Student perception of the educational environment in regular and bridging nursing programs in Saudi Arabia using the Dundee Ready Educational Environment Measure.

original article Student perception of the educational environment in regular and bridging nursing programs in Saudi Arabia using the Dundee Ready Educational Environment Measure Omar Mansour Al Nozha,a Hani T. Fadelb From the aDepartment of Internal Medicine, Taibah University College of Medicine, Madinah, Saudi Arabia; bDepartment of Preventive Dental Services, Taibah University Dental College and Hospital (TUDCH), Madinah, Saudi Arabia Correspondence: Dr. Hani T. Fadel · Department of Preventive Dental Services, Taibah University Dental College and Hospital (TUDCH), Madinah, Saudi Arabia · T: +966554406095 · · http://orcid.org/0000-0001-9113-2399 Ann Saudi Med 2017; 37(3): 225-231 DOI: 10.5144/0256-4947.2017.225 BACKGROUND: Taibah University offers regular nursing (RNP) and nursing bridging (NBP) bachelor programs. We evaluated student perception of the learning environment as one means of quality assurance. OBJECTIVES: To assess nursing student perception of their educational environment, to compare the perceptions of regular and bridging students, and to compare the perceptions of students in the old and new curricula. DESIGN: Cross-sectional survey. SETTING: College of Nursing at Taibah University, Madinah, Saudi Arabia. PATIENTS AND METHODS: The Dundee Ready Educational Environment Measure (DREEM) instrument was distributed to over 714 nursing students to assess perception of the educational environment. Independent samples t test and Pearson’s chi square were used to compare the programs and curricula. MAIN OUTCOME MEASURE: The DREEM inventory score. RESULTS: Of 714 students, 271 (38%) were RNP students and 443 (62%) were NBP students. The mean (standard deviation) DREEM score was 111 (25). No significant differences were observed between the programs except for the domain “academic self-perceptions” being higher in RNP students (P<.001). Higher mean DREEM scores were observed among students studying the new curriculum in the RNP (P<.001) and NBP (P>.05). CONCLUSION: Nursing students generally perceived their learning environment as more positive than negative. Regular students were more positive than bridging students. Students who experienced the new curriculum were more positive towards learning. LIMITATIONS: The cross-sectional design and unequal gender and study level distributions may limit generalizability of the results. Longitudinal, large-scale studies with more even distributions of participant characteristics are needed. T he learning journey of undergraduate nursing students is a long one. They start by preparing for university life—physically, mentally, socially and economically—and then identify the new skills necessary to continue.1 During that time, nursing students go through various natural stressful encounters and, as a consequence, gain the emotional strength and integrity necessary to carry on and survive setbacks.1 Graduation is accompanied by feelings of self-satisfaction and triumph. In an integrative review of the literature, Walker and co- ANN SAUDI MED 2017 MAY-JUNE WWW.ANNSAUDIMED.NET workers stated five main themes that contribute to the satisfaction of nursing students throughout their learning journey.2 These include authentic learning, motivation, resilience, support and collaborative learning.2 Essentially, these are what broadly constitute a good practicelearning environment and, among other aspects, are important to evaluate when assuring any given program’s quality.3 A number of tools have been used to assess the learning or educational environment in the health professions schools. Those that have shown to be the most suit- 225 original article able include the Dundee Ready Educational Environment Measure (DREEM) instrument, the Postgraduate Hospital Educational Environment Measure, the Clinical Learning Environment and Supervision and the Dental Student Learning Environment Survey.4 The DREEM inventory, a validated non-culturally specific tool, has been widely used in different settings and between health sciences to generate institutional profiles, compare student perceptions within and between programs or institutions, correlate perceptions with academic results, and to serve as a predictive tool for identifying students with different levels of achievements.5 Interestingly, and despite the available literature reporting on the learning environment perception among nursing students,6-13 there are no published reports comparing the perceptions of regular nursing and nursing bridging students. The Bachelor of Nursing at Taibah University has undergone multiple successive curricular improvements within 3-4 years. Changes ranged from improving the assessment methodology of some courses, to more major changes involving all aspects of the curriculum. This resulted in multiple versions of the program running simultaneously during the transition phase. In addition, the Bachelor of Nursing is offered through a regular nursing program (RNP) and a nursing bridging program (NBP), both of which are delivered by the same teaching staff and clinical instructors. Both programs have the same curriculum but improvements were applied at different time points due to a later student intake process for the NBP. This naturally occurring difference in program and curricular change allows for an analytic assessment of the different phases and versions of the program, which would ultimately aid in future quality improvements. Thus, the objectives of this study were 1) to assess the student perception of the educational environment at Taibah University College of Nursing using the DREEM inventory, 2) to compare the educational environment perception of students in the RNP with those in the NBP, and 3) to compare the perception of students experiencing the old curriculum with those experiencing the new one. The null hypothesis was that no differences should be expected between students from the RNP and the NBP or between those who experienced the old and new curricula in terms of learning environment, since all learning conditions were virtually the same. However, demonstrating otherwise would aid in the quality assurance movement. PATIENTS AND METHODS Study design and setting This was a cross-sectional, analytical survey carried out at 226 DREEM INSTRUMENT Taibah University College of Nursing during the period between February and March 2016. Taibah University is considered relatively new, having been established only in 2003 and comprising 28 different colleges over three campuses in the holy city of Madinah. The main program offered by the College of Nursing is the Bachelor of Nursing, which is studied over four years (8 levels) plus an internship year. Students may be enrolled in the program directly after graduating from high school (the RNP), or may join a bridging program after they have completed their diploma following an initial study in other health institutes or health colleges (the NBP). Those enrolled in the RNP should (...truncated)