The Analysis and Reporting of the Dundee Ready Education Environment Measure (DREEM): Some Informed Guidelines for Evaluators

Abstract

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.