Dundee Ready Education Environment Measure: psychometric testing with Chinese nursing students

Examining the effect of training with a teaching for understanding framework on intravenous therapy administration's knowledge, performance, and satisfaction of nursing students: a non-randomized controlled study

BACKGROUND

Nursing students require improvement in their intravenous infusion therapy management skills, yet traditional training models possess deficiencies. The Teaching for Understanding (TfU) Framework can enhance the teaching-learning process and support quality education. Therefore, utilizing TfU framework for training may promote the performance of nurses.

METHODS

Utilizing a non-synchronized design, 102 nurses were recruited using a convenience sampling method. Fifty-one student nurses from August 2019 to January 2021 were designated as the control group, and 51 student nurses from February 2021 to July 2022 were included as the intervention group. The control group received traditional teaching methods, while the intervention group was trained based on TfU framework. The impact was gauged through medical education environment perception, theory and practice assessments, and learning satisfaction surveys.

RESULTS

After the training, there was no significant difference between the control group and the intervention group in the theory assessment. However, the practice assessment scores of the intervention group were significantly higher than those of the control group. Compared with the control group, the learning satisfaction scores of the trained nurses in the intervention group were significantly higher, exhibiting significant differences, particularly in communication ability, teamwork cooperation, summing up capability, and interest in learning improvement. Furthermore, the scores of the learning perceptions, atmosphere, social self-perceptions, and total scores of the intervention group were significantly higher.

CONCLUSION

Training using TfU framework can heighten students' understanding and command over knowledge and skills, fuel their learning fervor, and enhance their communication and collaboration abilities. TfU framework should be disseminated in medical education to improve the quality of education.

Appraisal and Evaluation of the Learning Environment Instruments of the Student Nurse: A Systematic Review Using COSMIN Methodology

BACKGROUND

Nursing education consists of theory and practice, and student nurses' perception of the learning environment, both educational and clinical, is one of the elements that determines the success or failure of their university study path. This study aimed to identify the currently available tools for measuring the clinical and educational learning environments of student nurses and to evaluate their measurement properties in order to provide solid evidence for researchers, educators, and clinical tutors to use in the selection of tools.

METHODS

We conducted a systematic review to evaluate the psychometric properties of self-reported learning environment tools in accordance with the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) Guidelines of 2018. The research was conducted on the following databases: PubMed, CINAHL, APA PsycInfo, and ERIC.

RESULTS

In the literature, 14 instruments were found that evaluate both the traditional and simulated clinical learning environments and the educational learning environments of student nurses. These tools can be ideally divided into first-generation tools developed from different learning theories and second-generation tools developed by mixing, reviewing, and integrating different already-validated tools.

CONCLUSION

Not all the relevant psychometric properties of the instruments were evaluated, and the methodological approaches used were often doubtful or inadequate, thus threatening the instruments' external validity. Further research is needed to complete the validation processes undertaken for both new and already developed instruments, using higher-quality methods and evaluating all psychometric properties.

Perception of Current Educational Environment, Clinical Competency, and Depression among Malaysian Medical Students in Clinical Clerkship: A Cross-Sectional Study

The COVID-19 pandemic has altered the educational environment of medical students in clinical clerkship, with potential impacts on clinical competency and reported increased prevalence of depression. This study aimed to determine the relationship between the perception of the educational environment, self-perceived clinical competency, and depression among them. Subjects (N = 196) at the National University of Malaysia participated through convenience sampling in an online survey including sociodemographic data, COVID-19-related stressors, Dundee Ready Education Environment Measure (DREEM), self-perceived clinical competency, and Patient Health Questionnaire (PHQ-9). The cut-off point for depression was a PHQ-9 score ≥ 15. Multiple logistic regression followed bivariate analyses to identify factors for depression. The participants (mean age: 23.2 years, SD ± 0.98 years) were mainly female (71.9%) and Malay (59.2%). The prevalence of depression was 17.4% (95% CI: 12.3-23.4%). Most participants perceived the educational environment positively. In logistic regression, ethnicity (Adjusted OR = 3.1, 95% CI: 1.2-8.1) and DREEM score were significantly associated with depression, whereas self-perceived clinical competency was not. A higher DREEM score indicating a better perception of the educational environment was linked to a lower likelihood of depression (p = 0.046). Besides ethnicity, perception of the educational environment emerged as a factor associated with depression. This relationship between the educational environment and mental well-being warrants further exploration.

Cross-Cultural Adaptation and Validation of the Korean Version of the Dundee Ready Education Environment Measure (DREEM)

Internationally, Dundee Ready Education Environment Measure (DREEM) is being used to evaluate and compare students' awareness regarding medical education environment. This study aimed to adapt DREEM into Korean, to evaluate the reliability and validity, and to compare its structure to the original DREEM structure. The DREEM was translated using 6 steps which were suggested in cross-cultural adaptation protocols: translation, synthesis, back translation, expert committee review, pilot test, and psychometric study (N = 451). We performed confirmatory factor analysis including basic analysis. For evaluating the original model's goodness of fit with the acquired dataset, model fit indices and construct validity were discussed. The Korean version was completed upon through cross-cultural adaptation protocols. Statistical analysis with 451 data sets showed that the root mean square error of approximation = 0.06, goodness-of-fit index = 0.75, and Tucker–Lewis index = 0.73. Almost construct reliabilities were all over 0.707. Except for just one pair, all squares of correlation coefficients were greater than the corresponding average variance extracted. In conclusion, we developed the Korean version of DREEM. Although the original 5-factor structure was acceptable, low convergent and discriminant validity indices suggested that further studies for the Korean environment are necessary for the respecified or modified factor structures.

Educational environments in Asian medical schools: A cross-national comparison between Malaysia, Singapore, and China

INTRODUCTION

Perceptions of the educational environment (EE) represent an important source of information on medical students' learning experience. Understanding and addressing these perceptions can help inform initiatives designed to improve the learning experience and educational outcomes, while comparison of student perceptions across medical schools can provide an added perspective. The aim of the study was to compare the EEs of three Asian medical schools: Royal College of Surgeons in Ireland and University College Dublin Malaysia Campus, Yong Loo Lin School of Medicine, Singapore and Xiangya School of Medicine, China.

METHODS

Medical students in the clinical years (N = 1063) participated in a cross-sectional study using the Dundee Ready Educational Environment Measure (DREEM). Data were analyzed using SPSS version 22.

RESULTS

There were significant differences between the three medical schools in the total DREEM scores (F [2, 1059] = 38.29, p < .001), but all were in the category "more positive than negative" (mean score 135.42, range 128.97-142.44). Highest DREEM scores were noted in year 5 at RUMC (139.79 ± 79), year 3 at YLL (145.93 ± 14.52), and year 4 at XSM (138.56 ± 18.91). Variations in total and subscale DREEM scores were also found between clinical years in each medical school.

DISCUSSION

Total DREEM scores at the three medical schools are similar to those reported from other undergraduate settings. However, significant variations occurred in perceptions of the EE, as students progressed through the clinical years. Greater attention to the learning environment and the curriculum may improve students' educational experience.

Assessing the effects of the nursing education reform on the educational environment in Tajikistan: a repeated cross-sectional analysis

Background

A well-functioning education system for family nurses is a priority of the primary health care reform in Tajikistan. In 2015/2016, a baseline study was carried out to measure the educational environment at two nursing colleges, in Kulob and Dushanbe. Building on the study's recommendations, the educational reform has addressed several key issues to improve the educational environment among nursing students with a focus on strengthening competency-based learning and clinical skills. A follow-up study was carried out in late 2018 to comparatively analyse progress in the educational environment against the baseline and assess potential impacts of tailored interventions.

Method

A repeated cross-sectional survey involving 1239 students was applied to measure changes in the educational environment between 2015/2016 (baseline) and 2018 (endline) using the Dundee Ready Education Environment Measure (DREEM). We compared mean scores over time using Welch's two sample t-test and the Wilcoxon-Mann-Whitney test. Single items have additionally been analysed using critical threshold (flags) for mean scores, and the percentage of answers falling above or below predefined values. A multivariate non-parametric regression was applied to control for confounding factors. Internal consistency was examined using Cronbach's α.

Results

Cronbach's α for overall scores ranged between 0.87 and 0.89. Between 2015/2016 and 2018 the perceived educational environment improved with an increase of the mean total DREEM score from 131.8 to 146.9 in Dushanbe and from 134.9 to 151.2 in Kulob. Mean comparisons and multivariate regression revealed a significant increase of all sub-scores between 2015/2016 and 2018 with students' social self-perception exhibiting the smallest progress. Despite the general improvements observed, analysis at the level of single items revealed persistent weaknesses including a lack of competency-based learning and stress.

Conclusions

The education environment has improved in several important ways between 2015/2016 and 2018 which points to a likely positive contribution of the nursing education reform. This progress notwithstanding, there is still notable room for further improvement. Targeted efforts aimed at a better organization of practical trainings, improved didactical competences of teachers, and support structures for lonely and stressed students still seem to be lacking for the achievement of a good nursing education system in Tajikistan.

Student nurses' perceptions of their educational environment at a school of nursing in Western Cape province, South Africa: A cross-sectional study

Background

Educational environments have been found to bear a substantial relationship with the academic performance and success, as well as the retention, of students.

Objectives

The study objectives were to (1) evaluate the educational environment as perceived by undergraduate nursing students at a school of nursing (SON) in Western Cape province and (2) investigate whether the educational environment, or components thereof, is perceived negatively or positively among undergraduate nursing students of different year level, gender, home language and ethnicity.

Method

A quantitative research method with a cross-sectional design was implemented. Data were collected from 232 undergraduate nursing students from a SON at a university in Western Cape province, South Africa. The subscales and the items of the educational environment questionnaire were compared among undergraduate nursing students. Data were analysed by means of the IBM Statistical Package for Social Sciences (IBM SPSS-24) using analysis of variances (ANOVAs), independent-sample t-tests, mean scores, standard deviations and percentages.

Results

The mean score attained for the entire participant group was 195 (standard deviation [SD] = 24.2) out of 268 (equivalent to 72.8% of maximum score), which indicated that the educational environment was perceived substantially more positively than negatively. The overall mean score was significantly higher (p < 0.05) for male students (M = 202; SD = 21) and for black students (M = 202; SD = 21). The digital resources (DR) subscale was the only subscale with a statement or item that was rated as absolute negative (M = 1.9; SD = 0.9).

Conclusion

The educational environment at the institution concerned was perceived as predominantly positive by its undergraduate nursing students. Although the educational environment was predominantly perceived as positive, the results of this study also indicated that enhancements are required to improve the physical classroom conditions, skills laboratories, DR and the implemented teaching and learning strategies. It is vital for university management to prioritise the creation of an educational environment which would ensure that quality learning takes place.

Keywords

student’s perceptions; educational environment; nursing education; Western Cape; South Africa.

Informing the medical education reform in Tajikistan: evidence on the learning environment at two nursing colleges

BACKGROUND

The Tajik medical education system is undergoing a complex reform to enhance the transition of the healthcare system from its soviet legacy of emphasizing secondary level care/specialisation to become more family medicine and primary health care oriented. The current study presents the first empirical evaluation of the educational environment for nursing students in Tajikistan using the Dundee Ready Educational Environment Measure (DREEM). The study results contribute to the benchmarking efforts of monitoring and positively steering the educational environment over time.

METHOD

The study was based on a cross-sectional survey involving 630 nursing students at two nursing colleges in Tajikistan. Students' perception of the learning environment was measured using the DREEM. Internal consistency was examined using Cronbach's alpha. General scores were calculated and measured against international benchmarks. Data was further interpreted by comparing DREEM scores between students of different sex, at different colleges and different study years using T tests.

RESULTS

Cronbach's alpha ranged from 0.30 to 0.75 with an overall alpha of 0.89. General DREEM scores were slightly above average compared to similar studies with nursing students in other countries. In particular, results showed that students' academic self-perception and teachers' technical competences were generally favourably rated. Teachers' pedagogical skills were critically perceived by the study participants and teaching was generally viewed as too teacher-centred with an over-emphasis on factual learning.

CONCLUSIONS

Statistical results indicated acceptable levels of reliability of the DREEM tool when applied to the Tajik nursing educational context. Students rated the learning environment as generally satisfactory with average scores similar or slightly higher than comparable scores from similar studies involving nursing students. However, the on-going educational reform could have placed more emphasis on developing faculty pedagogical skills in nursing schools. Teaching approaches would benefit from being more competency based rather than so heavily focused on factual knowledge.

Investigating psychometric properties and dimensional structure of an educational environment measure (DREEM) using Mokken scale analysis - a pragmatic approach

BACKGROUND

Questionnaires and surveys are used throughout medical education. Nevertheless, measuring psychological attributes such as perceptions of a phenomenon among individuals may be difficult. The aim of this paper is to introduce the basic principles of Mokken scale analysis (MSA) as a method for the analysis of questionnaire data and to empirically apply MSA to a real-data example.

METHODS

MSA provides a set of statistical tools for exploring the relationship between items and latent traits. MSA is a scaling method of item selection algorithms used to partition an array of items into scales. It employs various methods to probe the assumptions of two nonparametric item response theory models: the monotone homogeneity model and the double monotonicity model. The background and theoretical framework underlying MSA are outlined in the paper. MSA for polytomous items was applied to a real-life data example of 222 undergraduate students who had completed a 50-item self-administered inventory measuring the educational environment, the Dundee Ready Educational Measure (DREEM).

RESULTS

A pragmatic and parsimonious approach to exploring questionnaires and surveys from an item response theory (IRT) perspective is outlined. The use of MSA to explore the psychometric properties of the Swedish version of the DREEM failed to yield strong support for the scalability and dimensional structure of the instrument.

CONCLUSIONS

MSA, a class of simple nonparametric IRT models - for which estimates can be easily obtained and whose fit to data is relatively easily investigated - was introduced, presented, and tested. Our real-data example suggests that the psychometric properties of DREEM are not adequately supported. Thus, the empirical application depicted a potential and feasible approach whereby MSA could be used as a valuable method for exploring the behavior of scaled items in response to varying levels of a latent trait in medical education research.

Relationships between optimism, educational environment, career adaptability and career motivation in nursing undergraduates: A cross-sectional study

BACKGROUND

For solving the problem of the abandonment of the career in nursing undergraduates, it is important to understand their motivation to choose nursing as a career and its associated personal and situational factors.

OBJECTIVES

To examine the relationships between optimism, educational environment, career adaptability, and career motivation in nursing undergraduates using the career construction model of adaptation.

DESIGN

This study adopted a cross-sectional design.

PARTICIPANTS AND METHODS

A convenience sample of 1060 nursing undergraduates from three universities completed questionnaires for measuring optimism, educational environment, career adaptability, and career motivation. Confirmatory factor analyses, descriptive analyses, comparison analyses, correlation analyses, and mediation analyses were performed accordingly.

RESULTS

Nursing undergraduates' career motivation was positively correlated with their career adaptability (r = 0.41, P < 0.01), the educational environment (r = 0.60, P < 0.01), and optimism (r = 0.26, P < 0.01). In addition, the effects of optimism and educational environment on career motivation were partially mediated by career adaptability in nursing undergraduates.

CONCLUSIONS

In nursing undergraduates, the educational environment had a relatively strong positive association with career motivation, while optimism had a weak one. Career adaptability played a mediating role in the relationships. Targeted interventions may improve nursing undergraduates' career motivation.

The quality of the educational environment in a medical college in Saudi Arabia

OBJECTIVES

The study aimed to examine the quality of the educational environment in the Faculty of Medicine, University of Tabuk, Saudi Arabia, and to compare between male and female students using the Dundee Ready Educational Environment Measure (DREEM).

METHODS

We utilized a cross-sectional survey design.  Participants were 221 medical students (96 males and 125 females) from all classes (1st to 6th year). Each participant responded to a translated version of the DREEM questionnaire that measures five domains: students' perception of learning (SPL), students' perception of teachers (SPT), students' academic self-perception (SASP), students' perception of atmosphere (SPA), and students' social self-perception (SSSP). Numerical differences between male and female students were analyzed using the Student's t-test.

RESULTS

The global average score of female students was significantly higher (105.0±22.9, 53% of maximum score) than male students (98.3±24.3, 49% of maximum score; t₍₂₁₉₎= -2.119, p= 0.035). The major gender difference was found in the SPT domain, with a higher score in the females (60%) compared to the male (50%) cohort (t ₍₂₁₉₎= -5.519, p = 0.000). Differences in the other domains were statistically insignificant. Out of the 50 DREEM items, the items that need attention were 32 and 23 on the male and the female sides respectively.

CONCLUSIONS

The perception of the educational environment by the female students is significantly better than male students. The study provides valuable information about many educational problems that need attention. DREEM-based surveys are highly recommended for periodic monitoring of the educational environment.

Educational environment and approaches to learning of undergraduate nursing students in an Indonesian school of nursing

The aims of this study were to assess students' perceptions of their educational environment and approaches to learning, and determine if perceptions of learning environment associates with approaches to learning. A survey was conducted to collect data from a regional private university in Indonesia. A total of 232 nursing students completed two questionnaires that measured their perceptions of educational environment and approaches to learning. The measurement was based on Dundee Ready Education Environment Measurement (DREEM) and Approaches and Study Skills Inventory for Students (ASSIST). Five learning environments dimensions and three learning approaches dimensions from two measures were measured. The overall score of DREEM was 131.03/200 (SD 17.04), it was in the range considered to be favourable. The overall score is different significantly between years of study (p value = 0.01). This study indicated that the majority of undergraduate nursing students' adopt strategic approach (n = 139. 59.9%). The finding showed that perceived educational environment significantly associated with approaches to learning. This study implicated the need to maintain conducive learning environment. There is also a need to improve the management of learning activities that reflect the use of student-centered learning.

Psychometric validation of the Spanish version of the Dundee Ready Education Environment Measure applied to dental students

AIM

To carry out a psychometric evaluation of the Spanish-language version of the Dundee Ready Education Environment Measure (DREEM) applied to dental students.

METHODS

A total of 1,391 students from nine Spanish public schools of dentistry responded to the DREEM questionnaire. To analyse the reliability of the DREEM questionnaire, the internal consistency was assessed and a 'test-retest' carried out. Validity was evaluated through analysis of item response rate, floor and ceiling effects, corrected item-total and item-subscale correlations and factor structure. A confirmatory factor analysis was performed to analyse the structure of the original DREEM scale.

RESULTS

Cronbach's alpha coefficient for the 'Educational Climate' (EC) global scale was 0.92. In the subscales, the 'observed' Cronbach's alpha coefficients ranged between 0.57 and 0.79 and were higher than the 'expected' ones; except for the Social subscale. In the DREEM questionnaire, all of the corrected correlation coefficients between the items and the EC global scale, and the items and their corresponding subscales, were >0.2; except for items 50 and 17. All goodness-of-fit indices of confirmatory factor analysis showed acceptable values (close to one or zero, depending on the case), and there was consistency in the results.

CONCLUSIONS

The Spanish-language version of the DREEM questionnaire is a reliable and valid instrument for analysing the EC for dental students and its factor structure is supported by the data. Although our findings indicate that the DREEM may be as culturally independent as was originally stated, more research should be directed at verifying the factor structure in various languages and cultural environments.

Veterinary students' perceptions of their learning environment as measured by the Dundee Ready Education Environment Measure

BACKGROUND

The Dundee Ready Education Environment Measure (DREEM) has been widely used to evaluate the learning environment within health sciences education, however, this tool has not been applied in veterinary medical education. The aim of this study was to evaluate the reliability and validity of the DREEM tool in a veterinary medical program and to determine veterinary students' perceptions of their learning environment.

METHODS

The DREEM is a survey tool which quantitatively measures students' perceptions of their learning environment. The survey consists of 50 items, each scored 0-4 on a Likert Scale. The 50 items are subsequently analysed within five subscales related to students' perceptions of learning, faculty (teachers), academic atmosphere, and self-perceptions (academic and social). An overall score is obtained by summing the mean score for each subscale, with an overall possible score of 200. All students in the program were asked to complete the DREEM. Means and standard deviations were calculated for the 50 items, the five subscale scores and the overall score. Cronbach's alpha was determined for the five subscales and overall score to evaluate reliability. Confirmatory factor analysis was used to evaluate construct validity.

RESULTS

224 responses (53%) were received. The Cronbach's alpha for the overall score was 0.93 and for the five subscales were; perceptions of learning 0.85, perceptions of faculty 0.79, perceptions of atmosphere 0.81, academic self-perceptions 0.68, and social self-perceptions 0.72. Construct validity was determined to be acceptable (p < 0.001) and all items contributed to the overall validity of the DREEM. The overall DREEM score was 128.9/200, which is a positive result based on the developers' descriptors and comparable to other health science education programs. Four individual items of concern were identified by students.

CONCLUSIONS

In this setting the DREEM was a reliable and valid tool to measure veterinary students' perceptions of their learning environment. The four items identified as concerning originated from four of the five subscales, but all related to workload. Negative perceptions regarding workload is a common concern of students in health education programs. If not addressed, this perception may have an unfavourable impact on veterinary students' learning environment.

DREEM on, dentists! Students' perceptions of the educational environment in a German dental school as measured by the Dundee Ready Education Environment Measure

OBJECTIVES

The educational climate in which future doctors are trained is an important aspect of medical education. In contrast to human medicine, it has been rather neglected in dental educational research. The aim of the study was to supplement this lack by applying and validating the Dundee Ready Education Environment Measure (DREEM) for the first time in a German-speaking sample of dental students.

METHODS

All dental students at the Medical Faculty of Heinrich-Heine-University Düsseldorf were asked to complete a German adaptation of the DREEM and the Düsseldorf Mission Statement Questionnaire (DMSQ) in a paper-pencil survey. Data from 205 participants were analysed. Psychometric validation included analysis of item homogeneity and discrimination, test reliability, criterion and construct validity (convergent, factorial).

RESULTS

DREEM item parameters were satisfactory, reliability (α = 0.87) and convergent validity (r = 0.66 with DMSQ) were also high. Factor analyses, however, yielded dimensions which did not fully correspond to the original DREEM subscales. Overall perception of the educational environment was positive (DREEM total score = 122.95 ± 15.52). Students in the clinical part of course rated the atmosphere more negatively, but their academic self-perception more positively than preclinical students.

CONCLUSIONS

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.

The Dundee Ready Education Environment Measure (DREEM): a review of its adoption and use

BACKGROUND

The Dundee Ready Education Environment Measure (DREEM) was published in 1997 as a tool to evaluate educational environments of medical schools and other health training settings and a recent review concluded that it was the most suitable such instrument.

AIMS

This study aimed to review the settings and purposes to which the DREEM has been applied and the approaches used to analyse and report it, with a view to guiding future users towards appropriate methodology.

METHOD

A systematic literature review was conducted using the Web of Knowledge databases of all articles reporting DREEM data between 1997 and 4 January 2011.

RESULTS

The review found 40 publications, using data from 20 countries. DREEM is used in evaluation for diagnostic purposes, comparison between different groups and comparison with ideal/expected scores. A variety of non-parametric and parametric statistical methods have been applied, but their use is inconsistent.

CONCLUSIONS

DREEM has been used internationally for different purposes and is regarded as a useful tool by users. However, reporting and analysis differs between publications. This lack of uniformity makes comparison between institutions difficult. Most users of DREEM are not statisticians and there is a need for informed guidelines on its reporting and statistical analysis.

Assessing the learning environment of a faculty: psychometric validation of the German version of the Dundee Ready Education Environment Measure with students and teachers

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 α), 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 α = 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 < 0.001) more positively by teachers (M = 117.63) than by students (M = 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.

Psychometric evaluation of the Dundee Ready Educational Environment Measure: Swedish version

BACKGROUND

The Dundee Ready Educational Environment Measure (DREEM) has been used in various studies to evaluate the educational environment. However, psychometric evaluations of the instrument seem sparse, for all known versions of the instrument.

AIM

The aim was to psychometrically evaluate the Swedish version of the DREEM instrument.

METHOD

A total of 503 students (undergraduate medicine), aged 19-46 years, in semesters 2, 6 and 10 were included in the study. Validity was evaluated through analysis of construct validity and reliability.

RESULTS

The instrument had in general both acceptable validity and reliability. Due to a rather poor model fit in the confirmatory factor analysis, an explorative factor analysis was also employed which suggested a new five-factor solution for the instrument.

CONCLUSIONS

The Swedish version of the DREEM instrument is shown to be valid and reliable, except for the factor structure. The new five-factor solution found in this study is not proven to be a superior measurement model compared with the original, but could be seen as an alternative model to the original, where the strong and weak areas are somewhat more easily identified.