Strides in Development of Medical Education

Document Type : Review


1 Student Research Committee, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

2 Student Research Committee, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran

3 Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran


Background: Higher education is not uniform. There are significant differences between higher education systems among different countries and even among institutions in a similar education or system; therefore, identifying the various types of entrepreneurial activities helps the mission of fourth-generation universities.
Objectives: The purpose of this study was to introduce the most important educational strategies to move towards fourth-generation universities.
Methods: We systematically searched the international databases, including PubMed, Web of Science, Scopus, ISC, SID, and Google Scholar, until 2021 using some relevant keywords. Then, screening and selecting eligible articles according to inclusion criteria were done by two researchers independently.
Results: Soft skills training, sustainable development training, training business law, reviewing the continuous training of professors, promoting ideation and creativity to solve problems, development of interdisciplinary training, decentralization of government accelerators and deployment of private accelerators, privatization of higher education, and internationalization are the most important educational strategies to move towards fourth-generation universities. One of the critical aspects and perspectives of the fourth-generation university is the development of job skills, professions, and competencies and empowerment of students and professors in line with the process of national development and solving society's problems scientifically.
Conclusion: This research's analytical results help the universities design and implement their strategies to reach the fourth-generation universities according to the standard implementation models of the fourth-generation universities.


  1. Lukovics M, Zuti B. New functions of universities in century XXI towards “Fourth Generation” universities. Journal Transition Studies Review. 2015; 22(2): 33-48.
  2. Robles MM. Executive perceptions of the top 10 soft skills needed in today’s workplace. Business communication quarterly. 2012;75(4):453-65. doi:10.1177/1080569912460400
  3. Lazareva O, Kovtun O. Developing soft skills at ESP classes in technical heis. 2017; 108-15. doi:10.26697/9789669726094.2017.108
  4. Akbulaev N, Mammadov I, Shahbazli S. Accounting Education in the Universities and Structuring According to the Expectations of the Business World. Universal Journal of Accounting and Finance. 2021;9(1):130-7. doi:10.13189/ujaf.2021.090114
  5. Eragamreddy N. Teaching creative thinking skills. International Journal of english language & translation studies. 2013;1(2):124-45.
  6. Ahmadian Chashemi M, Niazazari K, Salehi M. Designing the model of Fourth-generation University to Improve Education and Research Quality in Higher Education. Educational Development of Judishapur. 2021;11(4):901-11. [In Persian]
  7. Im H, Hokanson B, Johnson KK. Teaching creative thinking skills: A longitudinal study. Clothing and Textiles Research Journal. 2015;33(2):129-42. doi:10.1177/0887302X15569010
  8. Bindler RC, Richardson B, Daratha K, Wordell D. Interdisciplinary health science research collaboration: strengths, challenges, and case example. Applied Nursing Research. 2012;25(2):95-100. doi:10.1016/j.apnr.2010.06.004. [PMID: 20974103]
  9. Meskó B. The guide to the future of medicine: technology and the human touch. 1st ed. Budapest, Hungary: Webicina Kft; 2014.
  10. Salehi AM, Ahmadian M, Mohammadi HA, Khanlarzadeh E. Modification of educational curriculum based on the interdisciplinary approach: a requirement in the present era. Strides in Development of Medical Education. 2021;18(1). doi:10.22062/sdme.2021.91628
  11. Antal N, Kingma B, Moore D, Streeter D. University-wide entrepreneurship education. Bingley, UK: Emerald Publishing Ltd; 2014. doi:10.1108/S1048-473620140000024009.
  12. Metcalf LE, Katona TM, York JL. University Startup Accelerators: Startup Launchpads or Vehicles for Entrepreneurial Learning?. Entrepreneurship Education and Pedagogy. 2020;4(4):666-701. doi:10.1177/2515127420931753
  13. Manna MR, Paul MA, Mete J. Gender Inequality in Education at Present Context: In Indian Scenario. Gender Issues in India: Challenges and Strategies.2017;82.
  14. Óskarsson Þ. Who is best placed to provide health care? : a survey among managers of health care institutions. Island: Skemman;2011.
  15. Rabiei A, Nazariyan Z. The Barriers to the privatization of higher education in Iran and providing solutions for their removal. Iran Higher Education Journal. 2012;4(2):171-206.
  16. Shehnaz SI. Privatisation of medical education: viewpoints with a global perspective. Sultan Qaboos Univ Med J. 2010;10(1):6-11.
  17. Ghoraishi Khorasgani MS, Yamani M, Zakersalehi G, Mehran G. A Content Analysis Of Articles In Privatization Of Higher Education In Iran Scientific Journals. Journal Of Science And Technology Policy. 2017;9(3):61-76.
  18. Goudarzvand Chegini M. The fourth generation university labor; and action approach (case studies: Cambridge, Stanford, and Harvard universities. Iranian Journal of Engineering Education. 2018;20(78):1-16. doi:10.22047/IJEE.2018.128487.1541
  19. Iran Data Portal. 20 Year National Vision. Available From:
  20. Callagher L, Horst M, Husted K. Exploring societal responses towards managerial prerogative in entrepreneurial universities. International Journal of Learning and Change. 2015;8(1):64-82. doi:10.1504/IJLC.2015.069074
  21. Chang Y-C, Yang PY, Martin BR, Chi H-R, Tsai-Lin T-F. Entrepreneurial universities and research ambidexterity: A multilevel analysis. Technovation. 2016;54:7-21. doi:10.1016/j.technovation.2016.02.006
  22. D’este P, Perkmann M. Why do academics engage with industry? The entrepreneurial university and individual motivations. Journal of Technology Transfer. 2011;36(3):316-39. doi:10.1007/s10961-010-9153-z
  23. Dalmarco G, Hulsink W, Blois GV. Creating entrepreneurial universities in an emerging economy: Evidence from Brazil. Technological Forecasting and Social Change. 2018;135:99-111. doi:10.1016/j.techfore.2018.04.015
  24. Amaral M, Ferreira A, Teodoro P. Building an entrepreneurial university in Brazil: the role and potential of university–industry linkages in promoting regional economic development. Industry and Higher Education. 2011;25(5):383-95. doi:10.5367/ihe.2011.0061
  25. Arikewuyo MO, Ilusanya G. University Autonomy in a Third‐Generation University in Nigeria. Tertiary Education and Management. 2010;16(2):81-98. doi:10.1080/13583881003756468
  26. Bienkowska D, Klofsten M, Rasmussen E. PhD students in the entrepreneurial university‐perceived support for academic entrepreneurship. European Journal of Education. 2016;51(1):56-72. doi:10.1111/ejed.12160
  27. Di Berardino D, Corsi C. A quality evaluation approach to disclosing third mission activities and intellectual capital in Italian universities. Journal of Intellectual Capital. 2018;19(1):178-201. doi:10.1108/JIC-02-2017-0042
  28. Adeniran A, Nubi A, Adelopo A. Solid waste generation and characterization in the University of Lagos for a sustainable waste management. Waste management. 2017;67:3-10. doi:10.1016/j.wasman.2017.05.002. [PMID: 28532622]
  29. Amrina E, Imansuri F. Key performance indicators for sustainable campus assessment: a case of Andalas University. Industrial Engineering, Management Science and Applications. Berlin, Heidelberg: Springer; 2015: 11-8.
  30. Amaral LP, Martins N, Gouveia JB. Quest for a sustainable university: a review. International Journal of Sustainability in Higher Education. 2015;16(2):155-72. doi:10.1108/IJSHE-02-2013-0017
  31. Sylvestre P, Wright T, Sherren K. A tale of two (or more) sustainabilities: AQ methodology study of university professors’ perspectives on sustainable universities. Sustainability. 2014;6(3):1521-43. doi:10.3390/su6031521
  32. Kiani Mavi R. Indicators of entrepreneurial university: Fuzzy AHP and Fuzzy TOPSIS Approach. Journal of the Knowledge Economy. 2014;5(2):370-87. doi:10.1007/s13132-014-0197-4
  33. Bikse V, Lusena-Ezera I, Rivza B, Volkova T. The Transformation of Traditional Universities into Entrepreneurial Universities to Ensure Sustainable Higher Education. Journal of Teacher Education for Sustainability. 2016;18(2):75-88. doi:10.1515/jtes-2016-0016
  34. Budyldina N. Entrepreneurial universities and regional contribution. International entrepreneurship and management journal. 2018;14(2):265-77. doi:10.1007/s11365-018-0500-0
  35. Errasti N, Bezanilla M-J, García-Olalla A, Auzmendi E, Paños J. Factors and maturity level of entrepreneurial universities in Spain. International Journal of Innovation Science. 2018;10(1):71-91. doi:10.1108/IJIS-05-2017-0043
  36. Farrington D, Ismaili D. Finding the right person to lead a third generation university: a new approach in the Republic of Macedonia. Procedia-Social and Behavioral Sciences. 2011;15:2083-7. doi:10.1016/j.sbspro.2011.04.058
  37. Guerrero M, Urbano D. The development of an entrepreneurial university. The journal of technology transfer. 2012;37(1):43-74. doi:10.1007/s10961-010-9171-x
  38. Secundo G, Perez SE, Martinaitis Ž, Leitner KH. An Intellectual Capital framework to measure universities' third mission activities. Technological Forecasting and Social Change. 2017;123:229-39. doi:10.1016/j.techfore.2016.12.013
  39. VAMPA M. Albanian Universities mission on “the system” of long-life education. Mediterranean Journal of Social Sciences. 2014;5(19):126-38. doi:10.5901/mjss.2014.v5n19p126
  40. Disterheft A, Caeiro S, Azeiteiro UM, Leal Filho W. Sustainability science and education for sustainable development in universities: a way for transition. Berlin: Springer; 2013: 3-27. doi:10.1007/978-3-319-02375-5_1.
  41. Bodunkova AG, Chernaya IP. Fractal organization as innovative model for entrepreneurial university development. World Applied Sciences Journal. 2012;18(12):74-82. doi:10.5829/idosi.wasj.2012.18.120012
  42. Bronstein J, Reihlen M. Entrepreneurial university archetypes: A meta-synthesis of case study literature. Industry and Higher Education. 2014;28(4):245-62. doi:10.5367/ihe.2014.0210
  43. Etzkowitz H. The entrepreneurial university wave: from ivory tower to global economic engine. Industry and Higher education. 2014;28(4):223-32. doi:10.5367/ihe.2014.0211
  44. Etzkowitz H. The entrepreneurial university: vision and metrics. Industry and Higher Education. 2016;30(2):83-97. doi:10.1177/0950422218817734
  45. Etzkowitz H. Innovation Lodestar: The entrepreneurial university in a stellar knowledge firmament. Technological Forecasting and Social Change. 2017;123:122-9. doi:10.1016/j.techfore.2016.04.026
  46. Kirby DA, Guerrero M, Urbano D. Making universities more entrepreneurial: Development of a model. Canadian Journal of Administrative Sciences/Revue Canadienne des Sciences de l'Administration. 2011;28(3):302-16. doi:10.1002/cjas.220
  47. Lombardi R, Lardo A, Cuozzo B, Trequattrini R. Emerging trends in entrepreneurial universities within Mediterranean regions: An international comparison. EuroMed Journal of Business. 2017;12(2):130-45. doi:10.1108/EMJB-10-2015-0052
  48. Savetpanuvong P, Pankasem P. Entrepreneurial University model: A theoretical perspectives on strategy, entrepreneurship, and innovation. Proceedings of the IEEE International Conference on Management of Innovation and Technology; 2014 Sep 23-25; Singapore. doi:10.1109/ICMIT.2014.6942432.
  49. Urbano D, Guerrero M. Entrepreneurial universities: Socioeconomic impacts of academic entrepreneurship in a European region. Economic development quarterly. 2013;27(1):40-55. doi:10.1177/0891242412471973
  50. Albulescu VL, Litra M, Neagu C. The “third mission” of universities and some implications. UPB Science Bulletin, Series D. 2014;76(2):301-12.
  51. Berggren E. Researchers as enablers of commercialization at an entrepreneurial university. Journal of Management Development. 2017;36(2):217-32. doi:10.1108/JMD-06-2016-0117
  52. Guerrero M, Urbano D, Fayolle A. Entrepreneurial activity and regional competitiveness: evidence from European entrepreneurial universities. The Journal of Technology Transfer. 2016;41(1):105-31. doi:10.1007/s10961-014-9377-4
  53. Williams D, Kluev A. The entrepreneurial university: evidence of the changing role of universities in modern Russia. Industry and Higher Education. 2014;28(4):271-80. doi:10.5367/ihe.2014.0212
  54. Markuerkiaga L, Errasti N, Igartua JI. Success factors for managing an entrepreneurial university: Developing an integrative framework. Industry and Higher Education. 2014;28(4):233-44. doi:10.5367/ihe.2014.0214
  55. Berggren E. The entrepreneurial university’s influence on commercialisation of academic research–the illustrative case of Chalmers University of Technology. International Journal of Entrepreneurship and Small Business. 2011;12(4):429-44. doi:10.1504/IJESB.2011.039684
  56. Baaken T, Davey T, Rossano S. Marketing—Making a Difference for Entrepreneurial Universities. Making a Difference Through Marketing: Springer; 2016. 247-65. doi:10.1007/978-981-10-0464-3_18
  57. Etzkowitz H, Viale R. Polyvalent knowledge and the entrepreneurial university: A third academic revolution?. Critical Sociology. 2010;36(4):595-609. doi:10.1177/0896920510365921
  58. Minola T, Donina D, Meoli M. Students climbing the entrepreneurial ladder: Does university internationalization pay off?. Small Business Economics. 2016;47(3):565-87. doi:10.1007/s11187-016-9758-1
  59. Ratten V. Entrepreneurial universities: the role of communities, people and places. Journal of Enterprising Communities: People and Places in the Global Economy. 2017;11(3):310-5. doi:10.1108/JEC-03-2017-0021
  60. Reshetnikova MS. Analysis of the Russian experience in formation of entrepreneurial universities within the context of the triple helix model as a factor of economy endogenous growth. Espacios. 2017;38(33):36.
  61. Reyes CN. Framing the entrepreneurial university: the case of the National University of Singapore. Journal of Entrepreneurship in Emerging Economies. 2016;8(2):134-61. doi:10.1108/JEEE-09-2015-0046
  62. Etzkowitz H. Entrepreneurial Universities for the UK: a ‘Stanford University’at Bamburgh Castle?. Industry and Higher Education. 2010;24(4):251-6. doi:10.5367/000000010792609781
  63. Guerrero M, Toledano N, Urbano D. Entrepreneurial universities and support mechanisms: a Spanish case study. International Journal of Entrepreneurship and Innovation Management. 2011;13(2):144-60. doi:10.1504/IJEIM.2011.038856
  64. Guerrero M, Urbano D, Cunningham J, Organ D. Entrepreneurial universities in two European regions: A case study comparison. The journal of technology Transfer. 2014;39(3):415-34. doi:10.1007/s10961-012-9287-2
  65. Guerrero M, Urbano D, Fayolle A, Klofsten M, Mian S. Entrepreneurial universities: emerging models in the new social and economic landscape. Small business economics. 2016;47(3):551-63. doi:10.1007/s11187-016-9755-4