In the Socially Embedded Model of Thriving at Work, Spreitzer et al. (2005) proposed that thriving at work results in an individual experiencing vitality and learning, the outcome of which has benefits for the individual and the organisation. These authors argued that, when individuals are thriving at work, they are likely to improve their task performance and be more innovative. The benefits for the organisation are that employees are not only likely to perform well in their assigned work, but are also open to new ideas and opportunities to develop the business (Boyd, 2015; Porath et al., 2012; Spreitzer & Carmeli, 2009). In addition, thriving is associated with organisational citizenship behaviour (Spreitzer & Carmeli, 2009). Individuals who thrive at work are self-adaptive, able to develop and grow (Paterson et al., 2014) and tend to enable their organisations to thrive (Boyd, 2015). The ability of self-adaptiveness allows these individuals to develop better coping mechanisms in adjusting to life changes (Paterson et al., 2014).

It appears that thriving begets thriving, and the more individuals thrive, the more likely they are to seek out opportunities and engage in activities that will make them thrive. It is a positive loop associated with the agentic work behaviours that are connected with thriving (Hennekam, 2017). Agentic behaviour reflects in people being active and purposeful at work (Sia & Duari, 2018), and showing self-directed behaviour (Paterson et al., 2014). Spreitzer et al. (2005) proposed three fundamental agentic work behaviours for individuals to thrive at work: task focus, heedful relating and exploration. Task focus entails investing attention and energy into completing a task, with the individual feeling a sense of accomplishment upon successful completion (Boyd, 2015; Paterson et al., 2014; Sia & Duari, 2018; Spreitzer et al., 2005). Heedful relating refers to interacting with colleagues in a meaningful way (Abid, Zahra, & Ahmed, 2016). It requires good interpersonal skills, valuing teamwork (Paterson et al., 2014) and understanding one’s role in the organisation. Exploration is associated with increased vitality and learning through individuals engaging in exploratory behaviour, as well as being exposed to new ideas, information and ways of doing, which can be invigorating and educational (Sia & Duari, 2018; Spreitzer et al., 2005).

An added individual element to Spreitzer et al.’s (2005) model was proposed by Paterson et al. (2014), namely, psychological capital. Psychological capital is an antecedent of agentic behaviours (Paterson et al., 2014). Psychological resources comprise hope, efficacy, resilience and optimism (HERO), represented by the term HERO within (Youssef-Morgan & Luthans, 2015). Psychological resources (HERO) within resources were integrated into an empirically supported higher-order construct, psychological capital, referred to as PsyCap. Youssef-Morgan and Luthans (2015, p. 180) defined PsyCap as ‘an individual’s positive psychological state of development’, which is characterised by confidence and optimism about one’s future success, whilst maintaining perseverance and resilience when faced with challenges and setbacks. If an individual possesses all the components of PsyCap, he or she is more likely to have task focus, whilst efficacy is specifically related to heedful relating (Paterson et al., 2014), which acts as an enabler of thriving.

When individuals display agentic work behaviours, they produce certain resources that enable even more agentic behaviour, thus creating a reinforcing virtuous loop whereby these individuals are constantly replenishing their resources as they work (Boyd, 2015; Spreitzer et al., 2005). These resources include knowledge, positive meaning, positive affective resources and relational resources (Spreitzer et al., 2005). Knowledge is knowing what to do to complete a task and understanding the appropriate channels through which to access new information to gain more knowledge. Positive meaning refers to one’s sense of purpose and finding meaning in one’s work (Spreitzer et al., 2005). If one finds meaning in one’s work, it is easier to be task-focused, even when facing adversity (Niessen et al., 2012). Heedful relating is closely related to positive meaning, as people often gain a sense of meaning and purpose when engaging with colleagues. Positive affective resources are feelings such as joy, contentment and gratitude. When individuals experience these positive emotions, others are more likely to reciprocate, which then further promotes heedful relating. In addition, these individuals are more likely to be task-focused and willing to explore. Relational resources refer to the relationships and connections that individuals form with colleagues.

Spreitzer et al. (2005) described contextual elements as a workplace that encourages decision-making discretion (Hennekam, 2017), broad information sharing (Spreitzer & Porath, 2012) and a climate of trust and respect (Hennekam, 2017; McDonald, 2016; Perrakis & Martinez, 2012; Spreitzer & Carmeli, 2009). Decision-making discretion refers to individuals being empowered to make their own decisions and feeling in control of their day-to-day activities and duties (Hennekam, 2017; Sia & Duari, 2018; Spreitzer et al., 2005). Sia and Duari (2018) found a statistically significant positive correlation amongst decision-making, authority and thriving. Broad information sharing refers to information shared to a great extent within the organisation. If individuals do not know or understand their role in the organisation or the mission and strategy of the organisation, they will find it challenging to feel inspired to do better (Spreitzer & Porath, 2012). By understanding the bigger picture, individuals are more likely to collaborate and relate heedfully with others to achieve a mutual goal (Spreitzer et al., 2005). A climate of trust and respect is one where individuals have confidence in and appreciation of others (Hennekam, 2017). When individuals work in supportive and caring environments, heedful relating becomes easy, and they feel confident to explore and take on additional challenges. Paterson et al. (2014) proposed supervisor support as an additional element to Spreitzer et al.’s (2005) model, which is also regarded as an antecedent of agentic behaviours.

There are additional contextual elements, unique to women, that were not specifically considered in either Spreitzer et al.’s (2005) or Paterson et al.’s (2014) original work. Women may find it challenging to feel energised and experience vitality when their work–life balance is disturbed (Bedoya-Vaca et al., 2016; Perrakis & Martinez, 2012; Zulfiqar et al., 2018). Society subscribes to certain gender roles, which women feel obliged to adhere to or choose to live by, including being a good wife, a good mother and an ideal worker (Bosch, 2017). Working mothers with children tend to suffer considerable role stress as they try to balance their work- and family responsibilities (Perrakis & Martinez, 2012). Despite working mothers outsourcing home care and childcare responsibilities, they are still ultimately responsible for the successful co-ordination of domestic duties (Bosch, 2017). Despite women in a cohabiting relationship (where both partners work) having marginally reduced the time they spend on household tasks over the past decades, this reduction is related to women doing less work and household duties being outsourced, rather than men doing more work (Procher, Ritter, & Vance, 2018). In addition, these authors found that women who earn more than their spouses actually do more household tasks than the spouses who earn the same or less. Family-support, or lack thereof, is therefore an important element relating to women’s thriving. However, some studies have noted a shift in younger generations, where traditional gender roles seem to be less entrenched, with men more inclined to prioritise family responsibilities over their careers (Seritan et al., 2010; De Simone & Scano, 2018) and newer family structures such as the families of same-sex couples becoming more common.

Irrespective of gender changes in family structures, women continue to predominantly factor family responsibilities into their career plans (Farahat, 2009; Hossain et al., 2019; Yi, Lin, Kansayisa, & Costas-Chavarri, 2018). This does not imply that women are not thriving at work, but simply that they may be choosing or feeling compelled to make a choice (Buse, Bilimoria, & Perelli, 2013; De Simone & Scano, 2018; Farahat, 2009; Perrakis & Martinez, 2012). The choice seems to be: pausing one’s career and pursuing family life, or pursuing career progression and pausing family life resulting in a non-linear career trajectory (Bedoya-Vaca et al., 2016; De Simone & Scano, 2018; Farahat, 2009; Perrakis & Martinez, 2012; Seritan et al., 2010). Women, who actively pursue both and continue to have primary care responsibilities, face many challenges which may have negative consequences on their psychological and physical health (Bedoya-Vaca et al., 2016). Women tend to neglect themselves and their self-care as they prioritise work, their spouse and their children above their own needs (Heuser, Gibbins, Herrera, & Theilen, 2018). In addition, women may not get as many learning opportunities, as it is assumed that they are more family-oriented than men, and are thus not as ambitious to progress in their career (Bedoya-Vaca et al., 2016; Farahat, 2009; Roth et al., 2016). When women go on maternity leave, they are seen as not interested or devoted to their job, and, as result, may be denied learning opportunities in future (Roth et al., 2016), which could influence thriving at work.

Gender discrimination can be insidious and deeply rooted in the culture of an organisation, and the people in the organisation may not even realise that such discrimination exists (Roth et al., 2016). Women themselves may unknowingly perpetuate the cycle of gender discrimination (Wildschut et al., 2013). Gender discrimination practices include a lack of flexible work hours, not promoting a culture that supports work-life balance, biased performance assessment criteria and recruitment practices that favour men (Roth et al., 2016; Zulfiqar et al., 2018) or career trajectories that assume a life pattern similar to that of men.

A supportive work environment, which is conducive to individuals thriving (Paterson et al., 2014; Russo, Carmeli, Buonocore, & Guo, 2015), includes mentors who support individuals. Mentorship provides opportunities for learning and enables individuals to develop and grow. Women doctors experience a lack of mentorship, which begins in their undergraduate years (Babaria, Bernheim, & Nunez-Smith, 2011), and extends to their postgraduate and professional careers (Roth et al., 2016; Yi et al., 2018). This lack of mentorship is reported to be severe in male-dominated specialities like surgery (Wildschut et al., 2013; Yi et al., 2018). Since mentorship leads to increased learning, female doctors may have fewer learning opportunities, which will likely affect their ability to thrive negatively.

As doctors become more experienced and are promoted, they are often expected to do more administration and less clinical work. For those who find their passion in clinical work and patient interaction (Gibson & Borges, 2009), high loads of non-clinical administrative responsibilities result in reduced levels of work satisfaction (Gibson & Borges, 2009; Heuser et al., 2018). Using their expertise for clinical work may therefore increase their workplace thriving. Next we present the research design.

As the doctors were all working in shifts and did not have a lot of time available to participate in the research, convenience sampling was employed by initially contacting doctors who were known to the researchers, followed by snowball sampling where participants were asked to forward the invitation to other doctors (Zikmund, Babin, Carr, & Griffin, 2013). Convenience sampling supports the exploratory nature of the study and limits generalisability of results. The sample comprised 13 doctors who responded positively to the invitation, seven women and six men in each separate focus group, from various medical and surgical speciality fields and job ranks. The average work tenure was 9 years for the women and 14 years for the men. Informed consent was obtained from all participants.

We employed two focus groups to collect data (Zikmund et al., 2013). To ensure that participants felt comfortable to express themselves freely, the women and men were separated into two focus groups. In addition, as focus groups might inhibit open participation within a group context, for each group, the nominal group technique was used to ensure that all participants had an equal voice (McKillip, 2011). The nominal group technique invites each participant to independently make notes of their ideas and thoughts on an index card. Only after every participant has made all of their own notes, are they invited to contribute each of their statements with the group. An independent person acted as a facilitator of each session, whilst the main researcher was an observer who manually recorded key process and discussion points and other points of interest (see Liamputtong, 2015). Because thriving is a construct located in positive psychology, questions posed to participants were based on the format of unconditional positive questions in the discovery phase of appreciative inquiry (Cooperrider, Whitney, & Stavros, 2008). Participants were asked:

Secondary prompts were: ‘What was going on?’, ‘What factors contributed to you thriving?’, ‘What others were involved and how were they significant?’, ‘If you think about yourself, is there something that, as a woman/man, made you feel as if you were thriving?’ The facilitator asked the questions and the participants were given a few minutes to write on index cards ensuring that each participant had an equal opportunity to participate. Each participant was then given an opportunity to share his/her personal experiences and the observer documented their words in short hand.

For the first phase of data analysis, both participants and researchers participated in the analysis process. Collaborative analysis leads to ‘rich local understandings’ (Cornish, Alex Gillespie, & Tania Zittoun, 2013, p. 5). After sharing their experiences with each other, participants were asked to place their index cards on a wall and the facilitator guided the participants in identifying patterns which allowed further engagement and discussion, culminating in themes. The facilitator summarised the discussion and identified themes on the white board. Themes were related to factors that contribute to doctors thriving at work. After the data collection sessions, the observer’s handwritten notes were transcribed into two documents – one for each group. The documents included main points about each participant’s experiences, which were categorised into themes (Saldana, 2009) through a process of analytic induction (Daly, 2017, p. 45). In the write-up, all themes overlapped between the women and men except the themes that are stated under the heading specifically for women.

Confirmability and dependability in qualitative studies are often equated to reliability and objectivity in quantitative research (Jensen, 2012a, 2012b). As female researchers exploring gender dynamics in a presently male-dominated profession, the results of the research are more likely to be criticised for bias (Ogden, 2012). To ensure confirmability, the research process was transparent, with a clear description of the processes involved in data collection and data analysis. Findings are supported with verbatim excerpts from discussions during the focus groups. To ensure the credibility of the study, the researchers collaborated with participants during data analysis (Jensen, 2012a). Copies of the transcripts and identified themes were sent to the study participants for verification.

Women and men doctors’ ability to thrive at work relates to common contextual factors related to the workplace and social factors as reflected in Table 1.

Contextual factors influencing thriving at work are presented in Table 2 and discussed in the next section.

The framework provided in Figure 1 outlined constructs that are theoretically derived and represent the factors that contribute to thriving at work. When comparing the empirical results of participants against Figure 1, the workplace and social contextual factors were supported with a difference noted in the perception of supervisor support and mentorship as a workplace contextual factor, and work–life balance and social support as a social contextual factor. The source of supervisor support and mentorship was more upward hierarchical for the men, whereas the women were more systemic in their approach to being supervised and mentored. In addition, the perception of work-life balance and triggering factors for imbalance was different in the men and women group with the women noting life-factors as imbalance triggers noting a greater need for social support from friends and family. In addition, gender-related factors such as non-traditional roles, acceptance of non-linear career trajectories and self-empowerment and courage were stated by the women and were absent for the men. The additional findings are presented under contextual factors in Figure 2.