Development Strategies in Medical Education

Introduction
In most developed countries, accreditation programs are implemented to evaluate and improve medical education. Paying special attention to maintaining the quality of education and research in medical universities is considered one of the main concerns of the Iranian Ministry of Health and Medical Education. One of the most important benefits of accreditation is improving the quality of learning by guaranteeing the quality of the course under assessment. Accreditation is a process by which official accrediting authorities evaluate institutions using a set of criteria and standards through established procedures to ensure the quality of the education and research. This study aims to evaluate the quality and quantity of the existing education system in the universities and colleges located in the 6th macro-region of the country (Zanjan, Alborz, Qom, Qazvin, Arak, Khomein, Saveh) to improve the existing conditions according to society's expectations of higher education.

Methods
This project was carried out by conducting an external evaluation and qualitative analysis. With the convergent-parallel approach, the effects of institutional accreditation in medical universities and faculties in the 6th macro-region of the country were examined based on the national accreditation project including 66 standards and 351 indicators in 8 areas (mission and goals, management, resources and facilities, staff training, faculty, student services, research, student education). A field visit to educational-research facilities and a documentation study were conducted based on the eight areas. After collecting and reviewing the data, the accreditation results were presented. 

Results
The accreditation process for preparing self-evaluation reports and preparation for external evaluation lasted for one year. The performed accreditation program was similar to the accreditation done by external evaluators and conformed to the national standards. Considering the educational-research facilities as well as the achievement of necessary and preferred standards, we saw a significant growth in medical universities and faculties in the entire region. The strengths and weaknesses of universities and faculties were presented to advance the educational and research goals within the framework of the national accreditation program.

Conclusion
In this study, we tried to take positive steps by implementing an accreditation program to increase the quality of medical education. The results showed that the medical universities and faculties in the 6th macro-region of the country have taken effective steps to improve the existing conditions and reach the desired standards. The implementation of accreditation program in the entire region helped to identify the strengths and weaknesses of the education programs of medical universities. To reach the ideal level in all necessary standards (mandatory and preferred standards) and improve the quality of medical education, the medical universities and faculties in the 6th macro-region of the country should provide the necessary research and educational infrastructure, including equipment and educational spaces. It is necessary for all university personnel to become familiar with accreditation standards. For this purpose, periodic workshops seem to be necessary. Also, the medical universities in the region should take more effective steps to reach the optimal level of the ministerial standards.

Ethical Considerations
Compliance with ethical guidelines
This study  has ethical approval from Zanjan University of Medical Sciences (Code: IR.ZUMS.REC.1398.218).

Funding
This study is a part of larger research project, funded by Zanjan University of Medical Sciences.

Authors' contributions
Conceptualization, design, and project management: Alireza Abdanipour; design, and project management: Farhad Ramezani Badr; Statistical analysis: Ali Nowrozi; Counseling: Mehdi Ghaemi.

Conflicts of interest
The authors declare no conflict of interest.

Acknowledgments
The authors would like to express their gratitude to all managers and experts from medical universities and faculties in the sixth macro-region for their cooperation in this project.

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