A psychometric appraisal of the DREEM

239 final year medical students were asked to complete the DREEM inventory. Anonymised responses were entered into a database. Data analysis was performed using PASW 18 and confirmatory factor analysis performed.Whilst the total DREEM score had an acceptable level of internal consistency (alpha 0.89), subscale analysis shows that two subscales had sub-optimal internal consistency. Multiple group confirmatory factor analysis (using Fleming's indices) shows an overall fit of 0.76, representing a weak but acceptable level of fit. 17 of the 50 items manifest fit indices less than 0.70. We sought the best fitting oblique solution to the 5-subscale structure, which showed large correlations, suggesting that the independence of the separate scales is open to question.There has perhaps been an inadequate focus on establishing and maintaining the psychometric credentials of the DREEM. The present study highlights two concerns. Firstly, the internal consistency of the 5 scales is quite variable and, in our sample, appears rather low. Secondly, the construct validity is not well supported. We suggest that users of the DREEM will provide basic psychometric appraisal of the device in future published reports.In 1998, the World Federation for Medical Education highlighted the learning environment as one of the targets for the evaluation of medical education programmes [1]. It is widely agreed among medical educators that the effects of the educational environment, both academic and clinical, are important determinants of medical students attitudes, knowledge, skills, progression and behaviours [2,3]. Evaluation of the educational environment at both academic and clinical sites is key to the delivery of a high quality, student centred curriculum [4]. In order to conduct such evaluation across many sites, specialties and student groups use of a comprehensive, valid and reliable instrument is essential.Over the last 4 decades educators and researchers have attempted to define and me