title: Educational climate perception by preclinical and clinical medical students in five Spanish medical schools.
abstract: OBJECTIVE
  The purpose of this study was to investigate student's perceptions of Educational Climate (EC) in Spanish medical schools, comparing various aspects of EC between the 2nd (preclinical) and the 4th (clinical) years to detect strengths and weaknesses in the on-going curricular reform.
  
  
  METHODS
  This study utilized a cross-sectional design and employed the Spanish version of the "Dundee Ready Education Environment Measure" (DREEM). The survey involved 894 2nd year students and 619 4th year students from five Spanish medical schools.
  
  
  RESULTS
  The global average score of 2nd year students from the five medical schools was found to be significantly higher (116.2±24.9, 58.2% of maximum score) than that observed in 4th year students (104.8±29.5, 52.4% of maximum score). When the results in each medical school were analysed separately, the scores obtained in the 2nd year were almost always significantly higher than in the 4th year for all medical schools, in both the global scales and the different subscales.
  
  
  CONCLUSIONS
  The perception of the EC by 2nd and 4th year students from five Spanish medical schools is more positive than negative although it is significantly lower in the 4th year. In both years, although more evident in the 4th year, students point out the existence of several important "problematic educational areas" associated with the persistence of traditional curricula and teaching methodologies. Our findings of this study should lead medical schools to make a serious reflection and drive the implementation of the necessary changes required to improve teaching, especially during the clinical period.
authors.affiliation: School of Medicine, University of Barcelona, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Palés
authors.affiliation: School of Medicine, University of Barcelona, Spain.
authors.forename: Arcadi
authors.initials: A
authors.lastname: Gual
authors.affiliation: School of Medicine, University of Zaragoza, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Escanero
authors.affiliation: School of Medicine and Dentistry, University of Santiago de Compostela, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Tomás
authors.affiliation: School of Health Sciences, University of Las Palmas de Gran Canaria, Spain.
authors.forename: Felipe
authors.initials: F
authors.lastname: Rodríguez-de Castro
authors.affiliation: School of Medicine and Health Sciences, International University of Catalonia, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Elorduy
authors.affiliation: School of Medicine and Health Sciences, International University of Catalonia, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Virumbrales
authors.affiliation: School of Medicine, University of Zaragoza, Spain.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Rodríguez
authors.affiliation: School of Medicine and Dentistry, University of Santiago de Compostela, Spain.
authors.forename: Víctor
authors.initials: V
authors.lastname: Arce
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003479:Curriculum / Q000592:standards; D004503:Education, Medical, Graduate; D004504:Education, Medical, Undergraduate; D005260:Female; D006801:Humans; D008297:Male; D010465:Perception; D011786:Quality Control; D012577:Schools, Medical / Q000458:organization & administration / Q000592:standards; D013030:Spain / Q000453:epidemiology; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: DREEM; Educational climate; undergraduate curriculum