Participation
Phase 1 of the curriculum is basic science, operated by the college of science. The author of the present study did not have access to the students, and they do not belong to the curriculum and study. Second-year medical students have new experiences with the research concept. Thus, notice a slight decrease in students' participation was observed in the survey (n=55) compared to other levels (n=70+/-). However, there is equal participation of students in subsequent class levels (third-year: 19.2%, fourth-year: 21.9, fifth-year: 21.6%, and sixth-year: 21%).
Although participation seems equal across the different levels, females in the third level (n=46) are more than males (n=18), and the participation of males in the fourth level (n=48) is more than females (n=25). The total number of students in third-year is 122, of which 73 of them (60%) are females, which is an unequal representation in the study’s statistics. However, in fourth-year, the total number of students is 118, of which 60 of them are males. Although they are equal, the present study still observed unequal representation in the statistics.
General Scores
According to the literature, the following points are approximate guidelines for interpreting the overall score:
- 0-50 Very Poor
- 51-100 Plenty of Problems
- 101-150 More Positive Than Negative
- 151-200 Excellent
The mean score of the total sample is 104.9 (SD: 26.353), which, according to the literature review, is one of the lowest scores worldwide. Table 9 lists the score of different international institutes according to the value of the score.
In this study, out of 50 items, 22 items with a mean score of less than 2 need attention. Two items with a mean score ≥3 demonstrate strong area, and 26 items with a mean score between 2-3 need improvement in their area. Observing the items again for each gender, it was found that males had more items with low mean scores (30 items) compared to females (19 items), and more strong items among females (4 Items) compared to males (2 items). It was found that in Saudi Arabia, 82% (18 out of 22 ) of items that have lower scores (<2) are also a problematic area in other Medical schools in Saudi Arabia, including King Abdulaziz University and Umm Alqura University (Al-Hazimi, Zaini, et al., 2004)
Table 9: Comparison of DREEM total scores with other regional and international universities (sorted according to Score Mean)
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References
|
Country
|
University
|
Total DREEM Score
|
(Al-Ayed & Sheik, 2008)
|
KSA
|
KSU
|
89.9
|
(Till, 2004)
|
Canada
|
Canadian Memorial Chiropractic College
|
97
|
(Al-Hazimi, Zaini, et al., 2004)
|
Yemen
|
Sana’a University
|
100
|
(Zawawi & Elzubeir, 2012)
|
KSA
|
KSU
|
100
|
(Al-Hazimi, Zaini, et al., 2004)
|
KSA
|
King Abdulaziz University
|
102
|
This study (2018)
|
KSA
|
Jazan University
|
104.9
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(Bouhaimed et al., 2009)
|
Kuwait
|
Kuwait University
|
105
|
(Mayya & Roff, 2004)
|
India
|
Kasturba Medical College
|
107
|
(Al-Hazimi, Zaini, et al., 2004)
|
KSA
|
Umm Al-Qura University
|
107
|
(Jiffry et al., 2005)
|
Sri Lanka
|
University of Sri Jayewardenepura
|
108
|
(Makhdoom, 2009)
|
KSA
|
Taiba University
|
109
|
(Al-Mohaimeed, 2013)
|
KSA
|
Qassim University
|
112
|
(Al-Mohaimeed, 2013)
|
KSA
|
King Khalid University
|
112.95
|
(Roff et al., 2001)
|
Nigeria
|
Nigeria Undergraduate Medical School
|
118
|
(Shehnaz & Sreedharan, 2011)
|
UAE
|
Gulf Medical University
|
120
|
(Zawawi & Elzubeir, 2012)
|
KSA
|
KSAU-HS
|
131
|
(Varma et al., 2005)
|
UK
|
Birmingham University
|
139
|
(Al-Hazimi, Al-Hyiani, et al., 2004)
|
Dundee
|
Dundee Medical School
|
139
|
(Al-Naggar et al., 2014)
|
Malaysia
|
Malaysian medical school
|
125.3
|
(Le & Bedocs, 2021)
|
Malaysia
|
Malaysian medical school
|
134
|
Students’ Perceptions of Learning (SPoL)
The total sample mean score for SPoL is 22.98 (SD: 6.83), which is lesser than 50% of the maximum score. Male students have a lesser score (mean score: 21.75) than females (mean score: 24.24). In comparison with other studies in Saudi Arabia, the SPoL result for this study is almost the same for other schools except for King Saud Bin Abdulaziz University, which has the highest score in Saudi Arabia (SPoL mean score: 36.44) (Zawawi & Elzubeir, 2012). Other schools share almost the same results, ranging between 20 and 26. Table 10 summarizes the DREEM results in different local medical schools. Observing the individual items in the SPoL subscale, it was found that seven items with mean scores less than 2 (items: 48, 25, 44, 16, 47, 20, 1) need attention. No single item demonstrated a strong area with a mean score ≥ 3, and 5 items demonstrate a need for improvement (items: 24,7, 13, 38, 22), with a mean score range between 2-3.
Table 10: summery of DREEM result for local medical school
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STUDY
|
University
|
Total Score mean
|
SPoL
|
SPoT
|
SASP
|
SPoA
|
SSSP
|
(Al-Ayed & Sheik, 2008)
|
King Saud university
|
89.9
|
19.53
|
21.24
|
14.82
|
21.3
|
12.96
|
(Zawawi & Elzubeir, 2012)
|
King Saud university
|
100
|
23.18
|
23.79
|
13.59
|
24.66
|
15.37
|
(Al-Hazimi, Zaini, et al., 2004)
|
King Abdulaziz University
|
102
|
23
|
23
|
17
|
23
|
14
|
This study (2018)
|
Jazan University
|
104.9
|
22.98
|
23.81
|
19.14
|
24.24
|
14.72
|
(Al-Hazimi, Zaini, et al., 2004)
|
Umm Al-Qura University
|
107
|
25
|
24
|
18
|
25
|
15
|
(Al-Mohaimeed, 2013)
|
Qassim University
|
112
|
26
|
25
|
22
|
26
|
15
|
(Zawawi & Elzubeir, 2012)
|
King Saud bin bdulaziz Uni.
|
131
|
36.44
|
25.48
|
19.81
|
32.77
|
16.81
|
Looking at item No. 1, "I am encouraged to participate during teaching sessions," and item No. 7, "The teaching is often stimulating," with the exception of second-year students, it was found that all female subgroups have mean scores of more than 2, and all male subgroups have mean scores below 2.
Although the main objective of the curriculum is to improve the competency of graduates, students still did not find an appropriate effect of the teaching in improving their competency, as in item No. 16, "The teaching helps to develop my competence," with a mean score of 1.84.
It was also found that, according to item No. 20, "The teaching is well-focused," the total sample agrees that the teaching processes in the school are not focused. In addition to that, senior male students have lower scores (fifth-year mean: 1.46; sixth-year mean: 1.55) compared to senior female students' subgroup (fifth-year mean score: 1.94 and sixth-year mean score:2.00), although male and female students are supposed to have the same learning context, especially in the same level.
When asked about item 25, "The teaching over-emphasizes factual learning," it was found that the total sample score for this item is not acceptable (mean score: 1.57), and there is obvious score deference among fifth-year students, with female students having the highest score (1.89) and lowest for male (1.31).
As a higher education institute, the curriculum is supposed to engage students in adult learning activities. For item 44, "The teaching encourages me to be an active learner," mean score was 1.83; the mean score was 1.85 for item 47, "Long-term learning is emphasized over short-term learning"; and 1.55 for item 48, "The teaching is too teacher-centered," which reflect mainly the adult learning principles, demonstrate a failure of the curriculum to support learning principles of adult learning, according to Knowles (Craig 1996).
Please see Appendix II and III for individual scores for each item of the SPoL subscale, sorted by the total sample mean score.
Students’ Perceptions of Teachers (SPoT)
Looking at the second subscale, Students’ Perceptions of Teachers, which included eleven items, the same findings were obtained as the first subscale: a low total sample mean score of 23.81 out of 44 (SD: 7.094) and a lack of strong items.
In comparison to SPoT results from other studies in Saudi Arabia, it could be seen that this study has almost the same SPoT score as other schools in Saudi Arabia. Saudi Arabian studies revealed that this study was almost identical to other Saudi Arabian schools, with mean SPoT scores ranging between 21 and 25. Table 10 summarizes DREEM results from various local medical schools.
Negative items, including item 9, which asked whether “The teachers are authoritative,” item 39, which asked whether “The teachers get angry while teaching,” and item 8, which asked whether “The teachers ridicule the students,” have mean scores of 1.66 (SD 1.12), 1.7 (SD 1.09), and 1.84 (SD 1.29), respectively. These scores indicate the students’ agreement with these items, meaning they are problem areas that need further investigation. The other items in this subscale have mean scores between 2 and 3, indicating the need for improvement.
Generally, in all SPoT subscales, female students are happier than male students. Females had mean scores of more than 2 on eight items, while males had mean scores of more than 5 on only 5 items.
Feedback is an integral and important part of the teaching and learning environment in the medical field, as it improves the learners' knowledge, skills, and other competencies. Unfortunately, item 29, "The teachers are good at providing feedback to students," shows that all students are not satisfied with feedback quality and quantity (total sample mean score = 1.92; SD = 1.098). In addition to that, teachers still gave more feedback for female students (Mean score = 2.13) compared with males (Mean score = 1.7).
Please see Appendix II & III for individual scores for each item of the SPoT subscale, sorted by the mean score for the entire sample.
Students’ Academic Self-Perception (SASP)
Compared to other subscales, the students have a reasonable general mean score for the SASP subscale as 19.14 out of 32 for eight items, which is nearly equal for males (mean score: 18.49) and females (mean score:19.81).
Compared to SASP results from other Saudi Arabian studies, it could be seen that the school's mean score (19.14) is almost equal to the mean score of King Saud bin Abdulaziz University (19.81), which has the highest total DREEM score in Saudi Arabia (total mean score: 131). Table 10 summarizes DREEM results from various local medical schools.
Looking at individual items in the SASP subscale, the results revealed that items 5, 21, and 27 have mean scores less than 2 and thus require attention, there are no items that demonstrate a strong area with a score of 3, and items 26,41,31,45, and 10 items have a mean score range of 2-3 and thus require improvement in their area.
Although the score for item 10, "I am confident about my success this year," is 2.97 (SD 0.94), female students show a mean score of 3.12 (SD 0.86), and 2.83 (SD 0.99) for male students. This is in accordance with the percentage of pass in exams, which indicated a higher success rate among female students than male students.
Item 21, "I feel I am being well prepared for my profession," denotes that these juniors (second-level mean score: 1.9; third-level mean score: 2.08) are more optimistic compared to senior students (fifth-level mean score: 1.57; sixth-level mean score: 1.74).
The students have difficulty memorizing all they need as per item 27. This agreement among all students is mainly, as I expect, due to subjects contents, which is more than what they need to learn.
Please see Appendices II and III for individual scores for each SASP subscale item, sorted by the total sample mean score.
Students’ Perceptions of Atmosphere (SPoA)
The mean score for the total sample is 24.42 out of 48, with a total score of 12 items. Male and female students are almost the same as the mean of the total sample (mean score: 23.17 and 25.33, respectively). The educational environment in the medical field is novel for junior students, particularly junior students. Previously, female students had their academic activities conducted solely by female staff. Due to a shortage of female faculty in the second year, female students must deal with the new experience of being taught by male faculty. This could explain why second-year female students have the lowest mean score in this subscale (mean score: 21.91). In comparison to SPoA results from other studies in Saudi Arabia, this study can be viewed as almost identical to other schools, with the exception of King Saud Bin Abdulaziz University, which has the highest score in Saudi Arabia (SPoA Mean: 32.77) (Zawawi and Elzubeir 2012b). Other schools share almost the same results, ranging between 21 and 26. Table 10 summarizes DREEM results in different local medical schools.
Looking at individual items in the SASP subscale, items 11, 12, 42, 43, and 23 have mean scores less than 2 and need attention. No single item demonstrated a strong area with mean scores ≥ 3. Items 49, 34, 30, 17, 33, 35, and 36 demonstrate a mean score of 2-3, which indicates a need for improvement in their areas. Again, most female student groups have a mean score above the total sample mean score for all subscale items in contrast with the male students, except for item 11, where students asked about the atmosphere of ward teaching.
The academic atmosphere during teaching activity; ward teaching, lectures class, seminars, and tutorials are negatively assigned with a total agreement between male and female (item 11, 23, and 34), which has a great consequence on item 42, "The enjoyment outweighs the stress of the course," which also has a low mean score (mean: 1.48). This indicates a decrease in the atmosphere's motivation and a decrease in the mean score of item 43, "The atmosphere motivates me as a learner" (mean score: 1.74). Item 12, "This school is well time-tabled" with a mean score of 1.45, could explain some of the results of the low SASP subscale scores, which affect the overall atmosphere of teaching and learning.
Although junior students participate in some academic activity in the hospital, bedside teaching takes place mainly in the hospital and is restricted to fourth, fifth, and sixth-year students. As a result, the author of the current study must consider students' scores for senior students. When item 11, "The atmosphere is relaxed during ward teaching," was analyzed, the result was very depressive, with a mean score of 0.85 and 1.23 for the fifth and sixth levels, respectively.
Please see Appendices II and III for individual scores for each item of the SPoA subscale, sorted by a mean score for the total sample.
Students’ Social Self-Perception (SSSP)
The SSSP comprises seven items with 28 maximum possible scores. This study's total sample mean score is 14.72, almost 50% of the maximum score. In comparison to SSSP results from other studies in Saudi Arabia, it could be seen that this study has almost identical results to those from other schools, ranging between 12.9 and 16.8. Table 10 summarizes DREEM results from various local medical schools.
Items in the SSSP subscale were classified into three categories;
- Social items closely related to the school, item 3, "There is a good support system for students who get stressed," item 4, "I am too tired to enjoy the course," and item 14, “I am rarely bored on this course.” Those items have very low scores among all inventory items; mean scores = 1.02, 1.08, and 1.2, respectively. Surprisingly, except for one item, two different schools in Saudi Arabia, Umm Al-Qura University and King Abdulaziz University, have the same student perception of those items, with mean scores ranging from 0.92 to 1.2 (mean score for item 14 is 1.5 in Umm Al-Qura University)
- Items partially related to the school environment; item 28, "I seldom feel lonely," and item 19, "My social life is good." Those items with a mean score range of 2-3 indicate a need for improvement in that area.
- Items that are independent of the school environment: item 46, "My accommodation is pleasant," and item 15, "I have good friends in this school." These items demonstrate a strong point with a mean score of ≥ 3. In addition to that, it was discovered that the study’s results in those items matched the results of similar items in deferent Saudi Arabia DREEM (King Abdulaziz University and Umm Al-Qura University), and they are the only items that demonstrate a strong point with a score more than 3, which almost equal to the study’s result. Table 11 shows the results of various schools for items 15 and 46.
Table 11: score mean for item 15 and 46 in King abdulaziz U. and Umm Al-Qura U.
|
Item
|
THIS STUDY
|
King Abdulaziz U.
|
Umm Al-Qura U.
|
15. I have good friends in this course
|
3.47
|
3.4
|
3.11
|
46. My accommodation is pleasant
|
3.13
|
3.14
|
3.06
|
Looking at this subscale with regard to the subgroups, it could be seen that second-year students have the lowest score (mean 13.71), and among them, females have the lowest mean score (mean 13.32). These students usually face new changes and challenges in their lives, including a new academic environment, new colleagues, new culture; the study anticipates some social difficulties that they could face. Item 15, "I have good friends in this course," shows a good score for all subgroups; however, male and female second-year students show the lowest score (mean: 3.29) and again the lowest score for female students (mean: 3.18). Please see Appendix II & III for individual scores for each SSSP subscale question, sorted by the total sample mean score.