利用中文版DREEM量表探討畢業後一般醫學訓練學員對醫院教學環境的知覺感受

Using the Mandarin DREEM Questionnaire to Evaluate Postgraduate-Year Medical Trainees’Perceptions toward the Hospital Educational Environment

目的：本研究利用「鄧迪醫學教育環境評量」(Dundee Ready Education Environment Measure, DREEM)中譯量表評估畢業後一般醫學訓練(Post-Graduate Year, PGY)之學員對醫院臨床教育環境的感受及其相關因素之探討。方法：採橫斷性研究設計，研究對象於台灣南部某區域教學醫院接受醫事人員培訓計畫中的畢業後一般醫學訓練各醫事職類學員共149位。結果：中譯「鄧迪醫學教育環境評量」(DREEM)具有信效度(符合量表驗收標準)。研究發現「鄧迪醫學教育環境評量」分數與訓練時間有顯著關聯，受訓一年以上的學員對醫學教育環境的感受高於未滿一年的學員，除「學員對教師的知覺」(Students' Perceptions of Teachers, SPT)構面及其子題項均無顯著差異。結論：訓練時間會影響學員整體教育環境感受，特別是剛進入職場訓練學員感受較低，更需教學單位注意。中譯DREEM量表可提供醫院評估臨床醫學教育系統優劣，以確定需要改進之低分領域，持續改善教育環境。

Objectives. The aim of this research was to utilize a Mandarin version of the Dundee Ready Education Environment Measure (DREEM) scale to evaluate trainees’perceptions on a hospital’s clinical educational environment.
Methods. A cross-sectional study design was implemented, and 149 study subjects were chosen from the group of postgraduate-year (PGY) trainees at a teaching hospital in southern Taiwan between November 2017 and May 2018.
Results. The Chinese-translated DREEM scale demonstrated reliability and validity, and therefore acceptance criteria compliance. We found a highly significant association between DREEM scores and training duration. PGY trainees with over one year of training had better attitudes toward the educational environment than the trainees with under one year of training. The only parameter showing no significant difference was“students’perceptions of teachers”along with its corresponding subtopics.
Conclusion. Training time affects the overall perception of the educational environment, especially in the introductory stage of workplace trainee training (≤1 year), and this requires the attention of the teaching unit. The Chinese-translated DREEM scale can provide the hospital with an evaluation of the pros and cons of the clinical education system to identify low-scoring areas for continuous improvement of the educational environment.