A model for ethical universities in medical sciences universities: A qualitative study

Copy igh © 2025 Zanjan Uni e si y o Medical Sciences. Published by Zanjan Uni e si y o Medical Sciences. This wo k is licensed unde a C ea i e Commons A ibu ion-NonComme cial 4.0 In e na ional license (h ps://c ea i ecommons.o g/licenses/by- nc/4.0/). Noncomme cial uses o he wo k a e pe mi ed, p o ided he o iginal wo k is p ope ly ci ed. A model o e hical uni e si ies in medical sciences uni e si ies: A quali a i e s udy Kimia Eliasi 1 , Rasoul Da oodi 1* , Manjiehe Zaka yaei 2 1Depa men o Educa ional Adminis a ion, Zanjan B anch, Islamic Azad Uni e si y, Zanjan, I an. 2Depa men o Educa ional Sciences, Zanjan B anch, Islamic Azad Uni e si y, Zanjan, I an. A icle in o Abs ac In oduc ion Highe educa ion se es as a hub o science, ideas, and inno a ion. I has essen ial du ies, like ad ancing science and educa ion and aining he specialized wo k o ce ha socie y needs [1]. Mo eo e , he socie al con ex and cul u al de elopmen s ha e signi ican ly changed he ole o uni e si ies, which a e key o he highe educa ion sys em [2]. Recen ly, a no able shi has occu ed in he in ellec ual ole o uni e si ies ega ding e hical p inciples. Changes in socie al beha io and needs ha e p omp ed uni e si ies o adop a dynamic app oach, ocusing on e hics [3]. In oday's wo ld, especially in o ganiza ions, p o essional and o ganiza ional e hics a e c ucial and play a i al ole [4]. Addi ionally, he swi ad ancemen o science and new echnologies, combined wi h he decline o adi ional e hical s anda ds in mode n socie ies, highligh s he impo ance o de elopmen o p o essional e hics in uni e si ies [5]. E hics wi hin academia is i al o es ablishing a sys em A icle his o y: Recei ed 3 Aug. 2024 Accep ed 5 Feb. 2025 Published 14 Ap . 2025 Eliasi e al. J Med Edu De . 2025; 18(1): 10-22 Jou nal o Medical Educa ion De elopmen Backg ound & Objec i e: E hics in academia is key o c ea ing a quali y assu ance sys em in highe educa ion. I e lec s p og ess in socie y. In simple e ms, building an e hics- ocused uni e si y equi es a clea app oach o e hics. This s udy aims o p esen a model o an e hics- o ien ed uni e si y wi hin medical schools. Ma e ials & Me hods: This s udy used a g ounded heo y design and he da a heo y app oach om S auss and Co bin (1997). I in ol ed 26 p o esso s and expe s om medical schools and uni e si ies in he 6 h mac o- egion. Semi-s uc u ed in e iews we e conduc ed o ga he da a un il heo e ical sa u a ion was eached. The analysis was done using open, axial, and selec i e coding me hods. Resul s: The e hics-o ien ed uni e si y model in medical schools was s uc u ed wi h 168 p ima y codes, 34 subca ego ies, and six main ca ego ies. The indings iden i ied causal condi ions such as social and cul u al oles, heal hy compe i ion, e hical s anda diza ion, and alue-d i en ans o ma ion; con ex ual condi ions including undamen al alues, e hical en i onmen , cul u e, and ision; and in e ening condi ions like us , spi i uali y, esponsibili y, commi men , leade ship, and e hical in elligence. The main ca ego ies encompass educa ion, esea ch, knowledge, in e ac ion, aining, and e hical awa eness. S a egies in ol ed ins i u ionalizing e hics, de elopmen o p o essional e hics, e hical planning, de eloping e hical cha e s, ocusing on e hical communi y, e hical ole modeling, de elopmen o e hical capaci ies, and ensu ing e hical sus ainabili y. The ou comes highligh ed o ganiza ional heal h, mo al g ow h in socie y, en i onmen al e hics, indi idual and o ganiza ional de elopmen , and social capi al. Conclusion: Based on he ac o s iden i ied in he e hics-o ien ed uni e si y model, ecommenda ions we e made o i s de elopmen and implemen a ion. Keywo ds: e hics, e hics-o ien ed o ganiza ion, e hics-o ien ed uni e si y, medical sciences uni e si ies *Co esponding au ho : Rasoul Da oodi, Depa men o Educa ional Adminis a ion, Zanjan B anch, Islamic Azad Uni e si y, Zanjan, I an. Email: Rasoul.da [email protected] O iginal A icle How o ci e his a icle: Eliasi K, Da oodi R, Zaka yaei M. A model o e hical uni e si ies in medical sciences uni e si ies: A quali a i e s udy. J Med Edu De . 2025; 18(1): 10-22. [ DOI: 10.61186/edcj.18.1.10 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ] 1 / 13 Eliasi e al . : A Model o E hical Uni e si ies Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1¦ 2025 11 ha ensu es highe educa ion quali y and os e s a h i ing socie y [6]. The e o e, p omo ing and de eloping uni e si y e hics is essen ial o socie al g ow h and educing he cos s associa ed wi h une hical beha io . Uni e si ies aiming o de ine, o mula e, and implemen e hical alues in hei daily ac i i ies a e known as ‘e hical uni e si ies’ [3]. An e hical uni e si y is one ha , like an e hical o ganiza ion, ollows e hical p inciples and s anda ds as a amewo k o guide he beha io o i s s a and acul y [2]. In such ins i u ions, p io i izing e hics b ings many unc ional and e hical bene i s o employees and manage s. This is especially impo an oday, as o ganiza ions ace a ious alues, and paying a en ion o e hics can lead o signi ican cos s [7]. In an e hical uni e si y, sha ed unde s anding and ongoing pe cep ions o unc ions, ac ions, and p ocedu es a e es ablished, all wi h e hical implica ions. This en i onmen c ea es ways o desc ibe, explain, and p edic beha io s based on e hical p inciples, aligning wi h o ganiza ional policies and me hods ha p omo e posi i e e hical ou comes [3]. De eloping an e hical uni e si y can se e se e al impo an unc ions, such as e hical modeling, mo al men al image y, and os e ing an e hical clima e. One key aspec is he uni e si ies' e hical modeling ole o hei s uden s. P o esso s, s a , and adminis a o s can e ec i ely ins i u ionalize e hics by in e ac ing wi h s uden s and se ing as ole models. Ano he signi ican pa o e hical modeling in ol es p o iding indi idual and social counseling and guidance ecognized by uni e si y pe sonnel in he communi y [8]. Men al image y, o cogni i e simula ion, is he p ocess whe e indi iduals c ea e a men al ep esen a ion o an ac ion using a ious senses. E hical uni e si ies can use angible and isible ools in o ganiza ional and social con ex s o c ea e a posi i e men al image y o e hics [9]. Ul ima ely, e hical uni e si ies p omo e an e hical clima e in hei en i onmen s, educing he likelihood o issues like poli ical bias and con lic s [10]. While an e hics-based uni e si y is i al o p omo ing e hical alues in socie y, e iews o exis ing esea ch show ha only a ew dimensions o his idea ha e been empi ically s udied. Mo e comp ehensi e esea ch needs o be conduc ed o p o ide a sys ema ic amewo k o e hics- based uni e si ies in a eas like cul u e, s a egy, human esou ce managemen , and ope a ional p ocesses [11]. S udy om Eh ich e al. [12] highligh ha a en ion o e hics should be iewed as an in e connec ed chain wi hin educa ional sys ems, needing examina ion a all le els and in a ious aspec s. Addi ionally, Gu gu and Tonis [3] poin ed ou ha ins i u ionalizing uni e si y e hics is a new eali y o which manage s mus be adequa ely p epa ed. O e ecen decades, he signi icance o ocusing on he e hical dimension o uni e si y li e has become inc easingly ecognized h ough public awa eness. Managing e hics in he academic se ing in ol es coo dina ing all elemen s ela ed o he e hical li e o he uni e si y. C ea ing an e hics-based uni e si y is essen ial, as ou coun y's ounda ional documen s highligh . The ision o he highe educa ion sys em by 1404 s a es ha he Islamic Republic aims o lead in p oducing ci iliza ional knowledge and in p omo ing and de eloping global Islamic cul u e. I en isions pionee ing uni e si ies and esea ch ins i u es ha expand he on ie o p ac ical and e ec i e knowledge and sciences, oo ed in a ib an mindse ha seeks o a ain cul u al and p ac ical au ho i y in he egion and he Islamic wo ld. These ins i u ions will ha e lea ned, jus ice-lo ing, and ee- hinking p o esso s ained in Islamic and e olu iona y alues. These educa o s will be esponsible in poli ical, social, and economic a eas, capable o aining commi ed specialis s and excellen scien is s [13]. Wi h his pe spec i e, i 's clea ha o he coun y's g ow h and he ealiza ion o highe educa ion goals, simply adop ing Wes e n o o eign models won' add ess I anian socie y's cul u al and alue needs. Ins ead, de eloping a model ailo ed o I an's social, cul u al, scien i ic, economic, and poli ical condi ions is c ucial, aligning wi h i s Islamic alues o c ea ing an e hics-based uni e si y. Gi en oday's complex challenges, especially in medical uni e si ies, adi ional managemen and adminis a i e me hods a e no longe e ec i e. Thus, by unde s anding he undamen al changes needed in he p inciples and alues guiding medical uni e si ies, leade ship should ocus on os e ing a long- e m de elopmen p ocess and es ablishing an e hics-cen e ed app oach by g ounding p ac ices in cul u al alues. To achie e his, a comp ehensi e model should be designed, add essing a ious uni e si y aspec s, d awing om indigenous alues and s a egies o he coun y. This need has mo i a ed he esea che o conduc he cu en s udy aimed a p esen ing an e hics-o ien ed uni e si y model speci ically o medical uni e si ies. The s udy will ocus on ‘iden i ying and de eloping an e hics-o ien ed uni e si y model in medical uni e si ies.’ This model mus encompass p inciples, c i e ia, and ope a ional me hods o enhance p o essional and human [ DOI: 10.61186/edcj.18.1.10 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ] 2 / 13 Eliasi e al . : A Model o E hical Uni e si ies 12 Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1 ¦ 2025 e hics in educa ional and medical se ings. Thus, he co e ques ion o his s udy is: How can we c ea e an e ec i e and p ac ical model o medical uni e si ies ha enhances e hics in educa ion, esea ch, and medical se ices? Ul ima ely, he goal is o p esen an e hics- o ien ed uni e si y model in medical uni e si ies ha aligns wi h I an's cul u al and social con ex . Ma e ials & Me hods Design and se ing(s) In his s udy, he S auss and Co bin [14] g ounded heo y app oach was used o de elop a model o an e hical uni e si y in I anian medical uni e si ies. This me hod helps esea che s ga he heo ies om he eal expe iences o indi iduals in academic se ings who emphasize e hics by collec ing and analyzing da a. The s udy ook place a he medical science acul ies o Khomein, Sa eh, Zanjan, Qom, Albo z, Qaz in, and A ak. These uni e si ies a e pa o he 6 h mac o- egion. Da a was collec ed om expe s and specialis s in e hics a hese ins i u ions. Pa icipan s and sampling The pa icipan s included se e al expe s and specialis s in e hics om he medical science acul ies and uni e si ies in he 6 h mac o- egion. This included he uni e si ies o Zanjan, Qom, Albo z, Qaz in, and A ak, as well as he acul ies o Khomein and Sa eh. These membe s s udied and analyzed many ace s o scien i ic e hics and e hical beha io in uni e si ies, and hey possessed bo h heo e ical knowledge and eal-wo ld expe ience in academic e hics. Pa icipan s needed su icien heo e ical knowledge and expe ience in e hics o ake pa in he s udy. Be o e conduc ing in e iews, e bal consen was ob ained o ensu e ha he con en would be ich and use ul and o allow o addi ional o longe in e iews i necessa y. This app oach helps deepen he unde s anding o he esea ch opic since he in e iews need o p o ide meaning ul con en and esponsible esponses. Pu posi e sampling was used o selec pa icipan s, iden i ying expe s and specialis s who could p o ide aluable in o ma ion on he esea ch opic. Theo e ical sampling was also employed o each he heo e ical sa u a ion o he esea ch concep s. Theo e ical sa u a ion occu s when analyzing new da a, which no longe e eals new concep s o issues [15]. Da a we e collec ed om 26 pa icipan s o be e unde s and e hical p inciples and alues in medical uni e si ies. The in e iewees we e so ed in o di e en ca ego ies based on hei academic ank. Th ee pa icipan s held he ank o p o esso , including expe s in in e nal medicine, pa asi ology, and ana omical sciences who played a key ole in uni e si ies and educa ional cen e s. Nine pa icipan s we e assis an p o esso s wi h expe ise in den is y, medical educa ion, heal h economics, psychology, human esou ces, and pha macy. Two associa e p o esso s specialized in den is y and hospi al s udies. Finally, h ee pa icipan s we e doc o al s uden s. The emaining pa icipan s we e employees wi h heo e ical knowledge and p ac ical expe ience in e hics. This di e si y in academic ank highligh s he ange o specializa ions and expe iences among he in e iewees, enhancing he ichness o he collec ed da a (Table 1). Da a collec ion me hods Da a we e collec ed be ween Sep embe 2023 and Augus 2024. A o al o 33 in e iews we e conduc ed, wi h 28 being in pe son and i e by elephone (one was an in e iew). To gain deepe insigh s, some pa icipan s we e in e iewed mul iple imes. Speci ically, o he 28 in-pe son in e iews, 3 pa icipan s had wo in e iews each, while 16 had only one. Addi ionally, 2 pa icipan s we e in e iewed h ee imes. The in e iews we e conduc ed by one o he esea che s who had conduc ed in-dep h s udies in e hics and had gained su icien heo e ical knowledge be o e he esea ch. The ace- o- ace in e iews occu ed a a ious loca ions, including Zanjan Uni e si y o Medical Sciences, he Minis y o Heal h and Medical Educa ion, he den al o ice, he ci y heal h ne wo k, Aya ollah Mousa i Hospi al o Zanjan, and Qaz in Uni e si y o Medical Sciences. The in e iew ime ame a ied: 3 in e iews we e long (o e 100 minu es), including 150 minu es and ano he 100 minu es. The e we e also nine in e iews o a e age du a ion (40 o 60 minu es). Finally, 14 in e iews had sho du a ions (less han 40 minu es), including ace- o- ace and phone con e sa ions las ing be ween 17 and 35 minu es. The a e age leng h o he in e iews was abou 50 minu es. Tools/Ins umen s The esea ch was conduc ed using semi-s uc u ed in e iews. A he beginning o each session, he esea che in oduced himsel and explained he s udy's objec i es. Nex , in e iewees we e asked o ead and [ DOI: 10.61186/edcj.18.1.10 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ] 3 / 13 Eliasi e al . : A Model o E hical Uni e si ies Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1¦ 2025 13 sign a consen o m. Each in e iew s a ed wi h he open-ended ques ion: ‘Please in oduce you sel and explain you cu en ole in he uni e si y o heal h o ganiza ion.’ P obing ques ions ollowed o ga he mo e in o ma ion. Fo ins ance, he esea che asked, “Wha is you iew on he ole o e hics in he academic en i onmen , especially in medical uni e si ies?” The in e iewee esponded, “E hics in he academic en i onmen is c ucial, as we educa e s uden s and need o be good ole models o hem. This builds us and mu ual espec .” The esea che hen asked abou he elemen s ha could help c ea e an e hical en i onmen : “In you opinion, wha ac o s in a uni e si y can os e an e hical en i onmen ?” The in e iewee eplied, “Key elemen s include anspa ency in decision-making, ongoing educa ion on p o essional e hics, and encou aging open dialogue be ween acul y and s uden s.” Nex , ques ions add essed pe sonal expe iences and e hical challenges. The esea che inqui ed, “Ha e you aced any e hical challenges in you wo kplace ha you can sha e?” The in e iewee answe ed, “Yes, I once encoun e ed a si ua ion whe e a colleague p o ided inco ec in o ma ion o s uden s. I decided o alk o him and encou age him o sha e co ec in o ma ion.” The esea che also asked, “How can a cul u e o e hics be ein o ced among acul y and s uden s?” The in e iewee sugges ed, “Holding wo kshops on p o essional e hics and c ea ing a space o discussion and exchanging ideas can be e y e ec i e.” In he inal pa o he in e iew, he esea che posed closing ques ions. She asked, “Do you ha e any sugges ions o enhancing he e hical clima e in medical uni e si ies?” The in e iewee esponded, “Yes, we should es ablish speci ic p og ams o moni o e hical beha io and c ea e a secu e epo ing sys em o e hical iola ions.” The esea che also asked, “Wha esou ces o ools could help you and you colleagues imp o e e hical beha io ?” The in e iewee no ed, “Reliable educa ional esou ces and expe ad ice can help us be e handle e hical challenges.” Finally, he esea che encou aged in e iewees o men ion any o e looked poin s o issues. One in e iewee added, “A en ion o he men al heal h o acul y and s uden s should be a p io i y since psychological s ess can impac e hical decision- making.” Da a analysis The Co bin and S auss app oach [14] was used o da a analysis. This p ocess in ol ed echniques like ques ioning, con inuous compa ison, and a pa adigma ic model o ex ac concep s, con ex , and p ocesses om he da a. Theo y de eloped h ough w i ing no es du ing his p ocess. These no es we e e iewed o ind in e ela ionships be ween concep s and ca ego ies [14]. S o ylines and a amewo k we e also c ea ed o gene a e heo y and iden i y main ca ego ies. The i s au ho (K. A) ca ied ou da a collec ion and analysis unde he supe ision o he co esponding au ho (R. D) and he hi d au ho (M. Z). The esea ch eam supe ised he da a collec ion p ocess in pe iodic mee ings. The esea ch eam also did Da a analysis and in e p e a ion, wi h coding, classi ica ion, and da a e ie al pe o med manually using Mic oso Wo d. Lincoln and Guba's c i e ia we e applied o ensu e he esea ch's alidi y, eliabili y, con i mabili y, and ans e abili y [16]. Fo alidi y, semi-s uc u ed in e iew ques ions we e e iewed mul iple imes o ensu e cla i y. A summa y o he esea ch design was also sen o in e iewees o help hem p epa e o he in e iew. The esea che ca e ully e iewed he codes om he in e iews se e al imes o ensu e accu acy and p ecision. Fo ans e abili y, heo e ical sampling ocused on imely and accu a e analysis. High-quali y in o ma ion abou he phenomenon was collec ed, and necessa y heo e ical concep s we e ex ac ed om he in e iew da a. The esea che 's in e p e a ions we e assessed by o he s, and he in e iews we e examined o con i mabili y. Accu a e and imely in e iews we e conduc ed, and he esul s we e connec ed o heo e ical unde pinnings and exis ing li e a u e. E e y in e iew ook place in a welcoming se ing, wi h p o essionalism and anonymi y. Las ly, he o ganiza ion and applica ion o s uc u ed echniques o da a collec ion, w i ing, and in e p e a ion gua an eed he eliabili y o he s udy. To judge he calibe o he in e iews, a s ee ing commi ee comp ising ad iso s and supe iso s was also o med . [ DOI: 10.61186/edcj.18.1.10 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ] 4 / 13 Eliasi e al . : A Model o E hical Uni e si ies 14 Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1 ¦ 2025 Table 1. Cha ac e is ics o he pa icipan s No Gende In e iew du a ion (Minu es) Age Facul y o uni e si y In e iew loca ion Special y Educa ion le el Academic ank Posi ion Wo k expe ience Numbe o in e iew s 1 Female 150 36 Zanjan Uni e si y headqua e s Occupa ional enginee ing Mas e 's - Senio expe 10 yea s 2 2 Female 150 49 Zanjan Uni e si y headqua e s Occupa ional enginee ing Mas e 's - Head o depa men 20 yea s 2 3 Male 30 50 Zanjan Hospi al Anes hesia Gene al physician S uden Manage 28 yea s 1 4 Male 30 55 Zanjan Heal h ne wo k headqua e s Medicine Gene al physician - Dean 25 yea s 1 5 Male 30 45 Zanjan Heal h ne wo k headqua e s Medicine Gene al physician - Dean 15 yea s 1 6 Male 30 53 Zanjan Uni e si y headqua e s Budge PhD in public adminis a io n - Manage 23 yea s 1 7 Male 20 49 Sa eh, Pa asi ology PhD in pa asi ology P o esso Head o labo a o y depa men G oup leade 26 yea s 1 (Phone in e iew) 8 Male 20 45 Sa eh Minis y o heal h Heal h sec o PhD in medical educa ion Assis an p o esso Dean 19 yea s 1 9 Male 20 49 Zanjan Uni e si y headqua e s O ganiza ion al s uc u e PhD in public adminis a io n - Manage 24 yea s 3 10 Male 42 42 Khomein Qaz in uni e si y o medical sciences Human esou ces PhD in human esou ce managemen Assis an p o esso Manage 20 yea s 1 11 Male 45 47 Khomein Qaz in uni e si y o medical sciences Diseases PhD in psychology Assis an p o esso G oup leade 25 yea s 1 12 Male 40 41 Zanjan Clinic Res o a i e den is y PhD in es o a i e den is y Assis an p o esso Facul y membe 18 yea s 2 13 Female 40 40 Zanjan Clinic Radiology O al and maxillo acial adiology specialis Assis an p o esso Facul y membe 18 yea s 1 14 Female 45 46 Albo z Minis y o heal h Medicine Gene al physician - G oup leade 14 yea s 1 15 Female 45 46 Albo z Minis y o heal h Medicine Gene al physician - Dean 12 yea s 1 16 Male 35 41 A ak Zanjan Hospi al managemen PhD in heal h se ices managemen Associa e p o esso Dean 20 yea s 1 (Phone in e iew) 17 Male 17 45 Qom Zanjan In e nal diseases PhD in in e nal diseases P o esso Dean 9 yea s 1 (Phone in e iew) 18 Male 60 40 Qom Qaz in uni e si y o medical sciences Budge PhD in economic sciences - Manage 17 yea s 1 19 Male 35 41 Qom Qaz in uni e si y o medical sciences O ganiza ion al beha io PhD in human esou ces managemen S uden Manage 18 yea s 1 20 Female 35 56 Qom Qaz in uni e si y o medical sciences Ana omy PhD in ana omy P o esso Dean 20 yea s 1 [ DOI: 10.61186/edcj.18.1.10 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ] 5 / 13 Eliasi e al . : A Model o E hical Uni e si ies Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1¦ 2025 15 21 Male 100 58 Zanjan Uni e si y headqua e s Nu sing PhD s uden in heal h se ices managemen S uden Manage 25 yea s 3 22 Male 20 55 Minis y o heal h Zanjan Den is y PhD in den is y Associa e p o esso Dean 29 yea s 1 (Phone in e iew) 23 Male 60 52 Qaz in Qaz in uni e si y o medical sciences Economics PhD in heal h economics Assis an p o esso Manage 27 yea s 1 24 Female 25 41 Albo z Zanjan Pha macy Pha macis Assis an p o esso G oup leade 10 yea s 1 (Phone in e iew) 25 Female 25 43 Albo z Minis y o heal h Pha macy Pha macis Assis an p o esso G oup leade 8 yea s 1 26 Male 45 58 Zanjan In e na ional a ai s, uni e si y Pha macy Pha macis Assis an p o esso Manage 25 yea s 1 Resul s In he i s s age o open coding, 168 concep s we e iden i ied. Then, he da a om he second s age we e so ed in o 34 i s le el sub-ca ego ies. Nex , in he axial coding s age, 6 second le el sub-ca ego ies we e ecognized. Finally, in selec i e coding, hese 6 main ca ego ies we e aised o highe le els o abs ac ion and g ouped based on con ex ual, in e ening condi ions, in e ac ions/s a egies, and ou comes cha ac e is ics. The analysis p ocess and shown in Table 2. The analysis p ocess e ealed ha he e a e complex in e ac ions in ol ed in c ea ing a cul u e and e hical clima e in uni e si ies. These in e ac ions a e desc ibed below. Table 2. Open codes, sub-ca ego ies and ca ego ies o he e hical uni e si y model in medical sciences uni e si ies Open codes Ca ego ies Sub-ca ego ies Social ole o he uni e si y Role o he uni e si y in social and cul u al de elopmen wi h emphasis on e hical p inciples Causal condi ions Cul u al ole o he uni e si y Ad an age o heal hy compe i ion E hical s anda diza ion Value-d i en ans o ma ion Fundamen al alues De elopmen o cul u e and e hical en i onmen Con ex ual condi ions E hical cul u e E hical en i onmen E hical ision E hical esponsibili y S eng hening e hical p inciples and esponsible leade ship In e ening condi ions T us ing en i onmen E hical commi men E hical leade ship Spi i uali y E hical in elligence E hical educa ion De elopmen o e hics-based educa ion and esea ch Pi o al phenomenon E hical esea ch E hical knowledge E hical in e ac ion E hical aining E hical insigh E hical planning Ins i u ionaliza ion and de elopmen o e hics in he uni e si y In e ac ions/S a egies Ins i u ionalizing e hics De elopmen o p o essional e hics De eloping an e hical cha e Communi y-cen e ed e hics E hical ole modeling De elopmen o e hical capaci ies Ensu ing e hical sus ainabili y O ganiza ional heal h De elopmen o heal h and e hical g ow h in he o ganiza ion and socie y Ou comes Mo al g ow h in socie y En i onmen al e hics Indi idual and o ganiza ional lou ishing Social capi al [ DOI: 10.61186/edcj.18.1.10 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ] 6 / 13 Eliasi e al . : A Model o E hical Uni e si ies 16 Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1 ¦ 2025 Causal condi ions o ole o he uni e si y in social and cul u al de elopmen wi h emphasis on e hical p inciples Causal condi ions in his s udy e e o ac o s ha di ec ly impac he de elopmen and implemen a ion o he e hical uni e si y model. The ole o he uni e si y in social and cul u al de elopmen wi h emphasis on e hical p inciples, is seen as a key ac o in shaping social beha io s and alues. In e iewee 12 s a es: “Uni e si ies should unc ion as social ins i u ions, no only p o iding educa ion and esea ch bu also ac i ely add essing social issues.” This highligh s he impo ance o uni e si ies as cen e s o cul u al and social change. Uni e si ies can enhance public cul u e by o ganizing wo kshops and social p og ams. In e iewee 5 also unde sco es he cul u al ole o he uni e si y: “I is e y impo an o uni e si ies o play a cul u al ole. We need o suppo di e en cul u es and make su e ha all o ou s uden s eel a ease.” This sugges s cul u al di e si y can en ich he academic se ing and s eng hen s uden s' sense o belonging. In his con ex , in e iewee 19 no es he ad an age o heal hy compe i ion: “Science can mo e o wa d wi h he help o heal hy compe i ion in uni e si ies... S uden s will be mo e mo i a ed o lea n and come up wi h new ideas i hey a e in a compe i i e bu posi i e se ing.” This s a emen shows ha os e ing a heal hy compe i i e a mosphe e can enhance he quali y o educa ion and esea ch. E hical s anda diza ion is also a c ucial pa o his model. In e iewee 3 no es: “E hical s anda ds a colleges a e c i ical. We mus ollow e hical ideals a all le els o educa ion and adminis a ion.” This emphasizes he impo ance o es ablishing clea e hical guidelines o di ec beha io s and decision-making in uni e si ies. Value-d i en ans o ma ion is ano he key aspec . In e iewee 22 explains: “Value-o ien ed ans o ma ion en ails making bene icial changes in socie y. Uni e si ies should be ans o ma ional cen e s.” The connec ion be ween ‘ he ole o he uni e si y in social and cul u al de elopmen wi h emphasis on e hical p inciples’ and ‘ he de elopmen o a e hical cul u e and a mosphe e’ is in e wined. Uni e si ies, as educa ional and cul u al ins i u ions, a e esponsible o educa ing s uden s and p omo ing mo al and social alues. By os e ing an e hical en i onmen , hese ins i u ions can help s eng hen he o e all cul u e o socie y and, in u n, aid in social and cul u al de elopmen . By embedding e hical p inciples in o hei educa ional and esea ch p ocesses, uni e si ies c ea e a space whe e s uden s can g ow in o esponsible and e hical ci izens. The e o e, he ole o uni e si ies in social and cul u al de elopmen wi h a ocus on e hical p inciples is essen ial and una oidable o achie ing social and cul u al objec i es. Con ex ual condi ions o de elopmen o cul u e and e hical en i onmen Con ex ual condi ions e e o he ac o s ha in luence he o ma ion and de elopmen o an e hical cul u e and clima e in uni e si ies. These ac o s can help s eng hen e hical p inciples and play an impo an ole in c ea ing an educa ional en i onmen ha is suppo i e and commi ed o e hical alues. De eloping an e hical cul u e and clima e in uni e si ies equi es ocusing on undamen al alues. In e iewee 16 s a es, “Fundamen al alues such as hones y, espec , and esponsibili y mus be included in all ou educa ional p og ams.” This highligh s he necessi y o eaching e hical p inciples om he ea ly s ages o educa ion. In e iewee 8 emphasizes he impo ance o an e hical cul u e: “C ea ing an e hical cul u e equi es he coope a ion o all uni e si y membe s. We mus c ea e an en i onmen whe e s uden s and p o esso s adhe e o e hical p inciples.” This unde sco es he need o pa icipa ion om all uni e si y communi y membe s o build a s ong cul u e. In e iewee 25 also e e s o he e hical clima e: “An e hical en i onmen a he uni e si y allows s uden s o exp ess hei opinions and lea n om hei mis akes eely.” C ea ing a suppo i e en i onmen is i al o lea ning om expe iences. An e hical ision is also c ucial o he uni e si y's u u e. In e iewee 14 says, “An e hical ision is e y impo an o he uni e si y's u u e. We need o ha e long- e m goals ha a e based on e hical p inciples.” This s a emen emphasizes he impo ance o long- e m planning ha espec s e hical alues. The ela ionship be ween ‘de eloping an e hical cul u e and clima e’ and ‘s eng hening e hical p inciples and esponsible leade ship’ is closely in e wined. C ea ing an e hical cul u e and clima e in an o ganiza ion o uni e si y es ablishes a conduci e pla o m o s eng hening e hical p inciples and enhancing esponsible leade ship. When an e hical cul u e exis s in an educa ional o o ganiza ional se ing, i s membe s a e na u ally encou aged o uphold e hical p inciples and ac [ DOI: 10.61186/edcj.18.1.10 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ] 7 / 13 Eliasi e al . : A Model o E hical Uni e si ies Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1¦ 2025 17 esponsibly. Con e sely, esponsible leade ship oo ed in e hical p inciples os e s and sus ains his cul u e. In o he wo ds, e hical leade ship enhances he e hical clima e. I p omo es e hical beha io a all le els o he o ganiza ion by se ing as a model o o he s. The e o e, hese wo concep s mu ually in luence each o he and a e i al o achie ing a heal hy and dynamic educa ional o o ganiza ional en i onmen . In e ening condi ions o s eng hening e hical p inciples and esponsible leade ship In e ening condi ions e e o ac ions ha can help s eng hen e hics and esponsible leade ship in uni e si ies. These ac o s in luence he beha io s and decision-making o uni e si y membe s and con ibu e o c ea ing an e hically-d i en educa ional and esea ch en i onmen . S eng hening e hics and esponsible leade ship is a key aspec o he e hical uni e si y model. In e iewee 6 s a es: “E hical esponsibili y en ails aking esponsibili y o one's own ac s. Uni e si ies should encou age s uden s o ake hei socie al obliga ions se iously.” This emphasizes he impo ance o ins illing a sense o esponsibili y among s uden s. A clima e o us is ano he i al ac o in os e ing a posi i e educa ional en i onmen . In e iewee 1 no es, “A us ing en i onmen a a uni e si y may os e collabo a ion and bene icial in e ac ions be ween s uden s and p o esso s.” E hical commi men should exis a all le els o he o ganiza ion. In e iewee 18 men ions, “Commi men o e hics should exis a all le els o he o ganiza ion o achie e ou goals.” E hical leade ship is also c ucial. In e iewee 10 s a es, “E hical leade ship is impo an because leade s should be ole models o o he s.” Spi i uali y is ano he componen o his model. In e iewee 21 says, “Spi i uali y in educa ion can help s uden s become amilia wi h human alues.” This highligh s he signi icance o he spi i ual dimension in educa ing and shaping he nex gene a ion. Las ly, mo al in elligence plays a i al ole. In e iewee 4 s a es, “Mo al in elligence helps us make he igh decisions and ace mo al challenges.” The link be ween ‘s eng hening e hical p inciples and esponsible leade ship’ and ‘de elopmen o e hics-based educa ion and esea ch’ is closely connec ed. Responsible leade ship leads by example, ac ing on e hical p inciples and inco po a ing hem in o educa ional and esea ch p ac ices. By c ea ing a suppo i e and us ing en i onmen , e hical leade s can encou age s uden s and esea che s o emb ace and apply e hical p inciples in hei wo k. This way, s eng hening e hical p inciples in leade ship enhances e hical educa ion and esea ch. Con e sely, a s ong educa ional and esea ch en i onmen can suppo he g ow h o esponsible leade ship. This in e ac ion will imp o e he quali y o educa ion and help build a las ing cul u e o esponsibili y and e hics in socie y. The pi o al phenomenon o de elopmen o e hics-based educa ion and esea ch The pi o al phenomenon discussed is c ea ing and ins i u ionalizing an e hical cul u e in medical uni e si ies ounded on human and e hical p inciples. De eloping e hical educa ion and esea ch calls o a comp ehensi e app oach. In e iewee 26 s a es, “Educa ion should be based on human p inciples so ha s uden s can make he igh decisions in he u u e.” This highligh s ha e ec i e educa ion mus e lec human alues. E hical p inciples a e also c ucial in esea ch. In e iewee 9 says, “Ou esea ch should be conduc ed based on e hical p inciples o eliable esul s.” This unde sco es he need o uphold e hical s anda ds h oughou he esea ch p ocess. S uden s mus lea n o apply hei knowledge e hically. In e iewee 15 emphasizes, “S uden s should lea n how o apply hei knowledge by e hical p inciples.” Posi i e in e ac ions among uni e si y membe s a e i al as well. In e iewee 2 no es, “Posi i e in e ac ions be ween uni e si y membe s can help c ea e a heal hy lea ning en i onmen .” This highligh s he ole o e ec i e communica ion in enhancing educa ional quali y. Educa ing he nex gene a ion wi h e hical app oaches is c i ical. In e iewee 11 men ions, “Educa ing he nex gene a ion wi h e hical app oaches is essen ial because hey will shape he u u e o socie y.” Mo eo e , ha ing e hical insigh is bene icial. In e iewee 20 s a es, “E hical insigh helps us o unde s and be e how we can make he igh decisions.” The connec ion be ween ‘de elopmen o e hics-based educa ion and esea ch’ and “ins i u ionalizing and de eloping e hics in uni e si ies” is closely linked. To de elop e hical educa ion and esea ch, uni e si ies mus embed e hical p inciples in o hei s uc u e. When uni e si ies e ec i ely in eg a e e hical alues in o hei educa ional and esea ch p og ams and make hem pa o hei cul u e, hey c ea e an en i onmen whe e s uden s and esea che s ollow e hical p inciples. Con e sely, ins i u ionalizing e hics in uni e si ies c ea es a ounda ion o enhancing e hical educa ion and esea ch. This mu ual ela ionship will ele a e he quali y o educa ion and esea ch and os e a las ing cul u e o [ DOI: 10.61186/edcj.18.1.10 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ] 8 / 13 Eliasi e al . : A Model o E hical Uni e si ies 18 Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1 ¦ 2025 esponsibili y and e hics in socie y. The e o e, bo h concep s in luence each o he and a e i al o nu u ing a heal hy and dynamic educa ional en i onmen . In e ac ions/s a egies o ins i u ionaliza ion and de elopmen o e hics in he uni e si y To achie e he e hics-based uni e si y model, i 's c ucial o iden i y and analyze he ac o s in luencing he ins i u ionaliza ion and de elopmen o e hics in uni e si ies. This p ocess equi es ca e ul planning, he de elopmen o e hics cha e s, and ocusing on communi y needs. In e iewee 17 emphasizes, “Ca e ul planning is essen ial o ins i u ionalizing e hical p inciples; wi hou i , no p og ess will be made.” De eloping o icial cha e s o add ess e hical ma e s is also i al. In e iewee 24 no es, “Ins i u ionalizing e hical s anda ds in he o ganiza ion's s uc u e is e y impo an so e e yone knows wha is expec ed o hem.” Fos e ing p o essional beha io oo ed in e hical models can enhance se ice quali y. In e iewee 13 s a es, “De eloping p o essional beha io based on e hical p inciples can inc ease he quali y o se ices p o ided.” A Communi y-cen e ed e hics is ano he key elemen o ins i u ionalizing e hical p inciples. In e iewee 7 poin s ou , “The communi y ocus and social esponsibili ies o he uni e si y a e e y impo an because uni e si ies mus espond o he needs o socie y.” Addi ionally, modeling beha io s based on e hical p inciples can signi ican ly in luence s uden beha io . In e iewee 23 men ions, “C ea ing beha io al models based on e hical s anda ds can g ea ly impac s uden beha io .” The connec ion be ween ‘ins i u ionaliza ion and de elopmen o e hics in he uni e si y’ and ‘de elopmen o heal h and e hical g ow h in he o ganiza ion and socie y’ is deep and ecip ocal. The ins i u ionaliza ion o e hics in uni e si ies c ea es a ounda ion whe e s uden s and acul y adhe e o e hical p inciples in hei daily ac i i ies. When uni e si ies p omo e e hical alues, hey os e a heal hie educa ional en i onmen and con ibu e o socie y's social and cul u al well-being. Con e sely, de eloping heal h and mo al g ow h in o ganiza ions and socie y elies on s ong educa ional ins i u ions ha can in oduce u u e gene a ions o e hical p inciples. In his con ex , uni e si ies ac as cen e s o social ans o ma ion, c ucial in shaping e hical beha io s and alues ha lead o a heal hie and mo e esponsible socie y. Thus, hese wo concep s in luence each o he and a e i al o building a mo al and h i ing communi y. Ou comes o de elopmen o heal h and e hical g ow h in he o ganiza ion and socie y The de elopmen o heal h and e hical g ow h in he o ganiza ion and socie y, s emming om he e hics- based uni e si y model in medical uni e si ies, is c ucial o imp o ing he quali y o social and o ganiza ional li e. O ganiza ional heal h can only be achie ed by adhe ing o e hical p inciples. In e iewee 16 s a es, “O ganiza ional heal h is only possible by obse ing e hical p inciples; heal hie employees will be heal hie o ganiza ions.” Uni e si y ac i i ies also signi ican ly impac he mo al g ow h o socie y. In e iewee 25 no es, “The ole o he uni e si y in he g ow h and de elopmen o socie y om he pe spec i e o e hical p inciples is i al because hey will educa e he u u e gene a ion.” En i onmen al e hics is ano he impo an a ea. In e iewee 3 men ions, “P omo ing en i onmen al beha io s wi h e hical app oaches is one o ou main asks because p ese ing he en i onmen is a sha ed esponsibili y.” Mo eo e , bo h indi idual and o ganiza ional de elopmen a e in luenced by adhe ing o e hical p inciples. In e iewee 15 s a es, “Enhancing indi idual and o ganiza ional g ow h h ough e hical conside a ions can lead o sus ainable success.” Finally, social capi al plays a key ole. In e iewee 9 emphasizes, “Enhancing social capi al by elying on sha ed alues and human p inciples is one o he keys o he success o any o ganiza ion.” The in e iews showcased he pa icipan s' a ious pe spec i es and expe iences, each highligh ing di e en aspec s o he e hics-based uni e si y model. C ea ing an educa ional en i onmen g ounded in e hical alues will acili a e indi idual g ow h and con ibu e o socie al ad ancemen . Du ing he de elopmen o he heo y, he mos abs ac ca ego y was iden i ied. This ca ego y, e med he inal co e ca ego y o cen al code, ep esen s he highes le el o abs ac ion. As a esul , he ‘e hical and social de elopmen ’ ca ego y was chosen as he mos undamen al and inal co e ca ego y. This ca ego y is su icien ly abs ac and can encompass o he ca ego ies. I is also concep ually aligned wi h he quali a i e indings. In essence, he p ima y goal o he e hics-based uni e si y model is o os e mo al and social de elopmen in he coun y's medical uni e si ies. The e o e, e hical and social de elopmen is he co e ca ego y o cen al code. Figu e 1 illus a es he pa adigma ic model o an e hics-o ien ed uni e si y in medical uni e si ies. [ DOI: 10.61186/edcj.18.1.10 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ] 9 / 13