Original Articles

Medical Interns' Perspectives on the Educational Environment in Cardiology and Dermatology Settings at an Iranian University

Abstract

The quality of the educational environment is one of the key determinants of students' learning experiences and academic performance. This study aimed to assess medical interns' perceptions of the educational environmental quality in dermatology and cardiology wards at Ahvaz Jundishapur University of Medical Sciences (AJUMS). A descriptive cross-sectional design was employed, utilizing the Dundee Ready Education Environment Measure (DREEM) and the Ambulatory Care Learning Educational Environment Measure (ACLEEM). Data was analyzed using SPSS version 24, employing parametric tests for statistical analysis, including independent t-tests and Pearson’s correlation. Among 146 questionnaires distributed, 123 were completed (84% response rate) out of which 54.5% were female, 78.9% single, and mean age was 25.80±1.299 years. The total mean DREEM score was 119.03±23.71, indicating a moderate educational environment, with dermatology scoring significantly higher than cardiology (P<0.05). The total mean ACLEEM score was 104.92±27.03, with dermatology rated as optimal and cardiology as semi-optimal (P<0.05). Significant differences were noted in perception of learning, teachers, and atmosphere. Married interns had more positive perceptions. Age was mildly correlated with DREEM scores. While the educational environment in dermatology and cardiology wards at AJUMS is perceived as relatively favorable, the outpatient cardiology clinic requires significant improvements. Key areas requiring improvement included faculty engagement, feedback mechanisms, and infrastructural support.

1. Coffield F, Ecclestone K, Moseley D, Hall E. Learning styles and pedagogy in post 16 education: a critical and systematic review. London: Learning and Skills Research Centre; 2004.
2. Hall J, Atkinson A, Chan MK, Tourian L, Thoma B, Pattani R. The clinical learning environment in CanMEDS 2025. Can Med Educ J 2023;14:41-5.
3. Spencer J. Learning and teaching in the clinical environment. BMJ 2003;326:591-4.
4. Khoshgoftar Z, Ahmady S. Instruments for measuring medical education environments and scope of these applications. Strides Dev Med Educ 2014;11.
5. Ramani S, Leinster S. AMEE Guide No. 34: Teaching in the clinical environment. Med Teach 2008;30:347-64.
6. Dent JA. AMEE Guide No. 26: clinical teaching in ambulatory care settings: making the most of learning opportunities with outpatients. Med Teach 2005;27:302-15.
7. Obadeji A, Louw A, Couper I. Medical students’ perceptions of the learning environment and its implications on teaching and learning: a qualitative study in Nigeria. J Med Educ Dev 2024;17:29-38.
8. Strasser R, Hirsh D. Longitudinal integrated clerkships: transforming medical education worldwide? Med Educ 2011;45:436-7.
9. Rezaei K, Kohestani HR, Baghchegi N. Comparison of actual and preferred nursing student perception of clinical learning environment in Arak University of Medical Sciences, 2009. Iran J Med Educ 2011;11:457-66.
10. Whittle S, Whelan B, Murdoch-Eaton D. DREEM and beyond; studies of the educational environment as a means for its enhancement. Educ Health (Abingdon) 2007;20:7.
11. Mohammadi A, Mohammadi J. Students’ perception of the learning environment at Zanjan University of Medical Sciences. J Med Educ Dev 2013;6:50-60.
12. Riquelme A, Padilla O, Herrera C, Olivos T, Román JA, Sarfatis A, et al. Development of ACLEEM questionnaire, an instrument measuring residents’ educational environment in postgraduate ambulatory setting. Med Teach 2013;35:e861-6.
13. Naghizadeh Moogari Z, Koohpayehzadeh J, Roff S, Montazeri A, Soltani Arabshahi SK, Bigdeli S, et al. Psychometric analysis of the ambulatory care learning education environment measure (ACLEEM) in Iran. Med J Islam Repub Iran 2015;29:299.
14. Soemantri D, Herrera C, Riquelme A. Measuring the educational environment in health professions studies: a systematic review. Med Teach 2010;32:947-52.
15. Roff S, McAleer S. What is educational climate? Med Teach 2001;23:333-4.
16. Edgren G, Haffling AC, Jakobsson U, McAleer S, Danielsen N. Comparing the educational environment (as measured by DREEM) at two different stages of curriculum reform. Med Teach 2010;32:e233-8.
17. McKendree J. Can we create an equivalent educational experience on a two campus medical school? Med Teach 2009;31:e202-5.
18. Varma R, Tiyagi E, Gupta JK. Determining the quality of educational climate across multiple undergraduate teaching sites using the DREEM inventory. BMC Med Educ 2005;5:8.
19. Abraham R, Ramnarayan K, Vinod P, Torke S. Students’ perceptions of learning environment in an Indian medical school. BMC Med Educ 2008;8:20.
20. Aghamolaei T, Fazel I. Medical students’ perceptions of the educational environment at an Iranian Medical Sciences University. BMC Med Educ 2010;10:87.
21. Bouhaimed M, Thalib L, Doi SA. Perception of the educational environment by medical students undergoing a curricular transition in Kuwait. Med Princ Pract 2009;18:204-8.
22. Hasan T, Gupta P. Assessing the learning environment at Jazan Medical School of Saudi Arabia. Med Teach 2013;35:S90-6.
23. Jiffry MT, McAleer S, Fernando S, Marasinghe RB. Using the DREEM questionnaire to gather baseline information on an evolving medical school in Sri Lanka. Med Teach 2005;27:348-52.
24. Arjmand R, Zare M, Hashempoor A, Tahmasebi Boldaji F, Ghanbari S, Zivdar N. Assessment of educational environment in pediatric and internal medicine clinics in training hospitals of Ahvaz Jundishapur University of Medical Sciences. Iran J Med Educ 2024;24:122-30.
25. Ahmady S, Mohammadzadeh F. Evaluation of outpatient care educational environment in Ayatollah Taleghani Hospital of Shahid Beheshti University of Medical Sciences from the perspective of medical students in winter 1398. Iran J Med Educ 2020;20:425-8.
26. Haque M, Othman NSAB, Lutfi SNN, Islam MZ, Rahman NAA, Kibria GM, et al. Evaluation of out-patient care educational environment of National Defence University, Malaysia utilizing the ACLEEM Inventory. J Basic Clin Health Sci 2018;2:45-52.
27. Moosavi M, Koohpayehzadeh J, Soltani Arabshahi SK, Bigdeli S, Hatami K. Assessment of educational environment at main clinical wards in teaching hospitals affiliated to Iran University of Medical Sciences: stagers and interns viewpoints based on modified DREEM. Razi J Med Sci 2015;21:58-67.
28. Eftekharian F, Mehrpour AM, Kalani N, Sahraei R. Evaluation of the educational environments of clinics in hospitals affiliated to Jahrom University of Medical Sciences based on the perception of medical students. Dev Strategies Med Educ 2023;10:50-9.
Files
IssueVol 64 No 4 (2026) QRcode
SectionOriginal Articles
Keywords
Educational environment Clinical education Outpatient education Dundee ready education environment measure (DREEM) Ambulatory care learning educational environment measure (ACLEEM)
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Zare M, Hashempour M, Tahmasebi Boldaji F, Khoshgoftar Z. Medical Interns’ Perspectives on the Educational Environment in Cardiology and Dermatology Settings at an Iranian University. Acta Med Iran. 2026;64(4):210-216.