Abstract Introduction
The existence of issues in healthcare organizations and medical science hospitals that need to change and adapt to create coordinated and flexible organizational mechanisms and respond to transformative changes and human resource excellence and must strive to achieve organizational excellence indicators such as clinical excellence, creating unique value, managing unpredictable situations, and paying attention to a patient-centered approach to strengthen competitive advantage (Tj et al., 2025) has created the need to identify human resource excellence and analyze obstacles and drivers with a more comprehensive interpretation and explanation. Despite the above issues and challenges, organizational behavior and human resources studies are growing and developing with an increasing number of topics, methods, and researchers in this field, and require a more original and appropriate methodology (Oldham, 2025), especially since the use of the Q-hybrid approach has rarely been observed in the field of medical sciences and other fields. Therefore, considering the unique advantages of this method, and considering three important reasons, first, optimizing and responding better to the complexity and issues of human resource excellence in medical sciences, and the importance of measuring and operationalizing mental models with this method; second, the advantage of more comprehensive interpretation and explanation through this method, which can help develop theory in the field of human resource excellence; And third, given the limitations of qualitative or quantitative designs, what distinguishes the present study from similar works is the answer to these questions: first, based on a mixed approach in using Q methodology, in the research discourse space, what propositions about human resource excellence strategies can be formulated in the Q set? Second, what mental models and distinct valuations are revealed about human resource excellence? Third, what is the dominant valuation for human resource excellence from the perspective of each mental model? And fourth, based on the types of valuations, what are the pivotal indicators and strategic roles for human resource excellence?
Theoretical Framework
Achieving human resource excellence in the digital age requires a holistic view of legal, economic, social, and organizational structures. In addition, defining accurate evaluation indicators, identifying effective components, and continuous interaction between internal and external stakeholders are also essential (Ghlichlee, 2024; Tuli, 2023). Also, funding small teams of researchers can be an effective and practical way to promote communication and integration so that they can be effective in defining the future research agenda by creating international and interdisciplinary research teams with the aim of identifying and studying promising and advanced topics. one of the existential pillars of ensuring job security is the existence of safety and health in the workplace. Weak employee relations and socialization reduce empathy and intra-organizational cohesion and negatively affect organizational performance (Amany & Sharify, 2025). Studies show that voluntary job rotation, reduced working hours, reward strategies through compensation, legitimacy and formality, training and flexibility at the group level (Simon & Ferreiro, 2018), and employee behavior such as performance and organizational citizenship behavior (Alshareef et al., 2020; Nicolaescu et al., 2020) and career advancement, organizational commitment and loyalty, job satisfaction, satisfaction with pay, social support, and employee well-being are influential and fundamental issues in the field of HR excellence strategies (Hermawati & Mas, 2017; Kang et al., 2019; Alshareef et al., 2020).
Methodology
The Q method in policy research and its capabilities to guide, formulate, and advance policy are significant and unique; an area where its use is still being modeled and replicated (Molenveld, 2020). The first step in implementing the method is to collect the discourse space. In the second step, by examining and identifying the discourse space propositions about human resource excellence strategies, 87 related phrases or propositions were extracted, and after final confirmation of validity and reliability, including propositions 1 to 30, they were transferred to cards of appropriate size, and then provided to the participants to perform their ranking stage in the Q diagram. Step Three, Sample of Participants: The statistical population is the managers of medical science units in the city of Mashhad, who were selected through purposive and snowball sampling. After the fourth step, validity and reliability, and the fifth step, the valuation of Q sample statements, the sixth step, or factor analysis, was performed, and based on the software output, the factor loading values were compared with each other, and the important factors or beliefs that are more important were identified in factors 1 to 7. The seventh step, creating and expressing the final interpretation: Through factor analysis, the identification of criteria for important factors, such as z-scores, or factor score values, and factor arrays were identified and interpreted for each factor. In other words, the number of mental patterns and similarities and differences in views were revealed, and the interpretation was performed.
Discussion and Results
First, the descriptive statistics tables showed that the participants rated (30) Q cards and participated in completing the chart. For each mental model, the standard deviation was measured in order to obtain an approximate estimate of the items with the highest diversity of views among the participants. The eigenvalue of each mental model (first to seventh) in the column and the dispersion of the mental model or the share of variance explained for each one, as well as the cumulative amount of their eigenvariance, is about 74 percent, which indicates their internal beliefs and self-reference mentality. The total variance is 74 percent, with the first and second factors showing the highest number of changes or variance. To analyze the factor loadings obtained from the Q charts, the analysis was performed based on the rotated factors, so the status of the factors or mental models based on the number of participants and the way the Q chart was rated is the output of the software, which is called the factor loading matrix with orthogonal rotation method. The status of the agents is given in the coordinate set of Figure 1.
Based on the factor analysis matrix table, seven columns (factors 1 to 7) revealed that the most important valuation belongs to the first and second factors, because the presence of a greater number of participants in these two factors compared to other factors and the factor loading of the relevant column, which is more than 70 percent, indicates the relative importance of the statements.
Based on the standard scores, the highest score belongs to the pivotal index in that factor. Also, based on the lowest rank of the arrays and the lowest weight of the standard score for some statements by the participants, the roles required for human resource excellence have been identified.
Conclusion
The findings and results of the present study, in order of importance, are: 1. Discovering and analyzing seven mental models about human resource excellence, focusing on the discursive context of the research and using a Q-mixed approach, 2. Identifying groupings and interpreting the differences and similarities of participants' views on human resource excellence strategies, 3. Presenting fourteen indicators for human resource excellence strategies, and explaining seven pivotal indicators among them. 4. Explaining seven roles for organizational managers and human resource managers for the successful implementation of human resource excellence strategies based on the participants' opinions, and presenting four more important or strategic roles, 5. Identifying the dominant mental model, which, based on the way the cards are sorted by focusing on their "importance", the first and second mental models (factors 1 and 2) are known to be the most important models, and in contrast, from sorting the cards by focusing on "similarity", the total number of distinct mental models has been revealed.
In general, the most important achievement of the research is analyzed and presented in three sections: "Identification of factors or mental patterns", "Indicators", and "Roles". Among the key indicators are:
1) The level of managers' ability to increase employees' commitment and belonging to their jobs and workplaces (first indicator)
2) The level of comprehensive human resource health and promotion of psychological health (second indicator)
3) The level of implementation of resource attraction strategies based on operational goals and macro policies (third indicator)
4) The level of attention to efforts, innovation, and preservation of human capital (fourth indicator)
5) The level of job support aimed at increasing the sense of responsibility in the job (fifth indicator).
One of the strengths of these indicators is the connection and combination of the opinions of participants who had academic or expert perspectives and tried to pay attention to the content in selecting statements that would help in the form of planning that is appropriate to the organization's goals for human resource excellence and aligned actions in the field of practice.
Based on the evaluation method and its final interviews, the necessity of playing certain roles for managers in promoting human resource excellence has been explained, the most important of which are "the role of mentoring by applying the latest theories in the field of human resource excellence", and "playing a role in the effectiveness of corporate social responsibility and conscious efforts to combat various cognitive biases in the implementation of human resource excellence programs".