Perceptions by medical students of their educational environment for obstetrics and gynaecology in metropolitan and rural teaching sites

Figures & data

Figure 1. Map of Western Australia showing the site of the capital city, Perth, and the 10 rural locations at which medical students may be placed for teaching in obstetrics and gynaecology.

Table

Practice points

DREEM was a valuable and readily administrable tool to measure student perceptions of their learning environments over a variety of teaching sites Obstetrics and gynaecology can be taught across a range of metropolitan and rural sites without affecting student perceptions of their learning environment, providing appropriate clinical and academic support is in place Student perceptions of their learning environment are linked to their clinical academic outcomes

Table 1.  Demographics of medical students who participated in the study

Site of teaching / clinical placement	All	Male	Female	Overall p-value
Tertiary hospital (only)	84 (52%)	41 (49%)	43 (51%)	0.548
Tertiary hospital with placement at a secondary metropolitan hospital (4 weeks)	46 (29%)	21 (46%)	25 (54%)
Rural clinical school sites < 25000 population	17 (11%)	7 (41%)	10 (59%)
Rural clinical school sites > 25000 population	14 (9%)	4 (29%)	10 (71%)

Data represented as N (%)

Table 2.  DREEM score by gender

	All	Male	Female	p-value*
Total score	149 ± 18.2	147.7 ± 18.6	150.1 ± 18.0	0.347
Maximum = 200
Perceptions of learning	36.6 ± 5.5	35.9 ± 5.6	37.3 ± 5.3	0.229
Maximum = 48
Perceptions of teaching	34.4 ± 4.3	34.6 ± 4.3	35 ± 4.3	0.823
Maximum = 44
Academic self-perceptions	21.8 ± 3.6	21.6 ± 4.0	22 ± 3.3	0.525
Maximum = 32
Perceptions of atmosphere	36 ± 5.2	35.9 ± 4.9	36.1 ± 5.5	0.741
Maximum = 48
Social self-perceptions	19.8 ± 3.2	19.6 ± 3.5	19.9 ± 3.5	0.679
Maximum = 28

Data represented as mean ± SD.

Maximum is the maximum possible score that can be attained in the DREEM questionnaire domains.

*One-way ANOVA.

Table 3.  DREEM Scores by geographical teaching sites

	Tertiary hospital	Tertiary/ second. hospital^a	Rural sites (small)^b	Rural sites (large)^c	p-value*
Total score	148.8 ± 18.1	151.9 ± 16.6	141.9 ± 18.9	148.9 ± 22.8	0.291
Maximum = 200	(74%)	(76%)	(71%)	(75%)
Perceptions of learning	36.7 ± 5.2	37.2 ± 5.0	34.4 ± 7.0	36.9 ± 6.4	0.334
Maximum = 48	(77%)	(78%)	(72%)	(77%)
Perceptions of teaching	34.7 ± 4.3	35 ± 4.1	34.2 ± 4.7	35.6 ± 4.2	0.819
Maximum = 44	(79%)	(80%)	(78%)	(81%)
Academic self-perceptions	21.6 ± 3.6	22.9 ± 2.8	20.5 ± 4.0	21.1 ± 4.9	0.071
Maximum = 32	(69%)	(72%)	(64%)	(66%)
Perceptions of atmosphere	36.3 ± 4.7	36.8 ± 4.7	33.2 ± 4.4	35.2 ± 8.8	0.085
Maximum = 48	(76%)	(76%)	(69%)	(73%)
Social self-perceptions	19.5 ± 3.3	20.2 ± 3.2	19.7 ± 3.3	20.1 ± 2.9	0.714
Maximum = 28	(70%)	(72%)	(70%)	(72%)

Data represented as mean ± SD. The mean in also represented as 9% of the maximum score.

Maximum is the maximum possible score that can be attained in the DREEM questionnaire domains.

*One-way ANOVA.

^aTertiary hospital with placement at a secondary metropolitan hospital (4 weeks).

^bRural clinical school sites < 25000 population.

^cRural clinical school sites > 25000 population.

Table 4.  DREEM scores by binarised^a obstetrics and gynaecology examination results (written examination, clinical total marks)

	Written examination			Clinical examination			Total mark
	Low^b	High^c	p-value	Low^b	High^c	p-value	Low^b	High^c	p value*
Total score	146.8 ± 18.1	151 ± 18.2	0.142	144.1 ± 18.3	153.6 ± 17.1	0.001	144.7 ± 18.7	152.7 ± 17.5	0.006
Maximum = 200
Perceptions of learning	35.9 ± 5.9	37.3 ± 5.0	0.127	35.1 ± 5.7	38 ± 4.9	0.001	35.5 ± 5.9	37.6 ± 4.9	0.017
Maximum = 48
Perceptions of teaching	34.5 ± 4.6	35.1 ± 3.9	0.359	34.1 ± 4.5	38 ± 4.9	0.034	34.1 ± 4.7	35.3 ± 3.6	0.091
Maximum = 44
Academic self-perceptions	21.5 ± 3.8	22.1 ± 3.4	0.320	21 ± 3.6	22.6 ± 3.4	0.004	21.1 ± 3.7	22.4 ± 3.5	0.024
Maximum = 32
Perceptions of atmosphere	35.4 ± 4.8	36.6 ± 5.6	0.174	35 ± 4.8	36.9 ± 5.4	0.023	35.1 ± 4.6	36.8 ± 5.6	0.034
Maximum = 48
Social self-perceptions	19.5 ± 3.4	20.1 ± 3.1	0.238	18.9 ± 3.3	20.6 ± 2.9	0.001	18.9 ± 3.5	20.6 ± 2.9	0.001
Maximum = 28

Data represented as mean ± SD.

^abinarised on median.

^bLow mark < median; ^cHigh mark ≥ median.

*Independent samples t-test.

Table 5.  Linear regression showing prediction of 5th year obstetrics and gynaecology examination marks using DREEM scores^a

	Written examination		Clinical examination		Total marks
	R^2*	p-value**	R^2*	p-value**	R^2*	p-value**
DREEM score	0.027	0.069	0.070	0.003	0.060	0.006
Perception of learning	0.041	0.025	0.061	0.006	0.068	0.003
Perception of teaching	0.010	0.273	0.037	0.034	0.027	0.068
Academic self-perception	0.002	0.609	0.025	0.079	0.013	0.215
Perception of atmosphere	0.021	0.108	0.062	0.006	0.050	0.012
Social self-perception	0.027	0.069	0.059	0.007	0.055	0.009

^aadjusting for TER mark.

*R² represents proportion of variation in the model explained by the TER.

**p-value of predictor.