A Psychometric Appraisal of the Dundee Ready Education Environment Measure in a Medical School in Chile

Background: The Dundee Ready Education Environment Measure (DREEM) is used in the curricular development of future health professionals worldwide, but often without first locally testing its psychometric qualities, for example, construct validity and internal consistency. These characteristics are modified by different environments, but must he locally appropriate to obtain unequivocal and reliable conclusions about the strong and weak areas of a curriculum. Here, we report the results of the psychometric testing of DREEM results in our institution in Chile. Methods: All 1st-5th-year undergraduate medical students were asked to respond the DREEM questionnaire. The construct validity of the results was assessed by an exploratory factor analysis (ER), and their internal consistency was assessed by Cronbach's alpha. The Institutional Review Board approved the study, and each student signed an informed consent. Results: A total of 304 (88%) eligible students, aged 22 +/- 2 years, 46% of females, answered the questionnaire. The LEA determined four instead of the original DREEM's five subareas with clearly different item contents. The inner consistencies of the locally defined subareas of teaching, learning, teachers and organizational aspects, and self-perception surpassed the originals with Cronbach's alpha values of 0.79, 0.78, 0.77, and 0.82, respectively. Discussion: The optimal psychometric structure to accurately interpret our DREEM results differed from both the original and previous similar studies, including one from Chile. There are several potential explanations for these differences, but most importantly, they underline the need to first define the psychometric characteristics of the test results, to obtain accurate conclusions about the strengths and the weaknesses of a curriculum.