Showing satisfactory psychometric properties, DREEM proved suitable for assessing educational environments among dental students. Given the right circumstances, e.g., small and early clinically oriented classes, traditional curricula can generate positive environments.

Aims: The teachers' perspectives of the educational environment have as yet only been sparsely considered. This study aimed at validating the first German version of the Dundee Ready Education Environment Measure (DREEM) from the points of view of both students and teachers. Methods: Data from 1119 students and 258 teachers were available for analysis. Psychometric validation included the analysis of homogeneity and discrimination at item level as well as reliability (Cronbach's ), criterion and construct validity at test level. Effect sizes were calculated and the independent samples t-test was used for statistical inference testing of mean differences between two groups. Results: Item characteristics were satisfactory in both samples. Reliability was high with ¼ 0.92 (students) and 0.94 (teachers), respectively. Factor analyses revealed five dimensions which slightly diverged from the five subscales postulated by the DREEM authors though. The environment was evaluated significantly ( p 5 0.001) more positively by teachers (M ¼ 117.63) than by students (M ¼ 109.75). Further significant differences were observed with regard to gender, mother language, stage of studies and previous professional training among others. Conclusions: With convincing psychometric properties at item and test levels, the suitability of DREEM not only for students but also for teachers to assess the educational environment has been demonstrated.

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Background Medical students’ propensity to develop mental morbidity has been described for decades but remains unresolved. To assess student mental health person-centred and longitudinally, we have been investigating a cohort of German students since October 2019. After their first semester under ‘normal’ conditions, rapid changes became necessary due to the COVID-19 situation. In line with the initial aim, we investigated students’ change of mental health, perceived learning environment and burdens in the ‘new normal’. Methods Students in a newly founded German medical study programme (n = 63) answered a questionnaire each semester (October 2019 = entering medical school; December 2019 = ‘old normal’; June 2020 = ‘new normal’; December 2020 = ‘new normal’) on their well-being (FAHW-12), burnout (Maslach Inventory), depression (PHQ-9), perception of the learning environment (DREEM), burdens and protective attitudes in the ‘new normal’ (items designed for the study). Results Friedman tests reveal overall significant differences (all p < .001) in depression and burnout (emotional exhaustion, depersonalisation, personal accomplishment); changes in well-being were identified as just non-significant (p = .05). The effects were explained by a significant increase in burnout and depression identified post-hoc from October 2019 to December 2019. No increase in severity was identified in the ‘new normal’ semesters. The learning environment was perceived positively even with a significant improvement for June 2020 (repeated measures ANOVA p < .001). Study-related burdens (e.g. procrastination of online-learning material) took on greater relevance than burdens related to physicians’ occupation (e.g. potential for students' recruitment to the healthcare system during their studies). Conclusions The ‘new’ when entering medical school had a greater impact on our students’ mental health than the ‘new normal’. The readiness for change in the context of a newly designed study programme may have been beneficial with regard to students’ positively perceived learning environment during the virtual semesters. Monitoring medical students’ mental health longitudinally should be a concern regardless of a pandemic.