# Identifying the drivers and trends of Iran nursing education: a multi-methods study

## TL;DR

This study identifies key drivers and trends in Iran's nursing education to address challenges and prevent crises through policy and structural improvements.

## Contribution

The study introduces a multi-method approach combining meta-synthesis, interviews, and the Delphi method to identify 6 drivers and 31 trends in nursing education.

## Key findings

- Experts agreed on 6 drivers and 31 trends affecting nursing education in Iran.
- Key drivers include internet use, flexible systems, improved management, and globalization.
- Solutions include curriculum updates, better student-to-tutor ratios, and national accreditation.

## Abstract

Nursing education faces many challenges that can be solved with simple and low-cost measures if properly identified, otherwise these challenges will turn into crisis and their solution will be difficult and costly. Proponents or derivers carry out the task of advancing and solving challenges at the same time.

This study was conducted with the aim of identifying the drivers and trends of nursing education.

The research is developmental-applicative in terms of its purpose and descriptive-exploratory in terms of its nature, and a multi method was used to collect data. In the first stage, 723 articles published between 1990 and 2023 were examined using meta-synthesis. In the next stage, 23 semi-structured interviews were conducted with 17 nursing professors. Shannon’s entropy was used to analyze the content of obtained codes and then, concepts were ranked according to their weights. In the last step, the Delphi method was used to create an agreement.

In the first stage, after reviewing 9 related articles, 24 codes obtained. After analyzing the interviews, 365 codes identified. The experts agreed on 6 drivers and 31 trends. Empowering policies (such as drivers of using internet and designing systems with greater flexibility), structural and managerial policies (such as drivers of improving management methods/strategies and quality assurance), trans-organizational policies (such as driver of being on the path of globalization), and value policies (such as derivers of developing moral and culture-centeredness) are among the findings of present study.

In order to control the challenges of nursing education and prevent them from turning into crisis, operational and basic solutions can be used to improve curriculum in accordance with global standards and advances in knowledge and technology. It is also suggested to improve the student/tutor ratio, establish an accreditation body at the national level, and allocate performance-based budget for the qualitative development of education system.

The online version contains supplementary material available at 10.1186/s12912-025-03169-8.