Document Type : Original Articles


1 Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.

2 Prevention of Psychosocial Injuries Research Centre, Ilam University of Medical Sciences, Ilam, Iran

3 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.


 Abstract:Background: Systemic thinking can provide practice in multidisciplinary team working and improve the organizational efficacy. This study aimed to determine the association between systemic thinking and partnership working in the employees of a medical sciences university in the south of Iran.Methods: A cross-sectional study was performed in Zahedan University of Medical Sciences (ZAUMS) in 2015. The study population consisted of all employees in ZAUMS; 370 participants were selected through stratified random sampling. Two standard questionnaires were used for data gathering. The data were analyzed in SPSS (v21) using Pearson, One way ANOVA, and logistic regression. The level of significance was considered as 0.05.Results: In this study, 225 participants (60.8%) were female and their mean age was 34.7±8.7. The score of partnership working for 362 participants was higher than the mean standard (40). Systemic thinking had a positive association with partnership working (p=0.001) and married status of the participants (p=0.04). Partnership working in male and older staff was more than others in ZAUMS (p<0.001 and p=0.01, respectively). Conclusion: Systematic thinking had a positive association with the employees’ working partnership. Moreover, the male staff had better systematic thinking. It is recommended that the managers should promote systematic thinking in staff, especially in females, for better partnership and efficacy in organizations.


  1. References
  2. De Savigny D, Adam T. Systems thinking for health systems strengthening: World Health Organization; 2009.
  3. A G, S s. Relation between manager stratejic thinking and Demographic variables and good qualities. Human Resource Management 2015; 5(2): 121-38.
  4. Leischow SJ, Best A, Trochim WM, Clark PI, Gallagher RS, Marcus SE, et al. Systems thinking to improve the public's health. Am J Prev Med 2008; 35(2): S196-S203.
  5. El-Jardali F, Adam T, Ataya N, Jamal D, Jaafar M. Constraints to applying systems thinking concepts in health systems: A regional perspective from surveying stakeholders in Eastern Mediterranean countries. Int J Health Policy Manag 2014; 3(7): 399.
  6. Casey AJ, Goldman EF. Enhancing the ability to think strategically: A learning model. Management Learning 2010; 41(2): 167-85.
  7. Vetere A, Dallos R. Working systemically with families: Formulation, intervention and evaluation: Karnac Books; 2003.
  8. Leischow SJ, Milstein B. Systems thinking and modeling for public health practice. Am J Public Health 2006; 96(3): 403-5.
  9. Best A, Moor G, Holmes B, Clark PI, Bruce T, Leischow S, et al. Health promotion dissemination and systems thinking: towards an integrative model. Am J Health Behav 2003; 27(Supplement 3): S206-S16.
  10. Vetere A. Editorial: Bio/psycho/social models and multidisciplinary team working-can systemic thinking help? Clin child psychol psychiatry 2007; 12(1): 5-12.
  11. Trochim WM, Cabrera DA, Milstein B, Gallagher RS, Leischow SJ. Practical challenges of systems thinking and modeling in public health. Am J Public Health 2006; 96(3): 538-46.
  12. Organization WH. The world health report 2000: health systems: improving performance: World Health Organization; 2000.
  13. Naaldenberg J, Vaandrager L, Koelen M, Wagemakers A-M, Saan H, de Hoog K. Elaborating on systems thinking in health promotion practice. Glob Health Promot 2009; 16(1): 39-47.
  14. Hunter D, Perkins N. Partnership working in public health: the implications for governance of a systems approach. J Health Serv Res Policy 2012; 17(suppl 2): 45-52.
  15. Glasby J, Dickinson H, Miller R. Partnership working in England—where we are now and where we’ve come from. Int J Integr Care 2011; 11(Special 10th Anniversary Edition).
  16. Henwood M. Effective partnership working: a case study of hospital discharge. Health Soc Care Community 2006; 14(5): 400-7.
  17. Gardiner C, Gott M, Ingleton C. Factors supporting good partnership working between generalist and specialist palliative care services: a systematic review. Br J Gen Pract 2012; 62(598): e353-e62.
  18. Smith K, Bambra C, Joyce K, Perkins N, Hunter D, Blenkinsopp E. Partners in health? A systematic review of the impact of organizational partnerships on public health outcomes in England between 1997 and 2008. J Public Health 2009; 31(2): 210-21.
  19. Moammai H, Amini M, Dargahi H, Mashayekh M, Janbozorgi M. Strategic Thinking Measurement among Staff Managers of Tehran University of Medical Science. Journal of Health Administration 2013; 16(53): 73-84.
  20. Khademi AR, Ghaderi M, Ali M, Pouya M. Investigation of Cardio-Respiratory Fitness, Stress and Body Mass Index of Public Employees Regarding Working Partnership. Advances in Environmental Biology 2012; 6(3): 1051-5.
  21. Washington ML, Kurthakoti R, Halpin AL, Byrd S. Assessing Systemic Thinking in Undergraduates: An Exploratory Study Using a Total Enterprise Business Simulation. Developments in Business Simulation and Experiential Learning 2014; 41.
  22. Isfahani HM, Aryankhesal A, Haghani H. The Relationship Between the Managerial Skills and Results of" Performance Evaluation" Tool Among Nursing Managers in Teaching Hospitals of Iran University of Medical Science. Glob J Health Sci 2014; 7(2): p38.
  23. Hung T-M, Tang L-C, Ko C-J. How Mental Health Nurses Improve Their Critical Thinking Through Problem-Based Learning. J Nurses Prof Dev 2015; 31(3): 170-5.
  24. K Mk, H R, M R. Relation between Systemic Thinking and Teacher Innovation in Tehran School. Futures Management 2012; 23: 51-63.
  25. West GB. The importance of quantitative systemic thinking in medicine. The Lancet 2012; 379(9825): 1551-9.
  26. Shams A, Samooei R, Porriahi H. The Relation Between Cooperation of Employees and 5 Sources of Manager's Power in State Hospitals of Isfahan. 2011.
  27. Amini MT, Bakhtiari L, Dargahi H, Karimi O, Moammai H, Janbozorgi M, et al. Measurement Of Systemic Thinking Among TUMS Senior Managers Using Goldman Strategic Model. Payavard Salamat 2013; 7(3): 188-96.