Educational Quality of Services in Medical Universities of Islamic Republic of Iran: A Systematic Review and Meta-Analysis

Background: The comparison between customers’ expectations and real provided services is defined as the quality of service. In medical education system, the negative quality gap can threaten the lives as graduates are probably not capable of managing the health condition of their patients. The aim of this study was to demonstrate a whole picture for educational quality of services in medical universities of the Islamic Republic of Iran.Methods: Persian databases (SID, Elmnet, Magiran, and IranMedex) and English electronic databases including Scopus and PubMed were searched (from 2005 to 2017). Our main search terms include medical university, SERVQUAL, and quality of education. The methodological quality was assessed by a modified Newcastle–Ottawa Scale (NOS). Information was gathered for the following terms: author, publication year, keywords, and main conclusion. The main outcome measurement was the measured gap for tangibles, reliability, assurance, responsiveness, and empathy dimensions along with the total educational services quality gap. Pooled difference in means (95 CI%) were evaluated. All analyzes were performed using comprehensive meta-analysis software.Result: For this study, 143 cross-sectional studies were found for review. Based on the random effect models, total weighted mean difference (WMD) was -1.23 (95 CI%: -1.35 to -1.11), WMD of assurance was -1.24 (95 CI%: -1.41 to -1.08), WMD of reliability was -1.04 (95 CI%: -1.28 to -0.80), WMD of responsiveness was -1.38 (95 CI%: -1.52 to -1.24), WMD of tangible was -1.25 (95 CI%: -1.41 to -1.10), and WMD of empathy dimension was -1.18 (95 CI%: -1.34 to -1.03). Stratified analysis revealed that if universities types and quality of studies decreases, all dimensions of the quality gap would be deteriorated.Conclusion: Negative gap was reported for all faculties/universities. Students are the main customers of universities; hence items that are requested by students should be offered.  Determining where gaps lie in different dimensions can guide the allocation of financial resources in education systems, in addition to improving decision-making and strategic planning.