Background: There is a need to evaluate
perceptions of the educational environment of training institutions for health professionals as part of
any assessment of quality standards for education. The Dundee Ready Education
Environment Measure (DREEM) is a widely used tool for evaluating the
educational environment of medical and other health schools. However, methods
of analysis reported in the published DREEM literature are inconsistent which
could lead to misinterpretation of areas for change and, additionally, this
makes comparison between institutions difficult. Those involved in course
evaluation are usually not statisticians and there are no guidelines on DREEM’s
reporting or statistical analysis. This paper aims to clarify the choice of
methods for the analysis of the DREEM.Method: The statistical literature, typical properties of DREEM data and the results from a series of statistical simulations were used
to inform our recommendations. Results: We provide a set of guidelines for the
analysis and reporting of the DREEM. In particular, we provide evidence that
when comparing independent samples of Likert response data similar to that
generated by the DREEM, the non-parametric Wilcoxon Mann Whitney test performs well. Further, one should
be wary of using non-parametric methods on matched samples of such data as they
may be overly ready to reject null hypothesis. Conclusions: Our recommendations
have the potential to improve the accuracy and consistency with which the
inadequacies in the medical school environment can be identified and assess the
success of any changes. They should also facilitate comparison between
different institutions using the DREEM.
Cite this paper
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