Educational climate perception by preclinical and clinical medical students in five Spanish medical schools

OBJECTIVES: The purpose of this study was to investigate student's perceptions of Educational Climate (EC) in Spanish medical schools, comparing various aspects of EC between the 2(nd) (preclinical) and the 4(th) (clinical) years to detect strengths and weaknesses in the on-going curricular reform. METHODS: This study utilized a cross-sectional design and employed the Spanish version of the "Dundee Ready Education Environment Measure" (DREEM). The survey involved 894 2(nd) year students and 619 4(th) year students from five Spanish medical schools. RESULTS: The global average score of 2(nd) year students from the five medical schools was found to be significantly higher (116.2±24.9, 58.2% of maximum score) than that observed in 4th year students (104.8±29.5, 52.4% of maximum score). When the results in each medical school were analysed separately, the scores obtained in the 2(nd) year were almost always significantly higher than in the 4(th) year for all medical schools, in both the global scales and the different subscales. CONCLUSIONS: The perception of the EC by 2(nd) and 4(th) year students from five Spanish medical schools is more positive than negative although it is significantly lower in the 4(th) year. In both years, although more evident in the 4(th) year, students point out the existence of several important "problematic educational areas" associated with the persistence of traditional curricula and teaching methodologies. Our findings of this study should lead medical schools to make a serious reflection and drive the implementation of the necessary changes required to improve teaching, especially during the clinical period.