Abstract
INTRODUCTION: A key challenge for policymakers in medical education lies in grasping the future landscape of leadership. Without insights into emerging trends, they may face unforeseen issues, leading to expensive and inefficient decision-making. This study aimed at analyzing the trends and drivers influencing future leadership in medical education in Iran. METHODS: In this research, we employed a descriptive-exploratory approach This study consists of systematic reviews and interviews that have been analyzed using Structural Equation Modeling with the help of MicMac software (version 6.1.2, 2003/2004: 3IE/EPITA, France). We conducted a systematic review according to PRISMA. A literature search was performed using databases including Medline, Web of Science, ProQuest Dissertation & Theses, Scopus Embase, and Persian studies from SID, and Magiran. The inclusion criteria for the study were the articles which needed to contain one or more listed keywords, were published in a scientific journal, were written in English or Persian, were published between 2004 and 2024, had the full text available, and focused on educational leadership in medical schools. Additionally, interviews were conducted with 14 Iranian experts to pinpoint influential components. To be included, experts possessed relevant education in medical education, health policy, or higher education management; occupied an executive or managerial position in higher health education or health policy; had more than 15 years of work experience, and were willing to participate in the study. Afterward, the codes were presented in a focus group discussion of experts to define how extracted drivers would affect leadership in medical education in Iran. RESULTS: We identified 6081 articles in the initial literature search; 17 met inclusion criteria for final review. The study identified 37 drivers in medical education management and leadership. These drivers were categorized into four types: effective drivers (3), impressionable drivers (3), autonomous drivers (16), and bimodal drivers (15). Among these, the components of meritocracy in selecting managers and international relations within the education sector had the most significant impact. CONCLUSION: By understanding and planning around these influential and susceptible components, managers, and policymakers can gain foresight. This foresight can enhance the effectiveness of current decisions and activities, enabling a more desirable future. This can be achieved by systematically improving decision-making processes, revising procedures, and developing appropriate strategies in medical education leadership.