Junaid Sarfraz Khan, Saima Tabasum, Usman Khalil Yousafzai


Background: The main purpose of this study was to identify differences, if any, in the
Medical Education Climate between the Private and Public Medical Colleges in the Province
of Punjab affiliated with the University of Health Sciences, Lahore and to gather
recommendations from students on measures that need to be taken to improve the
environment. Methods: This Mixed Quantitative and Qualitative Prospective Study was
conducted in 2008. The population of the study consisted of 1612 MBBS Final Year Medical
Students of both Private and Public Medical Colleges. Stratified Random Sampling was done
to ensure representation of both Sectors. Dundee Ready Education Environment Measure
(DREEM) was used to assimilate Quantitative Data and a Questionnaire consisting of 10
items was used to accumulate Qualitative Data. To analyse Quantitative Data, t-test and Chisquare tests were used. Common themes were identified in the Qualitative Data. Results: All
the SIX Research Hypotheses were rejected and Null Hypotheses were upheld. Analysis of
Qualitative Data indicated a number of Examination, Curriculum, Teaching Methodology,
Teacher and Peer related Stressors without discrimination in students of both Private and
Public Sectors. Solutions by students focused on improving co-ordination between
Institutions and University of Health Sciences as well as developing and delivering
Clinically-Centred, Community-Oriented and Problem-Based Education through development
of appropriate Teaching Methodologies. Conclusions: Even though there is no difference in
the Medical Education Climate between the Private and Public Medical Education Sectors,
the Environment is less than Ideal. However, this can be improved through shifting the onus
of Education from Teacher-Centred Didactic Approach to a more Student-Centred SelfLearning Strategy. In this paradigm shift the UHS, Lahore needs to play a pivotal role in
order to effectively train the Trainers and standardise this change throughout Punjab.
Keywords: Medical Education Environment, Private Medical Sector, Public Medical Sector,
DREEM, Problem-based Education, MCAT, COME, PBL

Full Text:



Bansalrk. Private medical education takes off in India. Lancet


Khan AJ. Scope of medical colleges in private sector.

(Editorial) J Ayub Med Coll Abbottabad 2004;16:1–3.

Hoyt B. Public versus private: the medical resident

perspective. CMAJ 2005;11: 898-9.

Hansen MN. Private education and academic performance

among medical students. Tidsskr Nor Laegeforen


Hansen MN. Social background in recruitment of medical

students. Tidsskrift Nor Laegeforen 2005;25:2213–5.

Putnam CE. Reform and innovation: a repeating pattern

during a half-century of medical education in the USA. Med

Educ 2006;40:227–34.

Kumar S. Report highlights shortcomings in private medical

schools in India. BMJ 2004;328:70.

Crotty BJ. More students and less patients: the squeeze on

medical teaching resources. Med J Aust 2005;7:444–5.

Wheat Jr, Higginbotham JC, Yu J, Leeper JD. Physicians for

rural America: The role of institutional commitment within

academic medical centers. J Rural Health 2005;21:221–7.

Moos, R H. The social climate scales: A user's guide. Palo

Alto, CA: Consulting Psychologists Press; 1994.

Brekelmans, Wubbels, Levy M. Brekelmans, Wubbels and J.

Levy, Student performance, attitudes, instructional strategies

and teacher-communication style. In: Wubbels, Levy J.

(Editors) Do you know what you look like? London: The

Falmer Press; 1993.

Stern DT, Williams BC, Gill A, Gruppen LD, Woolliscroft

JO, Grum CM. Is there a relationship between attending

physicians’ and residents’ teaching skills and students’

examination scores? Acad Med 2000;75:1144–6.

Griffith CH, Wilson JF, Haist SA, Ramsbottom-Lucier M.

Do students who work with better house staff in their

medicine clerkships learn more? Acad Med 1998;73:S57–9.

Roop SA, Pangaro L. Effect of clinical teaching on student

performance during a medicine clerkship. Am J Med


Torre DM, Sebastian JL, Simpson DE. Learning activities

and high-quality teaching. perceptions of third-year IM

clerkship students. Acad Med 2003;78:812–4.

Elnicki DM, Kolarik R, Bardella I. Third-year medical

students' perceptions of effective teaching behaviors in a

multidisciplinary ambulatory clerkship. Acad Med


Irby DM. Three exemplary models of case-based teaching.

Acad Med 1994;69:947–53.

Irby DM. What clinical teachers in medicine need to know.

Acad Med 1994;69:333–42.

Bassaw B, Roff S, McAleer S, Roopnarinesing S, Lisle JD,

Teelucksing S, et al. Students' perspectives on the

educational environment, Faculty of Medical Sciences,

Trinidad. Med Teach 2003;25:522–6.

Genn J. AMEE Medical Education Guide No 23 (Part 1):

Curriculum, environment, climate, quality and change in

medical education–a unifying perspective. Med Teacher


Abraham R, Ramnarayan K, Vinod P, Torke S. Students

perception of learning environment in an Indian Medical

School. BMC Med Educ 2008;8:20.

Marsh HW, Yeung AS. Causal effects of academic

selfconcept and achievement: Structural equation models of

longitudinal data. J Educ Psychol 1997;89:41–54.

Marsh HW, Byrne BM, Yeung AS. Causal ordering of

academic self-concept and achievement: Reanalysis of a

pioneering study and revised recommendations. Educ

Psychol 1999;34:155–67.

Bradley IF, Clark DC, Eisner JE, DE Gruchy K, Singer DL,

Hinkleman K, et al. The student survey of problems in the

academic environment in Canadian dental faculties. J Dental

Educ 1989;53:126–31.

Hechter FJ. Influences on the academic achievement of

undergraduate dental students. Ph.D. thesis. Winnipeg, MB:

University of Manitoba; 1996.

Humphris G, Blinkhorn A, Freeman R, Gorter R, HoadReddick G, Murtomaa H, et al. Psychological stress in

undergraduate dental students: baseline results from seven

European dental schools. Eur J Dental Educ 2002;6:22–9.

Sanders A, Lushington K. Sources of stress for Australian

dental students. J Dental Educ 1999;63:688–97.

Standing Committee on Postgraduate Medical Education

(SCOPME). Good Practice in SHO Training. 1991.

Pimparyon P, Roff S, McAleer S, Poonchai B, Pemba S.

Educational environment, student approaches to learning and

academic achievement in a Thai nursing school. Med

Teacher 2000;22:359–65.

Roff S, McAleer S, Harden RM, Al-Qahtani M, Ahmed AU,

Deza H, Groenen G, Primparyon P. Development and

validation of the Dundee Ready Education Environment

Measure (DREEM). Med Teach 1997;19:295–9.

Roff S, McAleer S, Ifere OS, Battacharya S. A global

diagnostic tool for measuring educational environment:

comparing Nigeria and Nepal. Med Teach 2001;23:378–82.

Till H. Identifying the perceived weaknesses of a new

curriculum by means of the Dundee Ready Education

Environment Measure (DREEM) Inventory. Med Teach



  • There are currently no refbacks.

Contact Number: +92-992-382571

email: [jamc] [@] []