Assessment of the education environment of senior medical students at the University of the Free State, Bloemfontein, South Africa

Background. The education environment (EE) of a medical school plays a critical role in the learning of its students. The learner, other learners, teachers and the physical environment (campus and hospitals) influence the EE. In addition to recommendations of the Health Professions Council of South Africa (HPCSA) to revise the clinical training platform, staff and senior medical students occasionally experienced the EE in the clinical departments to be challenging. Objective. To assess the perceived EE in clinical departments at the University of the Free State, Bloemfontein, South Africa, among the 2012 fourthand fifth-year medical students. Differences in perceived EE scores between different demographic groups were also assessed. Method. Only the departments where students rotated in both their fourth and fifth years (Obstetrics and Gynaecology, General Surgery, Paediatrics and Neonatology, Internal Medicine, and Psychiatry) were assessed. The Dundee Ready Education Environment Measure (DREEM) questionnaire was contextualised for each department and distributed among fourth-and fifth-year medical students. Questionnaires were self-administered and participation was voluntary. Differences among demographic groups and departments were assessed using the Mann-Whitney U-test and KruskalWallis test (p<0.05). Results. The overall response rate was 87.7%. The overall median DREEM combined score for the departments was 137/200. Paediatrics and Neonatology was consistently top-rated, whereas Obstetrics and Gynaecology consistently received the lowest rating in all domains and subscale analyses. There were few significant differences between the DREEM scores of demographic groups. Conclusion. The overall EE in the clinical departments was mostly positive, although concerns were raised regarding some departments.