DETERMINATION OF MEDICAL EDUCATION ENVIRONMENT IN PUNJAB PRIVATE AND PUBLIC MEDICAL COLLEGES AFFILIATED WITH UNIVERSITY OF HEALTH SCIENCES, LAHORE-PAKISTAN
AbstractBackground: The main purpose of this study was to identify differences, if any, in theMedical Education Climate between the Private and Public Medical Colleges in the Provinceof Punjab affiliated with the University of Health Sciences, Lahore and to gatherrecommendations from students on measures that need to be taken to improve theenvironment. Methods: This Mixed Quantitative and Qualitative Prospective Study wasconducted in 2008. The population of the study consisted of 1612 MBBS Final Year MedicalStudents of both Private and Public Medical Colleges. Stratified Random Sampling was doneto ensure representation of both Sectors. Dundee Ready Education Environment Measure(DREEM) was used to assimilate Quantitative Data and a Questionnaire consisting of 10items 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: Allthe SIX Research Hypotheses were rejected and Null Hypotheses were upheld. Analysis ofQualitative Data indicated a number of Examination, Curriculum, Teaching Methodology,Teacher and Peer related Stressors without discrimination in students of both Private andPublic Sectors. Solutions by students focused on improving co-ordination betweenInstitutions and University of Health Sciences as well as developing and deliveringClinically-Centred, Community-Oriented and Problem-Based Education through developmentof appropriate Teaching Methodologies. Conclusions: Even though there is no difference inthe 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 onusof 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 inorder 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
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
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
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
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
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