Identifying E- Learning Dimensions, Categories & Indicators for Universities of Medical Sciences: Presenting a Model

of e-learning for universities of medical sciences. This study was a qualitative using a data-grounded theory approach. 30 academic experts and faculty members in the field of educational technology, distance learning and medical education were selected. The data was collected through in- depth semi- structured interviews. The systematic approach of Strauss and Corbin was conducted in three stages of open, axial and selective coding. The accreditation of the data was based on Delphi rounds and brainstorming sessions. Results: The results revealed that e – learning model for universities of medical sciences involved 4 main dimensions: academic, spatial planning regions, national – macro, and regional - international. Also 22 categories and 222 indicators have been extracted, and the final model was plotted according to the mentioned factors. Conclusions: According to the findings, it is hope that the application of this model can also realize the goals and programs of the transformation and innovation project in medical education. It is necessary that the government make investments at macro level on the infrastructure, legal aspects, and supports for e-learning, in line with the global evolutions in the near future. The present research aimed to identify the dimensions, categories and indicators of e - learning for universities of medical sciences. This study was a qualitative using a Data- Grounded Theory approach. 30 academic experts and faculty members in the field of educational technology, distance learning and medical education were selected. The data was collected through in- depth semi- structured interviews. The systematic approach of Strauss and Corbin (1990) was conducted in three stages of open, axial and selective coding. The accreditation of the data was based on Delphi technique and brainstorming sessions. were of then were

Introduction feedback [2][3][4]. Over the last number of decades there has been a shift in medical education practice from traditional forms of teaching to other media which employ online, distance or electronic learning [5]. As described by Howlett et al. [6], "Electronic or online learning can be defined as the use of electronic technology and media to deliver, support and enhance both learning and teaching and involves communication between learners and teachers utilizing online content". Online learning can provide students with "easier and more effective access to a wider variety and greater quantity of information" [7]. However, the transition from traditional to online learning is not without challenges. Increasing time constraints and demands are continually placed on students and educators alike, driving departments to find new ways of providing a more personalized, self-directed learning experience.

Review of literature
Regarding the theoretical foundations of research in recent years, different models, patterns and frameworks for e-learning are presented. The most important of which are discussed in Table   1.

Findings
The research data were conducted in three sections: analysis of interviews by coding method, Delphi method and brain storming, then research questions were answered.

Research Question 1: What are the e-learning indicators for Universities of Medical Sciences?
To answer the first research question, initially, the theoretical

Discussion and Conclusions
The present research aimed to identify the dimensions, categories and indicators of e -learning for universities of medical  [15], and Daneshgar et al. [16]. Also in the categories of management, organization, financial resources, ethics and culture, the legal factor are consistent with studies done by Khan [17], Omoda-Onyait& Lubega [18], Darab & Montazer [19] and Martínez-Caro et al. [20]. According to Agonács & Matos The Educational Transformation and Innovation Project in universities of medical sciences had a higher medical education spatial planning approach and paid attention to regional capabilities, and aimed to provide an opportunity for universities of medical sciences to believe in the regional capabilities in relation to their needs, and thus attempt to plan and manage higher education in the healthcare system. One of the values discussed in these policy-makings was to address educational justice. Several studies, including those by Khatib Zanjani et al. [25], Eslaminejad et al. Mazloom et al. [28], Zolfaghari et al. [29] and Naderifar et al. [30].
Moreover, the indicators of the government's scientific and technical supports include: learning from universities pioneering in e-learning, improving student admission methods, cooperation with knowledge enterprises for knowledge localization, and supporting the expansion of inter-university, regional, and international interactions. These findings are in line with those of Daneshgar et al. [21], Zarea Bidaki et al. [29], Mazloom et al. [16], Ostad et al. [31], Bagheri Majd [32], Kofi Ayebi [33], Walsh [34], Asadian et al. [35] and Ommati and Alipour [36]. The indicators of the supports from the higher medical education system mentioned by the experts in Areej [40], and King et al. [41].
The results of the present study in the regional and international Nural et al. [37], Rahimi et al. [44], Lotte et al. [45], and Eghball et al. [46]. These studies also concluded that e-learning can increase the number of students who can cooperate with their peers in universities across the world. The rising trend of globalization has led to extensive changes in medical education. Due to academic, cultural, social, economic, and political reasons, the governments, higher education centers, and the society are all in favor of merging international dimensions in the academic activities, whether for education or service provision. Because of these inevitable changes, the managers of universities play a critical role in leading universities in this ever-changing environment. According to Graham [5], Ghasemi et al. [11], Alshaher [21], Bhardwaj et al. [23] Lotte et al. [45], Islam et al. [47], and Trainee's Weng [48][49][50][51], one of an effective strategy for internationalization is to pay attention to different distance education systems, including e-learning.
One of the merits of this model is its comprehensiveness. The developed model comprises four dimensions of academic, spatial planning regions, national-macro, and regional-international.  11. It is suggested that electronic publishing be promoted in universities as the main route for content production.
12. It is suggested that a national authoritative body be formed for e-learning content policy-making. 13. It is suggested that regulations be developed for e-learning courses (validation, professionalism and professional ethics, incentives, respecting the copyright law in the development of educational contents) 14. It is suggested that the level of interaction be addressed in the virtual space (student-teacher and student-student interaction, and the interaction between content and students/ teachers). 15. It is suggested that investments be made on the development of e-learning courses on key and specialized domains of health, medicine, and telemedicine in the top Iranian universities of medical sciences with an e-learning and health economy approach; moreover, policy-makers in this domain should pay special attention to investment on telemedicine courses in order to internationalize the medical education courses. 16. It is suggested that e-learning capacities be used for developing and accelerating the trend of internationalization and recruitment of foreign students.
It is suggested that facilities be provided for low-income families to continue their education in e-learning universities.
a) It is suggested that research and education projects be b) It is suggested that specialized software programs be prioritized and used for merging e-learning in practical and clinical programs (a national virtual system, a medical consultation system, virtual hospitals, virtual drugstores, etc. d) It is suggested that e-learning futurism be developed in Iran as a periodical process.
e) It is suggested that the model and its appendixes be presented to MoHME for assessment and pilot implementation.