Volume 28, Issue 1 (5-2025)
jha 2025, 28(1): 7-22 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Esmaili Fard M, Hosseini S M, Alimohammadzadeh K, Mahdizadeh A. Glass ceiling beliefs and the career success of women graduated in healthcare management at university medical centers in Tehran. jha 2025; 28 (1) :7-22
URL: http://jha.iums.ac.ir/article-1-4617-en.html
URL: http://jha.iums.ac.ir/article-1-4617-en.html
1- Department of Health Services Management, TN. C., Islamic Azad University, Tehran, Iran.
2- Department of Health Services Management, TN. C., Islamic Azad University, Tehran, Iran. ,hosseinisch@yahoo.com
3- Health Economics Policy Research Center, TeMS. C., Islamic Azad University, Tehran, Iran.
4- Department of Community Health Nursing, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. & Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2- Department of Health Services Management, TN. C., Islamic Azad University, Tehran, Iran. ,
3- Health Economics Policy Research Center, TeMS. C., Islamic Azad University, Tehran, Iran.
4- Department of Community Health Nursing, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. & Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Full-Text [PDF 1133 kb]
(382 Downloads)
| Abstract (HTML) (982 Views)
Table 2. Frequency distribution of glass ceiling beliefs and its subscales in the participants
Table 4. Relationship between glass ceiling beliefs and career success in participants
r: Spearman correlation coefficient; p: p-value
Discussion
Most participants demonstrated resilience-related glass ceiling beliefs. They believed their flexibility in the face of challenges enable them to break the glass ceiling and advance in their career. However, it can also be concluded that despite this resilience, some women respond to pressures stemming from an imbalance between their goals and the structural methods available to achieve them, leading to feelings of helplessness and resignation. As a result, they abandon their goals and efforts to achieve them. In some cases, women do not aspire to high positions or power within organizations and do not share the same ambitions as men. The scores obtained from acceptance beliefs may reflect this tendency. Furthermore, the scores in the denial dimension indicate that a small number of participants believe that gender discrimination and its associated challenges do not hinder their career development.
These findings partly align with Tabe Bordbar et al., [20] who found that the highest participant scores were for resilience, resignation, denial and acceptance, respectively. In contrast, Ramezani et al., [21] found the highest scores for denial, followed by acceptance, resilience, and resignation, possibly due to different participant characteristics (mixed gender versus only women). The present study demonstrates that denial, as an optimistic glass ceiling belief, has a positive and significant effect on the participants’ perceived career success. Supporting these results, Smith et al. [15] found that denial predicted 10% of job satisfaction variance and 7% of work engagement variance. Additionally, Tabe Bordbar et al. [20], Fathy and Zidan [22] Khalid and Sekiguchi [23], and Balasubramanian and Lathabhavan [24] have all documented a positive association between denial and perceived career success. Therefore, the present study reinforces the significant positive impact of denial on women’s career success within organizations.
No significant correlation was found between acceptance and career success. Smith et al. [15] suggest that acceptance reflects a belief among women that they prioritize other life goals, such as family involvement, over career advancement. This acceptance may manifest as a set of pro-family/anti-career beliefs that lead women to accept existing disparities between men and women in attaining leadership roles, ultimately resulting in less ambition for promotion. However, acceptance can also be viewed positively as an optimistic perspective on balancing work and family life. Thus, it may foster positive feelings and actions both at home and in the workplace. Women who accept the glass ceiling may become more active in their home environments. Working women, especially married ones with children, often face pressure due to fulfill their roles as mothers and wives alongside their professional responsibilities. Cultural expectations may compel them to prioritize family obligations over career advancement, leading them to accept limitations on job promotion and diminishing their job satisfaction [20]. Although no significant relationship was found between acceptance beliefs regarding the glass ceiling and job success in our study, many other studies have reported a significant negative relationship between these two variables. In Smith et al.’s study [15], acceptance demonstrated a significant relationship with perceived career success. Conversely, Tabe Bordbar et al. [20] found no significant relationship between acceptance beliefs and career success and its sub-dimensions. Fathy and Zidan [22] reported that accepting women's glass ceiling belief as a pessimistic factor had a negative and significant effect on perceived career success, while Roman's study [25] indicated a negative relationship between acceptance and perceived career success factors.
The resilience subscale exhibited a significant positive correlation with career success, financial success, and the total career success score. In other words, individuals who frequently embody resilience-related glass ceiling beliefs report higher levels of career success. Psychological resilience is now recognized as a critical component of organizational excellence, and enhanced individuals' knowledge, skills and networks. Resilience functions as an adaptive response that enables individuals to succeed despite challenges (such as failures, conflicts, and positive events) and motivates continued pursuit of achievements [26]. Resilient individuals tend to navigate uncertain situations more effectively [27]. Research indicates that resilient people can return to or improve upon their previous performance level after facing difficult life circumstances. They are attuned to life's realities, find meaning in their experiences, and adapt swiftly to significant changes. Within the context of glass ceiling beliefs, resilience reflects women’s ability to overcome barriers by responding flexibly and persistently [15]. In our study, we identified a positive and significant effect of resilience on the career success of women educated in healthcare management. Numerous studies corroborate these findings; for instance, Smith et al. [15] found a significant relationship between resilience and perceived career success while demonstrating its positive correlation with work engagement and happiness, accounting for 7% of variance in happiness. Tabe Bordbar et al. [20] also revealed a positive association between resilience and career success. Mohammadkhani and Gholamzadeh [28] along with Roman [25] confirmed that resilience correlates positively with subjective factors related to career success.
In contrast to resilience, resignation related to glass ceiling beliefs did not show a significant correlation with career success measures, including interpersonal, financial, hierarchical success, or total career success scores. Resignation represents a negative stance in which individuals abandon career goals due to perceived barriers related to gendered promotion challenges [15]. Nevertheless, many prior studies have documented significant negative correlations between resignation and career success. In Tabe Bordbar et al.'s study [15], there was a negative and significant relationship between resignation and career success and its dimensions (p<0.001, r=0.518) [20]. Similarly, Smith et al.'s study [15] revealed that resignation negatively impacted various dimensions of women's career success, while Fathy and Zidan [22] showed that resignation had a negative and significant effect on career success. Furthermore, both Mohammadkhani and Gholamzadeh [28] and Roman [25] stated that resignation had a negative relationship with subjective factors of career success.
Limitations
One of the limitations of this study was the exclusive reliance on questionnaires for data collection, which may have led some participants to provide inaccurate or socially desirable responses. Additionally, the large number of questionnaire items and the extended response time required may have negatively affected the accuracy of responses.
Conclusion
This study contributes to the literature by confirming the positive and significant relationship between denial and resilience with the women’s perceived career success in organizations. In our research, no significant correlation was found between the resignation and acceptance (as pessimistic and negative factors) and career success or its subscales. Given the relationship between glass ceiling beliefs and the career success of female healthcare management graduates, healthcare managers can enhance female employees’ career success by designing and implementing programs that strengthen optimistic thinking (denial and resilience). Initiatives such as career counseling, leadership skill development workshops, and efforts to promote work-life balance can facilitate women’s career advancement in organizations and healthcare institutions. These measures may foster positive attitudes and perceptions toward promotion, minimize pessimistic thoughts (resignation and acceptance), and help women overcome glass ceiling barriers to attain career success. Managers can further increase women’s motivation and commitment and reduce turnover due to dissatisfaction by creating supportive work environments. Efforts in these areas will contribute to enhancing women’s managerial capabilities, improving organizational performance, and promoting equity within healthcare organizations.
Declarations
Ethical considerations: This study received ethics approval from the Research Ethics Committee of Islamic Azad University, North Tehran Branch, number IR.IAU.TNB.REC.1402.035. An informed consent form was also completed by the participants, and necessary measures were taken to ensure their confidentiality.
Funding: None
Conflicts of interests: There is no conflict of interests.
Authors’ contribution: M E F: Conceptualization, study design, data collection, methodology,
Full-Text: (303 Views)
Introduction
The presence of women in medical sciences is continually increasing [1-3]; however, studies show that women face significant obstacles when entering the profession or seeking promotions [4]. Women remain underrepresented in academic and management positions across various specialties and professional organizations [5]. These disparities, rooted in organizational and social culture, contribute to increased stress and burnout among women [6]. When employees are unable to achieve job success commensurate with their efforts, it can lead to turnover, raising costs and new challenges for organizations [7]. Career success encompasses positive achievements and satisfying work-related experiences that significantly enhance employee motivation and productivity [8,9]. Women face numerous organizational barriers to achieving carrier success, including unequal opportunities for career promotion, lack of support from supervisors and family, traditional attitude of senior managers towards women in leadership roles, resistance from subordinates regarding females in managerial positions, and pervasive gender stereotypes [10]. The “glass ceiling” refers to these invisible but powerful barriers that prevent women from climbing the promotion ladder in organizations [11].
According to Burn [12], the glass ceiling is a form of employment discrimination that gradually creates a real but invisible barrier to women's promotion to higher-level positions. Hull and Umansky [13] describe the glass ceiling as a set of social and organizational pressures that obstruct women’s access to high management positions by creating barriers against them. The glass ceiling can lead to conflicts between work and family obligations, increased stress, job dissatisfaction, intentions to leave an organization, and diminished commitment. Organizations can implement strategies to mitigate or eliminate perceptions of the glass ceiling. Women also play a critical role in breaking the barriers associated with this discrimination and its consequences. While methods aimed at dismantling the glass ceiling may incur initial costs for organizations, the long-term benefits are likely to outweigh these expenses [14].
Smith et al. [15] conceptualize glass ceiling beliefs as a multidimensional construct (denial, resilience, acceptance, and resignation). "Denial" refers to the belief that the promotion challenges are the same for all genders. "Resilience" reflects confidence in women’s ability to break the glass ceiling. "Acceptance" suggests that women prioritize other life goals, such as family, over career advancement. In contrast, "resignation" implies that women perceive the negative consequences of pursuing career promotion as greater than those faced by men. Optimistic beliefs (denial and resilience) can foster positive attitudes and actions, whereas pessimistic beliefs (acceptance and resignation) may lead to negativity toward career advancement [15]. Glass ceiling issues exist at all organizational levels [16]. This issue is particularly critical in healthcare organizations due to the nature of the services provided. Achieving health system goals requires not only individual expertise but also high organizational commitment and a desire to promote participation in group activities beyond individual tasks [17]. This study examines the relationship between glass ceiling beliefs and career success among women educated in healthcare management in university medical centers in Tehran.
Methods
This cross-sectional descriptive research targeted women with degrees in healthcare management, employed university medical centers in Tehran in 2023. Participants were selected using a convenience sampling method based on predefined criteria, including willingness to participate in the study and current employment. Participants who failed to answer 5% or more of the survey items were excluded. Assuming a correlation of at least 0.25 between glass ceiling beliefs and career success, with 95% confidence and 80% power, the minimum sample size was calculated to be 128. To account for potential attrition, 149 participants were recruited.
Data were collected using three part questionnaires: 1) Demographics (age, educational level, marital status, number of children, work experience, position, and interest in healthcare management); 2) Smith et al.'s Glass Ceiling Beliefs Questionnaire, which assesses denial (10 items), resignation (10 items), resilience (12 items), and acceptance (7 items) on a 7-point Likert scale (1= completely disagree to 7= completely agree). The reliability of the different dimensions of this questionnaire [15] using Cronbach's alpha was as follows: resignation (0.71), denial (0.81), acceptance (0.72), and resilience (0.70). The Persian version was validated by Manochehri et al. [18] and in the present study, the reliability was found to be 0.74 using Cronbach's alpha. Additionally, the validity of this questionnaire was confirmed by a group of experts and faculty members. 3) Career Success Questionnaire developed by Gattiker and Larwood in 1986, which measures career, interpersonal, financial, and hierarchical success (19 items, 5-point Likert (1= very little to 5= very much)). The Persian version was validated by Nejati et al. [19], and its reliability in our study was found to be 0.90 using Cronbach's alpha. Its validity was also confirmed by experts and faculty members.
All participants completed the survey in 10–15 minutes. Data collection took place from May to August 2023. Data analyses was conducted using SPSS v27, applying descriptive statistics, Spearman correlations, and Kruskal-Wallis tests (α=0.05).
Results
The majority of participants were aged 30-39 years old (40.9%), with a bachelor's degree (53.7%), had less than five years of work experience (47.7%), held an expert position (69.1%), and showed a high interest in healthcare management (63%). Among married respondents, 41.6% had no children (Table 1).
The presence of women in medical sciences is continually increasing [1-3]; however, studies show that women face significant obstacles when entering the profession or seeking promotions [4]. Women remain underrepresented in academic and management positions across various specialties and professional organizations [5]. These disparities, rooted in organizational and social culture, contribute to increased stress and burnout among women [6]. When employees are unable to achieve job success commensurate with their efforts, it can lead to turnover, raising costs and new challenges for organizations [7]. Career success encompasses positive achievements and satisfying work-related experiences that significantly enhance employee motivation and productivity [8,9]. Women face numerous organizational barriers to achieving carrier success, including unequal opportunities for career promotion, lack of support from supervisors and family, traditional attitude of senior managers towards women in leadership roles, resistance from subordinates regarding females in managerial positions, and pervasive gender stereotypes [10]. The “glass ceiling” refers to these invisible but powerful barriers that prevent women from climbing the promotion ladder in organizations [11].
According to Burn [12], the glass ceiling is a form of employment discrimination that gradually creates a real but invisible barrier to women's promotion to higher-level positions. Hull and Umansky [13] describe the glass ceiling as a set of social and organizational pressures that obstruct women’s access to high management positions by creating barriers against them. The glass ceiling can lead to conflicts between work and family obligations, increased stress, job dissatisfaction, intentions to leave an organization, and diminished commitment. Organizations can implement strategies to mitigate or eliminate perceptions of the glass ceiling. Women also play a critical role in breaking the barriers associated with this discrimination and its consequences. While methods aimed at dismantling the glass ceiling may incur initial costs for organizations, the long-term benefits are likely to outweigh these expenses [14].
Smith et al. [15] conceptualize glass ceiling beliefs as a multidimensional construct (denial, resilience, acceptance, and resignation). "Denial" refers to the belief that the promotion challenges are the same for all genders. "Resilience" reflects confidence in women’s ability to break the glass ceiling. "Acceptance" suggests that women prioritize other life goals, such as family, over career advancement. In contrast, "resignation" implies that women perceive the negative consequences of pursuing career promotion as greater than those faced by men. Optimistic beliefs (denial and resilience) can foster positive attitudes and actions, whereas pessimistic beliefs (acceptance and resignation) may lead to negativity toward career advancement [15]. Glass ceiling issues exist at all organizational levels [16]. This issue is particularly critical in healthcare organizations due to the nature of the services provided. Achieving health system goals requires not only individual expertise but also high organizational commitment and a desire to promote participation in group activities beyond individual tasks [17]. This study examines the relationship between glass ceiling beliefs and career success among women educated in healthcare management in university medical centers in Tehran.
Methods
This cross-sectional descriptive research targeted women with degrees in healthcare management, employed university medical centers in Tehran in 2023. Participants were selected using a convenience sampling method based on predefined criteria, including willingness to participate in the study and current employment. Participants who failed to answer 5% or more of the survey items were excluded. Assuming a correlation of at least 0.25 between glass ceiling beliefs and career success, with 95% confidence and 80% power, the minimum sample size was calculated to be 128. To account for potential attrition, 149 participants were recruited.
Data were collected using three part questionnaires: 1) Demographics (age, educational level, marital status, number of children, work experience, position, and interest in healthcare management); 2) Smith et al.'s Glass Ceiling Beliefs Questionnaire, which assesses denial (10 items), resignation (10 items), resilience (12 items), and acceptance (7 items) on a 7-point Likert scale (1= completely disagree to 7= completely agree). The reliability of the different dimensions of this questionnaire [15] using Cronbach's alpha was as follows: resignation (0.71), denial (0.81), acceptance (0.72), and resilience (0.70). The Persian version was validated by Manochehri et al. [18] and in the present study, the reliability was found to be 0.74 using Cronbach's alpha. Additionally, the validity of this questionnaire was confirmed by a group of experts and faculty members. 3) Career Success Questionnaire developed by Gattiker and Larwood in 1986, which measures career, interpersonal, financial, and hierarchical success (19 items, 5-point Likert (1= very little to 5= very much)). The Persian version was validated by Nejati et al. [19], and its reliability in our study was found to be 0.90 using Cronbach's alpha. Its validity was also confirmed by experts and faculty members.
All participants completed the survey in 10–15 minutes. Data collection took place from May to August 2023. Data analyses was conducted using SPSS v27, applying descriptive statistics, Spearman correlations, and Kruskal-Wallis tests (α=0.05).
Results
The majority of participants were aged 30-39 years old (40.9%), with a bachelor's degree (53.7%), had less than five years of work experience (47.7%), held an expert position (69.1%), and showed a high interest in healthcare management (63%). Among married respondents, 41.6% had no children (Table 1).
Table 1. Demographic characteristics of the participants
| Percentage | Frequency | Individual profile | |
| 39.6 | 59 | Less than 30 | Age (Years) |
| 40.9 | 61 | 30-39 | |
| 18.1 | 27 | 40-49 | |
| 1.3 | 2 | 50-59 | |
| 100 | 149 | Total | |
| 32.89±6.801 (21-51) | Mean ± SD (Min-Max) | ||
| 53.7 | 80 | Bachelor | Education |
| 35.6 | 53 | Master's degree | |
| 10.7 | 16 | Ph.D. | |
| 47.7 | 71 | Single | Marital status |
| 51.7 | 77 | Married | |
| 0.7 | 1 | Dependent | |
| 47.7 | 71 | Less than 5 | Work experience (Years) |
| 18.8 | 28 | 5-10 | |
| 20.1 | 30 | 10-15 | |
| 6.7 | 10 | 15-20 | |
| 6.7 | 10 | More than 20 | |
| 8.12±6.807 (1-27) | Mean ± SD (Min-Max) | ||
| 69.1 | 103 | The expert | Organizational position |
| 26.2 | 39 | Responsible expert | |
| 4.7 | 7 | Manager | |
| 41.6 | 32 | 0 | Number of children among married women |
| 35.1 | 27 | 1 | |
| 23.4 | 18 | 2 | |
| 19.5 | 29 | Too much | The level of interest in healthcare management |
| 43.6 | 65 | A lot | |
| 30.9 | 46 | Medium | |
| 4.7 | 7 | Low | |
| 1.3 | 2 | Very low | |
The mean glass ceiling beliefs score was 4.78±0.54, with the highest score in the resilience subscale (5.81±0.7) and the lowest score in the denial subscale (3.92±0.86) (Table 2).
Table 2. Frequency distribution of glass ceiling beliefs and its subscales in the participants
| SD | Mean | Maximum | Minimum | Glass ceiling beliefs and its subscales |
| 0.86 | 3.92 | 6.1 | 1.6 | Denial |
| 0.70 | 5.81 | 7 | 3 | Resilience |
| 1.18 | 4.67 | 7 | 1.9 | Resignation |
| 1.00 | 4.41 | 7 | 1.14 | Acceptance |
| 0.54 | 4.78 | 5.92 | 2.97 |
| Glass ceiling beliefs |
The mean career success score was 3.15±0.65, with the highest score in the interpersonal success subscale (3.98±0.61), and the lowest score in the financial success subscale (2.49±0.97) (Table 3).
Table 3. Frequency distribution of career success and its subscales in the participants
| SD | Mean | Maximum | Minimum | Career Success and Its Subscales |
| 0.73 | 3.26 | 5 | 1.62 | Career success |
| 0.61 | 3.98 | 5 | 2.5 | Interpersonal success |
| 0.97 | 2.49 | 5 | 1 | Financial success |
| 1.00 | 2.57 | 5 | 1 | Hierarchical success |
| 0.65 | 3.15 | 4.84 | 1.68 | Total |
Statistically significant positive correlations were found between denial and career success including all subscales (career, interpersonal, financial, hierarchical) and overall success. Resilience also showed a positive correlation with career success (p<0.001), financial success (p=0.032), and the total career success score (p=0.008). In contrast, resignation and acceptance showed no significant negative correlations with career success and its subdomains. The overall glass ceiling beliefs score correlated positively with career success (p=0.020), financial success (p=0.034), and overall career success (p=0.043). The total career success score showed the highest correlation with denial (r=0.418, p<0.001), resilience (r=0.215, p=0.008), resignation (r=0.076, p=0.358), and acceptance (r=0.011, p=0.899) (Table 4).
Table 4. Relationship between glass ceiling beliefs and career success in participants
| Glass ceiling beliefs | Career success | ||||
| Total | Acceptance | Resignation | Resilience | Denial | |
| r=0.191; p=0.020 |
r=0.026; p=0.757 |
r=0.055; p=0.502 |
r=0.293; p<0.001 |
r= 0.634; p<0.001 |
Career success |
| r=0.035; p=0.672 |
r=0.031; p=0.703 |
r=-0.083; p=0.341 |
r=0.032; p=0.694 |
r=0.194; p=0.018 |
Interpersonal success |
| r=0.173; p=0.034 |
r=-0.045; p=0.583 |
r=0.015; p=0.858 |
r=0.175; p=0.032 |
r=0.327; p<0.001 |
Financial success |
| r=0.088; p=0.285 |
r=-0.093; p=0.260 |
r=-0.123; p=0.135 |
r=0.152; p=0.065 |
r=0.414; p<0.001 |
Hierarchical success |
| r=0.166; p=0.043 |
r=-0.011; p=0.899 |
r=-0.076; p=0.358 |
r=0.215; p=0.008 |
r=0.418; p<0.001 |
Total |
r: Spearman correlation coefficient; p: p-value
Discussion
Most participants demonstrated resilience-related glass ceiling beliefs. They believed their flexibility in the face of challenges enable them to break the glass ceiling and advance in their career. However, it can also be concluded that despite this resilience, some women respond to pressures stemming from an imbalance between their goals and the structural methods available to achieve them, leading to feelings of helplessness and resignation. As a result, they abandon their goals and efforts to achieve them. In some cases, women do not aspire to high positions or power within organizations and do not share the same ambitions as men. The scores obtained from acceptance beliefs may reflect this tendency. Furthermore, the scores in the denial dimension indicate that a small number of participants believe that gender discrimination and its associated challenges do not hinder their career development.
These findings partly align with Tabe Bordbar et al., [20] who found that the highest participant scores were for resilience, resignation, denial and acceptance, respectively. In contrast, Ramezani et al., [21] found the highest scores for denial, followed by acceptance, resilience, and resignation, possibly due to different participant characteristics (mixed gender versus only women). The present study demonstrates that denial, as an optimistic glass ceiling belief, has a positive and significant effect on the participants’ perceived career success. Supporting these results, Smith et al. [15] found that denial predicted 10% of job satisfaction variance and 7% of work engagement variance. Additionally, Tabe Bordbar et al. [20], Fathy and Zidan [22] Khalid and Sekiguchi [23], and Balasubramanian and Lathabhavan [24] have all documented a positive association between denial and perceived career success. Therefore, the present study reinforces the significant positive impact of denial on women’s career success within organizations.
No significant correlation was found between acceptance and career success. Smith et al. [15] suggest that acceptance reflects a belief among women that they prioritize other life goals, such as family involvement, over career advancement. This acceptance may manifest as a set of pro-family/anti-career beliefs that lead women to accept existing disparities between men and women in attaining leadership roles, ultimately resulting in less ambition for promotion. However, acceptance can also be viewed positively as an optimistic perspective on balancing work and family life. Thus, it may foster positive feelings and actions both at home and in the workplace. Women who accept the glass ceiling may become more active in their home environments. Working women, especially married ones with children, often face pressure due to fulfill their roles as mothers and wives alongside their professional responsibilities. Cultural expectations may compel them to prioritize family obligations over career advancement, leading them to accept limitations on job promotion and diminishing their job satisfaction [20]. Although no significant relationship was found between acceptance beliefs regarding the glass ceiling and job success in our study, many other studies have reported a significant negative relationship between these two variables. In Smith et al.’s study [15], acceptance demonstrated a significant relationship with perceived career success. Conversely, Tabe Bordbar et al. [20] found no significant relationship between acceptance beliefs and career success and its sub-dimensions. Fathy and Zidan [22] reported that accepting women's glass ceiling belief as a pessimistic factor had a negative and significant effect on perceived career success, while Roman's study [25] indicated a negative relationship between acceptance and perceived career success factors.
The resilience subscale exhibited a significant positive correlation with career success, financial success, and the total career success score. In other words, individuals who frequently embody resilience-related glass ceiling beliefs report higher levels of career success. Psychological resilience is now recognized as a critical component of organizational excellence, and enhanced individuals' knowledge, skills and networks. Resilience functions as an adaptive response that enables individuals to succeed despite challenges (such as failures, conflicts, and positive events) and motivates continued pursuit of achievements [26]. Resilient individuals tend to navigate uncertain situations more effectively [27]. Research indicates that resilient people can return to or improve upon their previous performance level after facing difficult life circumstances. They are attuned to life's realities, find meaning in their experiences, and adapt swiftly to significant changes. Within the context of glass ceiling beliefs, resilience reflects women’s ability to overcome barriers by responding flexibly and persistently [15]. In our study, we identified a positive and significant effect of resilience on the career success of women educated in healthcare management. Numerous studies corroborate these findings; for instance, Smith et al. [15] found a significant relationship between resilience and perceived career success while demonstrating its positive correlation with work engagement and happiness, accounting for 7% of variance in happiness. Tabe Bordbar et al. [20] also revealed a positive association between resilience and career success. Mohammadkhani and Gholamzadeh [28] along with Roman [25] confirmed that resilience correlates positively with subjective factors related to career success.
In contrast to resilience, resignation related to glass ceiling beliefs did not show a significant correlation with career success measures, including interpersonal, financial, hierarchical success, or total career success scores. Resignation represents a negative stance in which individuals abandon career goals due to perceived barriers related to gendered promotion challenges [15]. Nevertheless, many prior studies have documented significant negative correlations between resignation and career success. In Tabe Bordbar et al.'s study [15], there was a negative and significant relationship between resignation and career success and its dimensions (p<0.001, r=0.518) [20]. Similarly, Smith et al.'s study [15] revealed that resignation negatively impacted various dimensions of women's career success, while Fathy and Zidan [22] showed that resignation had a negative and significant effect on career success. Furthermore, both Mohammadkhani and Gholamzadeh [28] and Roman [25] stated that resignation had a negative relationship with subjective factors of career success.
Limitations
One of the limitations of this study was the exclusive reliance on questionnaires for data collection, which may have led some participants to provide inaccurate or socially desirable responses. Additionally, the large number of questionnaire items and the extended response time required may have negatively affected the accuracy of responses.
Conclusion
This study contributes to the literature by confirming the positive and significant relationship between denial and resilience with the women’s perceived career success in organizations. In our research, no significant correlation was found between the resignation and acceptance (as pessimistic and negative factors) and career success or its subscales. Given the relationship between glass ceiling beliefs and the career success of female healthcare management graduates, healthcare managers can enhance female employees’ career success by designing and implementing programs that strengthen optimistic thinking (denial and resilience). Initiatives such as career counseling, leadership skill development workshops, and efforts to promote work-life balance can facilitate women’s career advancement in organizations and healthcare institutions. These measures may foster positive attitudes and perceptions toward promotion, minimize pessimistic thoughts (resignation and acceptance), and help women overcome glass ceiling barriers to attain career success. Managers can further increase women’s motivation and commitment and reduce turnover due to dissatisfaction by creating supportive work environments. Efforts in these areas will contribute to enhancing women’s managerial capabilities, improving organizational performance, and promoting equity within healthcare organizations.
Declarations
Ethical considerations: This study received ethics approval from the Research Ethics Committee of Islamic Azad University, North Tehran Branch, number IR.IAU.TNB.REC.1402.035. An informed consent form was also completed by the participants, and necessary measures were taken to ensure their confidentiality.
Funding: None
Conflicts of interests: There is no conflict of interests.
Authors’ contribution: M E F: Conceptualization, study design, data collection, methodology,
software, validation, data analysis, data management, writing– original draft, writing– review & editing; S M H: Conceptualization, study design, methodology, validation, data analysis, data management, writing– review & editing, supervision, final approval; K A: Conceptualization, Study design, methodology, writing– review & editing; A M: Software, data analysis, data management, writing– review & editing. All authors have read and approved the final text of the article.
Consent for publication: There is no need to obtain a copyright license.
Data availability: The data can be requested from correspond author.
AI deceleration: Editing in English part of the article was done using perplexity.ai software and all the author have confirmed the final version.
Acknowledgements: This article is a part of a thesis titled “The Relationship between Glass Ceiling Beliefs and Career Success of Women Graduates in Health and Medical Services Management in University Medical Centers in Tehran”, at the Master's Degree Level, approved by Islamic Azad University, North Tehran Branch, in 2023. The authors thank and acknowledge all participants in this study.
Consent for publication: There is no need to obtain a copyright license.
Data availability: The data can be requested from correspond author.
AI deceleration: Editing in English part of the article was done using perplexity.ai software and all the author have confirmed the final version.
Acknowledgements: This article is a part of a thesis titled “The Relationship between Glass Ceiling Beliefs and Career Success of Women Graduates in Health and Medical Services Management in University Medical Centers in Tehran”, at the Master's Degree Level, approved by Islamic Azad University, North Tehran Branch, in 2023. The authors thank and acknowledge all participants in this study.
Type of Study: Research |
Subject:
Health Services Management
Received: 2025/02/2 | Accepted: 2025/07/27 | Published: 2025/08/31
Received: 2025/02/2 | Accepted: 2025/07/27 | Published: 2025/08/31
References
1. Medical School Enrollment More Diverse in 2021 [Internet]. Association of American Medical Colleges; 2021 [cited 2022 7/5/2022]. Available from: https://www.aamc.org/news-insights/press-releases/medical-school-enrollment-more-diverse-2021
2. How Canada compares: results from the Commonwealth Fund's 2020 international health policy survey of the general population in 11 countries [Internet]. Canadian Institute for Health Information
3. Ottawa: 2021 [cited 2022 7/5/2022]. Available from: https://www.cihi.ca/sites/default/files/document/how-canada-compares-cmwf-survey-2020-meth-note-en.pdf
4. Social justice indicators 2021 [cited 2025 May 12]. Tehran: Statistical Centre of Iran, 2021. [In Persian]. Available from: https://amar.org.ir/Portals/0/Articles/edalat.ejtemaei.pdf?ver=aRY3mBrqS0F9TljIEwQ9mA%3d%3d
5. Khan MS, Usman MS, Siddiqi TJ, Ayub MT, Fatima K, Acob C, et al. Women in leadership positions in academic cardiology: a study of program directors and division chiefs. Journal of Women's Health . 2019; 28(2):225-32. doi: [DOI:10.1089/jwh.2018.7135]
6. MolkAra M. Analysis and investigation of the relationship between the glass ceiling syndrome and organizational silence. International Journal of Business Management and Entrepreneurship . 2022; 1(1):1-5. [In Persian]. Available from: https://mbajournal.ir/index.php/IJBME/article/view/3
7. Segovia-Saiz C, Briones-Vozmediano E, Pastells-Peiró R, González-María E, Gea-Sánchez M. Glass ceiling and gender inequalities in the careers of women academics in biomedical sciences. Gaceta Sanitaria. 2020;34(4):403-10. [In Spanish]. [DOI:10.1016/j.gaceta.2018.10.008]
8. Larson AR, Kan CK, Silver JK. Representation of women physician deans in U.S. medical schools. Journal of Women's Health . 2019;28(5):600-5. [DOI:10.1089/jwh.2018.7448]
9. Kelly EH, Rivera F, Tait VF, Hingle ST. Introduction: women in medicine. Pediatrics. 2021; 148(Supplement 2): e2021051440B. [DOI:10.1542/peds.2021-051440B]
10. Spurk D, Hirschi A, Dries N. Antecedents and outcomes of objective versus subjective career success: competing perspectives and future directions. Journal of Management. 2019; 45(1):35-69. [DOI:10.1177/0149206318786563]
11. Arvand J, Shafeeabadi A. Role of self-concept in physicians' job success. Journal of Medical Sciences. 2006;16(3):141-5. [In Persian]. Available from: http://tmuj.iautmu.ac.ir/article-1-115-en.pdf
12. Dan X, Xu S, Liu J, Hou R, Liu Y, Ma H. Innovative behaviour and career success: mediating roles of self-efficacy and colleague solidarity of nurses. International Journal of Nursing Sciences. 2018;5(3):275-80. [DOI:10.1016/j.ijnss.2018.07.003]
13. Özbilgin MF, Groutsis D, Harvey WS. International human resource management. Cambridge: Cambridge University Press; 2014. [DOI:10.1017/CBO9781107445642]
14. Cumbler E, Yirdaw E, Kneeland P, Pierce R, Rendon P, Herzke C, et al. What is career success for academic hospitalists? a qualitative analysis of early‐career faculty perspectives. Journal of Hospital Medicine. 2018; 13(6):372-7. [DOI:10.12788/jhm.2924]
15. Abele AE, Spurk D. The longitudinal impact of self-efficacy and career goals on objective and subjective career success. Journal of Vocational Behavior. 2009; 74(1):53-62. [DOI:10.1016/j.jvb.2008.10.005]
16. Mosadeghrad A, Tajvar M, Taheri S. Female managers' decision-making in healthcare organizations: challenges and solutions. Modern Research in Decision Making. 2020;5(1):51-94. [In Persian] Available from: https://sid.ir/paper/374112/en
17. Morrison AM, Glinow MV. Women and minorities in management. American Psychologist. 1990;45:200-8. [DOI:10.1037/0003-066X.45.2.200]
18. Burn SM. Women across cultures: a global perspective. 4th ed. McGraw Hill LLC; 2022.
19. Hull RP, Umansky PH. An examination of gender stereotyping as an explanation for vertical job segregation in public accounting. Accounting, Organizations and Society. 1997;22(6):507-28. [DOI:10.1016/S0361-3682(96)00028-1]
20. Cotter DA, Hermsen JM, Ovadia S, Vanneman R. The glass ceiling effect. Social Forces. 2001;80(2), 655-82. [DOI:10.1353/sof.2001.0091]
21. Babic A, Hansez I. The glass ceiling for women managers: Antecedents and consequences for work-family interface and well-being at work. Frontiers in Psychology. 2021;12:618250. [DOI:10.3389/fpsyg.2021.618250]
22. Smith P, Caputi P, Crittenden N. How are women's glass ceiling beliefs related to career success? Career Development International. 2012;17(5):458-74. [DOI:10.1108/13620431211269702]
23. Martínez-Fierro S, Lechuga Sancho MP. Descriptive elements and conceptual structure of glass ceiling research. International Journal of Environmental Research and Public Health. 2021;18(15):8011. [DOI:10.3390/ijerph18158011]
24. Koohi Rostamkalaee Z, Tol A, Akbari Haghighi F, Rahimi Froshani A, Pourreza A. Assessing the relation between organizational climate components with organizational commitment components among nurses in selected hospitals of TUMS. Journal of Health System Research. 2013;9(7):731-40. [In Persian] Available from: http://hsr.mui.ac.ir/article-1-658-en.pdf
25. Masoudian Y, Rajabi vasoukolaei G. Competence of hospital managers as a necessity for optimal and effective management of the Iranian health system; letter to the editor. Hospital. 2021;20(3):79-80. [In Persian] Available from: http://jhosp.tums.ac.ir/article-1-6499-en.html
26. Williams ES, Borkowski N, O'Connor SJ, Qu H. Evaluating journal quality: beyond journal rankings. The Journal of Health Administration Education. 2018; 7;35(1):29-46. Available from: https://www.ingentaconnect.com/contentone/aupha/jhae/2018/00000035/00000001/art00004?crawler=true
27. Nejati T. Investigating the relationship between the effectiveness of in-service training courses and personal career success in one of the organizations affiliated to the Ministry of Energy [Master's dissertation]. [Ahvaz]: Shahid Chamran University of Ahvaz; 2016. [In Persian].
28. Manouchehri B. Investigating the relationship between belief in the glass ceiling and mental success of female employees in Shiraz Municipality [Master's dissertation]. [Shiraz]: Payam Noor University; 2014. [In Persian].
29. Lawshe CH. A quantitative approach to content validity. Personnel Psychology. 1975;28(4). [DOI:10.1111/j.1744-6570.1975.tb01393.x]
30. Tabe Bordbar F, Kamani smh, Manouchehri B. Studying the relationship between women's glass ceiling beliefs and subjective success among female employees at Shiraz municipality. Journal of Woman and Society. 2016;6(24):125-43. [In Persian] Available from: https://sid.ir/paper/169104/en
31. Ramezani G, Pourbairamian G, Goharinezhad S, Norouzi A, Keshavarzi MH, Sohrabi Z. The role of glass ceiling in women's promotion to managerial positions from the perspective of faculty members at Iran University of Medical Sciences. Journal of Education and Health Promotion. 2021; 10:339. doi: 10.4103/jehp.jehp_111_21 [DOI:10.4103/jehp.jehp_111_21]
32. Fathy EA, Zidan HA. The impact of glass ceiling beliefs on women's subjective career success in tourism and hospitality industry: the moderating role of social support. The Scientific Journal of the Faculty of Tourism and Hotels, Alexandria University. 2020;17(2):137-62.
https://doi.org/10.21608/thalexu.2020.48439.1032 [DOI:10.21608/THALEXU.2020.48439.1032]
33. Khalid S, Sekiguchi T. The mediating effect of glass ceiling beliefs in the relationship between women's personality traits and their subjective career success. NTU Management Review. 2019;29(3):193-220. [DOI:10.6226/NTUMR.201912_29(3).0006]
34. Balasubramanian SA, Lathabhavan R. Linking women's glass ceiling beliefs and employee satisfaction: the mediation of engagement. International Journal of Human Resources Development and Management. 2018;18(1-2):72-90. [DOI:10.1504/IJHRDM.2018.092288]
35. Roman M. Relationships between women's glass ceiling beliefs, career advancement satisfaction, and quit intention [PhD thesis]. [Minneapolis, Minnesota] Walden University; 2017. Available from: https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=4933&context=dissertations
36. Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety. 2003;18(2):76-82.
https://doi.org/10.1002/da.10113 [DOI:0.1002/da.10113]
37. Mohammadkhani F, Gholamzadeh D. The influence of leadership styles on the women's glass ceiling beliefs. Journal of Advanced Management Science. 2016;4(4):276-82. [DOI:10.12720/joams.4.4.276-282]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Site Keywords
Health, Administration, Scientific Article, Iran University of Medical Sciences,
