Document Type : Original Article


1 PhD Scholar, Department of Neurophysiotherapy, D. Y. Patil School of Physiotherapy, Navi Mumbai, Maharashtra, India

2 Professor and Director, Department of Physiotherapy in Community Health, DY Patil School of Physiotherapy, Navi Mumbai, Maharashtra, India

3 Associate Professor, Head of Department of Neurophysiotherapy, DY Patil School of Physiotherapy, Navi Mumbai, Maharashtra, India

4 Professor and Head, Department of Physiotherapy, T.N. Medical College and B.Y.L. Nair Charitable Hospital, Mumbai, Maharashtra, India


BACKGROUND: Students’ perception of their academic environment has a substantial influence
on their actions, academic accomplishments, satisfaction, goal attainment, and behavior. The study
was carried out to evaluate the perception of academic environment in physiotherapy students, and
to identify the specific domains which could act as predictors of academic performance.
MATERIALS AND METHODS: This descriptive, cross-sectional research was conducted
over 12 months using total population sampling. Three hundred and forty-three (139 postgraduate
and 204 final year) final year and postgraduate physiotherapy students from five colleges of
Mumbai and Navi Mumbai, who conformed to the inclusion benchmarks, participated in the study.
Perception of educational environment was evaluated using Dundee Ready Education Environment
Measure (DREEM). Academic performance was evaluated using the percentage obtained in the
last university examination. Data were entered in MS Excel (©Microsoft, USA) and converted to
Stata Version 15.1© StataCorp, College Station, for further analysis. The mean values and standard
deviations for perception of educational environment were calculated and linear regression models
were used to conduct multivariate analysis for each item in the questionnaire.
RESULTS: The mean total DREEM score of physiotherapy students was 129.97 ± 22.72. Students
whose Students’ Academic Self‑perception scores were in the “Feeling more on the positive side”
category showed a 4.17 point increase in percentage scores as compared with those who reported
feeling like a total failure/had many negative aspects to their academic self‑perception (95% confidence
interval [CI]: 2.46, 5.89; P < 0.001). Students whose Students’ Perception of Learning (SPoL) scores
were in the “Teaching highly thought of” category showed a 2.75 point increase in percentage scores
as compared with those who viewed teaching poorly/negatively (95% CI: 0.44, 5.06; P = 0.02).
CONCLUSION: Physiotherapy students had a “more positive than negative” view of the academic
environment; however, a few “problematic areas” need to be remediated. Efforts to improve students’
academic self-perception may improve their academic performance since this was the strongest
predictor of their academic performance, followed by total DREEM scores and SPoL.


1. Gagne RM. The Conditions of Learning and Theory of Instruction.
4th ed. Montreal: Holt, Rinehart and Winston, Inc; 1985.
2. Wittrock M. Learning and Instruction. Berkeley, CA: McCutchan
Publishing Corp; 1977.
3. Elise JK. An Analysis of Learning Strategies used by Canadian
Surgical Residents. Thesis Submitted to the Faculty of Graduate
Studies Calgary, Alberta; 1998. Available from: https://prism. accessed on 1st November,
4. Newble DI, Entwistle NJ. Learning styles and approaches:
Implication for medical education. Med Educ 1986;20:162‑75.
5. Myint K, See‑Ziau H, Husain R, Ismail R. Dental students’
educational environment and perceived stress: The University
of Malaya experience. Malays J Med Sci 2016;23:49‑56.
6. Schönrock‑Adema J, Bouwkamp‑Timmer T, van Hell EA,
Cohen‑Schotanus J. Key elements in assessing the educational
environment: Where is the theory? Adv Health Sci Educ Theory
Pract 2012;17:727‑42.
7. Dunne F, McAleer S, Roff S. Assessment of the undergraduate
medical education environment in a large UK medical school.
Health Educ J 2006;65:149‑58.
8. Taylor N, Farina G. An Analysis of the Proposed Influences of
Multiple Factors on the Learning Characteristics of Physical
Therapy Students in Three Countries. A Dissertation submitted
to the Faculty of the Graduate School of Education and Human
Development of the George Washington University; 1997.
Available from:
50&diss=y.Last accessed on 1st November, 2021.
9. Harden RM. The learning environment and the curriculum. Med
Teach 2001;23:335‑6.
10. Genn JM. AMEE medical education guide no. 23 (part 1):
Curriculum, environment, climate, quality and change in medical
education – A unifying perspective. Med Teach 2001;23:337‑44.
11. Genn JM. AMEE medical education guide no. 23 (part 2):
Curriculum, environment, climate, quality and change in medical
education – A unifying perspective. Med Teach 2001;23:445‑54.
12. Rukban MO, Khalil MS, Al‑Zalabani A. Learning environment in
medical schools adopting different educational strategies. Educ
Res Rev 2010;5:126‑9.
13. Pimparyon P, Roff S, McAleer S, Poonchai B, Pemba S. Educational
environment, student approaches to learning and academic
achievement in a Thai nursing school. Med Teach 2000;22:359‑65.
14. Audin K, Davy J, Barkham M. University quality of life and
learning (UNIQoLL): An approach to student wellbeing,
satisfaction and institutional change. J Further Higher Educ
15. Roff S, McAleer S, Harden RM, Al‑Qahtani M, Ahmed AU,
Deza H, et al. Development and validation of the dundee
ready education environment measure (DREEM). Med Teach
16. Pai PG, Menezes V, Srikanth, Subramanian AM, Shenoy JP.
Medical students’ perception of their educational environment.
J Clin Diagn Res 2014;8:103‑7.
17. Palmgren PJ, Lindquist I, Sundberg T, Nilsson GH, Laksov KB.
Exploring perceptions of the educational environment among
undergraduate physiotherapy students. Int J Med Educ
18. Walankar P, Panhale V, Situt S. Students’ perception of the
educational environment in an Indian physiotherapy college.
Internet J Allied Health Sci Pract 2019;17(2), Article 1:1‑9
19. Deshmukh P, Chourasia S, Uikey P. Perception of educational
environment in physiotherapy undergraduate students. Int J
Recent Sci Res 2020;11:37059‑69.
20. Soemantri D, Herrera C, Riquelme A. Measuring the educational
environment in health professions studies: A systematic review.
Med Teach 2010;32:947‑52.
21. Roff S. The dundee ready educational environment
measure (DREEM) – A generic instrument for measuring students’
perceptions of undergraduate health professions curricula. Med
Teach 2005;27:322‑5.
22. Zawawi AH, Elzubeir M. Using DREEM to compare graduating
students’ perceptions of learning environments at medical
schools adopting contrasting educational strategies. Med Teach
23. McAleer S, Roff S. A practical guide to using the dundee ready
education environment measure (DREEM). AMEE Med Educ
Guide 2001;23:29‑33.
24. Davis MH. AMEE medical education guide no. 15: Problem‑based
learning: A practical guide. Med Teach 1999;21:130‑40.
25. Edgren G, Haffling AC, Jakobsson U, McAleer S, Danielsen N.
Comparing the educational environment (as measured by
DREEM) at two different stages of curriculum reform. Med Teach
26. Kohli V, Dhaliwal U. Medical students’ perception of the
educational environment in a medical college in India:
A cross‑sectional study using the dundee ready education
environment questionnaire. J Educ Eval Health Prof 2013;10:5.
27. Veerapen K, McAleer S. Students’ perception of the learning
environment in a distributed medical programme. Med Educ
Online 2010;15:1,51‑68[doi: 10.3402/meo.v15i0.5168].
28. Al‑Qahtani MF. Associations between approaches to study, the
learning environment, and academic achievement. J Taibah Univ
Med Sci 2015;10:56‑65.
29. Robbins SB, Lauver K, Le H, Davis D, Langley R, Carlstrom A.
Do psychosocial and study skill factors predict college outcomes?
A meta‑analysis. Psychol Bull 2004;130:261‑88.
30. Kriegbaum K, Jansen M, Spinath B. Motivation: A predictor of
PISA’s mathematical competence beyond intelligence and prior
test achievement. Learn Individ Dif 2015;43:140‑8.
31. Steinmayr R, Weidinger AF, Schwinger M, Spinath B.
The importance of students’ motivation for their academic
achievement –Replicating and extending previous findings. Front
Psychol 2019;10:1730.