Educational Environment: Students’ Perceptions Using the Dundee Ready Educational Environment Measure Inventory

INTRODUCTION

A learning environment is any setting, situation, or cultural context in which students learn. It includes a college’s or a class’s prevailing ethos and characteristics.^[1-3] It includes students’ interactions and treatment of each other, and how teachers create a conducive learning environment.^[4-7] A learning environment includes all activities that take place in the department, faculty, or university.^[8-10] It includes activities in both the classroom and the college setting. A college’s rules, governance structure, and other elements could also be considered components of a learning environment, as a variety of circumstances determine the quality of a learning environment.^[11,12-16] The educational environment plays a crucial role in the success of a curriculum and the academic achievement of students.^[17-19] The educational environment affects the quality of the curriculum, teaching methods, learning, and the development of student achievement as a professional.^[20-23] The undergraduate students’ learning path is long. Their preparation for university life is physical, mental, social, and financial. They discover new skills needed to progress.^[24-26] An institute’s educational environment plays a critical role in its success or failure. A new environment is introduced to students on their first day.^[5,8-10] When considering a new educational institution, students and parents should research the quality of classrooms, campuses, teachers, infrastructure, learning resources, extracurricular activities, and social climate, all of which contribute significantly to the learning experience. The institution should provide a curriculum suited to students’ needs in an optimal learning setting. Published data are scarce on this topic, particularly from our region. This gap prompted us to explore students’ perceptions of the educational environment at our healthcare institutions. Studies on specific student groups, like nursing, medical, or allied health students, without comparing across disciplines, may limit the generalisability of the findings. So, this study highlights the comparative analysis across different healthcare professions and distinctions perceived by the students regarding educational environments. These findings will assist stakeholders and policymakers in identifying areas for improvement and implementing necessary changes accordingly.

MATERIAL AND METHODS

This study employed a quantitative research design using a descriptive cross-sectional approach. The sample comprised 370 undergraduate students currently enrolled at a selected health science institution in Mangalore. Participants were selected through stratified proportionate random sampling. The population was divided into strata based on their educational program: Bachelor of Medicine, Bachelor of Science (MBBS), Basic Bachelor of Science in Nursing and Physiotherapy (B.Sc. Nursing and Physiotherapy), and year of study. Proportionate allocation was applied to determine the sample size for each stratum. Random sampling within each stratum was performed using a random number generator to ensure unbiased participant selection. A 5% confidence level (Z = 1.96), an estimated proportion (p) of 0.5 (maximum variability), and a margin of error of 0.05 were used to calculate the required sample size of 278.52, rounded up to 279. The study power was set at 80%. However, due to the exclusion of nine incomplete questionnaires, data from a total of 370 subjects were included in the final analysis. The inclusion criteria encompassed students enrolled in the B.Sc. Nursing (n=124), Bachelor of Physiotherapy (n=124), and MBBS (n=122) degree programs. Students in diploma programs and those undergoing internships were excluded from the study.

The data collection instrument for the study consisted of two components: the DREEM inventory questionnaire^[27] and a demographic proforma, with permission obtained from the relevant authority. The reliability of the instrument, assessed through internal consistency using Cronbach’s alpha coefficient, was calculated to be 0.88, indicating satisfactory reliability for use in the study setting. Formal approval to conduct the study was obtained from the head of the institution prior to data collection. Ethical clearance was granted by the Institutional Ethics Committee on 19th December 2023, with protocol number FMIEC-592/2023. Informed consent was obtained from all participants, and data collection took place between January 27th and January 31st, 2024.

Before data collection, participants were informed about the study’s purpose, and any questions or concerns they had regarding their participation were addressed. After receiving permission from the senior lecturer of the class, the researcher distributed the questionnaire to the students, who were given 10-15 minutes to complete it. The students were instructed not to discuss the questionnaire with others to avoid bias and ensure timely completion before returning it to the researcher.

RESULTS

Data was collected from 370 undergraduate students about students’ perceptions of the learning environment. The study revealed that 52% of subjects were between the age group of 17 to 20 years, and the mean age was 19±0.6, and more than half of the subjects were female (77.6%). Out of the total subjects, 34% of subjects were studying BPT, 33.5% of subjects were studying MBBS, and 33.5 % were studying nursing. An equal number of students (24.9%) were in their 1^st and 2^nd year, and 25.1% were in third and fourth years. The majority (70.90%) of subjects were residing in the hostel. All students (100%) were from India. Nearly half (48.90%) of the study subjects had a monthly income ≤ 50000/-.

The item-wise students’ perception of the educational environment, the mean score for 34 items ranging between 2.1-3, is one of the aspects of learning that needs improvement. With nine questions having a mean of greater than 3.1 and 3.5 considered as a positive aspect of their educational environment, and seven items with a mean of < 2 are factors that should be examined more closely as they signify problem areas. The highest-rated questions were “I am encouraged to participate in class,” with a score of 3.40±0.675, and “the teachers are knowledgeable,” with a score of 3.37±0.634 (see [Table 1] for detailed data).

Program-wise comparison of DREEM total score and subscale score among Nursing, Physiotherapy, and MBBS students, Total median (IQR) scores for Nursing students, Physiotherapy, and MBBS students, perception of their learning environment were 129, 126, and 130, respectively [Figure 1]. This revealed that the undergraduate students’ perceptions of their learning environment in the three programs were also “more positive than negative.” There was no significant difference between the programs in terms of their total DREEM score, P=0.083. [Figure 1].

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Figure 1:

Comparison of DREEM score across the programs for different domains. Bar diagram shows the total subjects(n-370) according to the different categories of the five DREEM domains; SPL: Student’s perception of learning, SPT: Student’s perception of teachers, SASP: Student’s academic self perception, SPA: Student’s perception of atmosphere, SSSP: Student’s social self perceptions, and the total DREEM score. Note: Median is reported; Statistical test used: ‡Kruskal Wallis test; P value <0.05 is considered statistically significant. DREEM: Dundee Ready Educational Environment Measure.

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With respect to the DREEM subscale median score, SPL: Scores were similar across all programs, with a median of 33 [Figure 1] and no significant differences in student perception of the learning process. However, it was found that students’ perception of learning was a “more positive approach.”

SPT: BPT and MBBS students score slightly higher (median 27) compared to B.Sc. Nursing (median 25) [Figure 1]. It indicates students’ perceptions of teachers about moving in the right direction. The difference was statistically significant (p = 0.0001), indicating varied perceptions of teacher effectiveness.

SASP: B.Sc. Nursing students score higher (median 24), followed by BPT (22) and MBBS (21) [Figure 1]. The significant p-value (0.0001) suggests that B.Sc. nursing students have a stronger academic perception. However, across the programs, the academic self-perception was more on the positive side.

SPA: MBBS students score highest (median 32), while BPT students have the lowest score (median 29) [Figure 1]. Their perception of the atmosphere was a more positive atmosphere. There was a significant difference in this domain between the three programs (p = 0.000).

SSSP: Scores were similar across programs (median: 17) [Figure 1], with no significant differences, suggesting uniform social self-perception across disciplines. The SSSP was “not too bad” in three programs.

The year-wise comparison of DREEM scores among nursing students: The Kruskal Wallis test for a sample size of 124 revealed that the nursing student’s perceptions of their learning environment in all the years also were “more positive than negative” There was no (p > 0.05) significant difference between the year of study in terms of their total DREEM score and subscale scores. [Table 2].

The year-wise comparison of DREEM scores among BPT students: The ANOVA and Kruskal-Wallis test for a sample size of 124 revealed that the physiotherapy students’ perceptions of their learning environment in all the years were “more positive than negative” [Table 3]. There was a p<0.05 significant difference between the years of study in terms of their total DREEM score and subscale scores [Table 3].

The year-wise comparison of DREEM scores among MBBS students: The ANOVA and Kruskal-Wallis test for a sample size of 122 revealed that the MBBS students’ perceptions of their learning environment in all the years were “more positive than negative [Table 4]. There was no significant p>0.05 difference between the years of study in terms of their total DREEM score, while there was a significant p<0.05 difference between the years of study with subscale domain SPL (p =0.040), SPT (p=0.0001), and SPA (p=0.0001) [Table 4].

There was a statistically significant difference between SASP in terms of their gender (p= 0.032*) [Table 5].

There was a significant association between students’ perception of the learning environment and the type of program p=0.032*and the year of study p=0.042*

DISCUSSION

The discussion section justifies the results of the current study by integrating them with similar and contrasting findings from various investigations conducted in different academic and cultural settings. This approach helps contextualise the study results and provides a rationale for interpreting the findings.

The current study found that undergraduate students across three nursing programs generally perceived their learning environment as “more positive than negative,” with no statistically significant differences observed among the programs (p = 0.083). This outcome aligns with the findings from a study at Mansoura University, Egypt, which also reported a “more positive than negative” perception of the educational learning environment among paediatric and maternity nursing students. However, the Egyptian study revealed a statistically significant difference between these two groups (p = 0.01), unlike the present study.^[7] This study uniquely assessed nursing students’ perceptions in two distinct subspecialties (paediatric and maternity), providing valuable insights into discipline-specific learning environments. The identification of significant differences (t=2.6, p=0.01) between paediatric and maternity students reflects robust statistical comparisons that highlight subgroup variations.

Similarly, a study conducted in Nepal involving nursing students from two colleges affiliated with Kathmandu University reported comparable perceptions of the learning environment, characterised as “more positive than negative,” with mean scores exceeding 70% of the maximum possible DREEM score. While the Nepalese study provided a broader representation across institutions, the focus on year-wise differences was limited, unlike the more detailed exploration of program-specific perceptions in the current study.^[1] This study compared perceptions of the learning environment between two colleges, adding depth to its findings by addressing institutional differences. High mean DREEM scores for both colleges provided a solid basis for concluding a “more positive than negative” learning environment.

Conversely, studies conducted in physiotherapy and MBBS programs often highlight statistically significant differences based on academic year or program structure. For instance, physiotherapy students in India demonstrated significant year-wise variations in total and subscale DREEM scores, particularly among interns who reported the highest scores. Such findings suggest that differences in perceptions may emerge due to variations in curriculum, teaching methods, and clinical exposure across disciplines, emphasising the need for discipline-specific assessments.^[14]

A comparable outcome was observed in an observational and analytical study conducted to evaluate the educational environment perception among B.Sc. nursing students at a specific nursing college in the Ernakulam district. The study aimed to assess the perception of the educational environment among B.Sc. nursing students and compare it across different academic years (1^st, 2^nd, 3^rd, and 4^th). The findings revealed a total mean score of 121.48 with a standard deviation of 14.73, indicating that the educational environment could be characterised as “more positive than negative.”^[17] This study evaluated differences across academic years, providing insights into how perceptions of the learning environment evolve during a student’s educational journey. The detailed assessment of DREEM subscales (e.g., perception of learning, atmosphere) offers a nuanced understanding of students’ experiences.

However, perceptions of the learning environment for physiotherapy students in all years were generally characterised as “more positive than negative.” A statistically significant difference (p < 0.05) was observed between the different years of study concerning both their total DREEM score and subscale scores. The results align with a cross-sectional study conducted among 420 undergraduate Indian physiotherapy students. The overall DREEM score for this student population was 122.66 ± 17.39, indicating a more positive than negative educational environment within the institution. Notably, there was a statistically significant difference in the overall DREEM score (p = 0.000) based on the year of study, with interns exhibiting the highest mean score and significant differences noted between 1^st (p = 0.000), 2^nd years (p = 0.014), and 4^th years (p = 0.000).^[15] The strength of this study was the sample size, robust statistical power, and representation. Highlighting significant differences between years of study reflects a dynamic perception of the educational environment linked to progression through the program. The “more positive than negative” perception aligns with global trends, supporting the generalisability of findings.

In the examination of DREEM scores among MBBS students on a year-wise basis, a similar investigation was conducted to assess students’ perceptions of their learning environment within an Indian medical college that follows a traditional curriculum. The study aimed to explore potential differences among students based on their stages in medical education and various sub-domains of perception. Findings indicated that all semesters exhibited a more favourable perception of learning, with an average mean score of 29.44. Their perception of course organisers was deemed to be moving in the right direction, with an average mean score of 26.86. Academic self-perception leaned more towards the positive side, with an average mean score of 20.14. Additionally, they held a positive perception of the atmosphere, reflected in an average mean score of 29.07, and their social self-perception could be categorised as “not too bad,” with an average mean score of 17.02.^[2] The detailed exploration of domains like course organisers, academic self-perception, and social perception provides comprehensive insights into students’ experiences. By evaluating perceptions within a traditional curriculum, the study offers a valuable comparison for institutions with similar educational frameworks.

Contradictory findings were observed in the study reported from CMS, Chitwan; the participants’ age and year of enrolment showed no significant differences in the perception of the educational environment and its subscales (p>0.05). The only noteworthy difference was identified in the nature of accommodation, which demonstrated a significant impact on students’ perception of teachers (p=0.014).^[1] The study’s exploration of factors like age, year of enrolment, and accommodation adds depth to understanding external influences on educational perceptions.

The absence of significant differences in the current study contrasts with findings from studies in other healthcare disciplines, such as engineering and physiotherapy, which observed discipline-specific or year-wise variations. However, the consistent “more positive than negative” characterisation of the learning environment in the present study aligns with global trends reported in nursing education.

This integration of findings demonstrates the consistency of the study results with global research trends while also highlighting areas where discrepancies may arise due to institutional, cultural, or curricular differences. By aligning the current findings with both corroborative and contradictory evidence, the discussion effectively substantiates the study’s outcomes and underscores the broader implications for nursing education.

CONCLUSION

This investigation has offered valuable insights into how students perceive the “learning environment,” utilising the DREEM inventory. The findings of this DREEM study suggest that it is essential to establish a supportive atmosphere. The highest-rated question was “I am encouraged to participate in class, and the teachers are knowledgeable”. Both male and female students had different academic self-perceptions. These findings suggest a uniform perception of the educational environment across the three programs, highlighting that institutional factors and academic culture may contribute to a consistently positive learning experience for students. The lack of significant differences underscores the effectiveness of current teaching strategies and learning environments in fostering a supportive and engaging atmosphere across disciplines. Future research should explore factors influencing subscale scores and program-specific perceptions to identify targeted interventions for further enhancing the educational environment. Additionally, multi-institutional studies involving diverse academic and cultural settings can provide broader insights into the generalisability of these findings.