Family medicine and sports medicine students' perceptions of their educational environment at a primary health care center in Germany: using the DREEM questionnaire

Understanding the Mentoring Environment Through Thematic Analysis of the Learning Environment in Medical Education: a Systematic Review

BACKGROUND

Mentoring's success has been attributed to individualised matching, holistic mentoring relationships (MRs) and personalised mentoring environments (MEs). Whilst there is growing data on matching and MRs, a dearth of ME data has hindered development of mentoring programme. Inspired by studies likening MEs to learning environments (LEs) and data highlighting common characteristics between the two, this systematic review scrutinises reports on LEs to extrapolate the findings to the ME context to provide a better understanding of ME and their role in the mentoring process.

METHODS

Using identical search strategies, 6 reviewers carried out independent literature reviews of LEs in clinical medicine published between 1 January 2000 and 31 December 2015 using PubMed, ERIC, Cochrane Database of Systematic Reviews, Google Scholar and Scopus databases. Braun and Clarke's (2006) approach to thematic analysis was adopted to circumnavigate LE's evolving, context-specific, goal-sensitive, learner-tutor relationally dependent nature.

RESULTS

A total of 4574 abstracts were identified, 90 articles were reviewed, and 58 full-text articles were thematically analysed. The two themes identified were LE structure and LE culture. LE structure regards the framework that guides interactions within the LE. LE culture concerns the values and practices influencing learner-tutor-host organisation interactions.

DISCUSSION

LE is the product of culture and structure that influence and are influenced by the tutor-learner-host organisation relationship. LE structure guides the evolving tutor-learner-host organisation relationship whilst the LE culture nurtures it and oversees the LE structure. Similarities between LEs and MEs allow LE data to inform programme designers of ME's role in mentoring's success.

DREEM in primary care: students' perspectives on educational environment of family medicine internship in primary care centres: experiences at Akdeniz University Faculty of Medicine in Turkey

Objective: In many countries, medical education programmes are expanding, and educational environments are starting to change from hospitals to primary health care centres. International organizations for medical education highlight that medical students should also be educated at primary and secondary care centres in addition to third-step health care. In this study, the evaluation of sixth-year (final year) medical students' perspectives on the educational environment of family medicine internship in primary care is presented, using the Dundee Ready Educational Environment Measurement (DREEM)Material and methods: This descriptive cross-sectional study was conducted with sixth-year medical students. Starting in the 2017-2018 academic year, sixth-year medical students started to enrol in educational courses in primary care. A total of 223 students completed internships in primary care for a two-week period, during which we applied the Dundee Ready Educational Environment Measure (DREEM) to evaluate the educational environment at the end of the internship. The collected questionnaires were analysed by using IBM-SPSS version 23 for Mac OS. Student's t-test and Mann-Whitney U Test were used for comparisons.Results: Of the 223 students, 192 (86%) completed the questionnaire. The total DREEM score was 138.62/200 (%63.5). The students rated the learning environment as positive. The mean score for students' perceptions of teaching, students' perceptions of teachers, students' academic self-perceptions, students' perceptions of the atmosphere and students' social self-perceptions were 31.65/48, 30.45/44, 23.46/32, 34.20/48 and were 18.56/28, respectively. The total mean score and subscale scores were not significantly different between males and females.Conclusion: This study suggests that students' perception of the global learning environment in primary care was more positive than negative. The lowest scores were recorded for Students' Perceptions of Learning and Students' Social Self-Perceptions, and the highest score was recorded for Students' Academic Self-Perceptions.

Evaluating the educational environment of an international animal model-based wet lab course for undergraduate students

Background

Essential Skills in the management of Surgical Cases – ESMSC is an International Combined Applied Surgical Science and Wet Lab course aimed at the undergraduate level. ESMSC combines interactive basic science workshops and case-based learning, with basic surgical training modules (BST) on Ex Vivo and In Vivo swine model. In Vivo Dissections include more advanced modules i.e. Abdominal Anatomy Dissections and Cardiac Transplant.

Aim

To evaluate the educational environment of a novel course, as well as to compare Medical students' perceptions across various groups.

Materials and Methods

83 Delegates from King's College London (KCL) and several Hellenic Medical Schools attended the ESMSC course. The DREEM inventory was distributed upon completion of the modules.

Results

The mean overall score for DREEM inventory was 148.05/200(99–196, SD = 17.90). Cronbach's Alpha value was 0.818, indicating good internal consistency of the data. Year 3/4 Students have a significantly positive “Perception of Learning”, when compared to Year 5/6 (36.43 vs. 33.75, p = 0.017). KCL Students have a more positive view of the course compared to their Greek counterparts (155.19 vs. 145.62/200, p = 0.034). No statistical significant difference was noted when comparing male vs. female students (p > 0.05).

Conclusions

Students seem to positively rate the ESMSC educational environment. Junior as well as KCL students appear to be more enthusiastic. Further research should focus on the optimal strategy for early involvement and motivation of various students' groups in BST.

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ESMSC is an International Surgical Science and Wet Lab course aimed at undergraduates.

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Students seem to positively rate the ESMSC educational environment.

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Year 3/4 Students have a significantly positive “Perception of Learning”, when compared to Year 5/6.

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KCL Students gave a more feedback on the course compared to their Greek counterparts.

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Further research should focus on involving and motivating students early in BST.

Impact of family medicine clerkships in undergraduate medical education: a systematic review

OBJECTIVE

Synthesise evidence about the impact of family medicine/general practice (FM) clerkships on undergraduate medical students, teaching general/family practitioners (FPs) and/or their patients.

DATA SOURCES

Medline, ERIC, PsycINFO, EMBASE and Web of Knowledge searched from 21 November to 17 December 2013. Primary, empirical, quantitative or qualitative studies, since 1990, with abstracts included. No country restrictions. Full text languages: English, French, Spanish, German, Dutch or Italian.

REVIEW METHODS

Independent selection and data extraction by two authors using predefined data extraction fields, including Kirkpatrick's levels for educational intervention outcomes, study quality indicators and Best Evidence Medical Education (BEME) strength of findings' grades. Descriptive narrative synthesis applied.

RESULTS

Sixty-four included articles: impact on students (48), teaching FPs (12) and patients (8). Sample sizes: 16-1095 students, 3-146 FPs and 94-2550 patients. Twenty-six studies evaluated at Kirkpatrick level 1, 26 at level 2 and 6 at level 3. Only one study achieved BEME's grade 5. The majority was assessed as grade 4 (27) and 3 (33). Students reported satisfaction with content and process of teaching as well as learning in FM clerkships. They enhanced previous learning, and provided unique learning on dealing with common acute and chronic conditions, health maintenance, disease prevention, communication and problem-solving skills. Students' attitudes towards FM were improved, but new or enhanced interest in FM careers did not persist without change after graduation. Teaching FPs reported increased job satisfaction and stimulation for professional development, but also increased workload and less productivity, depending on the setting. Overall, student's presence and participation did not have a negative impact on patients.

CONCLUSIONS

Research quality on the impact of FM clerkships is still limited, yet across different settings and countries, positive impact is reported on students, FPs and patients. Future studies should involve different stakeholders, medical schools and countries, and use standardised and validated evaluation tools.

Evaluating Student's Perceptions of the Learning Environment in an Indian Dental School

OBJECTIVE

To evaluate student's perception of the learning environment in a private dental institute in India based on DREEM inventory.

MATERIALS AND METHODS

This cross-sectional study included students in all four years of the undergraduate dental course of Panineeya Institute of Dental Sciences and Hospital, Hyderabad, India. Self-administered Dundee Ready Education environment Measure (DREEM) inventory consisting of 50-items on a five-point Likert scale was utilized to assess the students' perceptions regarding learning environment in this academic dental school. Comparison for the total and domain DREEM score means was carried out via independent t-test for dichotomous variables (gender) and ANOVA for more than two variables (year of study). Significant difference was noted for p < 0.05.

RESULTS

The response rate for this study was 86.8%. Mean age of the study participants was 19.61 + 1.50 y. The overall DREEM score for this population was 125.24 + 21.10 reflecting a more of positive than negative education environment in this institution. When individual domain scores were accounted, except for the domain SAS, females had a higher mean scores for all domains which was however statistically significant only for the domains SPL (p = 0.03) and SPT (p = 0.01). Likewise, significant differences were also noted for SPL and SPT based on the year of study, wherein for both the domains, third year students had significantly higher mean scores and least was recorded for fourth year students. Correlation of the various domains demonstrated significant positive correlation among the domains.

CONCLUSION

Overall this sample of dental students rated the learning environment in this dental institute as positive.