Exploring the Factors Influencing Massive Open Online Courses Development: A Qualitative Study of E-Learning Experts’ Perspectives on Iranian Universities of Medical Sciences

Document Type : Original Article


1 Department of E-Learning in Medical Sciences, Virtual School and Center of Excellence in E-Learning, Shiraz University of Medical Sciences, Shiraz, Iran

2 School of Business and Law, Edith Cowan University, WA, Southern Cross University, Faculty of Health, QLD, Australia


Background: Massive Open Online Courses (MOOCs) have had an increasing trend globally during the last two decades. They are emerging as flexible and complementary tools in open education. Nevertheless, their development demands substantial resources, and challenges persist in effectively involving faculty. This study aimed to explore the factors influencing MOOCs development based on e-learning experts’ perspectives within the Iranian universities of medical sciences.
Methods: This qualitative research was conducted in 2022 using the content analysis method. Purposeful sampling was used to select experts authorized in e-learning within Iranian medical sciences universities with at least two years of experience. Sampling continued until data saturation (n: 15). Data was collected using a semi-structured interview administered through online written approaches. Thematic analysis techniques were applied, involving the identification of codes. The data was analyzed at the level of open coding (items), axial coding (components), and selective coding (concepts) in a round-trip process.
Results: Thematic analysis resulted in 28 codes, 12 themes, and 4 categories. Influential factors on MOOCs development and engagement included: 1) structural factors (rules/regulations, clarity, structure); 2) human resources (empowerment, support, attitude, motivation); 3) cultural factors (symbols, unity); and 4) political factors (equity, participation, and negotiation, profit).
Conclusion: The development of successful MOOCs programs encompasses various factors, including cultural, human resource, political, and structural elements to empower and actively engage faculty members in MOOCs. Restructuring may be required regarding the multivariable changes to consider open, online education as a part of innovative educational pathways in universities.  


Azita Barzekar (Google Scholar)

Zahra Karimian (Google Scholar)


  1. Moeinikia M, Aryani E, Zahed Bablan A, Mousavi T, Kazemi SJESiMS. Perusal the factors affecting on the implementation of Massive Open Online Courses (MOOCs) in higher education (Mixed Method). Education Strategies in Medical Sciences. 2017;9(6):458-70. edcbmj.ir/article-1-1127-fa.pdf.
  2. Kaplan AM, Haenlein M. Higher education and the digital revolution: About MOOCs, SPOCs, social media, and the Cookie Monster. Business horizons. 2016;59(4):441-50. doi: 10.1016/j.bushor.2016.03.008.
  3. McAuley A, Stewart B, Siemens G, Cormier D. The MOOC model for digital practice. University of Prince Edward Island. 2010. https://www.islandscholar.ca/islandora/object/ir:15366.
  4. McAuley A, Stewart B, Siemens G, Cormier D. Massive Open Online Courses Digital ways of knowing and learning. The MOOC model for digital practice. 2010. bibsonomy.org/bibtex/2e7bcfd45ca6896ba6030b430f68a860e/pasmoi144.
  5. Mahajan R, Gupta P, Singh TJIp. Massive open online courses: concept and implications. Indian Pediatr. 2019;56(6):489-95. PubMed PMID: 31278230.
  6. Lowenthal P, Snelson C, Perkins RJTIRoRiO, Learning D. Teaching massive, open, online, courses (MOOCs): Tales from the front line. International Review of Research in Open and Distributed Learning. 2018;19(3). doi:10.19173/irrodl.v19i3.3505.
  7. Daniel J. Making sense of MOOCs: Musings in a maze of myth, paradox and possibility. Journal of interactive Media in Education. 2012(3). jime.open.ac.uk/articles/10.5334/2012-18.
  8. Jordan K. Massive open online course completion rates revisited: Assessment, length and attrition. International Review of Research in Open and Distributed Learning. 2015;16(3):341-58. doi: 10.19173/irrodl.v16i3.2112.
  9. Setia S, Tay JC, Chia YC, Subramaniam KJAime, practice. Massive open online courses (MOOCs) for continuing medical education–why and how? 2019;10:805. oi: 10.2147/AMEP.S219104. PubMed PMID: 31572042. PubMed Central PMCID: PMC6749982.
  10. Ossiannilsson E, Altinay F, Altinay ZJES. MOOCs as change agents to boost innovation in higher education learning arenas. Adv Med Educ Pract. 2016;6(3):25. doi: 10.3390/educsci6030025.
  11. Haggard S, Brown S, Mills R, Tait A, Warburton S, Lawton W, et al. The maturing of the MOOC: A literature review of massive open online courses and other forms of online distance learning. Department for Business, Innovation and Skills. 2013. https://hdl.handle.net/20.500.12799/3146.
  12. Razai MS, Kankam HK, Hourston GJ, Hoppe S, Oakeshott P. Lessons learned from producing guidance articles and rapid massive open online courses during the covid-19 pandemic in primary care. Journal of Primary Care & Community Health. 2020;11:2150132720963624. doi: 10.1177/2150132720963624. Pubmed PMID: 33000669; Pubmed Central PMCID: PMC7533919.
  13. Zhao F, Fu Y, Zhang Q-J, Zhou Y, Ge P-F, Huang H-X, et al. The comparison of teaching efficiency between massive open online courses and traditional courses in medicine education: a systematic review and meta-analysis. Annals of translational medicine (ATM). 2018;6(23). atm.amegroups.org/article/view/22669/html.
  14. Cusumano MA. MOOCs revisited, with some policy suggestions. Communications of the ACM. 2014;57(4):24-6. doi:10.1145/2580941.
  15. Cirulli F, Elia G, Lorenzo G, Margherita A, Solazzo G. The use of MOOCs to support personalized learning: An application in the technology entrepreneurship field. Knowledge Management & E-Learning. 2016;8(1):109. doi: 10.34105/j.kmel.2016.08.008.
  16. Karnouskos S, Holmlund M. Impact of massive open online courses (MOOCs) on employee competencies and innovation. School of Management. 2014. https://docplayer.net/2670994-Impact-of-massive-open-online-courses-moocs-on-employee-competencies-and-innovation.html.
  17. Sarrafzadeh M. Libraries and Librarians in the MOOC age. Sciences and Techniques of Information Management. 2016;2(1):11-32. doi: 10.22091/STIM.2016.655.
  18. Matoor M, Aliabadi, K., Mozayani, N., Delavar, A., Nili Ahmadabadi, M. A Critical Introduction to” Massive Open Online Courses (MOOCs)”. Critical Studies in Texts & Programs of Human Sciences. 2017;17(6):280-57 [in Persian]. criticalstudy.ihcs.ac.ir/article_2782.html?lang=en.
  19. Gholampour M, Rostami NMA, Pourshafei H. Identifying the Key Factors of the Success of MOOC Courses: Synthesis Research Based on the Roberts Model. Journal of Curriculum Research. 2020,9(2):139-162. doi: 10.22099/jcr.2019.5234.
  20. Lucio-Ramirez, C.A., Nigenda, J.P., Garcia-Garcia, M. and Olivares, S.L. (2020), “Clinical competence assessment: development of a mobile app to enhance patient centerderness”, Journal of Development and Learning in Organization:. 2020;34(2):17-20. doi:10.1108/DLO-08-2019-0186.
  21. Jafari E, Fathi Vajargah K, Arefi M, RezaeiZadeh MJRiCP. Qualitative meta-analysis on the conducted research in the field of MOOC (Massive Open Online Courses). Research in Curriculum Planning: 2017;14(53):27-41[in Persian].
  22. Innovations in Medical Education Packages Based on the Health system Higher Education Program. Ministry of Health and Medical Education; 2015 [Document].
  23. Ghazi Mirsaeed SJ, Ommati E. Comparative survey of MOOC presented on Maktab khaneh website based on quadruple indexes focusing on the field of medicine. Payavard Salamat. 2017;10(5):393-401 [in Persian].
  24. Higher Council of Virtual Education. Monitoring report on virtual education activities of Iranian schools and universities of medical sciences in the second half of 2020-2021 [Document].
  25. Ministry of Science RaT. Higher Education Research and Planning Institute. Ministry of Science, Research and Technology; 2020 [Document].
  26. Bolman LG, Deal TE. How great leaders think: The art of reframing: John Wiley & Sons; 2014.
  27. Bolman LG, Deal TEJC, and. Reframing Organizations: Artistry, Choice, and Leadership; 5th Edition 2013.
  28. Bush T. Theories of Educational Leadership and Management. 5th ed. SAGE Publication: University of Nottingham; 2020. https://uk.sagepub.com/en-gb/eur/theories-of-educational-leadership-and-management/book258644.
  29. Margaryan A, Bianco M, Littlejohn AJC. Instructional quality of massive open online courses (MOOCs). Computers & Education. 2015;80:77-83. doi:10.1016/j.compedu.2014.08.005.
  30. Hollands FM, Tirthali DJIRoRiO. Learning D. Resource requirements and costs of developing and delivering MOOCs. The International Review of Research in Open and Distributed Learning. 2014;15(5):113-33. doi: 10.19173/irrodl.v15i5.1901.
  31. Hatami J, Ali Abadi K, Delavar AJTJoME. Development of MOOCs instructional design model based on Connectivism learning theory. Journal of Medical Educations and Development. 2017;12(1):65-86 [in Persian].
  32. Zheng S, Wisniewski P, Rosson MB, Carroll JM, editors. Ask the instructors: Motivations and challenges of teaching massive open online courses. Proceedings of the 19th ACM Conference on Computer-Supported Cooperative Work & Social Computing; 2016. doi: 10.1145/2818048.2820082
  33. Najafi H, Rolheiser C, Harrison L, Håklev SJIRoRiO, Learning D. University of Toronto instructors’ experiences with developing MOOCs. International Review of Research in Open and Distributed Learning. 2015;16(3):233-55. https://files.eric.ed.gov/fulltext/EJ1067938.pdf.
  34. Malik RF, Buljac-Samardžić M, Akdemir N, Hilders C, Scheele FJBoq. What do we really assess with organizational culture tools in healthcare? An interpretive systematic umbrella review of tools in healthcare. BMJ Open Quality. 2020;9(1):e000826. doi:10.1136/bmjoq-2019-000826. PubMed PMID: 32075804; Pubmed Central PMCID: PMC7047493.
  35. Lieff SJ, Albert MJAM. The mindsets of medical education leaders: how do they conceive of their work? Acad Med. 2010;85(1):57-62. doi: 10.1097/ACM.0b013e3181c46e47. PubMed PMID: 20042823.
  36. Bajis D, Chaar B, Basheti IA, Moles RJRis. Identifying perceptions of academic reform in pharmacy using a four-frame organizational change model. Res Social Adm Pharm. 2018;14(10):921-30. doi: 10.1016/j.sapharm.2017.11.006. PubMed PMID: 29162326.