Perception of educational environment among medical students in Thailand

A multicenter cross-sectional study in China revealing the intrinsic relationship between medical students' grade and their perceptions of the learning environment

BACKGROUND

Medical school learning environment (MSLE) has a holistic impact on students' psychosomatic health, academic achievements, and personal development. Students in different grades perceive MSLE in different ways. Thus, it is essential to investigate the specific role of student's grade in the perception of MSLE.

METHODS

Using the Johns Hopkins Learning Environment Scale (JHLES) as a quantification instrument for the perception level of MSLE, 10,901 medical students in 12 universities in China were categorized into low or high JHLES group according to their questionnaires. We investigated the relationship between student's grade and JHLES category by univariate analysis employing Pearson Chi-square test and Welch's ANOVA. Then multivariable logistic regression analysis confirmed the predictive efficacy of student's grade. A nomogram concerning the prediction of low JHLES score probability in medical students was also constructed.

RESULTS

A significant difference between two JHLES categories among students in different grades was observed (p < 0.001), with the proportion of the high JHLES group dominating in grade 1, 5, and the graduate subgroups (p < 0.001). The mean JHLES score declined especially in the third and fourth graders compared to freshmen (p < 0.001), while the mean score among the fifth graders had a remarkable rebound from the third graders (p < 0.001). Most imperatively, identified by multivariable logistic regression analysis, students in grade 3 (OR = 1.470, 95% CI = 1.265-1.709, p < 0.001) and 4 (OR = 1.578, 95% CI = 1.326-1.878, p < 0.001) perceived more negatively than freshmen. The constructed nomogram provided a promising prediction model for student's low JHLES score probability, with accuracy, accordance, and discrimination (area under the curve (AUC) = 0.627).

CONCLUSION

The student's grade was a significant influencing factor in medical students' perception of MSLE. The perceptions among the third and fourth graders got worse, probably due to the worrying changes in various aspects of MSLE during that period. The relevant and appropriate interventions to improve medical students' perceptions are urgently needed.

Clinical students' perception of educational environment in a Nigerian university: a mixed method study

BACKGROUND

Learning environment (LE) research has been given priority in higher education institutions globally because of its influence on learning processes and outcomes. Although studies reporting the perceptions of health science students about LE in Nigeria are available, none have compared the perceptions of students from different health professions. Therefore, this study aimed to assess final-year clinical students' perceptions of their LE from four programs (dentistry, medicine, nursing, and physiotherapy) and compared their LE perceptions.

METHODS

This study adopted a cross-sectional study design using a mixed method approach. The quantitative survey involved all the final-year clinical students at the University of Ibadan, and they completed the Dundee Ready Education Environment Measure (DREEM) questionnaire. The qualitative aspect involved 24 consenting students in four focus group discussions.

RESULTS

A total of 214 out of 223 copies of the DREEM questionnaire were duly completed and returned, yielding 96.0% response rate. The participants' mean age was 24 ± 2.3 years (ranged between 22 and 25 years, p = 0.001). The mean DREEM scores of the students from the four programs ranged between 119.68 ± 18.02 and 147.65 ± 15.89 out of a maximum of 200, interpreted as more positive than negative perceptions of LE. Physiotherapy students' DREEM score was significantly higher than those of medical, dental, and nursing students (p < 0.001). The DREEM scores of other students did not differ significantly (p > 0.05). Dental and medical students had similar positive perceptions. The qualitative aspect revealed that the students had positive perceptions of their teachers' knowledge base and self-acquisition of knowledge but negative perceptions of their teachers' communication skills, infrastructural facilities, lecturer-student relationships, and hostel accommodations.

CONCLUSION

Although the survey indicated that these clinical students had more positive than negative perceptions of their learning environment, the qualitative aspect of the study revealed many challenges that the students were confronted with. The clinical students' perception of their learning environment could be improved if the university authorities would address these challenges.

Perspectives of the cohort of health professionals in the WiSDOM study on the learning environment, transformation, and social accountability at a South African University

BACKGROUND

The dearth of empirical research on transformative health professions education informed this study to examine the factors that influence the perspectives of the cohort of health professionals in the WiSDOM study on the learning environment, transformation, and social accountability at a South African university.

METHODS

WiSDOM, a prospective longitudinal cohort study, consists of eight health professional groups: clinical associates, dentists, doctors, nurses, occupational therapists, oral hygienists, pharmacists, and physiotherapists. At study inception in 2017, participants completed a self-administered questionnaire that included four domains of selection criteria (6 items); the learning environment (5 items); redress and transformation (8 items); and social accountability (5 items). In the analysis, we, rescaled the original Likert scoring of 1 (strongly disagree) to 7 (strongly agree) to a new scale ranging from 0-10. We calculated the mean scores for each item and across items for the four domains, with low scores (0.00-1.99) classified as poor and high scores (8.00-10.00) as excellent. We used multiple linear regression analysis to compare the mean scores, while adjusting for different socio-demographiccharacteristics.

RESULTS

The mean age of the 501 eligible participants was 24.1 years; the majority female (72.9%), 45.3% self-identified as Black African; and 12.2% were born in a rural area. The domains of selection criteria and redress and transformation obtained mean scores of 5.4 and 5.3 out of 10 respectively, while social accountability and the learning environment obtained mean scores of 6.1 and 7.4 out of 10 respectively. Self-identified race influenced the overall mean scores of selection criteria, redress and transformation, and social accountability (p < 0.001). Rural birth influenced the perceptions on selection criteria, redress and transformation (p < 0.01).

CONCLUSION

The results suggest the need to create inclusive learning environments that foreground redress, transformation, and social accountability, while advancing the discourse on decolonised health sciences education.

Linking the choice of the class format and preclass learning experiences sheds light on a step further in blended medical education

BACKGROUND

The core principle of HyFlex ('hybrid' and 'flexible') learning is to maintain learning equity under most circumstances. Within a blended framework in precision medical education, how different preferences of synchronous learning environment influence learning process and outcome is limited. We investigated students' preclass online video learning experiences and their choices toward synchronous class formats.

METHODS

This was a mixed-methods study. During the 2021 academic year, all 5th-year medical students who had viewed online video clips presenting core concepts were asked to complete a survey on their preference for future synchronous class format (face-to-face, online, or HyFlex) and asked to provide reflective comments on their self-learning. Anonymous survey data, online records, and summative assessment scores (short-term learning outcomes) were collected. Kruskal - Wallis or Chi-square tests were used to compare differences between groups, and multiple linear regression was managed to select the factors associated with various choices. The students' comments were coded in a descriptive thematic analysis.

RESULTS

Among 152 medical students, 150 responded to the questionnaires, and 109 provided comments. Medical students spent a median of 32 min online, significantly shorter in the face-to-face group than in the online and HyFlex groups. The online group had a lower preclass video completion rate for certain concepts. The choice was not associated with short-term learning outcomes. Student feedback revealed a higher frequency of multiple themes for each student in the face-to-face and HyFlex groups, and these themes fell into the categories of learning efficiency, focus concentration, and course attractiveness.

CONCLUSIONS

Linking the choice of the class format and learning experiences of preclass online videos sheds light on a step further within a blended framework of precision medical education. Supplement of online interactive elements may help secure learning engagement among students choosing 'online only' class format of HyFlex learning.

Perception of the Online Learning Environment of Nursing Students in Slovenia: Validation of the DREEM Questionnaire

At the time of the outbreak of the coronavirus pandemic, several measures were in place to limit the spread of the virus, such as lockdown and restriction of social contacts. Many colleges thus had to shift their education from personal to online form overnight. The educational environment itself has a significant influence on students’ learning outcomes, knowledge, and satisfaction. This study aims to validate the tool for assessing the educational environment in the Slovenian nursing student population. To assess the educational environment, we used the DREEM tool distributed among nursing students using an online platform. First, we translated the survey questionnaire from English into Slovenian using the reverse translation technique. We also validated the DREEM survey questionnaire. We performed psychometric testing and content validation. I-CVI and S-CVI are at an acceptable level. A high degree of internal consistency was present, as Cronbach’s alpha was 0.951. The questionnaire was completed by 174 participants, of whom 30 were men and 143 were women. One person did not define gender. The mean age of students was 21.1 years (SD = 3.96). The mean DREEM score was 122.2. The mean grade of student perception of learning was 58.54%, student perception of teachers was 65.68%, student academic self-perception was 61.88%, student perception of the atmosphere was 60.63%, and social self-perception of students was 58.93%. Although coronavirus has affected the educational process, students still perceive the educational environment as positive. Nevertheless, there is still room for improvement in all assessed areas.

Educational environment and its relation to academic performance as perceived by medical students in University of Khartoum. A cross Sectional Study, Sudan, 2020

This article was migrated. The article was marked as recommended. Purpose: to assess students' perception of educational environment and to evaluate the difference in perception related to academic performance and demographic characteristics in the Faculty of Medicine, University of Khartoum, 2020. Method: The authors performed an observational analytical cross-sectional study at the Faculty of Medicine, University of Khartoum, using a validated structured closed-ended self -administered questionnaire; the Dundee Ready Educational environment measurement (DREEM). They included all students registered in the faculty for the academic year 2020-2021 except the first semester students. They used proportionate stratified sampling to divide students into strata and sub-strata based on batch number and sex, respectively. Then, they selected students proportionately from each substrata using simple random sampling. Results: out of 405 randomly selected students, 341 (84.2%) filled the questionnaire. The mean total DREEM score was (104.48/200), indicating a positive perception of the learning environment. This, with only student's perception of atmosphere subscale showing negative results. Test results showed a significant difference between different student's age groups, academic phases and batches in regards to their perception of atmosphere (p-value 0.023, 0.001, 0.013 respectively). Regarding residence, a significant difference was found in total DREEM scores, with students residing in university dormitories having a more positive perception. Test results showed no significant difference in student's perception of educational environment in all DREEM subscales between achievers and underachievers. Conclusion: although the overall perception of educational environment was more positive than negative, the study highlighted various areas needing special attention. Theauthors believe that both faculty administration and students must work together to deliver tangible improvement in all aspects of educational environment.

Educational Environment Assessment by Multiprofessional Residency Students: New Horizons Based on Evidence from the DREEM

INTRODUCTION

The multiprofessional residency in health (MRH) is in its initial stage situated in the long history of the Brazilian and worldwide health system. There are few published analytical data on the teaching environment as perceived by residents. Roff et al. developed a questionnaire to assess the educational environment known as the Dundee Ready Education Environment Measure (DREEM), which is widely used in international literature.

AIM

To analyse perceptions of the educational environment among residents in various undergraduate health courses at a university hospital in the Midwest Region of Brazil using the DREEM.

METHODS

The DREEM was administered to MRH students in a postgraduate health course consisting of 2 years of in-service training at a university hospital in Brazil in 2017. The results were analysed using the Statistical Package of Social Sciences (SPSS 24.0).

RESULTS

Cronbach's alpha reliability coefficient for all the items in this study was 0.76, which indicates good internal consistency. The average (95% CI) total DREEM score was 85.23 (ranging from 79.2 to 91.26), which suggests problems in the educational environment as perceived by health residents and a more negative than positive environment.

CONCLUSIONS

Several problem areas were identified in all domains of the educational environment that was assessed.

Measuring the educational environment in a Sri Lankan medical school following curricular revision

BACKGROUND

In 2007, the Faculty of Medical Sciences, University of Sri Jayewardenepura revised its medical curriculum from discipline-based to one that was student-centered and integrated. This study aimed to evaluate the perceptions of students regarding the educational environment and compare them to those prior to curricular revision.

METHODS

The Dundee Ready Education Environment Measure (DREEM) questionnaire was administered to all volunteering students enrolled in the medical degree programme at the time of the study (n = 595). Results were compared to DREEM scores obtained prior to curricular revision.

RESULTS

The overall DREEM score and sub-scale scores were positive and showed improvement compared to previous scores. The score for Students' Perceptions of Atmosphere showed progression from 'there are many issues which need changing' to the next highest category 'a more positive attitude'. The mean scores in pre-clinical, para-clinical and clinical phases also showed an improvement. 'The teachers are knowledgeable' was the highest rated item overall and within each phase of learning. All sub-scales were rated highest by pre-clinical students and lowest by para-clinical students, in contrast to previous results where such patterns were not observed. Certain items, especially those related to teaching/learning, received exclusively low scores in particular student subsets.

CONCLUSIONS

Students' perceptions towards the educational environment overall, have improved following curricular revision. However, certain negative areas warranting further evaluation were highlighted.

Exploring Students' Perceptions of the Educational Environment in a Caribbean Veterinary School: A Cross-Sectional Study

Educational environment has a significant impact on students' learning and academic achievement. The aim of this article was to explore the perception of veterinary school students' regarding their educational environment at the University of the West Indies. In this cross-sectional study, the Dundee Ready Education Environment Measure (DREEM) was administered to veterinary undergraduate students from year 2 to year 5. The DREEM questionnaire consists of 50 items with five subscales: students' perceptions of learning, students' perceptions of teachers, students' academic self-perceptions, students' perceptions of atmosphere, and students' social self-perceptions. Each item was scored on a 5-point Likert scale ranging from strongly disagree (0) to strongly agree (4). The Cronbach's alpha for the overall DREEM score was 0.92, and for the five subscales, it ranged from 0.66 to 0.83. A total of 99 students responded (response rate: 86%). The students' overall DREEM mean score was 106.59 out of the global mean score of 200, indicating that students' perception of the educational environment was generally more positive than negative. In the five DREEM subscales, students were found to have a more positive perception of learning (55.15%); students' perception of teachers was generally positive (61.41%); and their perception of academic atmosphere was also positive (57.75%). Conversely, students' academic self-perception (51.41%) and social self-perception (42.61%) trended negatively. The findings suggest that improvement is needed in significant areas in the veterinary school, including curriculum review, faculty development, provision of sports and cultural facilities, stress management, and academic support systems.

Improving students' learning environment by DREEM: an educational experiment in an Iranian medical sciences university (2011-2016)

BACKGROUND

Students' perception of the educational setting is an important source for improving and applying changes to the educational environment. In this study, we reassessed undergraduate students' perception of the educational environment at two colleges of RUMS-Iran in the academic years of 2011 and 2016.

METHODS

In the present prospective study, the DREEM inventory consisted of seven courses for undergraduate paramedical and nursing-midwifery students (n = 982). After the first stage, educational seminars and workshops were set up for academic members and faculty staff on deficiencies and the ideal climate for optimizing the educational environment. The results of students' responses in 2011 were compared with those assessed in 2016. For the data analysis, the independent t-test and the one-way ANOVA were utilized.

RESULTS

In the academic year of 2010-2011, the DREEM inventory scored 115.33/200 (57.66%); it also scored 123.47/200 (60.7%) in the academic year of 2015-2016 (p ≤ 0.01). There was an interesting feeling about the first-year education, and female students felt a more positively perceived learning environment during all courses than male students at both stages of the study. There were significant positive differences (2 to 7%) in all domains of the components of DREEM in all courses between the academic year of 2010-2011 and the academic year of 2015-2016, showing that the DREEM score had changed and increased (p < 0.05), in the latter case.

CONCLUSIONS

Positive differences were observed in DREEM scores between the two stages of the study. DREEM helped reduce the areas of deficiencies in students' perception of many aspects of the educational environment. It also helped identify problematic areas in the improvement. In addition, DREEM could be used to optimize and make modifications to the educational environment.