Liang, Zhanming, and Kakemam, Edris (2025) Identifying competency development needs of hospital managers in Iran: a national survey. BMC Medical Education, 25. 122.

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Abstract

Background: A competent management workforce is crucial to achieve the effectiveness and efficiency of health service provision and to lead and manage the health system reform agenda. However, the traditional recruitment and promotion approach of relying on clinical performance and seniority provides limited incentives for competency development and improvement among hospital managers in Iran. There is limited evidence on the competency development needs of hospital managers in Iran that can guide setting training and development direction. This study aims to identify the competency development needs of three management levels (senior, mid-level, and frontline) in public hospitals and explore the difficulties that managers experienced.

Methods: The study adopted a cross-sectional survey using the validated management competency assessment partnership (MCAP) tool. The MCAP tool, consisting of 82 behavioral items that measure six core management competencies, was distributed to 162 public hospitals in 19 provinces in Iran between September 2021 and March 2022. The data were analyzed using descriptive and inferential statistics including the mean and standard deviation, chi-square test, independent-samples t-test, and one-way analysis of variance.

Results: In total, 1051 managers completed the survey either online or on paper. Peer and team conflict, employee performance, loss of skilled staff, and supervisor confrontation were the five difficulties most often encountered by all three levels of managers. The survey confirmed that only a small proportion of managers had the opportunities to participate in formal and informal management-related education/training, such opportunities were much lower for middle and frontline managers (P < 0.001). Middle managers were less confident in their demonstration of the core management competencies than that of senior and frontline managers (P < 0.001). Managers who completed management training organised internally by the hospitals consistently received higher mean competency scores for all competencies (P < 0.001).

Conclusion: The study provides compelling evidence highlighting the importance of developing strategies to systematically enhance the capabilities of hospital managers, particularly mid-level managers. Incentives to encourage hospital managers to participate in both formal and informal management training, along with the commitment from hospitals to establish mechanisms that build management capacity, support managers, and guide the preparation and recruitment of management positions, are essential.

Item ID:	86766
Item Type:	Article (Research - C1)
ISSN:	1472-6920
Keywords:	Hospital,Manager,Management,Leader,Competency,Competency Assessment
Copyright Information:	© The Author(s) 2025. Open Access: This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
Date Deposited:	19 Aug 2025 04:14
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