Medical Journal of the Islamic Republic of Iran最新文献

{"title":"Barriers and Facilitators to Participation in the Employees' Health Cohort Study of Iran (EHCSIR): A Qualitative Content Analysis.","authors":"Rezvan Rajabzadeh, Seyed Hamid Hosseini, Seyed Abbas Motevalian","doi":"10.47176/mjiri.40.63","DOIUrl":"https://doi.org/10.47176/mjiri.40.63","url":null,"abstract":"<p><strong>Background: </strong>Declining enrollment poses a threat to epidemiological validity. Despite the increasing number of occupational health cohorts, evidence regarding employee-specific determinants in Iran remains limited. This study examined the perceived barriers and facilitators to participation in the Employees' Health Cohort Study of Iran (EHCSIR) among staff at the Iran University of Medical Sciences.</p><p><strong>Methods: </strong>A qualitative study was conducted using purposive sampling to include 48 individuals: EHCSIR participants, non-participants, and coordinators. The data comprised 23 semi-structured interviews (12 participants, 7 non-participants, and 4 coordinators), four focus groups (14 participants and 11 non-participants), and narrative responses from 954 eligible employees outlining reasons for non-participation. Conventional qualitative content analysis was applied in eight stages, with thematic saturation guiding the termination of data collection. Analytic rigor was maintained through member checking, peer debriefing, and audit trails, adhering to established trustworthiness criteria.</p><p><strong>Results: </strong>The EHCSIR study identified barriers to employee participation across three domains: Organizational (insufficient managerial support, lack of replacement staffing, elevated mission costs, scheduling conflicts), Individual (family obligations, excessive workload, transportation challenges, distrust or fear of data disclosure, health limitations, inadequate information), and Cohort-specific (prolonged timelines, fatigue, lengthy questionnaires, lack of facilities, stringent requirements such as fasting or large-volume blood draws). Facilitators were also observed at three levels: Organizational (managerial endorsement and role modeling, paid leave, accessible transportation), Individual (health monitoring, cost savings, altruistic motivation, trust in the research team), and Cohort-specific (non-invasive methods, single-visit completion, extended assessment intervals, transparent in-person recruitment, organized management, supportive environment, systematic follow-up).</p><p><strong>Conclusion: </strong>Organizational, logistical, and perceptual factors significantly influence participation in occupational health cohorts. Improving management, infrastructure, communication, and institutional trust can enhance recruitment and retention in EHCSIR and inform similar strategies both in Iran and internationally.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"63"},"PeriodicalIF":0.0,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts of the 4^th International Congress of Trauma Highlights; 2025 Dec 23-26; Tehran, Iran.","authors":"","doi":"10.47176/mjiri.40.62","DOIUrl":"https://doi.org/10.47176/mjiri.40.62","url":null,"abstract":"","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"62"},"PeriodicalIF":0.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality Outcomes Following Pediatric Emergency Department Visits: A Systematic Review and Meta-Analysis.","authors":"Seyed Mohammad Hosseini Kasnavieh, Maryam Milanifard, Mohsen Sedighi, Roxana Hessam","doi":"10.47176/mjiri.40.61","DOIUrl":"https://doi.org/10.47176/mjiri.40.61","url":null,"abstract":"<p><strong>Background: </strong>Emergency departments with high readiness to admit children may reduce mortality rates, but comprehensive and comparative evidence is limited. This study is the first systematic review and meta-analysis conducted to determine the effect of pediatric emergency department readiness on in-hospital mortality.</p><p><strong>Methods: </strong>A search for relevant articles was conducted up to 17 December 2025 in the international databases PubMed, EMBASE, Scopus, and Web of Science. Relevant keywords were used for the search. Current study question: In children presenting to emergency departments (Population), how is the level of emergency readiness for pediatric care (Exposure) associated with mortality (Outcome)? This section was created using the PICO approach. Data analyses were conducted using the meta-analysis packages in STATA/MP.v17 (College Station, Texas, USA).</p><p><strong>Results: </strong>The overall in-hospital mortality rate was estimated to be about 2%. Meta-analysis showed that care at highest-readiness EDs (Quartile 4 wPRS) was associated with a significant reduction in mortality (OR=0.617; 95% CI, 0.491-0.744).</p><p><strong>Conclusion: </strong>Increasing the level of emergency department pediatric readiness can be associated with a reduction in in-hospital mortality. These findings highlight the importance of policy to improve standards of pediatric emergency readiness in all hospitals.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"61"},"PeriodicalIF":0.0,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Pain Assessment Tools in Prehospital Emergency Care: Evidence from Observational Studies.","authors":"Seyed Mohammad Hosseini Kasnavieh, Maryam Milanifard, Mohsen Sedighi, Roxana Hessam","doi":"10.47176/mjiri.40.60","DOIUrl":"https://doi.org/10.47176/mjiri.40.60","url":null,"abstract":"<p><strong>Background: </strong>In the prehospital setting, pain assessment and documentation are often insufficient due to time constraints and high workload. Although validated tools such as the Numerical Rating Scale (NRS), Visual Analogue Scale (VAS), and Verbal Rating Scale (VRS) exist for rapid pain assessment, their use in emergency medical services (EMS) remains unclear.</p><p><strong>Methods: </strong>This systematic review was conducted according to the PRISMA 2020 guidelines. A comprehensive search of PubMed, Web of Science, Scopus, and Google Scholar databases was performed for observational studies conducted in prehospital emergency settings, including both trauma and mixed patient populations reporting pain assessment practices.</p><p><strong>Results: </strong>Of the 1,834 identified articles, 8 studies in which pain intensity was measured using standard instruments such as NRS, VAS, or VRS were eligible for inclusion. The results showed that the documentation and assessment of pain in the prehospital setting were performed in only 22.5% to 46.7% of patients, indicating a generally low frequency of pain evaluation before hospital admission. Across the included observational studies, EMS-related pain management interventions were reported to be associated with reductions in pain intensity; however, due to methodological heterogeneity and the absence of quantitative synthesis, the magnitude of these changes could not be reliably estimated.</p><p><strong>Conclusion: </strong>Pain recording and assessment in the prehospital setting are below recommended standards, and only a limited proportion of patients are systematically monitored. This deficiency can lead to inadequate decision-making in pain management. Strengthening the training of EMS personnel for recording pain is essential to improve the quality of care.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"60"},"PeriodicalIF":0.0,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External Validation of the Trauma Early Mortality Prediction Tool (TEMPT) in an Iranian Trauma Population.","authors":"Mitra Oghazian, Atefeh Abdolahi, Fatemeh Rasooli, Sepideh Aarabi","doi":"10.47176/mjiri.40.59","DOIUrl":"https://doi.org/10.47176/mjiri.40.59","url":null,"abstract":"<p><strong>Background: </strong>Trauma remains the leading cause of mortality in the first four decades of life globally. Despite advances in trauma care, accurate early mortality prediction remains challenging. The Trauma Early Mortality Prediction Tool (TEMPT) was developed as a simplified scoring system, but its validity in diverse populations requires evaluation.</p><p><strong>Methods: </strong>This cross-sectional study analyzed trauma patients admitted to Sina Hospital between 2019 and 2021. TEMPT variables, including age, systolic blood pressure, International Normalized Ratio (INR), Partial Thromboplastin Time (PTT), base excess, temperature, and traumatic brain injury (TBI) presence, were collected retrospectively. Glasgow Coma Scale (GCS) and Injury Severity Score (ISS) were also assessed. Logistic regression and ROC curve analysis compared TEMPT's predictive performance. Of 1,052 eligible patients, 809 (77%) were excluded due to incomplete data, potentially introducing selection bias. The primary outcome was in-hospital mortality.</p><p><strong>Results: </strong>Of 1,052 eligible patients, complete data were available for 243 patients. The cohort was predominantly male (82.7%), with a mean age of 41.9±18.4 years. Overall mortality was 11.1%. Among TEMPT variables, only age (OR: 1.053, 95% CI: 1.02-1.08, <i>P</i>=0.002) and TBI presence (OR: 5.128, 95% CI: 1.28-20.47, <i>P</i>=0.021) significantly predicted mortality in multivariate analysis. GCS (OR: 0.754, 95% CI: 0.635-0.895, <i>P</i>=0.001) and ISS (OR: 1.042, 95% CI: 1.047-1.164, <i>P</i><0.001) demonstrated superior predictive accuracy. ROC analysis showed an AUC of 0.586 (95% CI: 0.422-0.750) for TEMPT, 0.847 (95% CI: 0.745-0.949) for GCS, and 0.865 (95% CI: 0.786-0.944) for ISS.</p><p><strong>Conclusion: </strong>TEMPT demonstrated limited external validity in this Iranian trauma population. Traditional scoring systems (GCS and ISS) outperformed TEMPT in mortality prediction. Population-specific validation and potential recalibration of scoring thresholds are essential before implementing TEMPT in diverse healthcare settings.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"59"},"PeriodicalIF":0.0,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hidden and Atypical Presentations of Myocarditis in Sudden Cardiac Death: A Narrative Review.","authors":"Roxana Hessam, Hamed Basir Ghafouri, Mahdi Rezai, Seyed Hossien Shaker, Seyed Mohammad Hosseini Kasnavieh, Maryam Milanifard, Mohsen Sedighi","doi":"10.47176/mjiri.40.58","DOIUrl":"https://doi.org/10.47176/mjiri.40.58","url":null,"abstract":"<p><strong>Background: </strong>Myocarditis is an inflammatory disease of the heart muscle, presenting from asymptomatic cases to sudden cardiac death. Its diagnosis is challenging, especially when classic cardiac symptoms are absent presents with unusual manifestations. Recognition of these unusual manifestations is essential to prevent sudden death and increase clinical awareness.</p><p><strong>Methods: </strong>This narrative review was conducted to summarize the evidence on myocarditis with occult and nonclassical manifestations and its role in sudden cardiac death. A systematic search was performed in PubMed, Scopus, Embase, Cochrane Library, and Google Scholar for studies published between 2000 and 2025. Search terms included English language, such as \"myocarditis,\" \"sudden cardiac death,\" \"atypical presentation,\" \"silent myocarditis,\" and \"gastrointestinal symptoms\".</p><p><strong>Results: </strong>A total of 10 studies were included and analyzed, focusing on clinical characteristics, nonclassical presentations, diagnostic findings, and outcomes. Myocarditis can be insidious and asymptomatic in young patients and increases the risk of sudden cardiac death. The diagnosis of these cases is often only possible after cardiac arrest or autopsy. In addition, myocarditis may present with nonclassical symptoms, particularly gastrointestinal symptoms, delaying diagnosis.</p><p><strong>Conclusion: </strong>Myocarditis, whether asymptomatic or with nonclassical manifestations such as gastrointestinal symptoms, can be a serious health threat, especially in young people, and in some cases can cause sudden cardiac death. Evidence suggests that many of these deaths in apparently healthy individuals are due to undiagnosed myocarditis. Early recognition and attention to nonclassical symptoms are essential to prevent sudden death and improve patient management.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"58"},"PeriodicalIF":0.0,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatio-Temporal Dynamics of Bloody Diarrhea Syndrome in Iran: A County-Level Identification of Clusters, Hot Spots, Outliers, and Seasonal Trends (2015-2019).","authors":"Dariush Bastam, Manoochehr Karami, Mahshid Nasehi, Masoud Salehi, Alireza Amouzandeh Nobaveh, Mohammad Zeinali, Babak Eshrati","doi":"10.47176/mjiri.40.57","DOIUrl":"https://doi.org/10.47176/mjiri.40.57","url":null,"abstract":"<p><strong>Background: </strong>Bloody diarrhea remains a significant public health challenge in developing countries. Despite general improvements in health indicators, Iran continues to experience geographical disparities in the incidence of foodborne and waterborne diseases. This study aimed to analyze spatiotemporal patterns, identify high-risk clusters, and detect local outliers of bloody diarrhea across all counties in Iran over a five-year period.</p><p><strong>Methods: </strong>This retrospective ecological study was conducted using data from the National Surveillance System on 62,787 confirmed cases of bloody diarrhea from 2015 to 2019. The unit of analysis was the county level. The Global Moran's I index was employed to test for spatial autocorrelation. Local spatial patterns were examined using the Getis-Ord Gi* statistic (Hot Spot Analysis) and Anselin Local Moran's I (Cluster and Outlier Analysis) in ArcGIS 10.4. Temporal trends were evaluated using deseasonalized time-series analysis.</p><p><strong>Results: </strong>The overall incidence rate showed a mild downward trend with a distinct seasonal peak in May (mid-spring). The disease predominantly affected children under 9 years of age (51.3%) and males (54.1%). Global spatial analysis confirmed significant clustering in all years except 2016. Hot spot analysis revealed a geographical shift in high-risk areas: while intense but transient clusters were identified in central Iran (Isfahan and Chaharmahal and Bakhtiari) only in 2015 (coinciding with a major outbreak), persistent high-risk clusters were established in the southeastern and eastern provinces from 2017 to 2019. Notably, the Anselin Local Moran's I test identified several \"High-Low\" outliers, indicating isolated local outbreaks within low-risk regions.</p><p><strong>Conclusion: </strong>The epidemiology of bloody diarrhea in Iran is characterized by a dual pattern: transient epidemic outbreaks in central/tourist regions and chronic endemicity in underdeveloped southeastern border areas. The findings indicate a spatial transition of the disease burden toward the southeast. Effective control strategies should prioritize infrastructure development in the endemic eastern belt and the implementation of targeted syndromic surveillance in identified outlier hot spots to manage seasonal outbreaks.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"57"},"PeriodicalIF":0.0,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological Insights into Xenobiotic-Induced Seizures: A Correlational Descriptive Study from a Poisoning Referral Center in Northwestern Iran.","authors":"Ali Banagozar-Mohammadi, Ali Ostadi, Arefeh Dawoodi, Javad Ahmadian Heris, Sana Mojtahedy, Nilofar Akhondi Koshki, Hassan Rezazadeh","doi":"10.47176/mjiri.40.56","DOIUrl":"https://doi.org/10.47176/mjiri.40.56","url":null,"abstract":"<p><strong>Background: </strong>Seizure is a common complication of poisoning caused by toxins and various drugs. Epidemiological insights into xenobiotic-induced seizures enable emergency physicians to anticipate seizure risk during toxic exposures, optimize triage decisions, and tailor strategies. This study aimed to investigate the epidemiological characteristics and essential factors related to xenobiotic-induced seizures.</p><p><strong>Methods: </strong>This descriptive cross-sectional study included 122 patients who developed seizures following poisoning with drugs, alcohol, opioids, pesticides, or stimulants between July 2021 and June 2022. Sociodemographic profiles and details of the poisoning/ toxic agents were collected through bedside interviews. Data were analyzed using descriptive and inferential statistics with SPSS version 21.</p><p><strong>Results: </strong>The majority of patients were men (110, 90.2%), with a mean age of 30.5 ± 11.99 years; 61 (50%) were married, and 95 (77.9%) resided in urban areas. Suicidal poisoning was the most frequent cause (62 cases, 50.8%), followed by poisoning related to substance abuse (33 cases, 27%). Opioids particularly tramadol (75 cases, 61.5%) were the leading cause of xenobiotic-induced seizures. All patients experienced generalized tonic-clonic seizures, with 87 (71.3%) having a single episode. Significant gender and occupation-based differences were observed: suicidal poisoning was more common among women, whereas substance abuse predominated among men. Education level was also found to influence the type of poisoning agent.</p><p><strong>Conclusion: </strong>Xenobiotic-induced seizures are predominantly associated with opioid poisoning, are prevalent among young males with suicidal tendencies and substance abuse. These findings highlight the need for targeted preventive strategies, early identification of at-risk individuals, and improved management protocols for poisoning-related seizures.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"56"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Artificial Intelligence in Enhancing Diagnostic and Triage Accuracy in Hospital Emergency Departments: A Systematic Review.","authors":"Mehdi Shakoori, Fatemeh Esmaili, Ezzat Abbariki, Esmail Heidaranlu","doi":"10.47176/mjiri.40.55","DOIUrl":"https://doi.org/10.47176/mjiri.40.55","url":null,"abstract":"<p><strong>Background: </strong>Emergency departments face challenges of overcrowding and human error. This systematic review evaluates the effectiveness of artificial intelligence (AI) in improving triage and diagnostic accuracy in emergency settings.</p><p><strong>Methods: </strong>This systematic review was conducted by searching PubMed, Scopus, Web of Science, and Google Scholar until September 2025. Inclusion criteria comprised original studies reporting at least one quantitative performance metric. Study quality was assessed using NOS and QUADAS-2. Data were synthesized narratively.</p><p><strong>Results: </strong>AI models outperformed traditional triage systems (AUC often >0.90). In clinical interpretation of AUC, its limitations in imbalanced datasets should be considered, and metrics such as PPV, NPV, and AUPRC should also be reported. For instance, despite an acceptable AUC, ChatGPT 4.0 led to significant over-triage due to low specificity (18.2%). However, risks of algorithmic bias and challenges of integrating AI with real-world clinical workflows remain major implementation barriers. User resistance and the need for continuous ethical oversight were also identified.</p><p><strong>Conclusion: </strong>AI holds potential to improve emergency triage, but current evidence is largely based on retrospective single-center studies. Clinical implementation should be gradual, starting in high-risk domains (e.g., sepsis screening), and supported by continuous ethical oversight.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"55"},"PeriodicalIF":0.0,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstacles to the Educational Leadership Succession Planning in Iranian Universities of Medical Sciences: A Qualitative Approach.","authors":"Leila Neisani Samani, Zohreh Sohrabi, Shoale Bigdeli, Aryan Gholipoor","doi":"10.47176/mjiri.40.54","DOIUrl":"https://doi.org/10.47176/mjiri.40.54","url":null,"abstract":"<p><strong>Background: </strong>Succession Planning (SP) is a human capital strategy for the continuity and promotion of the organization to a higher level and greater productivity. Universities of medical science have not been spared from these transformations; recently, they have faced various management development challenges. Identifying and eliminating these barriers is necessary for academic SP organization. To explain the obstacles to SP in the universities of medical sciences in Tehran, Iran.</p><p><strong>Methods: </strong>The present study has been designed as qualitative conventional content analysis research. Participants were purposively selected from experts and professionals with managerial and leadership positions, stakeholders, key informants of leadership SP in universities of medical sciences, high, senior, and middle managers in medical science education, and exemplary successful managers in the SP from August 2021 to December 2022. Data collection was done through 16 semi-structured, in-depth interviews using Maximum Variation Sampling. The validity and reliability of the data were obtained using Lincoln and Guba's criteria. Barriers to SP of educational leaders in universities of medical sciences were extracted.</p><p><strong>Results: </strong>Three main categories, 14 subcategories, and 75 final codes were discovered. The main categories were trans-organizational, organizational, and personal obstacles. Trans-organizational factors included a policy of selecting top academic leaders, inadequate support of top managers, and exogenous political and economic obstacles. Organizational factors included human resource (HR) management obstacles, challenging positions, a missing link of documentation of rich leadership experiences, relative incompatibility of organizational culture with the SP, resistance to change, lack of financial resources, and insufficient focus on talent management. Personal factors included the lack of new management competencies, self-centeredness, insufficient motivation, and an inefficient attitude.</p><p><strong>Conclusion: </strong>The succession process requires flat structures, decentralization, delegation, and mutual trust. It is necessary to review the policies for appointing chancellors of universities and other levels of management of hospitals and public health centers, and to redefine them based on talent management. Therefore, conducting studies on this issue is suggested to obtain definite results.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":"40 ","pages":"54"},"PeriodicalIF":0.0,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}