Investigating medical professionals' continuance intention of the cloud-based e-learning system: an extension of expectation-confirmation model with flow theory

Purpose The purpose of this study is to propose an integrated model based on expectation-confirmation model (ECM), flow theory and human-organization-technology fit framework to examine whether human, organizational and technology factors as antecedents to medical professionals' beliefs can affect their continuance intention of the cloud-based e-learning system. Design/methodology/approach Sample data for this study were collected from medical professionals at five hospitals in Taiwan. A total of 500 questionnaires were distributed, and 368 (73.6%) useable questionnaires were analyzed using structural equation modeling in this study. Findings Synthetically speaking, human, organizational and technology factors, as antecedents to medical professionals' continuance intention of the cloud-based e-learning system have been examined, and the results strongly support the research model with all hypothesized links being significant. Originality/value Particularly, it is worth mentioning that the application of capturing both ECM and flow theory for completely explaining three types of factors (i.e. human, organizational and technology factors) as external variables to medical professionals' cloud-based e-learning continuance intention is well documented, that is, information systems (IS) and nonIS determinants are simultaneously evaluated, and extrinsic and intrinsic motivators are both taken into consideration in this study's theoretical development of medical professionals' cloud-based e-learning continuance intention to acquire a more comprehensive and robust analysis.