Designing a development physical training model for students of Iranian medical sciences universities

Background and aims: The importance of developing physical training and the need to expand it among students increases when the social harms and anomalies observed in this space are carefully analyzed. Knowing the pattern and model governing this matter helps prevent social anomalies. Since no study was done to discover this model, the present research was conducted to investigate the design of the development model of physical training for students of Iranian medical sciences universities. Methods: This study was conducted with an exploratory-fundamental nature, a qualitative approach, and the foundation’s data strategy in 2021-2022. The data collection method was a semi-structured interview with 19 specialists and experts using purposeful sampling. The method of coding and forming concepts from the interviews was used to analyze the data. MAXQDATA2020 software was used to analyze the data. Then, the codes were categorized, and a conceptual model was presented. Results: The codes extracted from the interviews included 191 codes in 6 categories of causal conditions, central phenomenon, contextual conditions, intervening conditions, strategic conditions, and consequential conditions, as well as 38 components. Causal conditions include seven components and 27 codes; central phenomenon includes three components and 11 codes; contextual conditions include seven components and 36 codes; intervening conditions include eight components and 41 codes; strategic conditions include eight components and 43 codes and conditions a result includes five components and 24 codes.


Introduction
Sport is one factor that provides physical and mental health for people in society (1). As an essential part of the education system, in addition to having a fundamental and decisive position, it has various functions in the academic society of the country (2). Since universities are responsible for providing and training specialized, skilled, and healthy human resources, university sports are an essential part of the long-term goals of national development in sports and youth. University sports are very effective in providing physical and mental health for students and are of particular importance and special attention among students. In addition, the development of university sports can be considered essential and valuable support for developing sports in the country (3). Although many pieces of research have shown that participation in physical activity is beneficial for physical and mental health (4)(5)(6), inactivity among the people of the world is continuously increasing (7). In the meantime, since students play the leading role in raising the future generation and due to the weakness of physical abilities and weight gain observed among them, it has a unique priority (8).
Various stresses accompany student life due to special conditions. Many students feel lonely and isolated after entering the university environment and being separated from their families. On the other hand, facing different personality types in the professional and dormitory environment, lack of comfort facilities, economic shortages, reduction of support resources, and family supervision exposes them to psychological and social harm (9). Student sports activities at higher education levels help develop and organize a healthy lifestyle for students. However, in the modern world, due to virtual entertainment, this critical challenge is more and more endangered, which requires a quick solution (10).
Awareness of the values of physical activity affects the voluntary quality of students' personalities and their level Physical training model for students of success, and the positive attitude of students toward physical activity is an influential factor in the formation of a healthy lifestyle, intellectual abilities, and critical professional characteristics (11). Optimum benefit from sports activities in the university during leisure time leads to physical and mental health, improvement of the educational process, and social relations (12,13). On the other hand, medical students deal with people's health in society, and their growth and health are very effective in the growth and health of society. Therefore, physical training and sports should find a special place in their life and free time so that they have complete physical and mental health and can better fulfill the duties related to maintaining and improving the level of health of society (14,15). This fact is despite the research of Ramezankhani et al . Medical students need to perform better regarding physical activity (16). In addition, researches show that there are currently severe problems, such as poor mobility among medical students, which will negatively affect their health and society's overall level of health (14,15).
Therefore, it is necessary to pay attention to the sports activities and physical training of the students of the ministry of health during their university studies to familiarize them with the benefits of sports and physical training. They are, moreover, informed about its role in filling free time. However, before we achieve this, it is necessary to know the development model of this phenomenon in universities of medical sciences to pay more attention to its dark corners. A literature review shows that many studies have been conducted in student sports, each evaluated by different institutions, from various aspects, and with different methods. For example, Keshtidar (19). Among international researchers, Rogowska and Kuśnierz examined the health-oriented behavior of students (20), and Muñoz-Bullón et al investigated the effect of sports participation on students' academic performance (21).
Complete and comprehensive research has yet to be obtained in an integrated combination based on the data theory of the foundation regarding physical training and sports of the students of Iranian medical sciences universities. By accurately identifying all the factors, the importance and relationship of each of them should be measured, and the hidden and neglected aspects of this essential part of sports of the ministry of health and medical education should be revealed. Based on that, a comprehensive, local, and practical model can be achieved in the field of sports development in medical sciences universities and the field of health and solve countless problems in the sports field of the ministry of health and medical education in a logical and principled way.
Undoubtedly, the development model of students' physical training is considered a fundamental step to sensitize managers and decision-makers in this area and will be used in modifying current programs and developing future programs. Also, considering the effect of sports in maintaining and improving students' mental health levels, a model that discovers and introduces the development of physical training in the university according to the native psychological characteristics of our country seems to be strongly required. Therefore, the lack of a native model that reflects well the conditions related to the socio-cultural background of students in the health field and the many unknown aspects surrounding this model encouraged the research team to conduct this study. Since the research method is limited and it is not appropriate to answer such questions, this study was designed, proposed, and implemented to develop a physical training model for students of the ministry of health and medical education.

Methods
The current research was carried out with a fundamentalexploratory nature, a qualitative approach, and with the strategy of contextual theory in the years 2021-2022. The research aimed to achieve a paradigm model based on the data collected using semi-structured and systematic indepth interviews and existing theoretical studies. In the first stage, semi-open questions and an interview structure were designed using a literature review and a systematic review of past research in this field. Appointments were arranged with the eligible subjects, and the general purpose of the study was explained to them. The research team's duties and the participants' rights were emphasized. The written consent to participate in the study was given to them to read and sign if they agreed. Before each interview, permission was obtained to record the voice and take notes during the interview. To record the interviews, a voice recorder device that could not connect to the Internet was used so that the participants were sure of the security of the content of the interviews. Then, based on the interview guide, interviews were conducted with 19 specialists in the field of sports management. The participants were opinionated people with scientific, managerial, and academic activities in physical training. In the location, time, and duration of the interview, the convenience of the participants has been considered. According to the principles of sampling in qualitative research, purposeful sampling was used until the categories reached theoretical saturation. We did 19 interviews with duration between 20 and 40 minutes (34 ± 9) that were recorded with a voice recorder device. In this research, the systematic design of Strauss and Corbin has been used (22). The data analysis process started at the same time as sampling. Based on this systematic plan of foundation data theory, three stages of open, central, and selective coding were done to analyze the collected qualitative data. Then, by immersing the researcher into the data and concepts and examining their sequence and possible connections, a logical paradigm or an objective picture of the created theory was finally presented. Since the concepts are the main bases of building the theory, it was necessary to build a mechanism to use the primary raw data, preliminary categories related to the phenomenon under investigation by asking questions about the data, constant comparison analysis of data, events, and other states of the phenomena to extract similarities and differences. The open coding approach was used to analyze the data, according to the existing similarities and differences, and to perform the analysis and categorization, which started at the same time as the data collection, the MAXQDATA 2020 software, which is remarkable for coding in the research method, was used. In this way, a set of categories emerged from the primary raw data. In the next stage, the axial coding of one of the categories was chosen as the main category of the research, which had some impact and flowed in all the categories. By examining and discovering the desired category, other categories were theoretically related. In the last stage of coding, because it shows the main components of the proposed theory or process, the researcher acts in more selective coding based on these emerging components. At this stage, opinions and concepts were placed in the same category. Finally, the influential factors in the development model of physical training of medical science students in the country were identified, and a conceptual model was also presented.

Results
In this study, 7 participants were women (37.4 ± 7.3) years, and 12 were men (35.7 ± 6). Also, 90% of the interviewees had a Ph.D. degree, and 10% had a master's degree. Regarding occupation and administrative positions, seven were academic leaders, four were vice presidents of universities, 3 were federation members, and 5 were presidents of medical sciences universities. Table 1 is related to a part of the interviews, where the critical points of the interviews and focus groups are located along with the primary codes. The codes extracted from the interview in 6 main categories equal 191 codes. The extracted codes were further categorized in axial coding: causal conditions (Table 2), central phenomenon (Table 3), contextual factors (Table 4), intervening factors (Table 5), strategic factors (Table 6), and consequences (Table 7).

Discussion
The current research aims to provide a model for developing physical training and sports for students of medical sciences universities in Iran. The development of university sports can guarantee students' health and is one of the influential factors in the country's sports development. Accordingly, the role of universities is essential for developing sports in the country. Identifying the platforms and factors for the development of sports in universities, especially universities of medical sciences, in addition to improving students' health, causes the growth of sports in the country. Since the students of medical sciences universities are less active due to their academic conditions, and most of the time, due to their busy schedule and involvement in practical training in the hospital, they do not have the conditions and position to engage in sports activities (23). Therefore, identifying the solutions for developing physical training and sports and providing a comprehensive and complete model for physical training and sports for students of medical sciences universities is of double importance. The results of this research show that one of the conditions affecting the model of physical training and sports for students of the ministry of health and medical training is the role of motivation, determining the sports needs of students, management position, financial issues, providing free sports services to students, the promotion of sports comes from the student's family and the university environment is suitable for sports (24). Today, motivation is one of the most critical factors affecting sports activities. Sports psychologists generally divide motivation into two categories: internal and external. Those who are motivated from within have an internal pull to grow and acquire capabilities and selforganization on the way to achieving a goal, accomplishing an external task, or achieving success. Qualities, the level of personal abilities, self-organization, becoming skilled at work, and achieving success are the goals pursued by internally motivated people; achieving these goals is their reward. Determining the sports needs of students is one of the influential factors in promoting sports activities among medical students, and recognizing sports needs and taking action to implement them will lead to the development of sports among students (25). Therefore, understanding the sports needs of students is one of the essential activities of the physical training department of medical sciences universities. In the meantime, the managerial position in sports development should be addressed. The managers of the physical training department of the medical sciences university play a significant role in the development of sports activities and their growth among students. Today, any activity's correct and principled performance requires strong and capable management. Also, financial issues are always one of the most important causes of students not participating in sports; Students may refrain from sports activities due to financial problems in preparing sports clothes. The role of the family in promoting sports and the university environment should be addressed. The suitable environment of the university and the family's desire for their students' sports activities will lead to the development of sports among the students, and the more the university environment is conducive, the more the students' sports activities will be (26). Therefore, university administrators should provide a suitable environment for sports activities.
Among the conditions of the central phenomena affecting the model of physical training and sports of the students of the ministry of health, and medical Making students interested in sports 3 Placement of sports in the basket of people's lives 6 Promoting sports in students' families 7 Being happy in the university environment for sports The need to increase sports facilities in university environments 2 Determining the sports needs of students Recognizing the need for sports for students 1, 19 The suitability of the university environment for sports 16 Identifying the needs and desires of students 11 University   Cultural and advertising works 5

Student sports broadcasters
General departments of physical training and sports teams 3 Suitability of executive programs according to the culture 6 Education 9 Cultivation 9 Media coverage of sports 6 Using advertising billboards 14 Using the virtual media of the university to promote the benefits of sports 13,15 The role of the media in promoting sports 15 Ministry of Sport and Youth 8 * Participant number. The inability of administrators to promote sports 7 acting as an island 6 The existence of experts in the field of sports 9 Ignoring students' free time Lack of a written program to fill students' free time 7 The entry of non-specialists into sports 10 Not having statistics to exercise 13 Lack of plan to encourage students to do sports 19 Lack of information about students' free time 18

Lack of experts 19 Lack of information about students' interest in sports 18
Negative view of managers of sports increased because improving students' morale and energy will lead to more sports activities by students. Performing sports and physical activities by students will lead to the reduction of individual and social inconsistencies, including the reduction of smoking and the reduction of education, we can mention the improvement of the student's energy and morale, the reduction of individual and social inconsistencies, and the acquisition of physical fitness. In order to develop physical and sports activities in students, students' morale and energy should be Using the successful experiences of other countries 2 Provision of sports space 18 Implementation of strategic plans 8 Providing sports facilities 18 Designing physical activity according to one's age 9 Determine the goal 11 The pattern of students' physical activities 18 Compilation of physical activity pattern 19 * Participant number. Relieving student fatigue 7 Feeling alive 7 The effect of exercise on relieving boredom among students 7 Eliminate boredom and laziness 8 student aggression. Exercise always increases one's health, so physical and sports activities will lead to fitness and body beauty. Also, achieving body health requires doing physical and sports activities, so sports development among students will also lead to their physical fitness (27). Among the background factors affecting the model of physical training and sports for students of medical sciences universities, we can refer to the use of existing capacities, the development of the necessary sports infrastructure, the spreaders of student sports, access, meritocracy, empowering trainers, cultural and advertising issues (28). From the interviewees' point of view, among the background factors affecting the development of physical training and sports activities among students, we can mention the available capacities, such as the capacity of the family and native and local games. Today, local and family games can help to develop the model of physical training and sports among students.
The lack of necessary infrastructure will lead to the lack of development of sports among students; the development of student sports is not exclusive to the university; other bodies such as the department of physical training, sports teams, education, the ministry of sports and youth and the media should also be synchronized and agree with the university (29). Today, the national media, considering its effectiveness in society, can be an effective tool in developing sports among students by preparing a scientific program regarding the importance of sports in health and vitality. The coverage of sports by the mentioned institutions leads to realizing the goals of sports in different dimensions. In the meantime, we should pay attention to students' access to sports and the availability of facilities for developing physical and sports activities. The availability of sports facilities around the day and night and in the university will lead to sports development in students' free time. In addition to access to sports facilities, the presence of capable and up-to-date trainers in the science of physical training will lead to the development of physical activity and sports in students (30). Empowerment coaches, with their knowledge, will attract students to sports activities and provide the basis for their development. Today, the development of sports requires cultural and advertising issues. Cultivation and advertising regarding the effects of physical activity and sports will lead to its expansion among students. The use of advertisements regarding the place of physical training and sports among students is one of the effective solutions in its development, which should always be paid attention to (31). Among the factors affecting the model of physical training and sports of the students of the ministry of health and medical education are structural problems, neglect of students' free time, lack of community planning and codification, and lack of managers and encouragement plans for students to participate in sports. He pointed out the negative attitude of managers toward sports, the need for more awareness of students about the benefits of sports, and legal obstacles. Any activity has obstacles that can help its development by removing these obstacles and problems. From the point of view of the interviewees, structural problems can be mentioned among the obstacles to the physical training model of the students of the ministry of health and medical education.
Arbitrary decisions of the institutions, lack of coordination in different physical training departments of the university, parallel work in different departments of the university regarding physical training activities, and the number of sports trustees will lead to the lack of development of physical activities and sports in the university of medical sciences, which should be aimed at solving and should be tried (32).
Among the other interfering conditions of the physical training model of medical students, we can mention the neglect of students' free time; one of the most critical problems of student's free time is the lack of a written program to fill students free time and the lack of information about students' free time and the lack of information about students' interest in sports pointed out. Therefore, removing these obstacles will lead to physical activity and sports development during students' free time. Also, from the point of view of the interviewees, financial and budgetary obstacles are one of the reasons for not developing the model of physical training and sports for medical students. The lack of sufficient financial resources to carry out intra-university student competitions and send students to national competitions, the lack of spending on sports by the university, and the lack of budget are some of the obstacles to the development of physical training and sports in medical students, and solving these problems will lead to its development in students (33). Of course, there needs to be a manager, and the plan to encourage students to participate in sports is also one of the reasons for not performing physical training and sports activities among students. The non-prioritization of sports by senior university managers, the lack of sufficient attention of trustees to sports, the managers' negative attitude towards sports, and the managers' lack of knowledge and awareness of the benefits of sports have led to the formation of a negative view of the managers of the university of medical sciences towards sports.
Among the factors of the effective strategies on the model of physical training and sports of the students of the ministry of health and medical education can be the implementation of principled planning, providing information about the benefits and advantages of physical activity, increasing the awareness and information of students about the benefits and effects of physical activity. Understanding sports, changing students' attitudes toward it, increasing sports space and equipment per capita, holding a sports conference in the university, and developing a model for students' physical activities (34). From the interviewees' point of view, implementing any activity requires the implementation of written and principled planning. Planning is a continuous process that starts before making any decision and continues after the Physical training model for students implementation of that decision. In planning, managers seek to create and implement procedures to lead the forces to the goal as quickly as possible. Also, among other consequences, we can mention the increase in the student's awareness and information about the benefits and effects of physical activity. Increasing students' awareness of the benefits of physical training will increase their sports activities during their free time. Therefore, increasing the awareness of students about the benefits of sports and making them aware of their physical needs will lead to an increase in their knowledge and awareness of the benefits of exercising, and increasing awareness of the benefits of exercising will lead to the development of the model of physical training and sports for students.
Meanwhile, the per capita increase of sports space and equipment is one of the foremost practical approaches in the effective strategy in the model of physical training of students. Holding a sports conference at the university and compiling the pattern of students' physical activities is also a strategy that affects the model of physical training and sports of students (35). Of course, formulating the pattern of students' physical activities, using the experience of prosperous countries in this field, and specifying the goal can help the development of physical training and sports in students.
Among the practical consequences of the model of physical training and sports for the students of the ministry of health and medical education can be increased vitality and morale, increased sports participation in students, increased mental and physical health of students, reduced depression in students, and relieving fatigue and boredom of students. Implementing any activity has a consequence; increasing the vitality and improving the morale of students is always a concern of the country's officials (36). Increasing vitality and improving morale will lead to an increase in students' academic progress, and this increasing vitality and improving morale will lead to reducing depression in students and eliminating fatigue and boredom among students, which are factors in the shadow of increasing sports participation in students. The desire of students to exercise and invite students to participate in sports will lead to the maximum attendance of students, and maximum attendance will lead to an increase in sports participation in students and an improvement in the mental and physical health of students.
Accordingly, The final research model of physical training is illustrated in Figure 1. This is a qualitative study. So, we committed to the viewpoint and experiences of the participants. Individual differences in expressing experiences may have affected the quality of the final product. Although this is a deep process to drive a comprehensive model, like other qualitative studies, generalization of the results is limited.

Conclusion
So far, complete and comprehensive research has yet to be done in an integrated combination based on the foundation's data theory about physical training and sports of students of the country's ministry of health and medical education. By accurately identifying all the factors, the importance and relationship of each of them should be measured, and the hidden and neglected aspects of this primary sports sector of the ministry of health and medical education of the country should be revealed so that based on that, a comprehensive, local and practical model can be developed. Indeed, the model of physical training of students of the country's ministry of health and medical education will be a fundamental step in the development of physical training at the university because it is based on the fact that problems and deficiencies can be identified in different departments. It can be used as a criterion for correcting current and developing future programs.

Application of the results at the bedside
One of the most critical problems of today's society is inactivity, and in addition to its harmful effects on people's health, it can also affect other functional aspects of life. Therefore, it may be possible to use the sports development model of students to institutionalize sports in the health field. On the other hand, these results can be used for better use of physical activity in hospitalized patients.