# Developing a Framework for Managing Change Climate in Social Systems: Some Practical Implications for Medical Education Universities

Authors: Jafar Torkzadeh; Maasoumeh Mohtaram
Journal: Education Research International
 (2022)

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## Abstract

This study is aimed at exploring a framework to develop change climate in social systems based on a strategic approach. The methodology of the case study was qualitative. The potential participations included managers and specialists of management at Shiraz University of Medical Sciences who were selected using the purposive sampling of standard type. Qualitative data were collected using semistructured interview with managers and specialists of change area in university and studying related top documents. To calculate the validity and reliability, the parallel processing method and the credibility and conformability of the study data were used. The results showed that the development of change climate in universities in the form of a model consisting of 38 basic themes, 10 organizing themes can be achieved. Based on this, some practical implications for medical universities have been inferred and expressed.


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## Body

## 1. Introduction

Nowadays, considering organizations surrounding complex and changing forces, their meaningful survival depends on conformity and continuant adaptability with newly developed conditions, improvement, and fundamental change, if necessary. Since change along with the improvement approach makes the organizations more powerful, so, they can make an appropriate decision when exposing to their internal and external environment challenges and contingencies and also be responsive for their decisions. Indeed, universities are known as open social systems [1], and their existence and success in a competitive environment depend on applying changes in all structural and functional aspects and the development of essential capacities for understanding the environmental conditions and changes and also their appropriate responsiveness [2]. Obviously, the development of organizational and managerial capacities and achieving the effective changes in universities require the availability of conditions and necessary infrastructures at universities, especially developing change climate.Change climate in university refers to individuals and stock holders understanding about the desirable situation that the university tends to achieve [3]. And so, the more individuals have a better understanding of change and its essentiality, the more the resistance against it will decrease; the change will occur in a more effective way, and it will provide the situation for the university’s success. Therefore, the universities should direct all their attention to the development of the effective change climate and also direct the individuals’ understanding to their intended and desirable climate.It is necessary to mention that the development of change climate does not occur by itself, but it needs to be directed in a strategic condition. Kennedy (2004) [4] believes that in complicated and changing conditions of today, the existence of effective leaders is one of the most important and basic factors affecting the function and organization’s change. Because the effective leaders, having the collection of skills and existing knowledge about the current and ideal conditions of the system, attempt to guide and direct the organizational change in an effective way, Abbas and Asghar [5], emphasizing the important role of conditional change factors, believe that the effective leader, through emphasizing on development of culture and climate of organizational change, tries to direct their systems toward the effective and ideal change and hence helps their own survival in the organization, so they deserve special attention. Considering the dynamism, complexity, and ambiguity of continuing changes in university’s interactive environment, for the university managers to reach the success against their competitors, they should take a strategic approach in their leadership process and through this help their meaningful safety and survival. In fact, the strategic leaders, having the four key competencies—relationship with interactive environment and strategic recognition—direction, adaptability, and interactive environment management [6], and through affecting the systems and organizational processes directly rather than affecting the individuals, they develop the climate of change in universities according to their own expectations and expediencies. Thus, taking this strategy in the development of climate of change process seems really indispensable and essential.Based on the mentioned information, we may conclude that in today’s changing conditions, if the universities want to stay side by side with continuous fluctuation, they need to have a suitable, rational, and systematic framework for the development of change climate in a strategic environment, so that by using this, they can follow the change development trend with a higher speed and more triumph. However, the unavailability of comprehensive and native change patterns, especially university change patterns, have caused the progress or acceptance of change by the members and university beneficiaries to occur slowly and sometimes face resistance, and therefore, decrease of the organizations’ chance of success in this area. Regarding the development of appropriate contexts and processes emergency to change universities and the development of organization’s social areas for acceptance, support, and development of change, and also with regard to the importance of the development of change climate, according to a clear and comprehensive framework, this study made an attempt to explore a comprehensive framework for this concept in a strategic environment, using a qualitative case study. The results of this work can function as a guide for the university development managers and planners to develop the change climate at universities..


## 2. Theoretical Foundations

Change regards to the movement of the organization from the existing conditions to the ideal conditions, discounting the fact that the base and foundation of organizational change are attributed to which one of factors of human resources, structure, organizational goals, technology, or culture. Generally, one can think of change in different organizational levels, i.e., cognition, attitudes, behavioral or individual, group, organizational, or a combination of these factors [7]. During the time of change, the interactions among individuals with their counterparts and supervisors are very important, and its nature is one of the basic factors in preparing people for change. In this situation, people need each other’s trust, support, and cooperation for performing effective activities. So, one of the manager’s main duties and challenges for empowering the staff and facilitating their participation in a change process is creating commitment and loyalty about change in them. Thus, the organizational change effectiveness, to a large degree, is affected by the management or guidance of individuals’ interactive patterns and their feelings towards each other and the organization [3]. Regarding the importance of this issue, the study trends about climate of change have emphasized the importance of the development of the indexes about individuals’ interactive patterns, so that it will create self-confidence in them, and it will also develop their ability to face new challenges in their work environment. In this area, Jones, Jimmieson, and Griffiths [8] have highlighted the organizational climate index and have stated that organizational climate with its flexible and supportive structure leads to a positive attitude toward change. Ten Have and Ten Have [9] stated that in cooperative and supportive conditions, the individuals’ resistance against change decreases. Tierney [10] said that psychological aspects of change such as trust, cooperation, and support are the overviews for creation of change condition. In Bonchnoogh and Devos’s opinion, we can divide the mentioned factors into two elements: (1) context or climate of change levels (such as trust in leadership) and (2) process elements of change levels (such as cooperation in decision-making).Although there are different definitions about organizational climate, there is not much literature about organizational change concept, and few researchers have studied and defined this concept. For example, Holt, Armenakis, Feild, and Harris [11] believed that change climate means the perception of staff about the organizational change plan, a plan which is expected from an organization, is supported and is awarded. Bouckenooghe, Devos, and van den Broeck [3] in one study, using the human relation approach, introduced a framework of organizational climate aspect and process factors as elements of organizational change climate. In addition to the mentioned factors, they created a tool about organizational change climate and introduced its aspects and elements as follows: (1) readiness for change (emotional, cognitive, and purposive), (2) change relation quality, (3) cooperation, (4) top manager’s attitudes towards organizational change, (5) supervisors’ support, (6) trust in leadership, (7) cohesion, and (8) political relationship. Generally speaking, the mentioned aspects embrace a complex combination of change condition (for example, process factors), change process, and reaction to change. Among these, the qualities of change relations, participation, and top managers’ attitudes towards organizational change and support by supervisors are all related to change process. Internal change conditions (like change climate) include trust in leadership, cohesion, and political relationship. And finally, readiness for change is a multiaspect attitude to change including cognitive, emotional, and purposive readiness. Holt, Armenakis, Achilles, Field, and Harris [11] stated that by change climate we mean members’ understanding of programs and decisions about organizational change which determines the individuals’ behavior toward change in organizations.Studies show that there are not many surveys directly studying the development of change climate in universities with a strategic perspective. But there has been some research done about change and managing or guiding change whose results are to some extent related to our study. From Elaine [12] point of view, leadership style, decision-making methods, internal issues (issues about curriculum), and the faculty science independence are among the effective factors affecting the change exigency in universities. Holt et al. [11] believe that teaching the members affects the quality of effective organizational change program implementation. According to the research, some managerial actions like involving staff in change programs (Holt et al., 2003 [13]), evolutionary leadership style [14], management support of changes [15], and individual empowering [16] affect the success of organizational change programs. Herold et al. [17] believe that leader’s outlook, individuals’ direction and leadership quality, the degree of attention to member empowering, and the monitoring patterns used in the organizations affect the change leadership quality. These researchers believe that through creating and establishing a relationship with a change perspective which means involving the staff in the change and especially in decision-making, helping individuals in dealing with change-related challenges, and presenting regular feedback about change processes, leaders will be able to decrease the ambiguities about the change and create the necessary capabilities related to the change in staff.Caldwell, Herold, and Fedor [18] believe that there is a relationship between leader’s behavior and the quality or way of applying the change in an organization. Self, Armenakis, and Schraeder [19] and Furst and Cable [20] state that there is a relationship between managers’ support, leader–follower interactions, organizational support perceived by individuals, and organizational change. Some research results show that organizational culture affects the individual’s acceptance or resistance against the change [14, 15]. Rashid, Sambasivan, and Rahman [21] believe that organizational culture affects the individuals’ attitudes towards the change. Abraham, Sullivan, and Griffin [22] believe that the organizational structure type has an effect on the success of change programs. Moreover, according to the results obtained by Nilakant and Ramnarayan [23], organizational commitment is also among the factors affecting the organizational change.


## 3. Methodology

Given the purpose of this study to understand the climate of change development deeply in university with an intended strategic approach, this study used a qualitative case study. The potential participants of the study were the managers and specialists of change management and leadership in university who were selected according to the purposive sampling of standard, considering the topic of theoretical saturation. In order to collect the qualitative data, semistructural interviews with managers and specialists of change area in university and the study of related top documents were used. In order to calculate the reliability and validity of the collected data, the methods of credibility and conformability were used. It is also needed to mention that after obtaining the basic, organizer, and comprehensive themes related to the development of climate of change using the thematic analysis and thematic network (Braun and Clarke, 2006; 2013; [24, 25], Atrik – Stirling, 2001 [26]), the relationship among the themes was demonstrated in a thematic network.


## 4. Findings

### 4.1. How Does the Change Climate Develop and Form at University?

Using thematic analyzing, after extracting the key themes change climate development in universities with a strategic approach, the codes, basic themes, and comprehensive and organizing themes were obtained using the Nvivo 10 software. The key informants of this research were 15 managers and change management and leadership specialists in the university. Furthermore, the top documents related to the study topic like a strategic document of education research and technology development dialouge, 2015, Shiraz University strategic and operative plan, 2016 etc. were analyzed.After interviewing change leadership and management specialists and managers in university and studying the top document, the text of interviews and top documents was codified according to the Atraid–Stirling (2001 [26]) and Braun and Clarke (2006, 2013 [24, 25]) thematic networks. The sum of the obtained codes from interviews and top documents included 581 codes. Among these, 485 meaningful codes were selected, and of these 485 codes, 10 codes were put aside as “others,” and finally, 471 meaningful codes were used. Also, 110 meaningful codes were obtained from the top documents. After that, the codes were summarized in basic themes, as shown in Table 1. According to Table 1, in the third stage of creating thematic network, the basic themes were summarized as organizing themes. In order to avoid different understanding of the obtained themes and also to accelerate the collecting of basic themes, the organizing themes are categorized as shown Table 2.Table 1
Change climate organizing themes.
ThematicDefinitionStrategic foundations of changeFoundations show the thinking beds and grounds which are of upmost importance, and they are the ones which determine the source, path, and the destination of activities.Conceptual dimensionShows the conceptual image or the existing understanding about the role and exigency of basic functions of change process in an organization, the quiddity of aspects, features, methods, and basic necessities of change in an organization. In fact, this aspect points to the thought, knowledge, recognition, attitudes, and approaches towards climate of change development in a system.Structural dimensionIt presents any kinds of orientation and organizational activities and strategies done in order to realize and carry on the basic functions of climate of change in an organization.Functional dimensionIt shows all the activities which are done to proceed and realize the climate of change. This aspect includes activities concentrating on the development of change climate and also activities which pave the way for doing these actions and their related functional considerations.Individual levelThe presuppositions of this level are personal characteristics, experiences, abilities, skills, knowledge, and background of human factors and their needs and expectations from change process in an organization.Group levelThe themes that show the attention to attachment of two or more individuals and their interactions to reach the ideals of change process are considered as the basic presuppositions of this level.Organizational levelOrganizational level or in other words the structural aspect shows all the activities done to provide the conditions for the establishment and development of climate of change.Environment levelIt includes the structures, aspects and ultraorganization social, general, and technological activities which are mostly out of direct control or manipulation of the organization.Table 2
Change climate organizing themes.
Fundamental themesConstructive themesInteractive environment condition graspInteractive environment element graspConceptual dimension—environmental levelScenario makingUniversity internal environment graspConceptual dimension—organizational levelReadiness for changeChange management knowledgeChange execution commitmentConceptual dimension—individual levelChange team’s developmentGroup structure redesigningStructural dimension—group levelStrategic planningChange ultrastructure developmentChange culture makingJob requirements, processes, and structure redesigningStructural dimension—organizational levelConsidering the human element role in changeIndividuals’ competency developmentFunctional dimension—individual levelHuman interactionsGroup accompanyingStaff satisfaction attractionInteraction with informal groupsStructural dimension—group levelManaging and improving organizational resources andprocessesSupporting the changeChange leadershipIndividual informingOvercoming the resistance against the changeProviding necessary resources and facilitiesSystem’s constant quality improvementOrganizational learningInteractive programmingStaff trainingOn time change applicationConstant monitoring and evaluationManagement system developmentFunctional dimension—organizational levelRelationship with interact environmentOrganizational positive climate developmentResponse to environmental needs and conditionsInteruniversity scientific interaction developmentFunctional dimension—environment levelChange philosophySystematic thinkingApproachesChange foundationsAccording to Table2, the development of change climate requires the development of change climate management system in the conceptual, structural, and functional dimensions in all levels of individual, group, and organization, and while interacting with environment which is based on change philosophy, systematic thinking, and strategic approach in accordance with responding to the interactive environment and applying the change in the environment (change fundamentals). Based on Table 2, managers and specialists believe that the development of change climate includes 10 organizing themes, and each of them includes some basic themes. At the end, the relationship among the obtained codes in the NVivo software is shown in the following way (Figure 1). It is necessary to mention that because the ten themes mentioned above had mutual relationships to each other, they were considered in a matrix form (Figure 2). It was done in a way that each of the basic themes was determinant to the organizing themes one, two, or more basic themes according to their organization level (individual, group, organizational, or environmental) and their simultaneous coverage of structural, functional, or conceptual aspects of climate of change management system development. The organizing theme tables follow.Figure 1
The relationship between organizing themes in the NVivo software.Figure 2
The matrix of the relationship between organizing themes.


## 4.1. How Does the Change Climate Develop and Form at University?

Using thematic analyzing, after extracting the key themes change climate development in universities with a strategic approach, the codes, basic themes, and comprehensive and organizing themes were obtained using the Nvivo 10 software. The key informants of this research were 15 managers and change management and leadership specialists in the university. Furthermore, the top documents related to the study topic like a strategic document of education research and technology development dialouge, 2015, Shiraz University strategic and operative plan, 2016 etc. were analyzed.After interviewing change leadership and management specialists and managers in university and studying the top document, the text of interviews and top documents was codified according to the Atraid–Stirling (2001 [26]) and Braun and Clarke (2006, 2013 [24, 25]) thematic networks. The sum of the obtained codes from interviews and top documents included 581 codes. Among these, 485 meaningful codes were selected, and of these 485 codes, 10 codes were put aside as “others,” and finally, 471 meaningful codes were used. Also, 110 meaningful codes were obtained from the top documents. After that, the codes were summarized in basic themes, as shown in Table 1. According to Table 1, in the third stage of creating thematic network, the basic themes were summarized as organizing themes. In order to avoid different understanding of the obtained themes and also to accelerate the collecting of basic themes, the organizing themes are categorized as shown Table 2.Table 1
Change climate organizing themes.
ThematicDefinitionStrategic foundations of changeFoundations show the thinking beds and grounds which are of upmost importance, and they are the ones which determine the source, path, and the destination of activities.Conceptual dimensionShows the conceptual image or the existing understanding about the role and exigency of basic functions of change process in an organization, the quiddity of aspects, features, methods, and basic necessities of change in an organization. In fact, this aspect points to the thought, knowledge, recognition, attitudes, and approaches towards climate of change development in a system.Structural dimensionIt presents any kinds of orientation and organizational activities and strategies done in order to realize and carry on the basic functions of climate of change in an organization.Functional dimensionIt shows all the activities which are done to proceed and realize the climate of change. This aspect includes activities concentrating on the development of change climate and also activities which pave the way for doing these actions and their related functional considerations.Individual levelThe presuppositions of this level are personal characteristics, experiences, abilities, skills, knowledge, and background of human factors and their needs and expectations from change process in an organization.Group levelThe themes that show the attention to attachment of two or more individuals and their interactions to reach the ideals of change process are considered as the basic presuppositions of this level.Organizational levelOrganizational level or in other words the structural aspect shows all the activities done to provide the conditions for the establishment and development of climate of change.Environment levelIt includes the structures, aspects and ultraorganization social, general, and technological activities which are mostly out of direct control or manipulation of the organization.Table 2
Change climate organizing themes.
Fundamental themesConstructive themesInteractive environment condition graspInteractive environment element graspConceptual dimension—environmental levelScenario makingUniversity internal environment graspConceptual dimension—organizational levelReadiness for changeChange management knowledgeChange execution commitmentConceptual dimension—individual levelChange team’s developmentGroup structure redesigningStructural dimension—group levelStrategic planningChange ultrastructure developmentChange culture makingJob requirements, processes, and structure redesigningStructural dimension—organizational levelConsidering the human element role in changeIndividuals’ competency developmentFunctional dimension—individual levelHuman interactionsGroup accompanyingStaff satisfaction attractionInteraction with informal groupsStructural dimension—group levelManaging and improving organizational resources andprocessesSupporting the changeChange leadershipIndividual informingOvercoming the resistance against the changeProviding necessary resources and facilitiesSystem’s constant quality improvementOrganizational learningInteractive programmingStaff trainingOn time change applicationConstant monitoring and evaluationManagement system developmentFunctional dimension—organizational levelRelationship with interact environmentOrganizational positive climate developmentResponse to environmental needs and conditionsInteruniversity scientific interaction developmentFunctional dimension—environment levelChange philosophySystematic thinkingApproachesChange foundationsAccording to Table2, the development of change climate requires the development of change climate management system in the conceptual, structural, and functional dimensions in all levels of individual, group, and organization, and while interacting with environment which is based on change philosophy, systematic thinking, and strategic approach in accordance with responding to the interactive environment and applying the change in the environment (change fundamentals). Based on Table 2, managers and specialists believe that the development of change climate includes 10 organizing themes, and each of them includes some basic themes. At the end, the relationship among the obtained codes in the NVivo software is shown in the following way (Figure 1). It is necessary to mention that because the ten themes mentioned above had mutual relationships to each other, they were considered in a matrix form (Figure 2). It was done in a way that each of the basic themes was determinant to the organizing themes one, two, or more basic themes according to their organization level (individual, group, organizational, or environmental) and their simultaneous coverage of structural, functional, or conceptual aspects of climate of change management system development. The organizing theme tables follow.Figure 1
The relationship between organizing themes in the NVivo software.Figure 2
The matrix of the relationship between organizing themes.


## 5. Conclusion and Discussion and Practical Implications

The findings of this study indicate that holding a systematic approach, from the view point of change managers and specialists of the universities under study, in order to develop climate of change at universities, it is required to find an effective behavioral system in this area with a profound conceptual base and in a suitable structure. Based on this view, the development of climate of change at Universities of Medical Sciences requires a system formed of three dimensions, conceptual, structural, and functional, that would function as a base for the development of climate of change at university as a systematic pattern of the development of behavioral system, in a strategic condition, and with a proper leadership. By conceptual dimension in this systematic pattern, we mean the present cognitive imagination about the role and necessity of the development of change climate, what it would be, its dimensions, features, values, and requirements. It can be said that the conceptual dimension emphasizes the necessity and advantages of the development of change climate, conditions and subsequent contingencies, the general meaning, and the purpose of the development of change climate, realm, approaches, requirements, and considerations needed to reach the effective development of change climate. The structural dimension shows any direction, basic, and prepared mechanisms such as clear strategic direction, organizational plan, and creating suitable cultural conditions which are made according to the conceptual dimension and lead to the development of change climate at university. And finally, developing the climate of change requires performing a series of fundamental activities and measures based on conceptual and structural dimensions, known as functional dimension [6].It is needed to mention that the development of change climate at university will be well understood and achieved when the aforementioned systematic pattern is regarded in all organizational levels and layers (individual, group, organizational) and along with environmental interactions. Universities of Medical Sciences, like other organizations, consists of various levels and layers, so in order to develop the change climate, one should have a holistic approach and through considering all layers and levels of organization separately and in interaction with each other, practice the development of change climate. In this regard, at the first place, exerting any change and obtaining any success require the understanding and accepting the change programs by individuals as change factors and excerptors; therefore, while planning and applying the change program, it should be considered that the individuals have entered the university with predetermined characteristics, and their ability in managing and directing the change is different. Because individuals have a fundamental role in the quality and realization of change program, considering the individual level to develop the climate of change and reaching the success through empowering the members’ conceptual imagination about the necessity and basic uses of change, clarifying the destination and change direction, and presenting the needed knowledge and information about the change topic, etc., are necessary. Through this, individuals will get ready to apply the change and follow it; in addition, their commitment and accountability about change programs will increase, and they attempt to do the change programs in the best possible way. Goleman, Boyatzis, and McKee [27] state that the more the individuals’ self-awareness, the better they will experience the change process, and the more powerful and stable the change will occur.Of course, the individuals’ behavior in an organization is beyond the sum of activities. In fact, these behaviors perform individually. During the change process, some parts of their behavior are related to group membership at universities, criteria and standards in groups, and their understanding of the level of friendship among group members. Therefore, in order to develop the climate of change at universities in addition to rearranging the structure of groups, we must describe and develop change teams and create a field for getting the group satisfaction about the purposes and the process of change and their cooperation with change through describing and declaring the role of each member in a group, clarifying the extent and limits of members’ responsibilities, and involving them in decision-making about organization change, in addition to creating good conditions for members interaction. Bouckenooghe, Devos, and van den Broeck [3] believe that at the time of change, interindividual interactions with members and colleagues are very important, and the nature of these relations is among the essential features in forming the individuals’ readiness for change. In this situation, people need each other’s trust, support, and cooperation with each other to perform all effective activities. Thus, one of the basic duties and challenges of the managers to empower the staff and facilitate their cooperation in change process is creating the commitment and loyalty towards change. Therefore, the effectiveness of organizational change, to a large degree, depends on the management or leadership of individuals’ interactive pattern, their feelings toward each other, and the organization in the form of team and cooperative activities.It should be mentioned that according to the obtained matrix, people and groups will be successful in the change process only when the organization and its structure are ready for the change and its related measures. To reach this, we need to make changes in the organizational level based on the conceptual, structural, and functional dimensions. So, at this level, we should empower the conceptual imagination of the development of change climate at universities through making change scenarios and the internal climate of the university. Besides, it is necessary to determine the organizational mechanisms related to organizational change through strategic programing, remodeling the structures, organizational processes, and changing the university culture. Henceforth, in addition to attracting the support of managers and overcoming the organizational and individual resistance to the change, preparing the conditions for the successful development of change climate is crucial.Since the university is known as an open social system, the development of change climate at university must occur through interaction with the environment and its requirements and contingencies. In other words, in today’s complex and changing conditions, the kind of university will succeed that in addition to being aware of its internal conditions and contingencies, it strives to change or improve itself through making a dynamic relationship with its interactive environment and response to environment needs and contingencies. Mirkamali and Zeinali Pour [28] state that environment or external pressures like economic, technological, political, and social changes have a profound effect on the university organizational changes. Thus, in the development of change climate, it is essential to have a relationship with the environment and take necessary measures to develop a positive organizational climate and have a scientific relationship with other universities. As Hannagan and Bennett [29] demonstrated that organizational change requires considering environmental changes and studying their effects on internal changes of the organization. Therefore, organizations including universities must reach to the environmental requirements and coordinate with them in order to make a change inside them. Considering the importance of interactive role of all dimensions and levels in the development of change climate, it is needed to say that the quality and effectiveness of the development of change climate depend on the quality of change fundamentals to a large extent. Change fundamentals are the main elements in the development of change climate at universities, and their quality directs all the measures and activities related to the development of change climate in all dimensions and organizational levels.Among the main change fundamentals found in this research is the change philosophy. Change philosophy shows the nature of the change, and its clearance to the change agents and executives helps to understand the change exigency. In fact, until the source, destination, and the nature of the change are not clear and identified to the members, they will not understand the exigency of change and will resist against it.Bouckenooghe, Devos, and van den Broeck [3] state that the better the understanding of individual about the change and its exigency, the less their resistance against it will be: so, the change will occur in a more effective way and will pave the way for the university success.Furthermore, since the university is a complex, multidimensional, and multilevel system, the change climate development in all dimensions and various organizational levels must be done according to a systematic thinking and interactive view. Henceforth, the precise and comprehensive information which is needed for the development of climate of change will be collected, and the climate of change development promoter agents will be identified and reinforced. On the other hand, by choosing a systematic thinking, a special discipline will be created in activities and change processes which in turn will lead to the establishment of coordination and solidarity among all the levels and dimensions of change climate and its foundations. Accordingly, Block [30] and Leonard [31] stated that change leadership requires having a systematic thinking. Having the systematic thinking strengthens the leaders to comprehend the complexities of the change and directs the organization towards learning and obtaining new knowledge. Furthermore, since the university’s interactive environment is complex, dynamic, and multidimensional, the effectiveness of climate of change development depends on having a relationship with system’s new environment and choosing a strategic approach. In other words, since the change speed and extent are constantly increasing, having a strategic view toward the change because of the emphasis on systematic thinking, leadership views, and learning environment is necessary for the organization’s survival [32]. In addition, since this approach concentrates on basic elements of change in an organization, it will direct the change leadership attention from change consequences to the establishment of a balance among the functions and consequences of the change [33]. This approach, with the help of a systematic approach, creates an effective balance between the university and the environment and in addition to making a good relationship among all different strategic, operational, tactical, and technological levels of climate of change development; it produces a suitable concentration on goals, purposes, directions, and spending related sources of climate of change development [6]. Therefore, in order to develop the change climate, the university, through choosing a strategic approach for having a good relationship, with the environment, and creating a relationship between the university with the environment and future, must prepare a general content of the organization’s activities to reach its fundamental ideals and via this, help its survival in a future environment. Furthermore, because of a wide interaction among university members and departments, their effects on each other, the fast and constant change of university’s information and technologies, and the exigency of university coordination with these changes, it is not possible to choose a long-term fixed structure or pattern for all university levels and departments. Therefore, in each level of change and according to the change topic quality and features, we must use different patterns and change frameworks with a contingency approach and through this, develop the climate of change at universities. Moreover, since the universities, like other organizations, are constantly competing against each other, their success and survival depend on choosing an adaptable approach about change and the development of climate of change at universities to a large degree. What would be needed for this kind of change is predicting opportunities and threats, understanding the change scenarios in a long term, and accepting the change warmly. In this way, the university, through choosing and describing the game rules in a competition situation, in addition to making the others to follow it, will help its survival in a long term and the improvement of climate of change and individuals’ understanding of change (choosing the adaptable approach).In conclusion, the development of climate of change at the first place depends on determining the fundamental elements and clarifying the suitable directions and approaches for the Universities of Medical Sciences interactive environment’s conditions and contingencies. Therefore, based on this, the mechanisms and measures necessary in various organizational layers and levels will be designed and codified, and through this, the condition for Universities of Medical Sciences responsiveness to the environment and realization of organizational health will be constructed. In this regard and based on the findings of this study, practical implications for the development of climate change in medical universities can be proposed:(i)
Understand the philosophy of change in universities(ii)
Development of system thinking and adoption of strategic and adaptive approaches in order to respond to the environment(iii)
Leadership change and support senior university management of the change program(iv)
Proportional formation of conceptual, structural, and functional dimensions in proportion to each other and environmental conditions and requirements (responsiveness)(v)
A holistic and interactive approach to action(vi)
Immediate awareness, motivation, and empowerment and facilitate and strengthen the participation, commitment, and loyalty of individuals to the change program(vii)
Managing the interactive pattern of individuals at interpersonal, group (team), organizational, and environmental levels(viii)
Improvement and organizational empowerment (cognitive, structural, and functional) of the university(ix)
Dynamic interaction with the environment and its requirements in order to respond



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