No abstract

This paper describes the development and validation of a 40-item inventory, the Postgraduate Hospital Educational Environment Measure (PHEEM), by researchers in Scotland and the West Midlands using a combination of grounded theory and Delphi process. The instrument has since returned an alpha reliability >0.91 in two administrations in England and may be a useful instrument in the quality assurance process for postgraduate medical education and training.

The paper reports comparative data from a Nigerian undergraduate medical school and a Nepalese health professions institution in order to explore the value of the previously reported Dundee Ready Education Environment Measure (DREEM) in 'diagnosing' the environment and climate of particular institutions and making comparative analyses in two culturally diverse situations. The Nigerian undergraduate medical school scored 118 out of a possible 200 on the DREEM global score. There were significant differences on five of the items between the male and female students and several significant differences on individual items between the students in Years 4 and 5, Years 5 and 6, and Years 4 and 6. The Nepalese global score was 130/200 and there were significantly different scores for six items between the male and female students. The scores for Years 1-3 also showed several significantly different items. These scores permitted two distinct 'diagnoses' of the two medical schools.

The DREEM provides useful diagnostic information about medical schools, whether it is in developing or western developed countries.

The Dundee Ready Education Environment Measure (DREEM) was administered to 70 final-year medical students and 36 first-year medical interns (pre-registration house officers). The overall total mean DREEM scores for the five subscales-namely, students' perceptions of the atmosphere, students' perceptions of learning, students' social self-perceptions, students'perceptions of teachers and students' academic self-perceptions-was 109.9 and the total mean scores for the subgroups-male students, male interns, female students and female interns-were 103.39, 111.82, 111.33 and 113.15, respectively. The lowest scores were assigned to students' social self-perceptions and students' perceptions of the atmosphere. All of the participants except the male interns recorded the highest scores for the subscale academic self-perceptions.

Background: The medical programme at Lund University, Sweden, has undergone curricular reform over several stages, which is still ongoing. Students have been somewhat negative in their evaluations of the education during this time. Aim: To find out how the students perceived the educational climate using the Dundee Ready Education Environment Measure (DREEM), and to compare the findings taken at two given points in time. Method: The DREEM instrument was distributed in semesters 2, 6 and 10 in 2003 and 2005, to a total of 503 students. Results: The students rated their climate as positive. The total DREEM score (145) was somewhat higher than other published results and in the same range as for other reformed curricula. There was hardly any difference between the genders in their perceptions of the climate. Certain items were rated low and became subject of development between the measurements. These items concerned a perceived lack of a support system for stressed students and a lack of feedback and constructive criticism from teachers. Some improvement was detected in 2005. Conclusion: The educational climate was high in a reformed curriculum and could be maintained high during on-going curricular reform. Educational development resulted in better results on some items.

The recent introduction of the Dundee Ready Education Environment Measure (DREEM) has fulfilled a long-felt need for a test instrument specifically meant to evaluate health professions education institutions. It was intended in this study to ascertain the overall DREEM score for the newly established Faculty of Medical Sciences of University of Sri Jayewardenepura (FMS/USJ), Sri Lanka and to compare the DREEM score of the students in the pre-, para- and clinical phases of the traditional curriculum practiced in this school. A total of 339 students belonging to the pre- (n = 147), para- (n = 116) and clinical (n = 76) phases of the medical course participated in this study. The DREEM questionnaire was administered face-to-face after one of their routine lectures to each group of students. The age of the students ranged from 20 to 28 years and the gender distribution was almost equal. The overall DREEM score was 108 (54%) for the pooled data for all three phases. There was no significant difference on the overall DREEM score obtained by each phase of students. The overall DREEM scores of pooled data and also for each domain indicated that the position of the FMS/USJ qualifies to be placed just on the third grade (one below the best) within the overall DREEM scale. However, on analysis of the responses for each domain, Students' Perception of Teachers (SPT), Students' Academic Self-Perceptions (SAP) and Students' Social Self-Perceptions (SSP) showed significant difference between the pre-, para- and clinical phases. Similarly, 22 out of the 50 items showed significant differences between the pre- and clinical phases. Overall, the DREEM demonstrated compatibility of its scores along with the gradual development that took place at this medical school over the last 10 years. Thus, the DREEM could be utilized in a variety of situations.

Objective To assess the undergraduate educational environment in a large UK medical school. Method Prospective study using the already validated Dundee Ready Education Environment (DREEM) questionnaire ( Appendix 1). Setting A large UK medical school. Participants All medical students enrolled in the academic year 2002/2003. Main outcome measures Perception of the overall educational environment. In addition the impact of year of study and gender were examined. Results The DREEM questionnaire consisting of 50 items scored on a 0-4 Likert scale was completed by 749 medical students (55 per cent) in the academic year 2002/2003. The mean total score was 124 (out of a maximum of 200) indicating relative satisfaction with the perceived environment. There were no individual areas of excellence (that is no item scored >3.5). Some items scored consistently badly indicating cause for concern, for example lack of a support system for stressed students, school time-tabling, feedback from teachers and memorisation of facts. Clinical students perceived the environment to be significantly more positive than preclinical students (127 v 119, p<0.05). Female students perceived the environment to be significantly more positive compared to male students (126 v 123, p<0.05). Conclusions This tool identified areas of concern within a large UK medical school. Further use of the DREEM as a monitoring tool would be useful to re-evaluate the environment following appropriate intervention.