Perceptions of medical students regarding educational climate at different phases of medical training in a Malaysian medical school

Abstract

Introduction: Medical and allied health educators around the globe agreed that an optimal educational climate is a vital aspect for effective learning to take place. Without a doubt, appraisal of the educational climate has been emphasized as a key to the delivery of high quality medical education. In addition, the appraisal provides useful feedback to particular institution to improve their curriculum. Objective: This study was employed as part of the School of Medical Sciences (SMS) Universiti Sains Malaysia curriculum review process. It aimed to explore the strengths and weaknesses of the current medical curriculum thus could provide useful information to guide the curriculum review committee during the review process. Method: A cross sectional study was conducted on a total of 656 medical students from the first, third and fifth year of study. Purposive sampling method was applied. DREEM was administered to the medical students to evaluate the educational climate in the studied medical school. Result: A total of 511 (77.9%) medical students completely responded to the 50 statements of DREEM. The mean global score across phases of medical training was 128.36/200. The global scores for year 1, year 3 and year 5 were 138.94/200, 122.27/200 and 125.49/200 respectively. Results showed that; 1) the medical school had reasonably level of educational climates across phases of medical training; 2) the medical teachers were knowledgeable and well prepared for the teaching; 3) the students were overloaded with factual knowledge; 4) the medical teachers were quite harsh to students during teaching session especially in clinical phase; 5) students experienced a significant amount of stress that led to poor memory; 6) the learning process was inclined toward teacher-centered rather than student-centered learning; 7) students had a considerable healthy social relationships with peers as well as others; and 8) academic dishonesty became more apparent in the clinical phase. Conclusion: The medical school's educational environment across different phases of study was more positive than negative. However, there are plenty of rooms for improvement as perceived by the medical students. The medical school should address various important issues highlighted in this article during the curriculum review process.

Rethinking Education Environment: The Clinical Education Environment Framework

“…The participants also accentuated the importance of having nurturing education environment during teaching. These are consistent with the previous study in this institution that showed clinical year students' rating is lowest in DREEM items "the teachers are authoritarian", "the teachers get angry in teaching" and "the students irritate the teachers" as compared to the younger batches (11).…”

“…Growing evidence shows an alarming trend of declining positive perception among clinical medical students towards the clinical education environment during medical training. The findings were consistent across different educational settings suggesting a universal struggle shared by most of medical students (3,(11)(12)(13). It was proposed that in clinical years, medical students are exposed to hidden curriculum, whereby they observed conflicting values in doctor-patient relationship, mistreatment to students and junior staffs and feeling unimportant in the workplace learning (3,12,14).…”

“…It measures five aspects of education environment that are students' perception of learning, teaching, academic, atmosphere, and social elements (19). Nevertheless, given the limited validity evidence for the elements of existing educational environment tools, an educational environment framework may be needed as a guide to assess learners' perceptions of the relevant educational environment elements (11,16,20). This paper reported the findings on desirable education environment as experienced by clinical medical students in a medical school.…”

Anatomy education environment measurement inventory: A valid tool to measure the anatomy learning environment

“…There are many instruments available to measure the educational environment (Roff et al, ; Fraser, ; Chan, ). For instance, the educational environment related to the medical and allied health sciences field is commonly evaluated using the Dundee Ready Educational Environment Measure (DREEM; Roff et al, ; Al‐Hazimi et al, ; Varma et al, ; Arzuman et al, ; Yusoff et al, ). Although the DREEM has profound psychometric credentials established across different cohorts of undergraduate students of medical and allied health sciences, however, the items in DREEM reflect general construct of educational environment, and thus they may not cover certain important factors of the educational environment in a specific discipline.…”

The Impact of Learning Environment, Age, Gender, and Duration of Clinical Rotation to Quality of Life of Medical Students

“…Clinical stage education is very likely to cause stress on students, because at that stage students are faced directly with the patient, having responsibility for being directly involved in patient care. Other research stated that the source of stress in the clinical stage students is clinical lecturers who on average act violently towards students [4]. Research conducted by Henning et al on fourth-year medical students also stated the same thing about quality of life.…”