From Curriculum Transition to Maturation: A Mixed-Methods Evaluation of the Educational Environment in Outcome-Based Medical Education

Background: As outcome-based medical education (OBME) becomes established, students’ experiences offer insight into strengths and unresolved implementation challenges. Earlier cohorts at the Defence Services Medical Academy (DSMA) reported broadly favourable educational environments alongside concerns about assessment, workload, faculty support and social life. Objective: To assess the educational environment of 26th Intake interns and examine experiences that contextualise their Dundee Ready Education Environment Measure (DREEM) scores. Methods: This explanatory sequential mixed-methods study surveyed 33 interns using the 50-item DREEM, followed by purposively sampled individual interviews with 10 students. Descriptive statistics summarised survey scores; interview transcripts were thematically analysed using MAXQDA. Findings were integrated through an explanatory joint display. Results: The mean overall DREEM score was 134.2/200. Domain means (mean ± standard deviation) were 32.4 ± 5.9 for Students’ Perceptions of Learning, 29.6 ± 5.2 for Students’ Perceptions of Teachers, 25.3 ± 4.4 for Students’ Academic Self-Perception, 28.2 ± 4.8 for Students’ Perceptions of Atmosphere and 18.7 ± 3.7 for Students’ Social Self-Perception. Interviews identified five themes: growing adjustment to student-directed learning; improved but inconsistent assessment clarity; the importance of accessible feedback; peer-based learning support; and tensions between academic workload and social wellbeing. Conclusion: Interns generally viewed their environment positively, but their narratives identify differences in assessment communication, access to faculty and opportunities for rest and social interaction. These descriptive, single-cohort findings can inform local quality improvement; they do not establish that curriculum maturation caused changes from prior cohorts.