Educational Environment in Outcome-Based Medical Education: A Mixed-Methods Study of 25 th Intake Interns at the Defence Services Medical Academy, Myanmar

Abstract

The educational environment is an important determinant of students’ learning experiences, engagement, satisfaction, and professional development, particularly during major curriculum reform. The Defence Services Medical Academy (DSMA), Myanmar, has implemented Outcome-Based Medical Education (OBME) to promote competency-oriented, student-centred learning and closer alignment between educational outcomes, teaching, and assessment. Continued evaluation among successive student cohorts is necessary to determine how the curriculum is experienced in practice. This study evaluated the educational environment and experiences of 25 th Intake internship students undertaking the OBME programme at DSMA. An explanatory sequential mixed-methods design was employed. Quantitative data were obtained from 34 internship students using the 50-item Dundee Ready Education Environment Measure (DREEM) and analysed using descriptive statistics. The qualitative component used in-depth interviews and focus group discussions to explore students’ experiences, challenges, expectations, faculty support, and peer interaction; qualitative data were analysed thematically using MAXQDA. The overall mean DREEM score was 130/200, indicating an educational environment perceived as more positive than negative. Domain scores were 31.2 ± 6.5 for Students’ Perceptions of Learning, 28.7 ± 5.8 for Students’ Perceptions of Teachers, 24.5 ± 4.7 for Students’ Academic Self-Perception, 27.3 ± 5.2 for Students’ Perceptions of Atmosphere, and 18.3 ± 4.0 for Students’ Social Self-Perception. Five qualitative themes were identified: adaptation to OBME, faculty support, peer interaction, expectations versus experience, and positive aspects of the learning environment. Students valued collaborative learning, educational resources, faculty guidance, and greater responsibility for their learning. However, challenges were identified in self-directed learning, assessment, workload, consistency of faculty accessibility, and social interaction. The findings indicate that the educational environment for 25 th Intake interns was generally positive, while highlighting specific opportunities for curriculum improvement. Strengthened orientation, faculty development, clearer assessment communication, structured peer support, and regular cohort-based evaluation are recommended to support continued development of OBME at DSMA.