Student Perceptions of the Educational Environment at the University of Nebraska Medical Center Department of Pediatrics

Background: During clinic training in medical school, the learning environment plays a pivotal role in molding medical student's behavior. A systematic assessment of patient care learning environments needs to be conducted. With two medical schools utilizing limited pediatric patient base, student evaluations indicated dissatisfaction with inpatient and general clinic experiences. Objectives: The objective of this study was to generate a profile of clinic and inpatient strengths and weaknesses. This study received exempt approval. Patients and Methods: The Dundee Ready Education Environment Measure (DREEM) questionnaire was administered to students over the course of 3 academic years after inpatient and clinic assignments (2-week deployments each) in the 8-week clerkship. DREEM identifies student academic self-perceptions, perceptions of teachers, and perceptions of the educational atmosphere. Fifty questions are rated from 4 = strongly agree to 0 = strongly disagree for a total of 200. Anonymous responses were grouped by assignment and analyzed using Kruskal-Wallis test. Participants were asked for up to 3 suggestions to improve the rotation. An immersion/crystallization framework was used to identify themes. Two authors independently coded suggestions, and then discussed the themes to reach a consensus. Results: Overall results from DREEM indicated students' perceptions were positive for different learning environments. No statistical differences were noted between subscales. Thematic analysis identified concerns with scheduling, lack of teaching, and non-specific feedback. Conclusions: DREEM did not identify measurable deficiencies in the learning environment. However, thematic analysis uncovered specific issues that are currently being addressed.