The DREEM, part 2: psychometric properties in an osteopathic student population

Abstract

BackgroundThe Dundee Ready Educational Environment Measure (DREEM) is widely used to assess the educational environment in health professional education programs. A number of authors have identified issues with the psychometric properties of the DREEM. Part 1 of this series of papers presented the quantitative data obtained from the DREEM in the context of an Australian osteopathy program. The present study used both classical test theory and item response theory to investigate the DREEM psychometric properties in an osteopathy student population.MethodsStudents in the osteopathy program at Victoria University (Melbourne, Australia) were invited to complete the DREEM and a demographic questionnaire at the end of the 2013 teaching year (October 2013). Data were analysed using both classical test theory (confirmatory factor analysis) and item response theory (Rasch analysis).ResultsConfirmatory factor analysis did not demonstrate model fit for the original 5-factor DREEM subscale structure. Rasch analysis failed to identify a unidimensional model fit for the 50-item scale, however model fit was achieved for each of the 5 subscales independently. A 12-item version of the DREEM was developed that demonstrated good fit to the Rasch model, however, there may be an issue with the targeting of this scale given the mean item-person location being greater than 1.ConclusionsGiven that the full 50-item scale is not unidimensional; those using the DREEM should avoid calculating a total score for the scale. The 12-item ‘short-form’ of the DREEM warrants further investigation as does the subscale structure. To confirm the reliability of the DREEM, as a measure to evaluate the appropriateness of the educational environment of health professionals, further work is required to establish the psychometric properties of the DREEM, with a range of student populations.

Reassessing the educational environment among undergraduate students in a chiropractic training institution: A study over time

“…It is possible, contrary to previous claims made by the DREEM developers, 22 that the inventory might not be independent of culture, a viewpoint supported by others. 24,40,81 On the contrary, both in 2009 and 2012, our data revealed that students demonstrated disagreement with the statement ''The teachers get angry in class,'' displaying scores above the estimated mean and greater than the cutoff for strong areas. Nevertheless, the notion of authoritarianism could form an accurate assessment of the students' perception and must be investigated further.…”

“…Consequently, some recent concerns have surfaced about the psychometric robustness of the DREEM instrument. 24,[38][39][40] Although the DREEM instrument was initially reported to have good construct validity in its Figure 2 -The figure depicts the relationship between educational environment issues and negative perceptions. A teacher-centered approach, with teachers taking on traditional roles in student-centered curricula, could promote teaching that emphasizes factual overload, thus resulting in a stressful environment for students.…”

“…37,38,40 Reproductions of the original scale structures have been only moderately successful, probably indicating weaknesses in the instrument. 24,39 Because reliability and validity are products of data gathered, 88 there are also some questions regarding the cultural validity of data derived from the DREEM instrument used within our study.…”

“…Previous research has recently pointed to discrepancies in the DREEM in relation to the variability of Cronbach a in the 5 subscales. [38][39][40] Thus, it has been suggested in the literature that low a values could be a result of an inadequate number of statements, poor interrelatedness between items, or heterogeneous constructs. Conversely, very high values may indicate that some items are redundant because they are testing the same construct, though in a diverse form.…”

Analysis and Results: Confirmatory Factor Analysis the Malay Version of Dreem Inventory With Medical Students of Unisza, Kuala Terengganu, Malaysia

“…Thereafter, the DREEM inventory has demonstrated itself globally valuable in a diverse health-care setting such as medical, dental, nursing, and chiropractic the teaching-learning environments [16][17][18][19][20]. The far majority these studies revealed that "variety of descriptive statistics for the scale items, subscales, and the total DREEM score; internal consistency (Cronbach's alpha); and correlational statistics, investigating relationships between the DREEM total and subscale scores with characteristics such as age, gender, and program year level" [21].…”