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   Table of Contents      
ORIGINAL ARTICLE
Year : 2018  |  Volume : 23  |  Issue : 5  |  Page : 344-351

Characteristics of Shared Governance in Iranian Nursing Schools: Several Souls in One Body


1 Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Department of Psychiatric Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Department of Ophthalmology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 School of Nursing and Midwifery, Department of Medical Surgical Nursing, Iran University of Medical Science, Tehran, Iran

Date of Web Publication20-Aug-2018

Correspondence Address:
Dr. Foroozan Atashzadeh-Shoorideh
Vali-Asr Avenue, Cross of Vali-Asr Avenue and Hashemi Rafsanjani (Niyayesh) Highway, Opposite to Raja'ee Heart Hospital, Tehran 1996835119
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijnmr.IJNMR_4_18

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  Abstract 


Background: Shared governance is a decentralized structural model that gives individuals the right to make decisions and a position analogous to managers. The shared governance is different based on context in every organization. This study identified the characteristics of shared governance in Iranian nursing schools. Materials and Methods: In this qualitative research, 11 participants were selected using purposive sampling method. Deep semi-structured interviews were conducted, and the data were analyzed using conventional content analysis. Lincoln and Guba's criteria were used to verify the accuracy and trustworthiness of the data. Results: Through data analysis, the theme of “several souls in one body” was achieved in addition to the seven categories of “climates based on common interests,” “conscious participatory decision-making,” “mutual accountability,” “multiplicity of ideas,” “decentralized structure,” “interrelationship,” and “sublime organization.” Conclusions: According to the findings, the characteristics of shared governance in the social culture of Iran are like several souls in one body, emphasizing all aspects of participation and morality in the organization. Managers and administrators in higher education and nursing faculties need to pay attention to all aspects of shared governance, including spirituality in managing the covered institutions.

Keywords: Education, Iran, management, nursing, qualitative research


How to cite this article:
Sattarzadeh-Pashabeig M, Atashzadeh-Shoorideh F, Sadoughi MM, Khachian A, Zagheri-tafreshi M. Characteristics of Shared Governance in Iranian Nursing Schools: Several Souls in One Body. Iranian J Nursing Midwifery Res 2018;23:344-51

How to cite this URL:
Sattarzadeh-Pashabeig M, Atashzadeh-Shoorideh F, Sadoughi MM, Khachian A, Zagheri-tafreshi M. Characteristics of Shared Governance in Iranian Nursing Schools: Several Souls in One Body. Iranian J Nursing Midwifery Res [serial online] 2018 [cited 2018 Nov 16];23:344-51. Available from: http://www.ijnmrjournal.net/text.asp?2018/23/5/344/239281




  Introduction Top


Shared governance is a structural model that can be offered by organization members to manage their activities at a higher level of professional independence. In order to achieve shared governance, it is necessary for the entire staff to perceive the participatory leadership's principles, processes, and behaviors.[1] It is a concept that transcends well beyond participatory management and assigns all members of the group or organization to the decision-making besides possessing its characteristics.[1],[2]

It is a complex concept that has been characterized by various common features in different definitions such as independence and lack of dependency in performance, responsibility, empowerment, and participation and cooperation in decision-making.[1] Ramo (1997) suggested the indicators of shared governance, which has been supported by the American Association of University Professors (AAUP) and Statements on Governance of Colleges and Universities (1978). She stated that they can be modified based on institutional cultures.[3],[4] Therefore, the authors believe that subtle investigations have to be preliminarily undertaken, and their features correctly elucidated according to the culture governing each organization before taking measures to implement them.

Universities are the major proctors of education quality.[4] Nursing education sets the grounds for the rearing of professional nurses so that the ability to evaluate and recognize the health status and delivery of services and coordination of healthcare in various areas to individuals, families, and the society can be provided.[1] However, in many countries such as Iran, the faculty members in nursing schools are mostly devoted to teaching and research, but they are rarely involved in management and decision-making.[5],[6]

Shared governance suggests a solution in which the faculty members are indeed rendered as the managers. It allows the faculty members to take part in decision-making processes that influence their performances and is observed as a challenging competitor to traditional governance.[3],[5] Therefore, it is necessary for universities to align their shared governance in a direction toward participation in responsibilities.[2],[7]

Shared governance is an attractive concept, but the term is difficult to define; thus, there is no precise definition of the shared governance model.[8] Despite the common features expressed for shared governance, it is realized as somewhat participatory, partly traditional, tactical, and mostly symbolic.[6],[9] The ambiguity in shared governance is related to its quality. Shared governance is floating and is deemed as a stripped term that lacks a definite meaning. It usually takes the format of the context in which it is utilized, for example, by an individual or a group. It is a variable concept based on the culture and social context of a society, and the uncertainty in the definition of the term stems from the differences existing in the social and cultural contexts of communities.[9]

Educational institutions need to be managed with a cooperative approach in order to maintain growth, dynamism, and excellence. Therefore, it seems that the qualitative approach, management experience, and the views of faculty members in nursing faculties on shared governance can help clarify the challenges and make a path toward achieving a solution in the cultural context of the country.

Hence, it is necessary to elaborate and clarify the characteristics of shared governance within the cultural context and adapt it to the governing social structure in such a manner that no serious harms are done to its underlying concepts.[5] To the best knowledge of the author, no research, featuring different cultural specifications, has been carried out and/or reported in Iran regarding shared governance in the education system. Thus, the authors decided to undertake the clarification of shared governance properties in nursing schools in Tehran, Iran. The results of this study can help to increase the participation level of nursing faculty members in system management.


  Materials and Methods Top


The present qualitative research was part of a larger study conducted in 2017. The study population included all the faculty members of nursing schools, managers of three major medical universities in Tehran, and nursing board members of the Ministry of Health (MOH) of Iran. The inclusion criteria for the faculty members and managers included their willingness to participate in the study and a work experience of more than 5 years.

Using purposive and snowball sampling methods, 11 participants were selected from among faculty members of three nursing schools in Tehran and managers of universities and the MOH. Purposive sampling may begin with volunteer informants and may be supplemented with new participants through snowballing.[10] The study was conducted from October 2016 to June 2017. The participants were selected carefully by observing the maximum possible variation in terms of gender, age, work experience, and specifications.

After obtaining permission from the Ethics Committee at the Shahid Beheshti University of Medical Sciences, and going through other legal procedures, as well as obtaining informed written consent from the participants, the location and time of the interviews were agreed upon and selected according to their desire. All interviews were conducted according to the willingness of the participants in their offices. Semi-structured, deep, individual interviews were performed to collect the data with the permission of the participants. All interviews began with a general question (“What is your perspective toward the climate governing your college?”). The rest of the questions were constructed in proportion to the interviewees' experiences. The questions were mainly open-ended questions and differed according to each individual's ideas. The average time of the interviews was 65 minutes. Data saturation of the classes and subclasses was achieved in the eighth interview. The researcher conducted three more interviews to increase the accuracy of the findings, and no new classes were distilled.

Conventional content analysis is generally used in a study design whose purpose is to describe a phenomenon. It is appropriate when the theory or research texts are limited to a phenomenon. Researchers refuse to use predefined categories and allow categories and their names to be derived from data.[11] Therefore, considering that the shared governance concept is based on the context, for which there is no definite definition[8],[9] and its concept is not explained in Iranian educational centers, this qualitative content analysis was based on a conventional method. The method proposed by Graneheim and Lundman (2004) was applied for data analysis.[12]

The steps of analysis were described as the following. Immediately after the interviews, the first author listened to the recorded interview several times to reach a general perception, and then, transcribed them verbatim, as a result of which the units of analysis could be determined. The units of analysis were read part by part, and then, units of meaning, condensed units of meaning, and the preliminary codes were identified. In the next step, a comparison of the codes was carried out and this led to the classification of similar codes under identical subcategories. Similar subcategories were grouped into more abstract levels, and finally, the main theme was extracted through comparison of the categories and their more precise and subtle contemplation.[12]

To ensure the accuracy and trustworthiness of the data, Lincoln and Guba's (1985) criteria, cited by Polit and Beck, were considered.[10] To increase the credibility of data, the researcher devoted enough time to immerse into the data, study the subject, and engage with the participants. The obtained data from the interviews were reviewed and assessed by the supervisors and counselors after the implementation and coding. In addition, after analyzing the data, three participants were contacted, and the full text of the interviewing codes was given to them to determine their proportionality with the experiences of the participants. Then, one expert and two PhD candidates of nursing were asked to study the interviews, codes, and extracted materials. In order to enhance the confirmability, the research steps, its methodology, and the decisions made at various stages were elaborated on, so that, if necessary, other researchers could track the research. Moreover, the context of the study and the characteristics of the participants were described well, so that judging the transferability was made easy for the readers.

Ethical considerations

In line with the ethics code, permission was acquired under the code no. IR.SBMU.REC.2016.84 from Shahid Beheshti University of Medical Sciences, Tehran, Iran. The other ethical considerations included acquiring of an informed written consent, explaining the study objectives, and declaring the confidentiality of the interviews and personal information as well as the participants' freedom for continuing or discontinuing cooperation at any stage of the study.


  Results Top


The total number of study participants was 11, including 6 women and 5 men. The youngest and oldest participants were 41 and 56 years old, respectively. The minimum and maximum work experiences were 6 and 29 years, respectively. The minimum managing experience was 1 year and the maximum was 24 years. All participants, except a general physician, held PhD degrees in related fields [Table 1].
Table 1: Participants' demographic characteristics

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Moreover, the results of data analysis of interviews yielded 367 codes, 21 subcategories, 7 categories, and 1 major theme entitled “several souls in one body” as explained in [Table 2].
Table 2: Theme, categories, and subcategories

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The climate based on common interests

One of the characteristics of shared governance was the climate based on shared interests among the participants. The implementation of shared governance requires a context in which all members of the organization see their interests in the interests of others and the interests of the organization. This feature includes the following subcategories: “the common goals,” “mutual trust,” “mutual respect,” “equality among stakeholders,” “coordination,” “empathy,” and “adaptation to change.”

In shared governance, the goals of the individuals and the organization are intertwined. One participant with 6 years of experience commented on “common goals”: “I see my goals as the goals of the organization. I try to excel myself, and I try to progress according to my organization's strategies. The faculty managers also set the path for achieving these goals.”

The term “mutual trust” means that there is a lasting partnership with other members, if mutual trust is built between managers and staff. A participant with 26 years of management experience commented: “The first foundation of partnership is working in an environment that will rely on me and where I can trust others.”

“Mutual respect” was another subcategory that addresses the dignity of individuals in all roles of the organization. One participant with 17 years of experience said: “Everyone should respect others. Managers should also be respectful to others and their personalities.”

“Equality among stakeholders” means that all stakeholders, although with different influence in decision-making, are the same in terms of human dignity. A participant with 17 years of experience commented: “High-level managers should not look at the people under their command as subalterns, but they should see everyone as a loop in a chain which is connected to others.

“Collaboration” means that all parts of the organization and its members work together to achieve common goals together. A participant with 10 years of management experience said: “When we collaborate with each other, this can be called partnership. Otherwise, disorder may rise in the organization.”

The subcategory of “empathy” means to console one another during times of distress and difficulties without judgment, which leads to the creation of positive mutual feelings in the members and strengthens the participation. A participant with 4 years of management experience said: “There were times when I lost control. If they asked me what had made me angry and why this problem had happened, it would make me feel calm. That means participation.”

The last subcategory was “adaptation to change.” In order to implement continuous and constant partnership, it is essential that all members and collaborative programs adapt to internal and external organizational changes. A participant with 2 years of management experience said: “You should always be prepared for change. A person, who is flexible, can work collaboratively, because there may be a lot of changes in the middle of the way.”

Conscious participatory decision-making

The second feature of shared governance is participatory conscious decision-making, which means that in addition to “participatory decision-making,” “participatory understanding” and “transparent exchange of organizational knowledge” are also necessary for achieving actual participation of members in the organization's affairs.

The subcategory “participatory decision-making” means that individuals are involved in decisions whose results are relevant to them. A participant with 26 years of experience stated: “For example, decisions on educational issues, research, and issues related to the status of students' education at the faculty are conducted by the votes of members of the faculty in councils.”

“Participatory understanding” is the presence of a participatory perspective and attitude in all members. A participant with 3 years of managing experience commented on the subcategory: “If you have participatory understanding, you do not need a meeting room. You can talk on campus on the grass.”

Another subcategory is “transparent exchange of organizational knowledge,” which means timely access for decision-makers to full and transparent information related to decision-making, as well as timely report of decisions to related individuals. A participant with 6 years of experience said: “The chairman and the deputies make a decision together. Even if the decision is right for the faculty, if the consequences involve my group, I should be informed about the decision.”

Mutual accountability

The third characteristic of shared governance resulting from interviewing participants in this study was mutual accountability. It means that the response rate of individuals varies in different ways, which is a proportion of different powers to influence according to their various roles in decision-making. The power and area of control of individuals also varies according to their level of accountability in the organization leading to greater autonomy of individuals and greater productivity in the organization. It includes “accountability of all the stakeholders” and “the importance of accountability” subcategories.

The subcategory “accountability of the stakeholders” means that all members must be accountable for the responsibilities of the various roles that they undertake in the institution. Sometimes, they are in the position of answering, and sometimes they must be answered by others. A participant with 9 years of management experience said: “It is thought that only those who are in the management position should be accountable, but this is not true. All components of a system must be accountable according to their decision-making powers.”

The subcategory “the importance of accountability” means that participation can only be exploited if individuals are responsive to their collaborative and nonparticipatory roles. Otherwise, participation is nothing, but a waste of time. A participant with 9 years of managing experience said: “Accountability is both a necessity to participation and a part of participation, both of which are tangential and reciprocal.”

Multiplicity of ideas

The “multiplicity of ideas” is the fourth feature of shared governance from the perspective of contributors. This feature means that the existence of contradictions, controversies, and interactions in participation is natural due to differences in concerns and knowledge of the participant's view. This category contains the subcategories of “necessity of conflict” and “conflict management.” The subcategory of “necessity of conflict” means that participation and unification between individuals with the same thoughts and notions in an organization do not necessarily result in growth and sublimity, and that conflicts have to exist.

A participant with 3 years of working experience stated: “I kept on saying that we should not fear conflict, it is transient. Let members confront each other, let them talk about their different ideas.”

The subcategory of “conflict management” means that not only should the differences and disparities between the opinions and attitudes of individuals be accepted but also the skill of coping with conflict should be practiced.

A participant with 23 years of experience said: “There are controversies in contributing and you may oppose the opinions and beliefs of others. There is contradiction in participation, so both the manager and the members must be able to manage conflicts.”

Decentralized structure

Decentralized structure is the fifth feature of shared governance in view of the participants, which means creating basic changes based on decentralizing the power and authority on all aspects of the organization and on all organizational levels. The subcategory “participatory structure” points to the issue that, in addition to the importance of participation as a key factor among managers and members, all existing structures and processes must also be based on participation.

Another participant with 24 years of management experience said: “When we say that all components of the participatory model must be collaborative, we mean not only in implementation, but also in other aspects such as organizing, planning, and analysis.”

The subcategory of “participatory organizational culture” refers to the issue that the behavior and speech of the members, especially managers, must be based on participation. A participant with 20 years of experience said: “A few years ago, when I arrived at this college, I saw that the faculty managers, with modest and unselfish feelings, consulted experts on various issues, I learned from them.”

From the point of view of the participants, the subcategory of “decentralized management” means a reduction in the distance between the managers and the staff and building a more horizontal organizational structure.

A participant with 20 years of experience said: “We expect the university's academic environment to be in no way hierarchical; the scope of participation must be developed to even include those from outside the university.”

The subcategory of “continuing participation” means the importance of sustained participation in the creation of productivity in educational institutions. In this regard, a participant with 11 years of work experience stated: “Continuing participation is more important than making it.”

Interrelationship

The sixth feature of shared governance is the “interrelationship” of the participants. Because the decentralized organizational structure of the organizational pyramid is more horizontal, communication is bilateral between managers and employees. The subcategories of this category include “communication as a key factor,” “open vertical and horizontal communication,” and “establishment of appropriate formal and informal relations.”

In the subcategory of “communication as a key factor,” which indicates the crucial role of communication in shared governance, a participant with 10 years of management experience stated: “I think communication is so important that it can be viewed as a foundation for the partnership.

Another contributor with 4 years of experience in the field of “open vertical and horizontal communication” said: “In order to make participation and progress better, as a group manager, I need to know how to communicate with my students, with my senior faculty members, and with my colleagues.”

One participant in the subcategory of “formal and informal relations” stated: “When these links are set to good and correct criteria, these relationships will be very contributory and create motivation and dynamics.”

Sublime organization

The last category was sublime organization. According to the participants, contemplation parallel to the organization and individuals' sublimity, adopting “spiritual goals,” “promotion of religious ethical values,” and “following religious guidelines” give meaning to the participation. This cannot be facilitated unless the managers believe that the goals should be sublime and try to direct the organization toward spiritual goals via attracting every individual's participation.

A participant with 3 years of managing experience about the subcategory of “spiritual goals,” which suggested the importance of having thought and attitude of human excellence by all members, especially the managers of the organization, commented: “The dean of our faculty has inspective thoughts, he thinks of the ways that could enhance and sublime the human being. At any time and in every work, he is constantly endeavoring to find ways of sublimating humans and helping others.”

Moreover, the subcategory of “following ethical values” suggests the belief in ethical values, acting upon them, and their promotion by all members, especially the managers. Another participant with 27 years of work experience asserted: “If managers and employees follow principles such as honesty, integrity, and purity, they can get more and more constant partnerships.”

The last subcategory was “following religious guidelines,” which means that combining religious teachings about participation with the performance of managers and employees can be a powerful incentive for collaborative participation and can give participation a meaning. A participant with 24 years of management experience declared: “In our religion, we are very concerned about the issue of the council by many Quranic verses. There are a lot of subjects that we must pay attention to.”


  Discussion Top


This research was aimed at explaining the concept of shared governance, and the findings of the data analysis included the theme titled “several souls in one body” and seven categories. The first category was the climate based on common interests and included seven subcategories. The characteristics of this category are in line with the Ramo index “Climate for Governance.”[13] The subcategory of “common goals” is considered as one of the subcategories of this study. In similar studies, it has been stated that the existence of common goals among all stakeholders of educational institutions is considered necessary for healthy governance.[7],[14],[15],[16] The participants viewed “mutual trust,” which was the second subcategory, as necessary for shared governance. Tierney, in a similar study, has also stated that the functions of an institution in terms of shared governance are based on trust culture.[17] Consequently, a raised level of trust between the faculty managers and faculty members will lead to an increase in their perceptions of shared governance.[13]

“Mutual respect” was considered as the third subcategory, which is consistent with the studies that have recognized mutual respect between the scientific body and the governing body as the foundation of shared governance.[9],[14],[18] In addition, shared governance is a means of creating equality in the organization.[1] The participants also emphasized this issue, and thus, “equality among stakeholders” was determined as the fourth subcategory. “Cooperation,” which was one of the subcategories in this study, has been mentioned as one of the prominent features of shared governance in many studies.[4],[9],[14]

The emphasis of the participants on understanding by all members of the organization, especially by the directors in the face of problems and discomfort, has led to the subcategory of “empathy.” Cramer defined empathy as individuals' ability to put themselves in the position of their colleagues and look at their positions from their perspective. To be empathetic does not necessitate agreeing with others, but understanding that different perceptions and interpretations must be taken into account in order to reach a common agreement.[19] Shared governance is an ongoing process that requires constant review and evaluation for flexibility and adaptation to the environment, rather than a once-run process with fixed roles for individuals. Participants also emphasized the “adaptation to change,” which was formed as the last subcategory of the climate based on common interests to perform sustained and continuous progress.[1]

The second category was conscious participatory decision-making, which included three subcategories. The characteristics of this category are in line with the “joint decision-making” indicator demonstrated by Ramo.[16] “Participatory decision-making” was one of the ideas extracted from this study, and is one of the principle hallmarks of shared governance in similar studies;[2] in some cases, “participatory decision-making” has been used as one of the names of shared governance.[7],[20] Positive attitude toward participation is also an important factor in shared governance without which it is impossible to enforce shared governance,[21] which is in line with the subcategory of “participatory understanding” in the present research. Paying attention to the existence of necessary information for decision-making by participants led to the creation of the subcategory of “transparent exchange of organizational knowledge.” In shared governance, it is not only necessary to provide the members involved in decision-making with timely and appropriate information,[16],[20],[22] but it also leads to the creation of common knowledge for consensus in decision-making through the extensive knowledge of employees.[1]

The third category was “mutual accountability” (with two subcategories). This class is in line with the “joint responsibility” indicator put forward by Ramo.[16] Moreover, many studies have suggested shared governance as an accountability-based approach, and have defined it as a participatory responsibility between all key members, especially between management and faculty members in line with the goals of the institute. In this research, “the importance of accountability” and “accountability of all the stakeholders” were also extracted as subcategories.[5],[7],[14],[21],[23]

The fourth category extracted was multiplicity of ideas, which included two subcategories. In various studies, it has been suggested that some degree of tension is necessary and may lead to creativity and productivity. In addition, excessive relaxation in the relationships between the scientific body and the management body may be a sign of indifference or the conquest of the institution by one of these two domains.[14],[15] In this study, the “necessity of conflict” was extracted as a subcategory. Moreover, the “conflict management” subcategory is in line with the studies that emphasize the need to cope with conflict of opinion by all members of the organization, especially managers.[14],[15]

The decentralized structure as the fifth category of this research consisted of three subcategories. The “participatory structure” as one of the subcategories is consistent with similar studies. It shows that shared governance is a structural model.[1],[13],[21],[22] It is also a tool for stakeholders' participation[1] based on decentralized management.[5] Consistent with other similar studies, the “participatory organizational culture” in this study indicates that, to implement shared governance, all employees need to understand the principles, processes, and behaviors of participatory leadership[1] and unlike other methods of governance, the words “us” and “them” should not be used in the organization.[18]

The emphasis of participants on making the organizational structure more horizontal and empowering the employees has led to the extraction of the “decentralized management” subcategory. This subcategory is also consistent with that in the studies on shared governance which have defined it as a structural model in which the individuals of an organization can provide and manage their activities at a higher level of professional independence,[1] and have pointed out that the entry of the authority concept into shared governance leads to the creation of a decentralized culture.[17]

The sixth category was interrelationship, which included three subcategories. The characteristics of this category are in accordance with the “institutional communication” index proposed by Ramo.[7],[16] Furthermore, the results of various studies have indicated the interrelationship between all stakeholders of an institution as one of the most important elements of good practice. Moreover, they have emphasized the need for communication mechanisms such as the need for adequate communication and suitable opportunity for joint effort and planning by all stakeholders to participate in effective decision-making.[7],[16] In this research, “communication as a key factor” was extracted as a subcategory as well.

“Open vertical and horizontal communication” was one of the subcategories of this study. Ben-Ruwin has not only emphasized that negotiation and suitable communication within and among all stakeholders is necessary[7],[16] but has also mentioned the need for clear, timely, respectful, ethical, constructive, and accessible communication during the decision-making process in shared governance.[8] In addition, informal structures for collaborative decision-making and communication are as powerful as formal structures and processes in shared governance.

Furthermore, informal structures provide opportunities to build trust, respect, transparency, and communication that are needed for shared governance.[18],[21] However, in the present study, “formal and informal relations” are introduced as one of the subcategories.

As discussed above, although in most studies shared governance is reported as a culture-based concept, there is no governing board in schools in Iran, however there is administrative board in nursing schools in Iran. However, there are many similarities in the other six categories. The results of the interviews with the participants in this study were similar to the results of other studies. One of the reasons for this similarity seems to be the staff of the universities who are very professional and are capable of managing universities,[14] which can, despite different cultural backgrounds, provide a common attitude toward issues, especially management concepts.

The last category was “sublime organization” with three subcategories. This characteristic was not found in previous studies. Various studies have noted that the goal of shared governance is the coordination of all members in order to carry out the missions of the institute and to achieve its goals, but not to reach profits.[7],[14],[15] They have emphasized the vital importance of a common goal with a spirit of cooperation among managers, the governing board, and faculty members in order to have a healthy state.[16] Participants implied that they see shared goals of stakeholders in shared governance as a necessity. Moreover, they acknowledged that due to the idealistic sense of the majority of people, the existence of transcendental organizational goals and the idea of working for promotion and excellence among the members, particularly the managers, will give meaning to the partnership. This led to the formation of the “spiritual goals” subcategory. This ideal in the nursing faculties, which has the ultimate goal of human health, and in the Iranian society, which is based on the principles of spiritual and religious beliefs, can lead to the attraction of more people's participation.

The second subcategory was “promotion of religious ethical values.” Ramo considered ethics as an element of the “overall climate for governance” indicator, which is one of the indicators of shared governance.[16] He believes that it may affect the health of the shared governance in the institution along with tolerance of different views, cooperation, and solidarity among the stakeholders.[7] However, given that in Iran religious issues are intertwined with the private and social life of individuals and there are very influential ethical points in religious teachings, the managers can apply these points to their speech and actions as a powerful assistance for achieving shared governance.

The last subcategory was “following the religious guidelines.” No study was found on this subcategory. Nevertheless, the Iranian ancient culture is full of stories and poetry that advise people to collaborate with others. There are also many recommendations in the religious texts, behavior of pioneers, and religious thoughts on the manner of consulting with others, communicating with superiors and subordinates during partnership, and the way to deal with opposing views. If these points are followed and advertised by all of the members, and especially the managers, the institute can reach its maximum potential, and with the participation of individuals it can advance toward its transcendental goals.

Considering that this was a qualitative study, it was not possible to obtain the experiences and views of experts in other schools, and therefore, the results cannot be generalized to other centers and faculties. The findings of this study can help nursing faculty managers and administrators to provide support for collaborative support. It is also suggested that researchers and managers use the results of this study to conduct more extensive research on the feasibility of implementing shared governance.


  Conclusion Top


The results of the present study indicated that shared governance is an extensive concept that blends structure, climate, communication, and the entire array of the organizational performance with participation in such a manner that all members who share a diversity of ideas advance the organization such as souls in one body toward a culture-based sublimity.

Thus, it seems that, besides the need for efforts in line with the creation of structural changes in the governance system of the universities, the Ministry of Health should move toward decentralization by empowering managers and staff in participatory decision-making to improve teamwork at the social level. The managers are also recommended to take serious measures to acquire the necessary skills with regard to shared governance and teach them to their employees. Therefore, a better contribution to the adjustments of the existing rules and regulations would be achieved. Eventually, the organizations can become more increasingly participatory. As mentioned in the introduction section, shared governance is a culture-based concept, so it seems that in the Iranian culture spiritual and religious attitudes are considered as an important characteristic for establishing shared governance.

Acknowledgement

The present study is a part of a nursing PhD dissertation. The researchers think it is necessary to express his gratitude to the officials of the nursing school, Shahid Beheshti University of Medical Sciences, Tehran, Iran. In the meantime, the entire participants of the study and all the authorities of the nursing schools in Tehran and Iran Medical Sciences Universities are thanked for their contributions.

Financial support and sponsorship

Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Conflicts of interest

Nothing to declare.



 
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