PROACTIVE PERSONALITY, MOTIVATION AND EMPLOYEE CREATIVITY IN THE PUBLIC SECTOR HOSPITALS OF PESHAWAR CITY

Numerous practitioner-oriented investigations have argued that employees should be more proactive and creative on their jobs, as these behaviors are significant for job performance. Organizational investigations on the antecedents of proactivity and creativity have appeared differently and have explored various approaches in defining, determining and understanding proactivity and creativity. This investigation examines the mediating role of motivation between proactivity and creativity among the doctors in the public sector hospitals. To give a rigorous test of the hypotheses, a grounded study is conducted taking a sample of 220 doctors. The results confirm a positive significant relationship between proactive personality and creativity, and report a significant relationship with motivation too. Additionally, the study demonstrates that motivation does not mediate the relationship of these variables. The study discusses the implications of the findings for enhancing motivation.


INTRODUCTION
Medical profession has gained increasing attention from the last few decades, as doctors save lives of humans (Pakistan-Hotline, 2012). They need to take appropriate medical care of patients to the fullest extent of their abilities, because of which they are pleasing much esteem around the world (Kuther, 2017). Rehman (2012) argue that life savers in Pakistan do not have similar respect. In Pakistan doctors serve for approximately 60-70 h/week or even more due to shortage of doctors. In developing countries the working hours are restricted to 48 h/week. Infect, Cuba has 67 doctors for 10,000 people and in Pakistan there are merely 8 doctors per 10,000 population. However, the world average is 14/10000.
Higher Education Commission of Pakistan in 2008, reported that every year 1500 doctors migrate to developed nations and merely 10% return back. Brain drain of human capital, especially doctors, is a serious issue of Pakistan. Recently, gallop survey reports that approximately 33% Pakistani wish to migrate and maximum in history. The ratio of doctors among those are much higher. Every day doctors leave this country for more respectful career and secured life. West, Middle east and for East give them sufficient opportunities for self-growth and creativity. Kaukab (2005), also posits that qualified and specialists, migrate to Middle East and some Western countries.
Scholars have perceived that employees' professions have become "protean" and "boundary less" from last decade. Job experiences and diverse competencies are responsible for managing their career success. Therefore, researchers have documented that employees in the new and boundary less career need to be proactive (Seibert et al., 2001). Kim et al. (2005) explain that proactivity is critical for employees as well as institutional success. Van Dyne et al. (2000) argue that due to decentralization and fast changing situation, managers don't antedate contingences and cannot stipulate organizational member's behaviors. Thus, employees' initiatives to avail opportunities and the solution of problems are valuable for organizations (Crant, 2000). Spitzmuller and Van Dyne (2013) posit that proactivity satisfy personal needs such as well-being, self-development and satisfaction. Being proactive means, making things anticipating, stopping problems and grabbing opportunities. It initiate efforts to stimulate and bring changes in the work and have a different vision for future .
A growing consents of employees proactivity and creativity is important for organizational success, particularly when occupation practices convert flexible than past (Li et al., 2010). Miceli et al. (2012) elaborate that proactive behavior is related to innovation, career advancement and other workplace related behaviors. In this regard, Crant (2000) argue that proactive personality denotes behaviors to recognize opportunities, indorses changes and control situation to avail the opportunities. Bateman and Crant (1993) earlier explained it a personal characteristic of individual to influence the situation and have received significant attention in literature. Creativity gives competitive edge to organization and ensure prolong success (George and Zhou, 2001). Creativity refers the creation of important ideas, new product, procedures, rules, services and process (Woodman et al., 1993). Gong et al. (2012) explain that creativity generates novelty, which is critical for employee's occupation and organizational success. Shalley et al., (2004) argue that researchers have taken interest to explore the antecedents and background of creativity in organizational context. They have examined that proactivity signify individual characteristics like creativity (Zhou, 2003), and organizational context like work environment (Shin and Zhou, 2003). Theoretically, proactive employees show creativity, modify dealings in performance and inclined for creativity. Insufficient studies have investigated the impacts of proactive personality with creativity outside United States (Kim et al., 2010). Furthermore, no available research explore the mediating mechanism of motivation between proactive personality and creativity in medical profesion. Therefore, this investigation intends to examine the inner mechanism of proactive personality, creativity and motivation in South Asian culture, focusing the north region of Pakistan. Liang and Gong (2013) argued that proactive personality define a behavioral propensity to discern and execution of change. Proactive personality indicates personal disposition to engage in active role orientation, for instance originating changes and manipulating their environment. Such employees pledge changes, do action and continue until significant change happens in the accomplishment of their objectives (Crant, 2000). Bateman and Crant (1993) earlier conjured that proactive employees vigorously worked to control, manuplate the environment to pursue new information and practices for the upgrading of performance. It is noted that personality of an individual characteristic affect creativity (Kim et al., 2010).

Proactive Personality and Creativity
There is consent in literature that employees creativity is a complicated phenomena and the measurement of individual creativity is a persistent source of argument and critique (Runco, 2007). The concept of creativity has always intrigued human (Ford and Harris, 1992). Creativity is a paradox and some found a mystery (Boden, 2005). Employee creativity is concern to design valuable innovative products, events, services by employees working combinally in a multifaceted social system (Plucker et al., 2004).
Proactive behavior is positively connected with the employee creativity (Kim et al., 2009). It is an individual characteristic that influences creativity. Such initiative and breaking formal job discription are usally carried by proactive employess and have significance impact on creativity.
Proactive employees initiate changes in institutions to obtain their desire goals. Work role performance model has exposed nine employeess proactive deeds (Griffin et al. 2007). Such workforce manipulate work setting to enhance work performance (Bateman and Crant 1993), stimulate to acquire novelty (Major et al., 2006). Seibert et al., (1999) prior explained that proactive employees attempt to improve work performance to promote their career. Choi and Thompson (2005) argued that proactive workforce seek every opportunity to detect new methods, apprising their skills and exploring modern work techniques. Hence, creativity is an ultimate strand that fixes diverse proactive behaviors. The authors further eleborated that employees share job innovation for hospitable and productive work environment. Seibert et al. (2001), also connected such personality with employees, innovation for instance evolving new thoughts and displaying innovation in one's job which is due to creativity.
The judgements behind above opinions are not culturally guaranteed and need cross cultute validation (Bindl, 2010). Li and Gardner (1993) posited creativity in chinese culture refer to introduceing new procedure, develop new products, services and solution to the contemporary issues which are consistent with the Western culture. Westen culture also expalins it a novelty and efficacy (Amabile 1997;Oldham and Cummings 1996). Chan (2006) posulated in a Singaporean sample where proactive personality was positively linked creativity and work behaviors outcomes. In addition, Kim et al. (2009) also f that proactivity was connected with individuals creativity. Inferring from the above findings, this research expect that proactive employees might play the same role in the public sector hospitals of peshawar and develop the below mention hypothesis.
Hypothesis 1: Proactive personality has a significant impact on employees' creativity in the public sector hospitals of peshawar city.

Proactive Personality and Motivation
Being a proactive means preventing problems, anticipating and taking opportunities. It comprises self-initiated exertions to induce changes in work setting or to reach a different future. Parker et al. (2010) identified a range of proactive goals which employees intended to achiev. These includes "can do," "reason to," and "energized to" are linked with the motivational situations. The auther found that can do motivation emerge from insights of self-efficacy and control. Reason to motivation is connected to why someone is proactive and specifying reasons. Energized to motivation denotes to stimulate positive sentimental states that rapid proactive goal processes. Motivation theories assumed pre-set goals by institutional that stipulate the degree of employees performance (Locke and Latham, 1990), and established frame within which individuals chose their action (Vroom, 1964). Thus, traditional motivotional approaches focused on precise organizational goals that were accomplished by noticeably defined and proficient work behaviours (Steel and König, 2006). However, fewer explanation regarding employees attitudes at work has been explained in these theories (Shamir, 1991). The implication of proactive deed for vague and dynamic situations, shared with strong evidence that practical behaviour can ratify important outcomes. Hence, it is important for researchers to know how motivational processes stimulate and inspire proactivity at work (Bindl, 2010).
These themes turns into larger motivational theories for instance action theory (Hacker, 1985), social cognitive theory (Bandura, 1986), goal-setting theory (Locke and Latham, 1990), and relatest Crant (2000). Joo and Lim (2009) found a significance linkages of proactivity with motivation. Griffin et al. (2010) argued that self determination theory suggest that various types of autonomous motivation leads to proactive behaviours at work. Externallyregulated motivation is not connected with proactivity because it is self-initiated . Similerly, high level of prosocial motives are positively connected with proactivity (Grant and Mayer, 2009). Similerly, Joo and Lim (2009) investigated the same positve association of proactive employees with motivation and proposed more studies. To summarise there are sufficent evidences that proactive personaliy is connected with the employees motivation. Hence, the following hypothesis is developed to be tested.
Hypothesis 2: Proactivity has a significant impact on employees' motivation in the public sector hospitals of peshawar city.

Motivation as Mediator
Whilst the massive research has examined the paradigm of proactivity personality using an individual level perspective, others have focused on a team-level and even institutional level of analysis . Though the latter two foci signify very valuable endeavors, the emphasis of this study is individuallevel perspective that sets out to increase insights into the meditating significance of motivation. This investigation propose that proactivity wield concern for modification and make creative efforts when employees are motivated and get institutional support. Previous studies have proposed that proactive personality bring constructive change in work setting (Crant, 2000;Bakker et al., 2012;Ng and Feldman, 2013), and enhance employee creativity (Fuller Jr and Marler, 2009). Gong et al. (2012) earlier posited that hypothetically the impact of proactive behaviors in respect of motivation is not articulated and empirically verified. They further elaborated that proactivity is a spirited and dynamic process concerning prediction and action directed toward future impact, hence this study intend that proactive employees are prepared for future events, seize creativity and amplify the level of motivation to bring effective changes in institutions. Earlier, studies regarding proactivity and creativity are conducted in the West would hold in the Eastern context (Gong et al., 2012). This research intends in the public sectors hospitals of Peshawar, a city in Pakistan, where relatively authority distance exist and collectivist values prevails (Gorodnichenko and Roland, 2017). Thus, we construct the following hypothesis.
Hypothesis 3: Motivation will mediate the relation between proactivity and employees creativity in the public sector hospitals.

SAMPLE AND DATA COLLECTION
Sample is an appropriate choice for the researcher to collect data from the population. It is the representative of whole population (Farooq et al., 2017). The sample for this investigation consist of 220 doctors, employed in various public sector hospitals in Peshawar city. There are total six public sector hospitals in Peshawar included: Lady Reading Hospital, Hayatabad Medical Complex Peshawar, Khyber Teaching Hospital, Molvi Jee Hospital, Government Naseerullah Khan Babar Memorial Hospital Peshawar and Sefat Ghayor Hospital. As per the Khyber Pakhtunkhwa (KP) health department there are total 735 doctors serving in these hospitals. The sample frame for this study includes 735 doctors, employed in BPS 17 and above. Based on specific location i.e Peshawar, the number of institutions (6 hospitals) and ranks (BPS 17 and above) purposive sampling technique was used. Total 330 questionnaires were spread out of which 220 were received back with a response rate of 75.7%. Out of total, 80% of the respondents were male with an average age of 38 years and twenty percent were female doctors, participated in this research with an average age of 34 years. The average job tenure of male doctors were 9.5 years and for female it was 7 years.

Measures and Instruments
Employees proactivity and creativity was measured on a seven point Likert scale (1=strongly disagree and 7=strongly agree) and employees motivation was measured on a five point Likert scale ((1=strongly disagree and 5=strongly agree).

Proactive Personality
In this research Seibert et al. (1999) 10-item version of Bateman and Crant (1993) scale was used to assess proactive personality. Example items are "I am constantly on the lookout for new ways to improve my life," and "If I see something I don't like, I fix it."

Employee Creativity
Employees creativity was measured by George and Zhou (2001), who also used the 13-item scale. Sample items included "the various combination of new approaches which will help to achieve the objectives and organizational goals and to foster performance"

Employees' Motivation
The scale was adopted from Gagné et al., (2010). Six items were chosen to measure intrinsic and extrinsic motivation. Sample item included "My job is beneficial to my career." Table 1 reveals means, standard deviations, Cronbach Alpha and correlations of the variables. It describes that proactive personality is positively correlated with employees creativity (r = 0.54, P < 0.01), with motivation (r = 0.52, P < 0.01) and the correlation value of creativity and motivation is (r = 0.55, P < 0.01). These values give preliminary support to the projected hypotheses. The table also demonstrates Cronbach Alpha values. Cronbach Alpha values of proactive personality, creativity and motivation are 0.77, 0.73, and 0.71 respectively. The values of all variables are above 0.7 which suggest that the data is internally consistent (Hair et al., 1998).

Regression and Mediation Analysis
Mediation relation occurs after the basic investigations of an independent variable (A) on predict variable (C) is pass on by a mediator (B). It explains that variable-A influence C since A effect B, and B in response influence C. Baron and Kenny (1986) enquiry provided importance to the mediation analysis in the field of OB. However, in this study the mediation analysis of the Preacher and Hayes (2004) bootstrapping have been adopted due to its superiority.
Simple regression analysis was conducted to examine the relationship of variables. Table 2 above shows that proactivity has significant impact on creativity (β = 0.55, P < 0.05). In the same vein proactivity effect the level of motivation (β = 0.43, P < 0.05), and further it was found that motivation influence creativity (β = 0.15, P < 0.05). All recurring figures depicts the values cover the significance range and hence the established hypothesis is supported.

Mediating Regression Analysis
To comprehend the meditational effect, Preacher and Hayes (2004) technique has been applied using the bootstrapping mechanism between proactive personality and employees creativity. This is a superior test as compare to Barron and Kenny (1986), and Sobel test (Preacher and Hayes, 2004). Because 95% confidence interval was obtained with bias correction method using the 4000 bootstrapped samples. According to Preacher and Hayes (2004), if zero nowhere in the picture taking in account the 95% CI, predicting the indirect effect, confirm that mediation is determined. Table 3 demonstrate the direct effect of proactivity on creativity was (0.27, P < 0.01) and the indirect effect via motivation was (−0.21, P < 0.01, 95% CI = −0.38, 0.53), found insignificant. The standardized total (direct and indirect) effect of proactivity and motivation on creativity was found 0.06, that is due to both direct (unmediated) and indirect (mediated) effects of proactivity on creativity. It means that when motivation decreases by 1 standard deviation, creativity decreases by 0.06 standard deviations. The results of this investigation indicates that hypothesis H3 was not supported and failed to confirm that motivation mediate the relationship between proactivity and creativity.

DISCUSSION AND CONCLUSION
Results reveal a positive significant association between proactive personality and creativity. Kim et al. (2009) explored the same significant relationship between proactivity and creativity. Bason (2018) recently, conducted a study in the public sector and found a positive linkages between proactive personality and creativity. Furthermore, the study found a positive relationship of proactivity personality with motivation. Major et al., (2006) found the same positive association of proactive personality with motivation. Latest investigations have confirmed the same relationship (Prabhu et al., 2008;Grant and Berry, 2011). The study did not confirm the mediating role of motivation between proactivity and creativity. There are various reasons of low level of motivation among doctors. As far as compensation is concerned, doctors are not paid enough and have protested all over Pakistan. West, Middle East and some of our neighbors are paying approximately 5-10 time more, because doctors save life. There is no job structure and limited opportunities for promotion. Limited resources and research services in government hospitals are another causes of demotion. Approach to the paid medical journal to update their knowledge is inaccessible for those who served in rural areas, nor can they benefit from telemedicine. With fake medications and incorrect laboratory reports, it is difficult to cure his patient appropriately. Eventually, doctors are responsible if the patient   Determined by bootstrapping with bias correction hurts. Furthermore, the degraded environments in the government hospitals, also upset doctors' health. There are no more hygienic toilets nor suitable places to have meals and at the end the life saver are demotivated.
The future directions are also framed for the reason to extend the exploration of the same area, by comparing two different professional groups of Pakistan, i.e. Engineers and Doctors or Pakistani doctors with Bangladeshi doctors to sort out whether the concerns of the two groups in the same country and the concerns of the doctors in the two countries are similar or any disparity exits. This will a novel attempt in the existing literature.

Managerial Implication of the Study
Proactivity, creativity and motivation facilitate changes to future states. By forecasting and managing creative personalities in hospitals might carry fruitful innovation and modification in the future which will ultimately improve the conditions of public sectors hospitals. Proactivity and creativity is related with diverse benefits, hence, this study suggest the policy maker and the administration of public sector hospitals to support the doctors complex innovation through advance medical technology to better diagnose and treat their patients. This study uncover the mediating mechanism of motivation for the reaction of proactive personality on individual creativity and suggest to the relevant government body to minimize the brain drain of doctors from the war provoked province through proper motivational techniques. Doctors are disappearing and target killings, rather than receiving compassions from the community and compensation from government, they are ill-treated in media and on others social forms. The government should provide security and respect them. Huge percentage of doctors in Pakistan are being found any time on strike and hence declare Pakistan as challenging to be live for next 5 years, and likely Pakistan might have sufficient amount of shortage of doctors. Pakistan Medical Association (PMA) has been voicing over this concern. So the government should redesign their compensation, job structure, access to paid journal, improve the sanitary conditions and legislation to avoid fake laboratory report. Thus we can stop the brain drain of doctors and can enhance the creativity and motivational level of doctors by applying the best strategic framework of motivation. The emerging significance of proactivity, motivation and creativity will lead to the importance of doctors in general and will grab the attention of government to understand their problems.