The Dundee Ready Education Environment Measure (DREEM): Perception of educational environment and its impact on academic performance of medical, dental and pharmacy students

  • Syed Muhammad Mubeen Hamdard
Keywords: Education, Students, Environment, University



Objective: To assess the perceptions of health professional students to educational environment and to ascertain differences among gender and faculties. The study also assesses the internal consistency of DREEM questionnaire of health profession students.

Methods: A cross sectional, institutional based study was done during March to June 2017 among students of health professions of faculty of medicine and faculty of pharmacy at Hamdard University, Karachi.  Using proportionate quota sampling technique, DREEM questionnaire was administered to both medical and pharmacy undergraduate students.  Data was analysed by SPSS version 22.  Descriptive statistics was used to calculate mean with standard deviation of overall DREEM and its five subscales.  Independent sample t-test was used to identify gender and faculty related differences between perception of educational environment.  Cronbach’s alpha was also calculated to test the reliability of DREEM questionnaire.

Results: Out of 6oo students, fifty percent were selected from each faculty in which 327 (54.5%) were male students. Total mean score of DREEM was 130.1/200 (65%).  Student’s academic self-perception domain got the highest score (97.1%) and the lowest score in students’ perceptions of atmosphere (47.7%).  Statistically significant differences (P < 0.05) was found between student’s social self-perception and gender.  A high level of reliability was found for the total DREEM inventory with an alpha coefficient of 0.82.

Conclusion: More positive than negative educational environment of the university was found with no differences among medical and pharmacy students. 


1. Warger T, EduServe, Dobbin G. Learning environments: where space, technology and culture converge. [Online] 2009 [Cited 2017 January 15]. Available from:URL:
2. Lizzio A, Wilson K, Simons R. University students’ perceptions of the learning environment and academic outcomes: Implications for theory and practice. Stud Higher Educ 2002;27:27 52.
3. Genn JM. Curriculum, environment, climate, quality and change in medical education: a unifying perspective. In: Genn JM, ed. Curriculum, environment, climate, quality and change in medical education: a unifying perspective. AMEE Education Guide No 23. Dundee: Association for Medical Education in Europe; 2001 pp 7-28.
4. Genn JM. AMEE Medical Education Guide No. 23 (Part 1): Curriculum, environment, climate, quality and change in medical education a unifying perspective. Med Teach 2001;23:337 44.
5. Roff S, McAleer S, Skinner A. Development and validation of an instrument to measure the postgraduate clinical learning and teaching educational environment for hospital based junior doctors in the UK. Med Teach 2005; 27: 326-31.
6. Keitz SA, Holland GJ, Melander EH, Bosworth HB, Pincus SH. VA learner's perception survey. The foundation of educational quality improvement. Acad Med 2003; 78: 910-7.
7. Roff S, McAleer S, Harden R, Al Qahtani M, Ahmed AU, Deza H, et al. Development and validation of the Dundee Ready Education Environment Measure (DREEM). Med Teach 1997;19:295 9.
8. MayyaSS, Roff S. Students' Perceptions of Educational Environment: A Comparison of Academic Achievers and Under-Achievers at Kasturba Medical College, India. Educ Health 2004;17:280-91.
9. Jawaid M, Raheel S, Ahmad F, Aijaz H. Student's perception of educational environment at Public Sector Medical University of Pakistan. J Res Med Sci 2013; 18: 417-21.
10. Roff S. The Dundee Ready Education Environment Measure (DREEM)–a generic instrument for measuring students’ perceptions of undergraduate health professions curricula. Med Teach 2005;27:322 5.
11. Al Hazimi A, Zaini R, Al Hyiani A, Hassan N, Gunaid A, Ponnamperuma G, et al. Educational environment in traditional and innovative medical schools: A study in four undergraduate medical schools. Educ Health (Abingdon) 2004;17:192 203.
12. Soemantri D, Herrera C, Riquelme A. Measuring the educational environment in health professions studies: a systematic review. Med Teach. 2010 Dec 1;32(12):947-52.
13. Hammond SM, O'Rourke M, Kelly M, Bennett D, O'Flynn S. A psychometric appraisal of the DREEM. BMC Med Educ. 2012;12(1):2.
14. Irum S, Iqbal MZ, Naumeri F. Perception of medical students regarding educational environment in a public sector medical college: A cross-sectional survey using the Dundee Ready Education Environment Measure questionnaire. Annals of King Edward Medical University. 2018;24(1).
15. Khan JS, Tabasum S, Yousafzai UK, Fatima M. DREEM on: validation of the Dundee Ready Education Environment Measure in Pakistan. J Pak Med Assoc. 2011;61(9):885-8.
16. Rehman R, Ghias K, Fatima SS, Hussain M, Alam F. Dream of a conducive learning environment: One DREEM for all medical students!. J Pak Med Assoc. 2017;67(1):7-11.
17. Nouh T, Anil S, Alanazi A, Al-Shehri W, Alfaisal N, Alfaris B, Alamer E. Assessing correlation between students’ perception of the learning environment and their academic performance. J Pak Med Assoc. 2016;66(12):1616-1620.
18. Tontuş HÖ. DREEM; dreams of the educational environment as its effect on education result of 11 Medical Faculties of Turkey. J Exp Clin Med. 2010;27(3):104-8.
19. Nahar N, Talukder MH, Khan MT, Mohammad S, Nargis T. Students' perception of educational environment of medical colleges in Bangladesh. BSMMU J. 2010;3(2):97-102.
20. Lokuhetty MD, Warnakulasuriya SP, Perera RI, De Silva HT, Wijesinghe HD. Students’ perception of the educational environment in a Medical Faculty with an innovative curriculum in Sri Lanka. South East Asian J Med Educ 2010;4:9-16
21. Imran N, Khalid F, Haider II, Jawaid M, Irfan M, Mahmood A, et al. Student's perceptions of educational environment across multiple undergraduate medical institutions in Pakistan using DREEM inventory. J Pak Med Assoc. 2015;65:24-8.
22. Kossioni AE, Varela R, Ekonomu I, Lyrakos G, Dimoliatis ID. Students’ perceptions of the educational environment in a Greek Dental School, as measured by DREEM. Eur J Dent Educ. 2012;16(1):e73-8.
23. Thomas BS, Abraham RR, Alexander M, Ramnarayan K. Students’ perceptions regarding educational environment in an Indian dental school. Med Teach. 2009;31(5):e185-8.
24. Brown T, Williams B, Lynch M. The Australian DREEM: evaluating student perceptions of academic learning environments within eight health science courses. Int J Med Educ. 2011;2:94.
25. Rahman NI, Aziz AA, Zulkifli Z, Haj MA, Mohd Nasir FH, Pergalathan S et al. Perceptions of students in different phases of medical education of the educational environment: Universiti Sultan Zainal Abidin. Adv Med Educ Pract. 2015;6:211-22.
26. Streiner DL, Norman GR, Cairney J. Health measurement scales: A practical guide to their development and use. Oxford University Press, USA; 2015.
27. Riquelme A, Oporto M, Oporto J, Mendez JI, Viviani P, Salech F et al. Measuring students' perceptions of the educational climate of the new curriculum at the pontificia universidad catσlica de chile: Performance of the Spanish translation of the Dundee Ready Education Environment Measure (DREEM). Education for Health. 2009 May 1;22(1):112.
28. de Oliveira Filho GR, Vieira JE, Schonhorst L. Psychometric properties of the Dundee Ready Educational Environment Measure (DREEM) applied to medical residents. Med Teach. 2005;27(4):343-7.