Comparison of undergraduate educational environment in medical and nursing program using the DREEM tool

Abstract

Introduction

Educational environment (EE) in a health educational institute can bring about an enduring impact on the students' motivation, knowledge, critical thinking along with their social life. Therefore, identifying strengths and the need for change in the education environment is vital for the enhancement of the students' learning.

Objective

This study aimed to compare the perceptions of nursing and medical students about their EE in a private university, Karachi Pakistan.

Methodology

Data from two cross-sectional studies of 884 students from both medical and nursing schools of Aga Khan University was acquired and analyzed. EE was measured by a well-known inventory i.e. ‘Dundee’ Reading Educational Environment Measure (DREEM). The scores were constructed using standardized guidelines. Mann-Whitney U test and two way ANOVA were used in statistical analysis.

Results

With 84.1% average response rate, the mean + SD DREEM score was measured as 126 ± 20.3. Nursing students regarded more positive perception about their EE (127.3 ± 19.3) as compared to medical students (124.6 ± 21.3) and was found to be statistically significant (P = 0.027). Medical students scored higher in the domain of Perception of Atmosphere (PoA); whereas, nursing students scored higher in Academic Self Perception (ASP). Both of the groups have rated lower scores on the domain of Perception of Teaching (PoT).

Conclusion

Both medical and nursing students appreciated the EE pertaining to Perception of Learning (PoA), Academic Self- Perception (ASP), Perception of learning (PoL) and Social Self-perception (SSP). The study showed that nursing students' perception on their EE was relatively more satisfactory than medical students. However, both medical and nursing students identified areas of improvement in the domain of Perception of Teaching (PoT). This finding indicates dire need to devise innovative teaching strategies both for medical & nursing education.

Introduction

Student satisfaction of their Education Environment (EE) is an important component for the ensuring quality of learning. The learning journey of a student comprises of their physical, cognitive, cultural, psychological, emotional, educational and motivational growth (Patil and Chaudhari, 2016a, Patil and Chaudhari, 2016b; Tokuda et al., 2010a, Tokuda et al., 2010b). In addition to that, EE is found to be one of the most important, known determinants for the students' growth, judgment, motivation, and accomplishments. EE encourages healthy competition and critical thinking among students (Imanipour et al., 2015; Jawaid et al., 2013). It is also one of the substantial indicators for assessing the students' learning experiences along with the curriculum (Pai et al., 2014). Students' satisfaction is found to be strongly linked with the quality of the educational program. EE could further have an eventual impact on implementing clinical safe practices (Bakhshialiabad et al., 2015a, Bakhshialiabad et al., 2015b). EE is, thus, an essential aspect of an educational institution, playing a vital role in endorsing students' motivation, success, independence, self-confidence, learning, and critical thinking skills (Imanipour et al., 2015). Outlining strengths and weaknesses of the learning environment can, consequently, amplify the EE for the existing, along with the upcoming students in any program of study, including medical and nursing students. The EE can be evaluated using the suitable and relevant evaluation tool.

Literature suggested that Dundee Ready Educational Environment Measure (DREEM) questionnaire has been the most comprehensive and reliable tool (Ali et al., 2012; Barcelo, 2016a, Barcelo, 2016b; Palmgren and Chandratilake, 2011; Roff et al., 1997a, Roff et al., 1997b) to assess learning environments for the past two decades (Palmgren and Chandratilake, 2011). The DREEM tool is commonly used to compare learning environments of various health institutions and courses (Ali et al., 2012; N. Imran et al., 2013; Palmgren and Chandratilake, 2011). In the past, there have been several studies conducted to compare medical and nursing students' perceptions using the DREEM tool to enhance curriculum and learning experiences (Bakhshialiabad et al., 2015a, Bakhshialiabad et al., 2015b; Barcelo, 2016a, Barcelo, 2016b). Past literature suggested that several health care institutions have used the DREEM tool. St. Louis University compared views of medical laboratory science students and nursing students for improvement of their curriculum as well (Barcelo, 2016a, Barcelo, 2016b). While, Islamic Azad University, compared perception of medical, nursing and midwifery students regarding their EE (Farajpour et al., 2017). University of Huddersfield compared views of various medical science courses' students (Ousey et al., 2014). The institution is offering nursing & medical education program successfully since the last three decades. Both programs have independently assessed the learning environment. However, a comparison of both programs has not been undertaken. Therefore, the purpose of the current study is to compare medical and nursing student's perceptions of the learning environment using the DREEM tool at Aga Khan University. Thus, this study could, potentially help faculty, Office of the Registrar, and Dean of Students' to develop necessary measures in enhancing both medical & nursing students' experience of learning. This would provide the platform for improvement in curriculums & learning experiences.