Abstract
Clinical clerks learn more than they are taught and not all they learn can be measured. As a result, curriculum leaders evaluate clinical educational environments. The quantitative Dundee Ready Environment Measure (DREEM) is a de facto standard for that purpose. Its 50 items and 5 subscales were developed by consensus. Reasoning that an instrument would perform best if it were underpinned by a clearly conceptualized link between environment and learning as well as psychometric evidence, we developed the mixed methods Manchester Clinical Placement Index (MCPI), eliminated redundant items, and published validity evidence for its 8 item and 2 subscale structure. Here, we set out to compare MCPI with DREEM. 104 students on full-time clinical placements completed both measures three times during a single academic year. There was good agreement and at least as good discrimination between placements with the smaller MCPI. Total MCPI scores and the mean score of its 5-item learning environment subscale allowed ten raters to distinguish between the quality of educational environments. Twenty raters were needed for the 3-item MCPI training subscale and the DREEM scale and its subscales. MCPI compares favourably with DREEM in that one-sixth the number of items perform at least as well psychometrically, it provides formative free text data, and it is founded on the widely shared assumption that communities of practice make good learning environments.
Similar content being viewed by others
References
Dent, J., & Harden, R. M. (2013). A practical guide for medical teachers (4th ed.). London: Churchill Livingstone.
Dornan, T., Boshuizen, H., King, N., & Scherpbier, A. (2007). Experience-based learning: A model linking the processes and outcomes of medical students’ workplace learning. Medical Education, 41(1), 84–91.
Dornan, T., Muijtjens, A., Graham, J., Scherpbier, A., & Boshuizen, H. (2012). Manchester Clinical Placement Index (MCPI). Conditions for medical students’ learning in hospital and community placements. Advances in Health Sciences Education, 17(5), 703–716.
Dornan, T., Tan, N., Boshuizen, H., Gick, R., Isba, R., Mann, K., Scherpbier, A., Spencer, J., & Timmins, E. (2014). How and what do medical students learn in clerkships? Experience based learning (ExBL). Advances in Health Sciences Education, 19(5), 721–749.
Genn, J. (2001). AMEE Medical Education Guide No. 23 (Part 1): Curriculum, environment, climate, quality and change in medical education—a unifying perspective. Medical Teacher, 23(4), 337–344.
Gracey, C. F., Haidet, P., Branch, W. T., Weissmann, P., Kern, D. E., Mitchell, G., & Inui, T. (2005). Precepting humanism: Strategies for fostering the human dimensions of care in ambulatory settings. Academic Medicine, 80(1), 21–28.
Graham, J., & Dornan, T. (2013). Power in clinical teachers’ discourses of a curriculum-in-action. Critical discourse analysis. Advances in Health Sciences Education, 18(5), 975–985.
Könings, K., Brand-Gruwel, S., & Merrienboer, J. J. G. (2005). Towards more powerful learning environments through combining the perspectives of designers, teachers, and students. British Journal of Educational Psychology, 75(4), 645–660.
Lave, J., & Wenger, E. (1991). Situated learning: Legitimate peripheral participation. Cambridge: Cambridge University Press.
Liaison Committee on Medical Education Accreditation standards from http://www.lcme.org/ (Accessed June 4, 2014).
Mayya, S., & Roff, S. (2004). Students’ perceptions of educational environment: A comparison of academic achievers and under-achievers at Kasturba Medical College, India. Education for Health, 17, 280–291.
Miles, S., Swift, L., & Leinster, S. J. (2012). The Dundee Ready Education Environment Measure (DREEM): A review of its adoption and use. Medical Teacher, 34(9), e620–e634.
Moyer, C. A., Arnold, L., Quaintance, J., Braddock, C., Spickard, A, I. I. I., Wilson, D., et al. (2010). What factors create a humanistic doctor? A nationwide survey of fourth-year medical students. Academic Medicine, 85(11), 1800–1807.
Roff, S., McAleer, S., Harden, R. M., Al-Qahtani, M., Ahmed, A. U., Deza, H., et al. (1997). Development and validation of the Dundee ready education environment measure (DREEM). Medical Teacher, 19(4), 295–299.
Schönrock-Adema, J., Bouwkamp-Timmer, T., van Hell, E. A., & Cohen-Schotanus, J. (2012). Key elements in assessing the educational environment: Where is the theory? Advances in Health Sciences Education, 17(5), 727–742.
Shochet, R. B., Colbert-Getz, J. M., Levine, R. B., & Wright, S. M. (2013). Gauging events that influence students’ perceptions of the medical school learning environment: Findings from one institution. Academic Medicine, 88(2), 246–252.
Soemantri, D., Herrera, C., & Riquelme, A. (2010). Measuring the educational environment in health professions studies: A systematic review. Medical Teacher, 32(12), 947–952.
Van der Zwet, J., Zwietering, P., Teunissen, P., van der Vleuten, C., & Scherpbier, A. (2011). Workplace learning from a socio-cultural perspective: Creating developmental space during the general practice clerkship. Advances in Health Sciences Education, 16(3), 359–373.
Wayne, S., Fortner, S., Kitzes, J., Timm, C., & Kalishman, S. (2013). Cause or effect? The relationship between student perception of the medical school learning environment and academic performance on USMLE Step 1. Medical Teacher, 35(5), 376–380.
Wenger, E. (1998). Communities of practice: Learning, meaning, and identity. Cambridge: Cambridge University Press.
World Federation of Medical Education. (2012). Basic Medical Education WFME Global Standards for Quality Improvement. WFME Office, University of Copenhagen, Denmark. http://www.wfme.org/standards/bme (Accessed June 18, 2014).
Acknowledgments
Thank you to our students who so diligently completed their forms! Also to Ms. Colette Spicer and Ms. Anne Burke, Medical School Office for administrative support.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kelly, M., Bennett, D., Muijtjens, A. et al. Can less be more? Comparison of an 8-item placement quality measure with the 50-item Dundee Ready Educational Environment Measure (DREEM). Adv in Health Sci Educ 20, 1027–1032 (2015). https://doi.org/10.1007/s10459-015-9582-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10459-015-9582-4