Dear Sir
The Dundee Ready Educational Environment Measure (DREEM) is widely used to evaluate educational environment across healthcare settings (Roff et al. Citation1997). The time at which the questionnaire is administered during the academic year varies greatly in published studies and the original authors do not advise in this regard. We suggest that the timing of administration of the DREEM may affect results.
All year 3 students (n = 108) in our undergraduate medical program completed the DREEM at the end of each of the three clinical attachments (n = 324). At any one time, over a four-month period, an identical number of students are deployed in secondary, tertiary and general practice sites for 4 weeks. Clinical attachments are described as Attachments 1, 2 and 3, referring to their temporal order. Within each of these attachments, DREEM scores represent the educational environment at an identical mix of sites. Differences on DREEM score between Attachments 1, 2 and 3 would not be expected.
Mean total DREEM scores varied significantly between first, second and third attachments (p < 0.01). The score rose from the first to the second attachment but fell back in the third attachment to a level below the original score. Significant differences in Perceptions of Learning, Atmosphere and Teachers were found reflecting the same pattern as the total score (p < 0.05). This effect appeared to be related to duration of clinical exposure as mean scores did not vary when analysed by calendar month.
Fluctuation in student motivation may underlie these findings through its effect on beliefs about learning and perception of learning environment. Motivation has been found to decline over the course of one academic year of profession-oriented education (Braten & Olaussen Citation2005).
We found that DREEM scores for identical attachments can vary to a statistically significant level over time in the course of a single academic year. This has not been reported elsewhere. We suggest that colleagues consider this, as it may be of importance when interpreting and comparing DREEM studies.
Deirdre Bennett, Martina Kelly & Siun O’Flynn, Medical Education Unit, School of Medicine, University College Cork, Ireland. Email: [email protected]
References
- Braten I, Olaussen B. Profiling individual differences in student motivation: A longitudinal cluster-analytic study in different academic contexts. Contemp Educ Psychol 2005; 30: 359–396
- Roff S, McAleer S, Harden RM, Al-Qahtani M, Ahmed AU, Deza H, Groenen G, Primparyon P. 1997. Development and validation of the Dundee Ready Educational Environment Measure (DREEM). Med Teach 19(4):295–299.