DREEM on: validation of the Dundee Ready Education Environment Measure in Pakistan.

OBJECTIVES: To validate DREEM in medical education environment of Punjab, Pakistan. METHODS: The DREEM questionnaire was anonymously collected from Final year Baccalaureate of Medicine; Baccalaureate of Surgery students in the private and public medical colleges affiliated with the University of Health Sciences, Lahore. Data was analyzed using Principal Component Analysis with Varimax Rotation. RESULTS: The response rate was 84.14 %. The average DREEM score was 125. Confirmatory and Exploratory Factor Analysis was applied under the conditions of eigenvalues >1 and loadings > or = 0.3. In CONFIRMATORY FACTOR ANALYSIS, Five components were extracted accounting for 40.10% of variance and in EXPLORATORY FACTOR ANALYSIS, Ten components were extracted accounting for 52.33% of variance. Total 50 items had internal consistency reliability of 0.91 (Cronbach's Alpha). The value of Spearman-Brown was 0.868 showing the reliability of the analysis. In both analyses the subscales produced were sensible but the mismatch from the original was largely due to the English-Pakistan contextual and cultural differences. CONCLUSION: DREEM is a generic instrument that will do well with regional modifications to suit individual, contextual and cultural settings.

Determination of medical education environment in Punjab private and public medical colleges affiliated with University of Health Sciences, Lahore-Pakistan.

BACKGROUND: The main purpose of this study was to identify differences, if any, in the Medical Education Climate between the Private and Public Medical Colleges in the Province of Punjab affiliated with the University of Health Sciences, Lahore and to gather recommendations from students on measures that need to be taken to improve the environment. METHODS: This Mixed Quantitative and Qualitative Prospective Study was conducted in 2008. The population of the study consisted of 1612 MBBS Final Year Medical Students of both Private and Public Medical Colleges. Stratified Random Sampling was done to ensure representation of both Sectors. Dundee Ready Education Environment Measure (DREEM) was used to assimilate Quantitative Data and a Questionnaire consisting of 10 items was used to accumulate Qualitative Data. To analyse Quantitative Data, t-test and Chi-square tests were used. Common themes were identified in the Qualitative Data. RESULTS: All the SIX Research Hypotheses were rejected and Null Hypotheses were upheld. Analysis of Qualitative Data indicated a number of Examination, Curriculum, Teaching Methodology, Teacher and Peer related Stressors without discrimination in students of both Private and Public Sectors. Solutions by students focused on improving co-ordination between Institutions and University of Health Sciences as well as developing and delivering Clinically-Centred, Community-Oriented and Problem-Based Education through development of appropriate Teaching Methodologies. CONCLUSIONS: Even though there is no difference in the Medical Education Climate between the Private and Public Medical Education Sectors, the Environment is less than Ideal. However, this can be improved through shifting the onus of Education from Teacher-Centred Didactic Approach to a more Student-Centred Self-Learning Strategy. In this paradigm shift the UHS, Lahore needs to play a pivotal role in order to effectively train the Trainers and standardise this change throughout Punjab.