Development Strategies in Medical Education

Introduction
Faculty members constitute the main pillars of each university, especially medical universities, whose roles are definitely more important than physical factors such as physical space, facilities, equipment and materials. Faculty members in Iran are ranked such as instructor, assistant professor, associate professor, and professor. Continuing the promotion to distinguished professor and tenured professor is also possible [1]. The promotion system for faculty members of universities plays a major role in directing the activities of faculty members. [4]. As faculty members seek guidance for promotion, it is not uncommon for them to seek advice from senior professors and the peers who had promotion [13]. With the phenomenological study of the lived experiences of clinical professors, we can find barriers, solutions and effective motivational factors in the process of promotion for clinical faculty members. Therefore, this qualitative study aims to explore the barriers, solutions and effective motivational factors in the process of promotion for clinical faculty members in Iran.

Methods
This is a qualitative phenomenological study. Participants were clinical professors. Sampling was done using a purposive method until reaching data saturation. Data were collected using interview. First, interviews were conducted with 9 qualified clinical professors from Jahrom University of Medical Sciences. Data analysis was done based on Colaizzi’s 7-step method. After transcription, the text was read several times. Then the data was broken into semantic units (codes) in the form of statements related to the main study question. Then, the codes were classified based on conceptual and semantic similarity and were integrated as much as possible. Finally, the data were placed in the main categories, and the themes were extracted. The themes were confirmed by the participants, Lincoln and Guba’s criteria (credibility, dependability, confirmability and transferability) were used to measure the accuracy and validity of the findings. 

Results
We extracted 69 initial codes and semantic units. Finally, 5 themes were extracted as barriers which included: Lack of knowledge of professors regarding the promotion process, lack of human resources, structural challenges, regulation challenges, audit board challenges. Three main themes were extracted as solutions which included: Increasing the awareness of professors, quantitative and qualitative development of facilities, and modification of the evaluation system. Two main themes were extracted as motivational factors which included intrinsic and extrinsic factors (Table 1).



Conclusion
Our findings can be helpful for policy making, management and planning processes in the field of academic promotion for clinical professors. The emphasis of the professors on the slow handling of the promotion cases was more oriented towards inequality and discrimination, which shows that the implementation of some policies despite solving one challenge can lead to the emergence of another challenge. Also, it was indicated that some challenges persist over time and the measures taken have not been able to solve them. Also, the participants pointed out the differences in Type 3 universities in terms of the promotion process and the specific challenges of these universities, which can also be taken into account in macro-planning.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethics committee of Jahrom University of Medical Sciences (Code: IR.JUMS.REC.1401.059). Verbal informed consent was obtained from all participants.

Funding
This study was funded by Jahrom University of Medical Sciences.

Authors' contributions
The authors contributed equally to preparing this paper.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgments
The authors would like to thank the Clinical Research Development Unit of Peymanieh Hospital in Jahrom County and all participants for their cooperation in this study.


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