Determination of rate of customer focus in educational programs at Isfahan University of Medical Sciences¹ based on students’ viewpoints

Abstract

Background:

Today, the challenges of quality improvement and customer focus as well as systems development are important and inevitable matters in higher education institutes. There are some highly competitive challenges among educational institutes, including accountability to social needs, increasing costs of education, diversity in educational methods and centers and their consequent increasing competition, and the need for adaptation of new information and knowledge to focus on students as the main customers. Hence, the purpose of this study was to determine the rate of costumer focus based on Isfahan University of Medical Sciences students’ viewpoints and to suggest solutions to improve this rate.

Materials and Methods:

This was a cross-sectional study carried out in 2011. The statistical population included all the students of seven faculties of Isfahan University of Medical Sciences. According to statistical formulae, the sample size consisted of 384 subjects. Data collection tools included researcher-made questionnaire whose reliability was found to be 87% by Cronbach's alpha coefficient. Finally, using the SPSS statistical software and statistical methods of independent t-test and one-way analysis of variance (ANOVA), Likert scale based data were analyzed.

Results:

The mean of overall score for customer focus (student-centered) of Isfahan University of Medical Sciences was 46.54. Finally, there was a relation between the mean of overall score for customer focus and gender, educational levels, and students’ faculties. Researcher suggest more investigation between Medical University and others.

Conclusion:

It is a difference between medical sciences universities and others regarding the customer focus area, since students’ gender must be considered as an effective factor in giving healthcare services quality. In order to improve the customer focus, it is essential to take facilities, field of study, faculties, and syllabus into consideration.

INTRODUCTION

In order to have sustainable developments in today's competitive field, all the public and private organizations need a sort of performance evaluation system and a quality control through which they could measure the efficiency and effectiveness of their programs and human resources.[1] The customer is referred to with different terms in the literature of modern management science, such as partner, boss, capital, and profit, and the ultimate outcomes of the whole activities of the organizations are apparent through his judgment. It is the customer who evaluates the quality of products and the services of the organizations and makes them to compete against each other.[2] On the other hand, customer focus means presenting information to customer in the whole organization, categorizing strategies and tactics to meet practically the market needs, and gaining a public commitment feeling to fulfill the decided programs.[3] In other words, customer focus is a sort of organizational culture that leads to the creation of customers’ best value in the most efficient and effective manner.[4] And finally, we can say that customer focus is a set of beliefs which give a preference to the customer's benefits over the other beneficiaries such as organization owners, managers, and the staff in order to create a profitable firm.[5] In spite of severe competition dominating the world's economy, providing the customers with more services and quality improving are not considered to be an added value anymore, but they are undeniable necessities.[6] In this regard, in higher education, which is one of the most significant foundations for education, development, and human resource provision and which plays the most important part in all the developments in every country,[7] the process of structural changes has begun decades ago. Population growth, extension of elementary and secondary public education, and growing of the middle class have increasingly boosted demands for university entrance.[8] Therefore more institutes and universities because of population growth are needed. These enormous human resources with high potential abilities are considered as university customers. Today, the private interests accompanying national universities have ventured to provide education because of increasing and various demands for education. Different universities (Payame Noor, non-profit universities, Islamic Azad University, applied sciences university, University of Applied Science) try to attract more customers into their systems to gain benefits offered by government and applicants.[9] A university which is aware of its customers’ needs would be the winner of this conflict. It means that the university should be a so-called “customer focus”. Hence, universities must comprehensively measure their customer-related important results and also determine what results they have achieved in relation to their customers.[10] The reason is that the students are important elements and the main addressees of higher education. For the time being, the students’ viewpoints are considered as an essential factor in quality monitoring at universities all over the world.[11] Students as applicants and clients of higher education can play an important part in evaluating education quality as well as educational services. Universities do not have fixed customers; those who are customers now will not be the same customers later. These present customers will be replaced by new students and individuals.[12] Regarding this fact, Samavi et al. showed that the customer focus rate based on the students’ viewpoint was less than average in Faculty of Agriculture in Shahid Chamran University of Ahvaz and Ramin University of Agriculture and Natural Resources.[13] Furthermore, in a survey of students’ satisfaction, Izadi et al. showed that approximately 40% of samples were satisfied by the provided educational services, and the University of Mazandaran had a mean of 49.11% considering its customer focus.[9] In their study of quality evaluation of educational centers’ services of Payame Noor Universities of East and West Azerbaijan provinces, Zavvar et al. showed that the students were not satisfied with the quality of educational centers’ services and also the total students’ perception mean was 2.68% (below the average) and their expectation value was 4.44% (too high).[14] Lots of researches have been carried out about the quality of higher education by well-known institutes in England, Australia, Norway, America, and other countries. Some special environmental conditions in higher education in England made it essential to have an effective quality management. These conditions can be mentioned as: Increasing conditions for greater accountability, student numbers rise, growing diversity of student population and consequently participatory innovation development and seeking for international tools, resource reduction for educational programs, students’ high expectations as customers, more flexible educational conditions both in undergraduate and graduate levels, and increased cooperation between institutes.[15] In spite of these facts, Tom and Cheng believe that the quality of education is difficult to achieve and also it is a multi-dimensional concept and somewhat ambiguous; also, at the broadest level of education, it is a set of input, process, and output elements of education system and it provides some services, but does not completely cover the inner and outer strategic competencies by meeting implicit and explicit needs. If we consider higher education as a system, every quality management program should assess the inputs, processes, and outcomes.[16] So, today's challenges of quality and customer focus improvement and systems development in higher education are important and inevitable. Responses to social needs, increased educational spending, diversity in educational methods and centers and their consequent increasing competition, and the need for adaptation of new information and knowledge to focus on students as the main customers are some highly competitive challenges among educational institutes. Therefore, universities are widely regarded as the spot where students show compliance with modern requirements and needs. Our country's universities, especially the Medical Sciences ones, need to strongly consider the quality development during processes, operations, and affairs in order to maintain and promote eligibility in a competitive environment which improves the quality and quantity of students’ education that will run the future's health care system. One of the effective ways in this regard is entering the path to excellence and improvement through performing superior models, especially customer focus-based ones. Hence, the purpose of this study was to determine the rate of costumer focus, based on Isfahan University of Medical Sciences students’ viewpoints and to suggest solutions to improve this rate.

MATERIALS AND METHODS

This was a cross-sectional study carried out in 2011. The statistical population included all the students of seven faculties of Isfahan University of Medical Sciences. According to statistical formulae, the sample size consisted of 366 subjects. Data collection tools included a researcher-made questionnaire, the face and content validity of which was tested throughout several stages according to the opinions of some experts and learning management, education sciences, and quality management professors, and finally the questionnaire was approved. Determining the reliability of the questionnaire was done through a pilot study with 30 subjects and its Cronbach's alpha coefficient was 87%. Based on Likert scale, scoring was done varying from completely agree to completely disagree between 0 and 4 points and then it was graded on a scale of 0–100. The questionnaires were distributed as simple random sampling among different fields of studies in faculties. Finally, using SPSS software, descriptive statistics (frequency percent, mean, etc.) and inferential statistics [independent t-test and analysis of variance (ANOVA) significance test] of data were analyzed.

RESULTS

According to the results, the gender distribution of the considered samples was 61.2% females and 38.8% males. Moreover, frequency distribution of educational level of samples was 39.6% BS students, 4.4% MS students, and 56% MD students. Frequency distribution of the students consisted of the maximum students in Medicine faculty (43.5%) and the minimum students in Rehabilitation faculty (6%). Finally, after analyzing the data, based on Table 1, the mean of overall score for customer focus (student-centered) is shown in Figure 1. It is based on students’ viewpoints and their faculties.

Table 1.

Determining relation between the overall score for customer focus and examined demographic factors

Figure 1.

The mean of overall score for customer focus (studentcentered) from students’ viewpoints in faculties

The mean of overall score for customer focus (student-centered) from students’ viewpoints had the maximum score (50.21) in Health Faculty and the least score in Nursing Faculty (42.01). Finally, the Isfahan University of Medical Sciences had a mean of overall score of 46.54 for customer.

The research hypotheses including a relation between the mean of overall score for customer focus and gender, educational levels, and students’ faculties are examined in these table and figure.

1. There was a meaningful relation between gender and their overall score for customer focus (student-centered) (P=0.001) and it was more in females (48.53) than in males (43.41).

2. There was a meaningful relation between students’ educational level and their overall score for customer focus (student-centered) (P=0.003). The MS level had the highest score (50.21) and the BS level had the lowest (43.77) score

3. There was a meaningful relation between students’ faculties and their overall score for customer focus (student-centered) (P=0.017). It had the highest score in Faculty of Health (50.21) and the lowest in Faculty of Nursing (42.01) [Table 1].

DISCUSSION

Higher education is considered to be one of the most remarkable institutes in every country. It is a demanding task to manage higher education affairs because of its great importance. Higher education deals with human beings and they are not like objects to have the quality of plasticity to be easily made into different shapes. Furthermore, the assessment of humans is a big enterprise. Man is faced with an environment of changes which will shape his behavior very often and especially university students tend to perceive everything in an ideal world. Moreover, graduate unemployment found in every part of the country can negatively affect the survey of customer focus rating in higher education. For many years, Isfahan University of Medical Sciences, as an able institute of the country's healthcare, has trained many students in order to develop the health services of the country and Isfahan Province. It is too difficult to evaluate the extent of Isfahan University of Medical Sciences success, but the students are the present university customers and they would be the future health system managers, so they can be requested to help improve the university in order to develop the country. Considering the above-mentioned facts, the following results were achieved in accordance with the research goals which will be discussed later:

1. The mean of overall score for customer focus (student-centered) from the students’ viewpoints was the highest in Faculty of Health (50.21) and the lowest in Faculty of Nursing (42.01). Finally, the mean of overall score for customer focus was 46.54 in Isfahan University of Medical Sciences.

   In this regard, it was shown in a survey that the rate of customer focus based on the students’ viewpoints in Faculty of Agriculture in Shahid Chamran University of Ahvaz was 31.79%. Besides, the rate of customer focus was calculated to be 33.51% based on the students’ viewpoints in Ramin University of Agriculture and Natural Resources.[13] It was below the achieved score in Isfahan University of Medical Sciences. Poor facilities in the above-mentioned universities are some of the reasons which affect the rate of customer focus from students’ viewpoints in comparison with universities of -medical sciences. Furthermore, in a case study conducted in Mazandaran University, the students’ satisfaction was examined according to the EFQM model of customer criteria. Results showed that nearly 40% of the participants were satisfied with the educational services and the mean of customer focus was about 49.11%. It can be concluded that there is an approximately equal ratio between the satisfied and unsatisfied subjects, which is compatible with our results. The results are roughly in line with our research results. Analyzing the data obtained in evaluation of the quality of educational services in Payame Noor University across East and West Azerbaijan indicates a negative mean for students’ perception gap and their expectations of the quality of educational centers’ services in all components and aspects of the model. T test has shown the meaningful (α=0.001) and it suggests it suggests that students are not satisfied with the quality of educational centers’ services in Payame Noor University. At the same time, the overall mean of students’ perception was 2.68 (below average) and their expectations’ mean was 4.44% (too high).[14] The above results are not compatible with ours, and according to the evidences, we can mention the reasons as poor quality of faculty members, facilities, teaching methods, and educational processes. In this field, special environmental conditions in higher education have demanded an efficient quality management in England. These conditions include: Increasing conditions for greater accountability, student numbers rise, growing diversity of student population and consequently participatory innovation development and seeking for international tools, resource reduction for educational programs, students’ high expectations as customers, more flexible educational conditions both in undergraduate and graduate levels, and increased cooperation between institutes.[15] In spite of these facts, Tom and Cheng believe that the quality of education is difficult to achieve and also it is a multi-dimensional concept and somewhat ambiguous. At the broadest level of education, it is a set of input, process, and output elements of education system, and it provides some services, but does not completely cover the inner and outer strategic competencies by meeting implicit and explicit needs. If we consider higher education as a system, every quality management program should assess the inputs, processes, and outcomes.[16] The reason why the Faculty of Heath has the highest mean of overall score for customer focus (50.21) from the students’ viewpoints is that there are enough facilities for students such as typing and duplicating units, cafeterias, elevators, etc. Moreover, the faculty officials highly make any attempt to assist the students and departments emphasize the importance of qualitative work to improve the educational levels; teaching methods are in conformity with the course contents; the faculty members are available most of the time and they properly devote themselves to the students; the remarkable features of different fields of study are clarified to tempt and motivate the students; teaching methods are consistent with students’ previous knowledge and other qualities; and courses are designed to suit the needs of society; and so on, whereas the above-mentioned factors are less obvious ones in the Faculty of Nursing. What follows is the discussion of research hypotheses:

1. There was a meaningful relation between gender and their overall score for customer focus (student-centered) (P=0.001) and it was more in females (48.53) than in males (43.41).

   In this regard, students’ gender did not make any difference in the state of quality of services considering the study of valuation of the quality of educational centers’ services of Payame Noor University in East and West Azerbaijan. Besides, results show that there was no relation between the students’ gender (male and female) and the quality of the services in Payame Noor University of Azerbaijan, and the comparison of service quality gap was meaningful in t-test. Saktiuvel et al. showed in their studies that gender is not a determining factor in satisfying the students.[14] Obviously, according to the performed surveys, gender has not been a determining factor in the rate of quality and customer focus in universities. Evidences show that it may be possible to find this inconsistency between Isfahan University of Medical Sciences and other universities due to the nature of practice and training of medical sciences universities wherein females practice more eagerly and accurately than males do. More researches are required to support this claim.

2. There was a meaningful relation between students’ educational level and their overall score for customer focus (student-centered) (P=0.003), and the MS level had the highest score (53.65) and the BS level had the lowest score (43.77).

   Regarding this result and according to the surveys of customer focus rate based on the students’ viewpoints in Faculty of Agriculture in Shahid Chamran University of Ahvaz and Ramin University of Agriculture and Natural Resources, there was a positive and meaningful correlation (P=0.05) between students’ educational levels and viewpoints and customer focus in both the universities, and it implies more desirable viewpoints of the MS students which is incompatible with our survey. Furthermore, Tan and Kak have reported a high and positive relation between educational levels and even graduated students.[14] The reason why most MS students were more satisfied with customer focus is that their number was less than BS students and more facilities and educational opportunities were available to them. But the study of quality evaluation of educational centers’ services of Payame Noor Universities of East and West Azerbaijan provinces shows that there is no relation between students’ educational level and the quality of services.[14]

3. There was a meaningful relation between students’ faculties and their overall score for customer focus (student-centered) (P=0.017), and it had the highest score in Faculty of Health (50.21) and the lowest in Faculty of Nursing (42.01).

   In this regard, in the case study of Mazandaran University, a relation was found between students’ faculties and their customer focus score (0.01), and the Faculty of Law had the maximum score for customer focus (49.72).[10] Besides, to find out the rate of customer focus according to faculties in Ahvaz and Ramin universities, the meaningful difference (0.001) between students’ customer focus score from their viewpoints shows differences in faculties.[13] Besides, there was a meaningful difference between the score of customer focus from students’ viewpoints and that of departments in both universities, which indicates students’ viewpoints. The departments of both universities, which indicates students’ different needs in different fields and departments and it is different even in faculties. In the study of quality evaluation of educational centers’ services of Payame Noor Universities of East and West Azerbaijan provinces, only computer students’ dissatisfaction in comparison to other students was meaningful in multivariate analysis of variance (MANOVA).[14] Therefore, each faculty must separately identify their students’ requirements and shortcomings regarding different aspects of customer focus and try to fix them. The faculties should not impose their solutions on others since the survey results stipulate that faculties and departments have their own customer focus.

CONCLUSION

According to Astin, it is essential to consider the effect of institute on the students when the performance of higher education is evaluated because the institute gains its actual superiority through influencing the students. In order to create a shift in their lives positively, the top institutes can mostly influence the students’ progress in science and individuality,[17] which is consistent with our survey considering the customer focus standards. On the other hand, today's challenges of quality improvement and customer focus as well as systems development are important and inevitable matters in higher education institutes. There are some highly competitive challenges among educational institutes including accountability to social needs, increasing costs of education, diversity in educational methods and centers and their consequent increasing competition, and the need for adaptation of new information and knowledge. Therefore, universities are widely regarded as the spot where students show compliance with modern requirements and needs. Iranian country universities need to strongly consider the quality development during processes, operations, and affairs in order to maintain and promote eligibility in a competitive environment. In order to direct the improvement of educational processes toward customer focus in universities, the evaluation process is needed to highlight the strengths and weaknesses of the program through corrective action procedures. It will lead to quality improvement and increased profitability.

Suggestions

According to direct and indirect inference of the findings of this survey and those related to customer focus questions in the questionnaire, the following recommendations are presented in order to improve customer focus in universities:

Despite all existing limitations, internal evaluation conducted by university departments has led them “to use interactive models and mechanisms in planning to improve the level”.

The university should consider students as educational programs consumers and their demands should be dealt with this process.

Students’ feedback of educational planning should be applied.

To improve the quality of education, the university should incorporate other customers (parents, the students of other faculties, etc.) within.

The remarkable features of different fields of study should be clarified to tempt and motivate the students. The department's goals should be congruent with social needs in different fields as well as with individual needs and students’ expectations. Students should be sufficiently informed about the nature of different fields and it's mission. Faculty members should properly devote their time to students and they should be available most of the time.

Faculty members should apply varied teaching methods instead of the routine ones.

Faculty members should review the subject matters to master them before teaching.

The university should determine learning processes or costumer-oriented programs to ensure educational programs.

Current syllabus should be changed to improve the student's quantitative and qualitative information.

Current educational opportunities should be used optimally.

Administrators should pay attention to students’ opinions in evaluating and performing new programs.

Educational methods should be focused on students.

As finding medical an non medical universities have some differences about customer oriented since universities and others regarding the customer focus area, since students’ gender must be considered as an effective factor in giving healthcare services quality. In order to improve the customer focus, it is essential to take facilities, field of study, faculties, and syllabus into consideration. If universities want to win against their problems and challenges, they should emphasize the improvement criteria of the quality of education and try to improve that by recognizing the existing barriers. So, it is necessary to revise the university's strategies and educational programs to make them compatible with society's needs and students’ expectations. Students’ facility needs and the quality of education should be emphasized in the course of planning and expanding qualitatively fields and opportunities.