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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 5  |  Issue : 1  |  Page : 53-59

A cross-sectional study of students' perception of educational environment and its determinants using the Dundee Ready Education Environment Measure scale


Department of Community Medicine, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, Maharashtra, India

Date of Submission11-Nov-2019
Date of Decision17-Apr-2020
Date of Acceptance14-May-2020
Date of Web Publication08-Jul-2020

Correspondence Address:
Dr. Sanjay Raguel Quraishi
Department of Community Medicine, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bjhs.bjhs_70_19

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  Abstract 


INTRODUCTION: Educational environment is important for students' learning. Continuous quality improvement and innovation are very essential in a medical college. The Dundee Ready Education Environment Measure (DREEM) is a reliable and validated instrument that identifies specific problem areas within an institution for different components of the same student body. Problems can be taken care of, if we identify them.
OBJECTIVES: The objectives of this study were as follows: (1) to assess perceptions of the educational environment of students and (2) to identify gender-, age-, and semester-wise differences in the perceptions.
MATERIALS AND METHODS: Study design: Institution-based cross-sectional study. Study place: Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli. Study duration: 6 months. Study subjects: Medical students of all semesters. Exclusion criteria: attendance < 60% and not willing to participate. Study Tool: DREEM Scale. Sample size: All students.
STATISTICAL ANALYSIS: Mean score, Standard Deviation (SD), and Z-test.
RESULTS: There were total 440 students (203 boys and 237 girls) of total four semesters. Age ranged from 17 years to 28 years (mean 20.34 ± SD 1.59). Majority of the students were from the fourth semester (147). The mean DREEM score was 118.13 ± SD 21.43, which indicates that educational environment is “more positive than negative.” A significant association was found between students' academic self-perceptions (SASP) and students' perception of atmosphere (SPA) score and semester.
CONCLUSION: Students' perception of overall educational environment was as of more positive. Subscale scores and item analysis show the areas of weaknesses such as authoritarian teachers and teachers get angry in class which needs improvement. The global score was independent of age, sex, and semester. The score of SASP and SPA was significantly high in second-semester students.

Keywords: Dundee Ready Education Environment Measure scale, educational environment, students perception education


How to cite this article:
Kadam YR, Quraishi SR, Waghachavare VB, Dhobale RV, Mane AS, Gore AD. A cross-sectional study of students' perception of educational environment and its determinants using the Dundee Ready Education Environment Measure scale. BLDE Univ J Health Sci 2020;5:53-9

How to cite this URL:
Kadam YR, Quraishi SR, Waghachavare VB, Dhobale RV, Mane AS, Gore AD. A cross-sectional study of students' perception of educational environment and its determinants using the Dundee Ready Education Environment Measure scale. BLDE Univ J Health Sci [serial online] 2020 [cited 2020 Aug 15];5:53-9. Available from: http://www.bldeujournalhs.in/text.asp?2020/5/1/53/289204



Continuous quality improvement and innovations are very essential in a medical college. Students' learning depends on the educational milieu. The quality of educational environment is indicative of the effectiveness of an educational program.

It has been widely accepted by health educators that both academic and clinical educational environments are important determinants of medical students' attitudes, knowledge, skills, progression, and behaviors.[1]

One of the definitions of the “ideal” academic environment is the one that best prepares student for their future professional life and contributes toward their personal development and psychosomatic and social well-being.[2]

Educational environment can be interpreted as all the factors which influence the student's ability to develop the appropriate professional characteristics required for delivering quality patient care.

Learning depends on many internal and external factors: internal factors such as motivation, perception of relevance, and learning styles and external factors such as educational environment. Educational environment includes course and curriculum factors and teacher factors.[3]

It can mean the physical surroundings within which learning takes place, such as access to library facilities, seminar rooms, or simulation equipment in its simplest way. In its broadest sense then, an educational environment is anything which impacts the learner's capacity to develop the appropriate professional attributes and that includes the “quality of patient care.”

Best assessors of educational environment will be students only. Hence, students' perception of the educational environment is the best method to assess that environment. This will help the planners, administrators, and teachers to know the strength and weaknesses of the institute which will help to improve the educational environment where the learning of students will become more effective.

That is why this study was undertaken to assess the perceptions of educational environment by students of medical college and hospital so as to identify problem areas that can be remediated and sociodemographic factors associated with it.


  Materials and Methods Top


This study was conducted in a medical college situated in western Maharashtra. It was a cross-sectional study. Study subjects were the students of all semesters.

After getting clearance from the institutional ethical committee and permission from dean, data collection was started using a questionnaire. This questionnaire had two parts: Part 1 had questions regarding age, sex, and semester. Part 2 was the Dundee Ready Education Environment Measure (DREEM) scale. Students were contacted during their lectures with prior permission from respective teachers. Before the distribution of questionnaire, students were explained about the importance of the study and questionnaire. They were also informed about the need of careful filling in the questionnaire. Students were explained that the participation in the study voluntary and they were assured of anonymity. They were instructed not only to attempt all the questions but also to answer them honestly. Data collection was done from all the students of all semesters available at that time.

Dundee Ready Education Environment Measure Scale

The DREEM has been developed to enable universal diagnostic inventory for analyses of undergraduate environments in medical schools and other health professional institutes.[4] Many studies have found DREEM, a valid, reliable, and sensitive instrument.[5] It identifies specific problem areas within an institution for different components of the same student body which can be taken care of.

It is nonculturally specific and allows quality assurance comparisons between courses as well as within components of a course. It has total 50 questions to assess five subscales such as:[6],[7]

  1. Students' perceptions of learning (SPL): 12 items with a maximum score of 48
  2. Students' perceptions of teachers (SPT): 11 items with a maximum score of 44
  3. Students' academic self-perceptions (SASP): 8 items with a maximum score of 32
  4. Students' perception of atmosphere (SPA): 12 items with a maximum score of 48
  5. Students' social self-perceptions (SSSP): 7 items with a maximum score of 28.


Each item has to be rated using a five-point Likert scale ranging from 4 for strongly agree, 3 for agree (A), 2 for uncertain (U), 1 for disagree (D), and 0 for strongly disagree (SD). Nine negative items (numbers 4, 8, 9, 17, 25, 35, 39, 48, and 50) were scored in reverse.

Interpretation of score:[6],[8]

  1. Items that have a mean score of 3 and above reflect a positive educational environment
  2. Items with a mean between 2 and 3 are aspects of the climate that could be enhanced
  3. Items with a mean less than 2 are indicative of problem areas.


The 50-item DREEM has a maximum score of 200. Interpretation of global score is as follows:

  • 50: Very poor
  • 51–100: Plenty of problems
  • 101–150: More positive than negative
  • 151–200: Excellent.


Statistical analysis

Only completed questionnaires were included. Mean score and SD were calculated for each question. Mean, range, and SD were calculated for all five subscales. The association between subscale scores and sociodemographic factors such as sex, age, and semester was assessed using the Chi-square test and ANOVA. Statistical analysis was done using SPSS 22 software (IBM Corp, Armonk, New York, USA).


  Results Top


There were total 440 students of total four semesters. Out of 440 students, 203 were boys and 237 were girls. The age ranged from 17 years to 28 years. The mean age was 20.34, with SD 1.59.

Semester wise: 130 belonged to the second semester, 147 to the fourth semester, 134 to the sixth semester, and 29 to the eighth semester.

Items with a mean score of 3 and above were 2, 10, and 15. Items with a score less than 2 were 9, 17, 25, 39, 48, and 50. The score of the rest of the items ranged from 2 to 3. Item number 2, the teachers are knowledgeable, had the highest mean score, i.e. 3.28. Item number 25, the teaching overemphasizes factual learning, scored only 1.48 that was the lowest score [Table 1]a, [Table 1]b, [Table 1]c, [Table 1]d, [Table 1]e.
Table 1:

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Mean Dundee Ready Education Environment Measure score

The mean DREEM score was 118.13, with SD 21.43. The minimum score was 50 and maximum 182. The mean score of 118.13 indicates that educational environment is “more positive than negative.” There were only two (0.5%) students who gave a very poor score, i.e. ≤50. Seventy-five students (17%) awarded score ranging 51–100; this indicates that “there are plenty of problems” in academic environment. Total 335 (76.14%) students had given a score of 101–150 which is interpreted as “more positive than negative,” whereas 28 (6.36%) students provided a score of “excellent,” i.e. 151–200.

The association of sociodemographic factors with total DREEM score was assessed. For this purpose, the classification of total DREEM score was used. However, group of “very poor” was merged with “plenty of problems” group as it was too small for analysis. It was found that students feeling plenty of problems were of young age group of 17–19 years, of female sex, and of 8th semester. A significant association was found between score and semester [Table 2].
Table 2: Association between sociodemographic factors and global Dundee Ready Education Environment Measure score groups

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Second-semester students gave the highest mean DREEM score, and it was decreased gradually as semesters advanced. Similarly, in age group-wise distribution, a high score was offered by younger age group, i.e. 17–19 years' age group, and decreased with advancing age group. However, the observed difference was not significant [Table 3].
Table 3: Distribution of sociodemographic factors and mean global Dundee Ready Education Environment Measure score

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Boys have offered a high total DREEM score than girls. However, the observed difference was not significant [Table 4].
Table 4: Association between age and subscale scores

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Students' perceptions of learning

The mean score of POL was 26.50 with SD 6.30. It ranged from 12 to 48. Very poor score (0–12) was given by 6 (1.4%) students. Total 165 (37.5%) students gave a score between 13 and 24. A score of 25–36 indicating “a more positive perception” was accorded by 243 (55.23%) students, whereas 26 (5.90%) students awarded a score of 37–48 meaning “teaching highly thought of.” Students perception of learning seemed to be more factual learning oriented showing more positive perception.

Students' perceptions of teachers

The mean score of POT ranged from 11 to 41. The mean POT was 26.57 with SD 4.68. Only two (0.5%) students gave a score between 0 and 11 interpreting “abysmal,” and 80 (18.1%) students provided a score between 12 and 22 recommending “need of some training.” There were 332 (75.45%) students who presented with 23–33 score interpreting as teachers “moving in right direction.” According to 26 (5.90%) students, teaching faculty was model teachers as a score granted by them was 34–44. Students perception of teachers had higher mean score for teachers are knowledgable is a ringing bell for teachers to remain updated with academic knowledge in subject.

Student's academic self-perception

A score for SASP was 18.10 and SD 4.22. The minimum SASP was 8 and maximum 32. A score of 0–8 was awarded by 5 (1.1%) students meaning feeling of total failure, whereas 147 (33.4%) presented with 9–16 score indicating “many negative aspect.” About 261 (59.31%) students felt “more on the positive side” by offering 17–24 score, whereas only 26 (5.90%) were “confident” as their score was in the range of 25–32.

Students' perception of atmosphere

A score for POA was 29.38, with SD 6.32. The minimum POA was 12 and maximum 48. For POA, only three (0.7%) students provided with a score of 0–12 suggesting “terrible environment.” Total 71 students gave a score of 13–24, suggesting that “there are many issues which need change.” However, 320 (72.72%) students had a more positive attitude as they gave a score of 25–36 and 45 (10.22%) students offered a score of 37–48 meaning “a good feeling overall.”

Students' social self-perceptions

A mean score of SSSP was 18.15 with SD 3.51. It ranged from 7 to 28. There were only two (0.5%) students who awarded score “7” interpreting “miserable.” About 57 (13.1%) students permitted a score of 8–14 that means “not a nice place.” However, 312 (70.90%) students presented a score of 15–21 indicating atmosphere “not too bad” and 68 (15.45%) felt “very good socially” by giving 22–28 score.

From the above results, it is evident that the number of students giving more than 50% score for total DREEM score and its subscale is as follows:

  • Total DREEM score: 366 (83.17%)
  • SPL: 269 (61.13%) students
  • SPT: 358 (81.36%) students
  • SASP: 287 (65.22%) students
  • SPA: 365 (82.95%) students
  • SSSP: 380 (86.36%) students


Subscales and sociodemographic factors

The age-wise distribution of mean score of all five subscales is presented in [Table 4]. The mean scores of SPL, SASP, SPA, and SSSP were highest in the age group of 17–19 years, whereas it declines with increasing age. However, the observed difference was significant only for SASP subscale score [Table 4].

The gender-wise distribution of mean score of all five subscales is presented in [Table 4]. Boys had a high score for all five subscales. However, the observed difference was not significant [Table 5].
Table 5: Association between gender and global score and subscale score

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The semester-wise distribution of mean score for all five subscales: mean score of SPL, SASP, and SPA was high for second-semester students and gradually declined with senior semesters. The observed difference in semester-wise mean scores of SASP was statistically significant [Table 6].
Table 6: Semester-wise distribution of scores of subscales

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  Discussion Top


For any educational institute, self-assessment is important as a part of continuous process of improvement. DREEM scale is a useful tool for self-evaluation of a health professions institute. This is a type of internal assessment.

The study came out with the global score indicating educational environment which is more positive than negative. Almost all Indian studies which we were able to access had similar findings.[9],[10],[11],[12]. Even similar findings are noted by some of the researchers from other countries.[13],[14],[15],[16],[17] However, there are two studies who have reported lower global scores indicating plenty of problems in their educational environment.[7],[18]

For all five subscales, students have awarded a score more than 50%. This indicates that students had more positive perception of learning; teachers are in the right direction. For academic self-perceptions, they feel they are more on positive side, a more positive attitude about an atmosphere, and students' social self-perception is not too bad.

Even though the students interpreted the overall educational environment as positive, there is still scope to improve further which needs identification of weaknesses. The proportion of students who gave < 50% score is one of the indicators. This proportion was highest, i.e. more than one-third of students for SPL and SASP.

The next indicator was the individual items, with a mean less than 2. There are “two” teacher-related items such as teachers are authoritarian and teachers get angry in the class. There was one more item, “student irritate teacher”. The mean score for this item was low, this reflects that some teachers need training in transactional analysis for handling teacher–student relationship more effectively.[19]

Students offered a poor score for item “cheating is a problem in this school.” A similar finding is also reported by other Indian studies also.[10],[14],[16] Mayya et al. have reported in their study that this score is dependent on academic achievement. There are other studies who have reported the better score for this item number 17.[7],[9],[13],[15],[18] These findings suggest that this particular area is in need of attention.

According to students, the strengths of this institute are educational environment, teachers are knowledgeable, and they are confident about their passing means, which is suggestive of their satisfaction about learning.

Gender wise: there was no significant difference in global DREEM score and its subscales. Similar findings have been noted by Abraham et al.[12] and Aghamolaei et al.[18] However, Farajpour et al. found global score, POL, and SSSP significantly better by girl students,[13] and Roff Set al. found that global score given by girls was better.[4]

Global score and all subscale scores given by girls were better in a study conducted in Iran by Farazpour A. However, this study includes all health disciplines.[13]

The mean score of global DREEM and all five subscales decreased with increasing age and semesters. Similar findings for global score are noted by Gupta et al.[11] and Ayed et al.[7] Students might be getting exhausted toward the end of course as total period of undergraduation including internship is 51/2 year, which is quite lengthy. However, Unnikrishnan et al. found a significantly high score given by an eighth-semester student than the sixth.[9] However, they have studied only sixth and eighth semesters and studied the educational environment of community medicine only. Eighth-semester students already clear the subject in the seventh semester.


  Conclusion Top


Students' perception of overall educational environment was as of more positive. Subscale scores and item analysis show the areas of weaknesses such as authoritarian teachers and teachers get angry in class which needs improvement.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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Hutchinson L. Educational environment. BMJ 2003;326:810-2.  Back to cited text no. 3
    
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Khan JS, Tabasum S, Yousafzai UK, Fatima M. DREEM on: Validation of the Dundee Ready Education Environment Measure in Pakistan. J Pak Med Assoc 2011;61:885-8.  Back to cited text no. 5
    
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McAleer S, Roff S. A Practical Guide to Using the Dundee Ready Education Environment Measure (DREEM). http://www.gppro.co.uk/swacpo/document/dreems2.doc. [Last accessed on 2019 Nov 10].  Back to cited text no. 6
    
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Al-Ayed IH, Sheik SA. Assessment of the educational environment at the College of Medicine of King Saud University, Riyadh. East Mediterr Health J 2008;14:953-9.  Back to cited text no. 7
    
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Tontuş HÖ. DREEM; dreams of the educational environment as its effect on education result of 11medical faculties of Turkey. J Experim Clin Med 2010:27:104-08.  Back to cited text no. 8
    
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Unnikrishnan B, Rekha T, Mithra PP, Kumar N, Reshmi B. Perceptions of medical students about their educational environment in community medicine in a medical college of Coastal Karnataka. Indian J Community Med 2012;37:130-2.  Back to cited text no. 9
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Gupta M, Lehl SS, Singh R. The educational environment of the indian undergraduate medical students: Is it good enough? J Assoc Physicians India 2018;66:20-6.  Back to cited text no. 10
    
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Mayya S, Roff S. Students' perceptions of educational environment: A comparison of academic achievers and under-achievers at Kasturba Medical College, India. Educ Health (Abingdon) 2004;17:280-91.  Back to cited text no. 11
    
12.
Abraham R, Ramnarayan K, Vinod P, Torke S. Students' perceptions of learning environment in an Indian medical school. BMC Med Educ 2008;8:20.  Back to cited text no. 12
    
13.
Farajpour A, Raisolsadat SM, Moghadam S, Mostafavian Z. Perception of educational environment among undergraduate students of health disciplines in an Iranian university. Int J Med Educ 2017;8:300-6.  Back to cited text no. 13
    
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Demirören M, Palaoglu O, Kemahli S, Ozyurda F, Ayhan IH. Perceptions of students in different phases of medical education of educational environment: Ankara university faculty of medicine. Med Educ Online 2008;13:8.  Back to cited text no. 14
    
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Arzuman H, Yusoff MS, Chit SP. Big Sib Students' Perceptions of the Educational Environment at the School of Medical Sciences, Universiti Sains Malaysia, using Dundee Ready Educational Environment Measure (DREEM) Inventory. Malays J Med Sci 2010;17:40-7.  Back to cited text no. 15
    
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Tontus HO. DREEM; dreams of the educational environment as its effect on education result of 11 medical faculties of turkey. J Experim Clin Med 2010;27:104-8. [DOI: 10.5835/jecm.omu. 27.03.002].  Back to cited text no. 16
    
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Varma R, Tiyagi E, Gupta JK. Determining the quality of educational climate across multiple undergraduate teaching sites using the DREEM inventory. BMC Med Educ 2005;5:8.  Back to cited text no. 17
    
18.
Aghamolaei T, Fazel I. Medical students' perceptions of the educational environment at an Iranian Medical Sciences University. BMC Med Educ 2010;10:87.  Back to cited text no. 18
    
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Kumar SP. Transactional analysis in Physical therapy: Extending interpersonal communication skills to evidence- informed shared decision making. J Phys Ther 2012;5:1-5.  Back to cited text no. 19
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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