Assessment of the clinical educational environment using the Dundee Ready Education Environment Measure inventory among paramedical students in Iran: A cross-sectional study

This study assessed the clinical educational environment at Sirjan School of Medical Sciences using the Dundee Ready Education Environment Measure (DREEM). A cross-sectional study was conducted among 276 undergraduate students in nursing, midwifery, laboratory sciences, emergency medicine, and anesthesia who had completed at least three semesters and entered clinical training. Data were collected using demographic forms and the validated Persian version of the DREEM questionnaire. The mean total DREEM score was 113.07 (SD=20.91), indicating an overall moderate-to-positive perception of the educational environment. Among the DREEM domains, Students’ Perceptions of Learning had the highest mean score (28.02 [standard deviation (SD)=6.90]), followed by Students’ Academic Self-Perception (26.05 [SD=5.44]) and Students’ Perceptions of Teachers (24.61 [SD=6.63]). The lowest domain score was observed for Students’ Social Self-Perceptions (16.52 [SD=4.30]). DREEM scores differed significantly according to age group (F=15.455, P<0.001) and academic major (F=3.484, P=0.009). Students older than 26 years reported the highest mean DREEM score (141.61 [SD=16.64]), while students aged 21–23 years had the lowest score (108.89 [SD=21.91]). Across majors, midwifery students had the highest mean DREEM score (121.80 [SD=24.22]), whereas anesthesiology students had the lowest score (107.46 [SD=17.65]). The academic field was significantly associated with the DREEM score. Compared with nursing students, emergency students had significantly higher DREEM scores (B=9.155, SE=3.046, β=0.189, P=0.003), with a 95% confidence interval (CI) ranging from 3.157 to 15.153. Similarly, laboratory students scored significantly higher than nursing students (B=6.918, SE=3.310, β=0.131, P=0.038; 95%CI: 0.400 to 13.437). Paramedical students perceived the clinical learning environment positively, though discipline-specific differences highlight areas for improvement. Strengthening psychosocial support and promoting learner-centered teaching strategies are recommended to enhance the quality of clinical education. These findings provide practical implications for curriculum development and faculty training in allied health programs.