also between organizations, jobs and occupations. there is a relationship exist between training and turnover. Sherman & Bohlander (1992), found that training in managerial competencies, skills and programs with growth opportunities will be used to increase job commitment and reduce employee turnover.  2001), stated that a relationship is widely confirmed when turnover intention was measured to get to know one's response on job security and it is assumed that employees react to a high level of job security over time with a high level of turnover intention. According to Helmi, (2006), similar study carried out by 'University of Technology MARA', Malaysia on hotel employee revealed that other predictors such as career development opportunities program besides having good HR practices, is essential to oppose turnover intentions. Those organizations that fail to provide satisfaction for employees in term of career growth will indirectly leads to the prospects of employment elsewhere which more attractive than the current job. Zimmerman, (2009) shares the similar view by stating that it is proven that there is a significant relationship between employee's job performance management and turnover intention which results revealed in a survey conducted by collecting data from 165 respondents on performance management and turnover intention.

Research Design
This research is using a quantitative research as it is the best method to measure the influence of the variables. Cohen et.al, (2000) stated that survey research is one of the methods that use scientific sampling and questionnaire design uses statistical method for measurement. Cohen also explained that the benefit for quantitative research is it provides estimation of population at large. A quantitative research will be able to gather valuable data and prove the correlation between training, job security, career development opportunities, and performance appraisal and employee turnover statistically. Therefore, a set of questionnaires was design and to ensure the questionnaire reliability, a pilot test was run before distributing to actual respondents.

Research Instrument
Instrument used in this research is a questionnaire to gather the data from the research sample. The questionnaire consists of 31 questions which are divided into three sections. A total of 274 questionnaires were distributed via hardcopy. Data collection method was taken into consideration while structuring the questionnaire so that the questionnaire distributed could be collected easily and conveniently. Respondents participated by selecting from the multiple choice responses using a 5 point Likert Scale which

Reliability Test
Reliability test is done to identify the internal consistency of the items in every section of the questionnaires. The questionnaire is considered to be reliable when it is repeated application results in consistent scores and the stronger the relation between items, the higher the reliability of the scale. According to Uma Sekaran (2003), the closer the reliability coefficient to 1.00, is the better. In general, reliabilities less than 0.60 are considered poor, those in the range of over 0.70 are considered good and acceptable. The pilot test on 30 respondents was conducted among hospital employees from five respective hospitals in Kuala Lumpur. Randomly select the targeted respondent for this test and their willingness to participate in the research was confirmed.  There are two hundred and seventy four hospital employees that participated in this study. As shown in Table 3.0, the total output obtained from the frequency and percentage analysis done by using the SPSS software version 20.0. The respondents background was divided into six categories respectively gender, age, civil status, educational qualification, salary scale and years of working experience. The descriptive analysis shows that female respondent stands as the highest among all. This can be seen in the above table as female reach 63.9% whereas male respondent stands for 36.1% only. This indicates that more than half of the hospital employees that participate in this study are female compare to male.
The highest range of age among hospital staff participants are ranged between (21-30) age group as they reach for 42%. This is not a surprise as understandably, young people or the youth group tend to voice out their rights. Whereas employees in age between (31-40) is not much lesser than the youth by 34.7% followed by employees in age group more than 41 is 14.6%. The least employees who participated are the ones ranged between (16)(17)(18)(19)(20) which only reach for 8.8% among the total employees. This is mainly due to the fact of lacking of qualification, thus less awareness of job rights. Focusing on the participants marital status, 55.1% of the respondents are married, whereas 37.2% seems to be single and 7.7% left considered to be widows. This indicates, married participants are the most participated for this study. In terms of educational background of the participants, majority are qualified with Diploma that is 37.6% followed by 25.2% with Bachelor Degree. SPM holders are 11.7% lesser than Bachelor Degree and not much difference as seen for the STPM holders as they 13.9% higher than SPM holders who participated. Whereas Masters Holder participants are even lesser with 9.5%, same goes to PhD holders with only 2.2% of participants. Focusing on the participants monthly salary range reflect that participants with salary range in between RM2500-RM3000 is the highest of 41.6% meanwhile salary range of RM1500-RM2000 stands for 32.5% which slight difference compare to the highest salary range. Participants with salary range of RM3500-RM4000 shows 20.1%. However the lowest participant who participated involves those with the highest salary range of above RM4500 which stands with 5.8% only.
Based on the analysis made, 35.4% participants experience between 1-3 years of working in hospitals whereas 32.1% experienced more than 3 years' experience meanwhile only 11.7% participants work for less than 1 year. The above table explains the relationship between Turnover Intention (dependent variable) among hospital employees and HRM practices includes training, job security, career development opportunities and performance appraisal (independent variable) in hospitals. As indicated in the above table, the relationship between dependent and independent variable shows positive relationship. Based on the Correlation Analysis, the degree of significant of each independent variable in relation to employee's turnover intention is 0.696 for training, job security as 0.125 followed by performance appraisal is 0.263 and career development opportunities as 0.185. Training has a greater relationship with turnover intention among International Journal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456-6470 @ IJTSRD | Available Online @ www.ijtsrd.com | Volume -2 | Issue -1 | Nov-Dec 2017

Correlation Analysis between Dependent & Independent Variable
Page: 1455 hospital employees followed by performance appraisal, career development opportunities and job security. The implication of employee turnover has become a serious concern in today's organization. Many factors that contribute to the increase in the turnover rate of hospital employee from time to time. This study is proposed to associate previous research findings in order to create an organized structure of employee turnover so that organizations will be aware of affecting factors that leads to turnover intention. The current study reveals, factor such as training and performance appraisal are showing highest importance in determine turnover intention among hospital employees. This is followed by job security and career development opportunities. Most importantly, strategic factor such as human resource practices should be given priority in this matter because it is important to make sure employee retention in an organization. There is a mutual relationship between employee and organization. Employees will repay in terms of their loyalty to the organization if they feel that they getting appreciation from the organization. On the other hand, managers are acting like a role model which can easily influence employee's turnover intention. Thus, managers must understand in depth the meaning and characteristics of turnover intention. As an employer, need to comprehend the real contributing factor on turnover intention among hospital employee and take a corrective action to prevent issues arise related to HRM practices which could employee look for a different job in the future.

RECOMMENDATION FOR FUTURE RESEARCH
This study has covered several directions for future studies. Specifically, future research should replicate the framework of this study in other settings, such as manufacturing, telecommunication, customer care, education and others which could bring the different insights to the body of knowledge in HRM practice and turnover literature. The results on turnover intention from different sector especially in terms of HRM practices will reveal different results. Comparative study from various sectors particularly from manufacturing, education or service sectors will be more accurate in term of identifying contributing factors for employee's turnover intention from unlike background. Expanding research area in other sectors at the same time can produce a vast view on the HRM practices. On the other hand, the regression analysis in this study shows that only 50.8% turnover intention has been identified through four independent variable that were training, job security, performance appraisal and career development opportunities among hospital employee. In other words, there are remaining 49.2% of other relevant factors need to be identified by upcoming researchers. This is because turnover intention is attributed to many factors, not limited to training, job security, career development opportunities and performance appraisal only. In addition, the future research also need to extent the current study's quantitative design into a mixed mode design which should include additional data collection technique such as interviews to investigate the issues in depth way. This is because through interviews, more detailed information could be gain from the target respondent. By combining methods of qualitative and quantitative data collection, will increase the understanding on the influence of HRM practices on turnover intention.

CONCLUSION
The appropriate human resources management is important to enable the medical services are delivered effectively and efficiently. This research shows that HRM practices such as training, job security, career development opportunities and performance appraisal has great influence on healthcare employee's turnover intention in order to achieve patient satisfaction. All the literatures reviews has determine the necessity of HRM practices in term of achieving organization goals, and also stress on the point to develop the performance of hospital employees through periodic training in order to improve the quality of healthcare service. On the other hand, it is critical to the success of the national healthcare to reform a strong, well-motivated and highly trained medical profession. Therefore, alternative approaches for practicing HRM practices successfully in order to reduce turnover intention among hospital employees should be determine by hospital since the practices of human resource management is crucial in most of the hospitals in Kuala Lumpur. The senior management in hospitals should have a clear strategic direction and clear objectives to improve the management of employees in the hospital. Ministry of Health who had assisted me in making sure all the questions in the questionnaire is valid and is suppose to measure what it intended to measure. I would like to sum up that this research project will not be successful without the guidance and support from everyone mentioned above.