Bridging the Macro–Micro Divide in Health Entrepreneurship: A Multi-Stakeholder Qualitative Study of Faculty and Student Entrepreneurial Intention

In the world of medical and health sciences, the primary goal has long been to train students to become skilled clinicians, researchers, or public health officials who work within established systems. However, a growing number of educators and policymakers are asking a different question: how do we encourage these future health professionals to become creators of new solutions? This question centers on "entrepreneurial intention," which is simply the desire and plan to start a new venture, such as a health technology company or a community service program. Unlike the idea that some people are just born with a "business gene," modern understanding suggests this intention is shaped by a mix of personal confidence, the support of family and friends, and the environment provided by universities. In the complex field of health, where new ideas must navigate strict safety rules and ethical duties, understanding what drives a student to take the leap is crucial for building a more responsive and innovative healthcare system.

Researchers in Iran set out to understand exactly how this desire to start a business forms among health science students. They conducted a deep, qualitative study involving thirty people, split into two groups: twelve faculty members and experts who design the educational system, and eighteen students or recent graduates who are currently navigating their studies or early careers. Instead of using surveys to count how many people felt a certain way, the team held in-depth, face-to-face conversations. They asked open-ended questions about what motivated these individuals, what barriers they faced, and what they believed was needed to succeed. The researchers recorded every word, analyzed the transcripts to find common patterns, and compared the perspectives of the teachers against those of the learners. The goal was not just to list factors, but to see if the people running the system and the people inside it were actually seeing the same reality.

The study revealed that the desire to start a health business is not a single switch that gets flipped; it is a complex web of influences. On one side, there are personal traits like self-confidence, persistence, and a belief in one's own abilities. On the other, there are external forces: the financial and emotional backing of family, the presence of successful role models, and the ethical belief that one's work should serve society. In the Iranian context studied, spiritual faith and a sense of professional responsibility played a significant role, with many participants viewing entrepreneurship as a way to fulfill a duty to help others rather than just to make money. The researchers found that when students saw faculty members or graduates who had successfully started businesses, it made the path feel more real and achievable. Conversely, a lack of practical skills, fear of failure, and a culture that prefers stable, traditional jobs acted as powerful brakes on these ambitions.

However, the most striking discovery of the study was a fundamental disconnect in how the two groups perceived the same environment. While both faculty and students agreed on the general list of challenges and opportunities, they described them from completely different heights. The faculty members and experts tended to speak in "macro" terms, focusing on high-level policies, the structure of university incubators, national regulations, and the broad ecosystem of innovation. They discussed the need for curriculum reform, better laws, and strategic partnerships between universities and industry. The students, by contrast, spoke in "micro" terms, grounded in their daily lived experiences. They worried about the immediate fear of failing, the confusion of not knowing where to start, the difficulty of getting a single permit, and the lack of a mentor to guide them through the first few steps.

To illustrate this gap, imagine a mapmaker and a hiker. The mapmaker sees the entire mountain range, the weather patterns, and the geological shifts that will shape the terrain over decades. The hiker, however, is focused on the loose rock under their boot, the steepness of the next step, and the need for a hand to hold. Both are looking at the same mountain, but their immediate concerns are worlds apart. In this study, the faculty were the mapmakers, discussing the shape of the mountain, while the students were the hikers, worried about the next step. The researchers found that the students did not necessarily disagree with the faculty's big-picture analysis; rather, they felt that the big-picture solutions did not translate into the practical, tangible help they needed right now. A student might hear a professor talk about "strengthening the innovation ecosystem," but the student's immediate reality was a lack of seed money or a confusing bureaucratic process that took months to navigate.

The study identified specific barriers that felt different depending on who was looking at them. For faculty, the problem was often that university incubators were inefficient or that the curriculum was too theoretical. For students, the problem was that these incubators felt like empty rooms with desks and chairs, offering no real guidance or connections to investors. When it came to funding, faculty discussed the need for government budgets and private investment platforms, while students asked for simple, accessible loans or small grants to get their first idea off the ground. The researchers also noted that while both groups recognized the potential of digital health and new technologies, the faculty saw these as opportunities for large-scale knowledge-based companies, whereas students saw them as accessible ways to start small, flexible businesses that could solve immediate local problems.

Despite these differences in perspective, the study found that the path forward requires bridging this gap. The researchers concluded that for entrepreneurial intention to turn into real action, the high-level policies and structural changes proposed by the faculty must be translated into concrete, accessible support for the students. This means that universities cannot just talk about creating an "ecosystem"; they must provide the specific tools students need to survive the early stages of a venture. This includes practical workshops where students can write real business plans, access to mentors who have actually started businesses, and streamlined administrative processes that do not overwhelm a novice. The study suggests that when the macro-level support of the institution is aligned with the micro-level needs of the student, the intention to innovate becomes a sustainable reality.

Ultimately, the paper argues that strengthening health entrepreneurship is not just about teaching business skills or changing laws. It is about connecting the vision of the institution with the reality of the learner. The researchers emphasize that in health sciences, where the stakes involve human life and safety, the drive to innovate must be rooted in ethical responsibility and a commitment to social good. By understanding that the people designing the system and the people living in it see the world differently, universities can build better bridges. This approach ensures that the desire to create new health solutions is not lost in translation, allowing the next generation of health professionals to turn their ideas into value-creating behaviors that truly serve their communities.