本研究運用高層理論 (upper-echelons theory) 探討領導者信任與團隊衝突的關係，同時也檢視團隊信任的中介效果與環境動態性的干擾角色。本研究之研究對象為醫療機構，透過問卷調查法共蒐集了148家醫院、521位醫院高階主管的資料進行統計分析。研究結果顯示，領導者(院長)信任對經營團隊信任有顯著正向影響，同時，團隊信任對關係衝突與任務衝突均有顯著負向影響。此外，團隊信任對領導者信任與任務衝突及關係衝突分別具有部分中介與完全中介效果。最後，研究結果也顯示，環境動態性對領導者信任與經營團隊信任的關係具有負向干擾效果。
本研究檢視動態環境下，醫療機構高階經營團隊之領導者信任、團隊信任與團隊衝突的關聯性，研究結果對理論與實務均有積極貢獻。第一，以往有關信任的研究多以人際或一般工作團隊為探討對象，本研究將其擴展至經營團隊層次。第二，在團隊層次的信任議題上，本研究首次將垂直與平行兩個信任議題進行整合檢視。第三，本研究也填補了過去甚少檢視兩個信任議題，及其與經營環境及團隊衝突關聯性的重要研究缺口。第四，以往有關高層理論的研究多以人口統計變數作為經營團隊心理與社會特質的代理變數，本研究直接檢視經營團隊信任對團隊衝突的意涵，將可提高研究結果的信度與效度，也補足了過去高階經營團隊領域的研究缺口。最後，本研究首次將高層理論運用到醫療機構組織，研究結果對醫療機構高階經營團隊互動的管理意涵具有重要價值，也提供可行的方向作為後續研究的基礎。

This study employs the upper-echelons theory to explore the effect of trust in leader on top management team (TMT) conflict. The mediating role of TMT trust and the moderating effect of environmental dynamism are also explored. The unit of analysis is hospital organization. Based on the survey approach, research data were collected from 521 executives in 148 hospitals. Analytical findings show that trust in leader exerts a positive effect on TMT trust, which in turn negatively influences both TMT task and relationship conflict. TMT trust also mediates, either partially or fully, the association between trust-in-leader and task as well as relationship conflict. Moreover, environmental dynamism negatively moderates the relationship between trust in leader and TMT trust.

The study has significant theoretical implications. First of all, prior research focused mainly on inter-personal or workplace-team trust. By joint examination of vertical and horizontal trust at the TMT-level, the research sheds light on the trust theory. Second, an integrated consideration of two trust concepts and their associations with two conflict issues under the consideration of environmental dynamism, the study also addresses an unexplored topic in the trust, upper-echelons, and conflict literature. Third, prior TMT research tends to use demographical composition as proxies of TMT socio-psychological characteristics. By directly collecting data from TMT members and evaluate their social dynamics, the study can advance the reliabilities and validities of research findings in the line of TMT research. Moreover, the study first extends the TMT examinations to the healthcare (or specifically, hospital) contexts, which can expands the theoretical implications of the upper-echelons theory and brings value to the explorations of non-business executive dynamics and their social and performance implications. Limitations and future directions were discussed for further extensions.

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