title: Perceptions by medical students of their educational environment for obstetrics and gynaecology in metropolitan and rural teaching sites.
abstract: BACKGROUND
  Medical student education in Western Australia is expanding to secondary level metropolitan hospitals and rural sites to accommodate workforce demands and increasing medical student numbers.
  
  
  OBJECTIVE
  To determine if students' perceptions of the teaching environment for obstetrics and gynaecology differ between tertiary, secondary level metropolitan hospitals and rural sites, and to determine if students' perceptions of their learning environment are associated with improved academic performance.
  
  
  METHODS
  An evaluation was conducted of medical students' perceptions of their learning environment during an obstetrics and gynaecology program at a variety of sites across metropolitan and rural Western Australia. The evaluation was based on the Dundee Ready Education Environmental Measure (DREEM) questionnaire.
  
  
  RESULTS
  There were no significant differences in students' perceptions of their learning environment between the tertiary hospital, combined programs involving a tertiary and secondary metropolitan hospital, rural sites with a population of more than 25,000 and rural sites with a population less than 25,000 people. Perceptions were similar in male and female students. The overall mean score for all perceptions of the learning environment in obstetrics and gynaecology were in the range considered to be favorable. Higher scores of perceptions of the learning environment were associated positively with the measures of academic achievement in the clinical, but not written, examination.
  
  
  CONCLUSIONS
  Medical students' perceptions of their learning environment in obstetrics and gynaecology were not influenced by the geographical site of delivery or their gender but were positively related to higher academic achievement. Providing appropriate academic and clinical support systems have been put in place the education of medical students can be extended outside major hospitals and into outer metropolitan and rural communities without any apparent reduction in perceptions of the quality of their learning environment.
authors.affiliation: The University of Western Australia, Western Australia, Women and Infants Research Foundation, Western Australia. di.carmody@uwa.edu.au
authors.forename: Dianne F
authors.initials: DF
authors.lastname: Carmody
authors.forename: Angela
authors.initials: A
authors.lastname: Jacques
authors.forename: Harriet
authors.initials: H
authors.lastname: Denz-Penhey
authors.forename: Ian
authors.initials: I
authors.lastname: Puddey
authors.forename: John P
authors.initials: JP
authors.lastname: Newnham
mesh_terms: D004504:Education, Medical, Undergraduate; D005260:Female; D006176:Gynecology / Q000193:education*; D006780:Hospitals, Rural; D006786:Hospitals, Urban; D006801:Humans; D016014:Linear Models; D008297:Male; D009774:Obstetrics / Q000193:education*; D010465:Perception; D013337:Students, Medical / Q000523:psychology*; D014904:Western Australia