Examining a paradigm for cultural development at Tabriz University of Medical Sciences

Introduction Knowledge and technology have changed our lives tremendously in the last few centuries and societies have shown tendencies towards changes, evaluation, and development in the information and technology era. Thus, it seems that development is the only logical direction towards a progressive society. Development is defined as transferring from a lower level to a higher level and occurs when the current state loses its mobility and exhilaration, and structural and fundamental changes seem imperative and vital.1 Nowadays economic, political and social development is achieved by focusing on culture. Cultural development changes human perception, vision, capabilities and beliefs, resulting in specific behaviors and reactions to development.2 Culture includes common life styles,3 beliefs, values, rules, norms, symbols and behaviors of a group of people or a system.4 Behavior and social interaction is affected by culture. It has long been believed that universities are detached from the community. They have been linked to international and national academic and research communities, and have enjoyed high levels of institutional autonomy by nationally regulated, assessed, and funded systems of higher education.5 Examining the relationship between university culture and cultural development is important in two dimensions: first, there is a mutual relationship between science and technology and culture. If the appropriate culture for developing knowledge and technology in a society has not


Introduction
Knowledge and technology have changed our lives tremendously in the last few centuries and societies have shown tendencies towards changes, evaluation, and development in the information and technology era.Thus, it seems that development is the only logical direction towards a progressive society.Development is defined as transferring from a lower level to a higher level and occurs when the current state loses its mobility and exhilaration, and structural and fundamental changes seem imperative and vital. 1 Nowadays economic, political and social development is achieved by focusing on culture.Cultural development changes human perception, vision, capabilities and beliefs, resulting in specific behaviors and reactions to de-velopment. 2 Culture includes common life styles, 3 beliefs, values, rules, norms, symbols and behaviors of a group of people or a system. 4Behavior and social interaction is affected by culture.It has long been believed that universities are detached from the community.They have been linked to international and national academic and research communities, and have enjoyed high levels of institutional autonomy by nationally regulated, assessed, and funded systems of higher education. 5xamining the relationship between university culture and cultural development is important in two dimensions: first, there is a mutual relationship between science and technology and culture.If the appropriate culture for developing knowledge and technology in a society has not been generated, science and knowledge will not be expanded.Additionally, we cannot assess their feedback and the society's fundamental problems will not be resolved. 6cademic and cultural structures are closely related to each other and each one is necessary for the function of the other.Secondly, universities and higher education institutes have been affected by western countries without comprehending the appropriate culture and values.Mismatches between universities and historical and cultural traditions have caused serious problems.On one hand universities must preserve society's cultural values and traditions yet on the other hand they are obliged to propagate new values and require science and technology.Universities should be able to understand these two important aspects; otherwise they will suffer from internal and external conflicts. 7ultural development is one of the main aspects of economic progress.A country must adjust itself to and keep pace with technology in order to progress. 8In order to understand changes in the new world, people must be able to express their feelings and communicate with each other.Therefore, people need continuous training, which is the main condition of development.Individuals must be able to adjust themselves to such changes in order to understand occupational changes.This ability is obtained by establishing a set of processes via gaining information, taking occupational training responsibilities, and learning expression techniques. 9onsidering the interactions between cultural developments in our society and universities and understanding the importance and obligations of cultural development for knowledge and technology, 10 we formulated an important question.The question is, "What is the appropriate paradigm for cultural development in the management era of Tabriz University of Medical Sciences?"Thus the objective of this study is to assess the current status of cultural development and then offer a proper paradigm for improving this status at the Tabriz University of Medical Sciences.

Materials and Methods
This research was conducted via survey, and applied and conducted at a micro level. 11The statistical population consisted of all 270 employees and managers of Tabriz University of Medical Sciences.The participants of the present descriptive study consisted of 160 employees and managers (104 managers and 56 employees) of Tabriz University of Medical Sciences.The sample size was chosen via cluster random sampling method calculated using Krejcie & Morgan's table.Inclusion criteria were working in the Tabriz University of Medical Sciences, being willing to participate in the study, having an academic education (at least associate's degree), and being a manager or employee.Exclusion criteria were not willing to participate in the study, fired or retired staff, not having an academic education and not being a manager or employee.Data was collected using a questionnaire prepared by the authors.This questionnaire was designed based on theoretical foundations and literature reviews and studies.The Delphi method was used to design the questionnaire.This questionnaire included 80 Likert-type items to assess the staff 's current status and optimal state.Using the Likert scale decreased potential sources of bias.The questionnaire measured the research octoploid variables (eight Georges' cultural development components).For assessing questionnaire validity, the questionnaire was reviewed by three professors and then their judgment was taken into account and certain changes were implemented.For assessing reliability, the questionnaire was distributed to 20 individuals based on our sample size.The Cronbach alpha coefficient was 90.The variables assessed in this study are cultural education, creativity promotion and innovation, definite attitudes regarding culture, cultural identity, public culture and traditional culture, promotion of culture exchange, cultural heritage preservation and access to culture in current status and optimal status among the Tabriz University of Medical Sciences staff.In order to decrease potential sources of bias such as individual's refusal to answer questions, the study objectives were precisely described to individuals.Data were analyzed using SPSS version 16 (SPSS Inc., Chicago, IL, USA) software.Data normality was evaluated by the Kolmogorov-Smirnov test and expressed by mean and standard deviation or median (minimum and maximum) in tables.An independent samples t test was performed to compare means and median values between two groups.Additionally, the Friedman test was used to prioritize the effective factors for cultural development.The Pearson correlation test was used for assessing the correlation of study variables between the current and optimal states.All statistical tests were two-tailed, with a P value of <0.05 considered statistically significant.In this study, 69.4% of staff are men and 30.6% are women.The staff 's education level was also assessed: 66.3% had bachelor's degrees, 33.1% had master's degrees and 10.6% had associate's degrees.The staff 's mean time in employment was 14.13 ± 7.25.

Results
Here we review the findings regarding the questions mentioned in this study: The current status of cultural development at Tabriz University of Medical Sciences variables and its components in the health management of East Azerbaijan are shown in Table 1.Table shows the highest and lowest means and standard deviation with maximum and minimum levels.The optimal status of cultural development at Tabriz University of Medical Sciences and statistical indicators of cultural development and its components are summarized in Table 2. Table 3 shows the mean scores, current and optimal statues of the effective factors of cultural development at Tabriz University of Medical Sciences.According to a chi-square test, there is a statistically significant difference between cultural development in the current and optimal states (P < 0.001).A significant difference among the effective factors of cultural development was observed.There were significant differences in study variables between the currant and optimal states among the Tabriz University of Medical Sciences staff.For comparing these variables between the two states, an independent samples t test was used.Afterwards, we used the Pearson correlation test for assessing the correlation of study variables between the current and optimal states.Findings are presented in Table 5.According to Table 5, the correlation between study variables was confirmed between the current and optimal states.Therefore, the paired t test was indicated in order  In the current status variables were prioritized as following: 1-Empowerment of cultural identity 2-Promotion and innovation of creativity 3-Expansion of definite attitudes on culture 4-Preservation of cultural heritage 5-Access to culture 6-Encouragement of public culture and traditional culture to assess the differences between the two states.Table 6 indicates these differences.

Discussion
As the results of the research indicate, cultural education in an optimal state is of a higher rank than other indicators.Thus it seems necessary to pay more attention to cultural development and sustainable development.
After analyzing the role of cultural development on creativity and innovation, it can be said that cultural development plays a fundamental role in all cultural issues.Therefore, providing basic changes and increasing public awareness and promoting public culture in order to add the importance of creativity and innovation is vital.On the other hand, cultural development should help us follow our beliefs.
It can be concluded that the results of this research on cultural education are in consistent with the results of Zahedil 12 and Lahasaeizadeh's 2 studies regarding design- programs for preservation and efficient management of historical and cultural resources 7. Assurances on compatibility and coordination or preventing incompatibility in diverse cultural policies.8. Identifying various cultural needs and supporting opportunities for cultural expression; persuasion and encouragement of people to participate in cultural innovations, cultural values, and establishing cultural development process.9. Protecting, preserving and respecting cultural heritage areas.In order to increase staff 's perception on the importance of cultural dimensions, it is necessary to consider the staff 's performance alignment with the organization mission to coordinate and unify such activities.Therefore, behavioral alignment in cultural scopes and values and skills should be considered as competitive organizational strategies.These strategies help the staff compete with each other at organizational levels and pay attention to ethical values.

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Promotion of cultural exchange 8-Cultural education.In the optimal condition variables were prioritized as following: 1-Cultural education 2-Expansion of definite attitudes on culture 3-Preservation of cultural heritage 4-Promotion of cultural exchange 5-Promotion and innovation of creativity 6-Access to culture 7-Encouragement of public culture and traditional culture 8-Empowerment of cultural identity In Table4the effective factors of cultural development of the Tabriz University of Medical Sciences are compared.

Table 1 .
Mean of current cultural status and its components in the health management

Table 2 .
Mean of optimal status of cultural development

Table 3 .
Mean of effective factors on cultural development

Table 4 .
Comparing effective factors of cultural development of the Tabriz University of Medical Sciences

Table 5 .
Comparing the correlation of study variables between the current and optimal status (n = 160)

Table 6 .
Comparing the differences of study variables in the current and optimal status Not having easy access to all the cities of East Azerbaijan faculties, employees and managers in the universities decreased the sample size and variety.• Design effect were not considered in this study; this was another limitation in this study.Increasing staff 's authority for their responsibilities and pursuing creative thinking in organizations while supporting creative and talented individuals.3. Providing research tools and facilities such as laboratories, libraries, and information centers.4. Converting cultural democracy to reality and adjusting cultural programs with current methods.5. Providing cultural training and information dissemination and occupational training; coordinating educational, cultural and free time activities.6. Setting general and specific goals, policies, plans, and