No abstract

Students' perceptions of their educational environment have been studied at all levels of the education system, from primary through post-secondary education. Recent imperatives towards enhanced quality assessment monitoring at a time when health professions education is increasingly committed to student-centred teaching and learning have stimulated a revival of interest in this field. This paper reports a body of research in health professions institutions around the world based on the Dundee Ready Educational Environment Measure (DREEM), a reliable, validated inventory that claims to be generic to undergraduate health professions education and non-culturally specific.

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.

Perceptions of poor performers are significantly different from those of better performers in the same institution. More importance should be given to the perceptions of students to improve the educational environment, as perceptions are associated positively with learning outcome, learning approach and attitude toward studying. Use of the DREEM as a monitoring tool might permit timely interventions to remediate problematic educational environments.