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Pages: 1149-1156

Medical Environment Assessment In Morocco From The Students’ Perspective: A National Survey

Skakia Maher, Ghita Hjiej, Ayoub Kharkhach, Hajjioui Abderrazak, Abda Naima, Bentata Yassamine, Fourtassi Maryam

Category: JMSR Medical Education

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Introduction: The educational medical environment designs all the factors that accompany and surround the learning process including actors, locations, interactions and the general atmosphere. It represents one of the key elements of learning and reflects the quality of implementation of the educational process. Its regular evaluation is part of the recommendations of the international academic authorities for any training institution willing to improve its services and the performance of its students. The aim of the present study was to assess the medical educational environment in Moroccan public medical schools from the students’ perspective. Methods: We conducted a large survey to assess students' perception of their educational environment using the DREEM scale, which is made of 50 items divided into 5 categories. An online questionnaire collecting demographics, academic and psychological data, in addition to the DREEM scale, to Moroccan medical students in social networks, targeting the seven faculties of the public sector. Results: 2515 responses were collected from students in different levels of medical studies. The average total DREEM score was 90.5 +/- 23.6 and was significantly higher among male students (p<0.001), students enrolled in lower levels of studies (p<0.001), High performing students and (p<0.001) and students without mental distress (p<0.001). Also, there was a statistically significant raise of the total DREEM score within participants exposed to the new reform, in each of the five older medical faculties. Conclusion: Our results highlight the existence of many problems in the medical education system in Morocco, as reflected in the students' perception, concerning the different medical faculties with very slight variations. Hence it is both important and urgent to address these problems, particularly in the context of this new reform being implemented.

Keywords: DREEM, Medical Environment, Medical Education, Medical School, Morocco


  1. Teamur A & Fazel I. "Medical students' perceptions of the educational environment at an Iranian Medical Sciences University." BMC medical education 10.1 (2010): 87.
  2. Palés, J., Gual, A., Escaneroi, J., Tomás, I., de Castro, F. R., Elorudy, M., & Arce, V. (2015). Educational climate perception by preclinical and clinical medical students in five Spanish medical schools. International journal of medical education, 6, 65.
  3. Al Ayed, I. H., & Sheik, S. A. (2008). Assessment of the educational environment at the College of Medicine of King Saud University, Riyadh. EMHJ-Eastern Mediterranean Health Journal, 14 (4), 953-959, 2008.
  4. Shehnaz, S. I., & Sreedharan, J. (2011). Students’ perceptions of educational environment in a medical school experiencing curricular transition in United Arab Emirates. Medical teacher, 33(1), e37-e42.?
  5. Chan, C. Y. W., Sum, M. Y., Tan, G. M. Y., Tor, P. C., & Sim, K. (2018). Adoption and correlates of the Dundee Ready Educational Environment Measure (DREEM) in the evaluation of undergraduate learning environments–a systematic review. Medical teacher, 40(12), 1240-1247.
  6. Hojat, M., Vergare, M. J., Maxwell, K., Brainard, G., Herrine, S. K., Isenberg, G. A., & Gonnella, J. S. (2009). The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Academic medicine, 84(9), 1182-1191.
  7. Dunne, Fidelma, Sean McAleer, and Susan Roff. "Assessment of the undergraduate medical education environment in a large UK medical school." Health Education Journal 65.2 (2006): 149-158.
  8. Zawawi, Alia H., and Margaret Elzubeir. "Using DREEM to compare graduating students? perceptions of learning environments at medical schools adopting contrasting educational strategies." Medical Teacher 34.sup1 (2012): S25-S31.
  9. Fourtassi, M., Abda, N., Bentata, Y., & Hajjioui, A. (2020). Medical education in Morocco: current situation and future challenges. Medical Teacher, 42(9), 973-979.
  10. Belayachi, J., Razine, R., Boufars, A., Saadi, A., Madani, N., Chaouir, S., & Abouqal, R. (2015). Moroccan medical students’ perceptions of their educational environment. J Educ Eval Health Prof, 12(12), 47.
  11. Roff, S. U. E., McAleer, S., Harden, R. M., Al-Qahtani, M., Ahmed, A. U., Deza, H., & Primparyon, P. (1997). Development and validation of the Dundee ready education environment measure (DREEM). Medical teacher, 19(4), 295-299.
  12. Soemantri, Diantha, Cristian Herrera, and Arnoldo Riquelme. "Measuring the educational environment in health professions studies: a systematic review." Medical teacher 32.12 (2010): 947-952.
  13. Edgren, Gudrun, et al. "Comparing the educational environment (as measured by DREEM) at two different stages of curriculum reform." Medical teacher 32.6 (2010): e233-e238.
  14. Ostapczuk, M. S., Hugger, A., De Bruin, J., Ritz?Timme, S., & Rotthoff, T. (2012). DREEM on, dentists! Students’ perceptions of the educational environment in a German dental school as measured by the Dundee Ready Education Environment Measure. European Journal of Dental Education, 16(2), 67-77.
  15. Dimoliatis, I. D., et al. "Validation of the Greek translation of the Dundee ready education environment measure (DREEM)." Education for Health 23.1 (2010): 348.
  16. Jakobsson, U., Danielsen, N., & Edgren, G. (2011). Psychometric evaluation of the Dundee ready educational environment measure: Swedish version. Medical teacher, 33(5), e267-e274.
  17. Kohli, V., & Dhaliwal, U. (2013). Medical students’ perception of the educational environment in a medical college in India: a cross-sectional study using the Dundee Ready Education Environment questionnaire. J educ eval health prof, 10(5), 10.
  18. Aghamolaei, T., & Fazel, I. (2010). Medical students' perceptions of the educational environment at an Iranian Medical Sciences University. BMC medical education, 10(1), 1-7.
  19. Khan, A. S., Akturk, Z., & Al-Megbil, T. (2010). Evaluation of the learning environment for diploma in family medicine with the Dundee Ready Education Environment (DREEM) Inventory. Journal of Educational Evaluation for Health Professions, 7.
  20. Abraham, Reemet al. 2008. Perceptions of academic achivers and under-achievers regarding learning environment of Melaka Manipal Medical College, India, Using DREEM Inventory. South East Asian Jouranl of Medical Education 2 ; 48-54.
  21. Tokuda, Yasuharu, et al. "Undergraduate educational environment, perceived preparedness for postgraduate clinical training, and pass rate on the National Medical Licensure Examination in Japan." BMC medical education 10.1 (2010): 35.
  22. Ugusman, Azizah, et al. "Assessment of learning environment among the first year Malaysian medical students." Journal of Taibah University Medical Sciences 10.4 (2015): 454-460.
  23. Roff, Sue, et al. "A global diagnostic tool for measuring educational environment:comparing Nigeria and Nepal." Medical teacher 23.4 (2001): 378-382.
  24. Oghagbon, Efosa Kenneth. "Impact of location and government funding on medical Students Perception of Learning Environment in Nigeria." European Journal of Natural Sciences and Medicine 1.2 (2018): 5-16.
  25. Ojuka, D., Aseta, F., Githambo, B., & Wambua, B. (2021). The Medical Education Environment at the University of Nairobi, Kenya: an assessment with the DREEM tool. Annals of African Surgery, 18(2), 96-102.
  26. Ahmed, Y., Taha, M. H., Alneel, S., & Gaffar, A. M. (2018). Evaluation of the learning environment and the perceived weakness of the curriculum: student perspective. International Journal of Research in Medical Sciences, 7(1), 165.
  27. Knowles M. 1973. The adult learner: a neglected species. Houston (TX): Gulf.
  28. Khursheed, I., & Baig, L. (2014). Students’ perceptions of educational environment of a private medical school in Pakistan. J Pak Med Assoc, 64(11), 1244-9.
  29. Sarwar, S., & Tarique, S. (2016). Perception of educational environment: Does it impact academic performance of medical students. Environment, 66(1210).
  30. Yamada Y, Klugar M, Ivanova K, Oborna I. 2014. Psychological distress and academic self-perception among international medical students: the role of peer social support. BMC Med Educ. 14:256.
  31. Wasson, L. T., Cusmano, A., Meli, L., Louh, I., Falzon, L., Hampsey, M., & Davidson, K. W. (2016). Association between learning environment interventions and medical student well-being: a systematic review. Jama, 316(21), 2237-2252.
  32. Dyrbye, L. N., Satele, D., & West, C. P. (2021). Association of Characteristics of the Learning Environment and US Medical Student Burnout, Empathy, and Career Regret. JAMA Network Open, 4(8), e2119110-e2119110.
  33. Struyven, K., Dochy, F., & Janssens, S. (2008). Students’ likes and dislikes regarding student-activating and lecture-based educational settings: Consequences for students’ perceptions of the learning environment, student learning and performance. European Journal of Psychology of Education, 23(3), 295-317.