From Curriculum Transition to Maturation: 
A Mixed-Methods Evaluation of the Educational Environment in Outcome-Based Medical Education

Ye Phyo Aung; Tun Tun Naing; Tayzar Hein; Zaw Phyo; Soe Thu Ya; Pyi Hein Kyaw; Tin Tun; Myint Thein Naing; Lay Ko

doi:doi:10.11648/j.mededu.20260203.11

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From Curriculum Transition to Maturation: A Mixed-Methods Evaluation of the Educational Environment in Outcome-Based Medical Education

Ye Phyo Aung^*

, Tun Tun Naing

, Tayzar Hein

, Zaw Phyo

, Soe Thu Ya, Pyi Hein Kyaw

, Tin Tun

, Myint Thein Naing

, Lay Ko

Published in American Journal of Medical Education (Volume 2, Issue 3)

Received: 7 October 2026 Accepted: 16 October 2026 Published: 29 October 2026

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Abstract

Background: As outcome-based medical education (OBME) becomes established, students’ experiences offer insight into strengths and unresolved implementation challenges. Earlier cohorts at the Defence Services Medical Academy (DSMA) reported broadly favourable educational environments alongside concerns about assessment, workload, faculty support and social life. Objective: To assess the educational environment of 26th Intake interns and examine experiences that contextualise their Dundee Ready Education Environment Measure (DREEM) scores. Methods: This explanatory sequential mixed-methods study surveyed 33 interns using the 50-item DREEM, followed by purposively sampled individual interviews with 10 students. Descriptive statistics summarised survey scores; interview transcripts were thematically analysed using MAXQDA. Findings were integrated through an explanatory joint display. Results: The mean overall DREEM score was 134.2/200. Domain means (mean ± standard deviation) were 32.4 ± 5.9 for Students’ Perceptions of Learning, 29.6 ± 5.2 for Students’ Perceptions of Teachers, 25.3 ± 4.4 for Students’ Academic Self-Perception, 28.2 ± 4.8 for Students’ Perceptions of Atmosphere and 18.7 ± 3.7 for Students’ Social Self-Perception. Interviews identified five themes: growing adjustment to student-directed learning; improved but inconsistent assessment clarity; the importance of accessible feedback; peer-based learning support; and tensions between academic workload and social wellbeing. Conclusion: Interns generally viewed their environment positively, but their narratives identify differences in assessment communication, access to faculty and opportunities for rest and social interaction. These descriptive, single-cohort findings can inform local quality improvement; they do not establish that curriculum maturation caused changes from prior cohorts.

Published in	American Journal of Medical Education (Volume 2, Issue 3)
DOI	10.11648/j.mededu.20260203.11
Page(s)	41-49
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2026. Published by Science Publishing Group

Keywords

Medical Education, DREEM, Educational Environment, Outcome-Based Medical Education, Mixed Methods, Curriculum Evaluation, Internship, Myanmar

References

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[7]	Noreen K, Khan KA, Nehra RA. Students’ perception of learning environment using Dundee Ready Education Environment Measure (DREEM) inventory. Pak J Public Health. 2018; 8(2): 112-116. https://doi.org/10.32413/pjph.v8i2.154
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[12]	Veloski J, Boex JR, Grasberger MJ, Evans A, Wolfson DB. Systematic review of the literature on assessment, feedback and physicians’ clinical performance: BEME Guide No. 7. Med Teach. 2006; 28(2): 117-128. https://doi.org/10.1080/01421590600622665
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APA Style

Aung, Y. P., Naing, T. T., Hein, T., Phyo, Z., Ya, S. T., et al. (2026). From Curriculum Transition to Maturation: A Mixed-Methods Evaluation of the Educational Environment in Outcome-Based Medical Education. American Journal of Medical Education, 2(3), 41-49. https://doi.org/10.11648/j.mededu.20260203.11

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ACS Style

Aung, Y. P.; Naing, T. T.; Hein, T.; Phyo, Z.; Ya, S. T., et al. From Curriculum Transition to Maturation: A Mixed-Methods Evaluation of the Educational Environment in Outcome-Based Medical Education. Am. J. Med. Educ. 2026, 2(3), 41-49. doi: 10.11648/j.mededu.20260203.11

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AMA Style

Aung YP, Naing TT, Hein T, Phyo Z, Ya ST, et al. From Curriculum Transition to Maturation: A Mixed-Methods Evaluation of the Educational Environment in Outcome-Based Medical Education. Am J Med Educ. 2026;2(3):41-49. doi: 10.11648/j.mededu.20260203.11

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@article{10.11648/j.mededu.20260203.11,
  author = {Ye Phyo Aung and Tun Tun Naing and Tayzar Hein and Zaw Phyo and Soe Thu Ya and Pyi Hein Kyaw and Tin Tun and Myint Thein Naing and Lay Ko},
  title = {From Curriculum Transition to Maturation: 
A Mixed-Methods Evaluation of the Educational Environment in Outcome-Based Medical Education},
  journal = {American Journal of Medical Education},
  volume = {2},
  number = {3},
  pages = {41-49},
  doi = {10.11648/j.mededu.20260203.11},
  url = {https://doi.org/10.11648/j.mededu.20260203.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.mededu.20260203.11},
  abstract = {Background: As outcome-based medical education (OBME) becomes established, students’ experiences offer insight into strengths and unresolved implementation challenges. Earlier cohorts at the Defence Services Medical Academy (DSMA) reported broadly favourable educational environments alongside concerns about assessment, workload, faculty support and social life. Objective: To assess the educational environment of 26th Intake interns and examine experiences that contextualise their Dundee Ready Education Environment Measure (DREEM) scores. Methods: This explanatory sequential mixed-methods study surveyed 33 interns using the 50-item DREEM, followed by purposively sampled individual interviews with 10 students. Descriptive statistics summarised survey scores; interview transcripts were thematically analysed using MAXQDA. Findings were integrated through an explanatory joint display. Results: The mean overall DREEM score was 134.2/200. Domain means (mean ± standard deviation) were 32.4 ± 5.9 for Students’ Perceptions of Learning, 29.6 ± 5.2 for Students’ Perceptions of Teachers, 25.3 ± 4.4 for Students’ Academic Self-Perception, 28.2 ± 4.8 for Students’ Perceptions of Atmosphere and 18.7 ± 3.7 for Students’ Social Self-Perception. Interviews identified five themes: growing adjustment to student-directed learning; improved but inconsistent assessment clarity; the importance of accessible feedback; peer-based learning support; and tensions between academic workload and social wellbeing. Conclusion: Interns generally viewed their environment positively, but their narratives identify differences in assessment communication, access to faculty and opportunities for rest and social interaction. These descriptive, single-cohort findings can inform local quality improvement; they do not establish that curriculum maturation caused changes from prior cohorts.},
 year = {2026}
}

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TY  - JOUR
T1  - From Curriculum Transition to Maturation: 
A Mixed-Methods Evaluation of the Educational Environment in Outcome-Based Medical Education
AU  - Ye Phyo Aung
AU  - Tun Tun Naing
AU  - Tayzar Hein
AU  - Zaw Phyo
AU  - Soe Thu Ya
AU  - Pyi Hein Kyaw
AU  - Tin Tun
AU  - Myint Thein Naing
AU  - Lay Ko
Y1  - 2026/10/29
PY  - 2026
N1  - https://doi.org/10.11648/j.mededu.20260203.11
DO  - 10.11648/j.mededu.20260203.11
T2  - American Journal of Medical Education
JF  - American Journal of Medical Education
JO  - American Journal of Medical Education
SP  - 41
EP  - 49
PB  - Science Publishing Group
SN  - 3070-1570
UR  - https://doi.org/10.11648/j.mededu.20260203.11
AB  - Background: As outcome-based medical education (OBME) becomes established, students’ experiences offer insight into strengths and unresolved implementation challenges. Earlier cohorts at the Defence Services Medical Academy (DSMA) reported broadly favourable educational environments alongside concerns about assessment, workload, faculty support and social life. Objective: To assess the educational environment of 26th Intake interns and examine experiences that contextualise their Dundee Ready Education Environment Measure (DREEM) scores. Methods: This explanatory sequential mixed-methods study surveyed 33 interns using the 50-item DREEM, followed by purposively sampled individual interviews with 10 students. Descriptive statistics summarised survey scores; interview transcripts were thematically analysed using MAXQDA. Findings were integrated through an explanatory joint display. Results: The mean overall DREEM score was 134.2/200. Domain means (mean ± standard deviation) were 32.4 ± 5.9 for Students’ Perceptions of Learning, 29.6 ± 5.2 for Students’ Perceptions of Teachers, 25.3 ± 4.4 for Students’ Academic Self-Perception, 28.2 ± 4.8 for Students’ Perceptions of Atmosphere and 18.7 ± 3.7 for Students’ Social Self-Perception. Interviews identified five themes: growing adjustment to student-directed learning; improved but inconsistent assessment clarity; the importance of accessible feedback; peer-based learning support; and tensions between academic workload and social wellbeing. Conclusion: Interns generally viewed their environment positively, but their narratives identify differences in assessment communication, access to faculty and opportunities for rest and social interaction. These descriptive, single-cohort findings can inform local quality improvement; they do not establish that curriculum maturation caused changes from prior cohorts.
VL  - 2
IS  - 3
ER  -

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Author Information

Ye Phyo Aung

Department of Medical Education, Defence Services Medical Academy, Yangon, Myanmar

Contact Email

http://orcid.org/0000-0002-4361-4075
Tun Tun Naing

Department of Medical Education, Defence Services Medical Academy, Yangon, Myanmar

Contact Email

http://orcid.org/0009-0007-3774-6868
Tayzar Hein

Department of Medical Education, Defence Services Medical Academy, Yangon, Myanmar

Contact Email

http://orcid.org/0009-0005-9003-6334
Zaw Phyo

Department of Medical Education, Defence Services Medical Academy, Yangon, Myanmar

Contact Email

http://orcid.org/0009-0000-5676-5692
Soe Thu Ya

Department of Medical Education, Defence Services Medical Academy, Yangon, Myanmar

Contact Email
Pyi Hein Kyaw

Department of Medical Education, Defence Services Medical Academy, Yangon, Myanmar

Contact Email

http://orcid.org/0009-0007-5834-4534
Tin Tun

Department of Biochemistry, Manipal University College Malaysia, Melaka, Myanmar

Contact Email

http://orcid.org/0009-0006-2120-2498
Myint Thein Naing

Department of Neurology, Defence Services Medical Academy, Yangon, Myanmar

Contact Email

http://orcid.org/0000-0002-7940-0204
Lay Ko

Department of Otorhinolaryngology-Head and Neck Surgery, Defence Services Medical Academy, Yangon, Myanmar

Contact Email

http://orcid.org/0009-0001-7772-0968

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Plain Text BibTeX RIS

APA Style

Aung, Y. P., Naing, T. T., Hein, T., Phyo, Z., Ya, S. T., et al. (2026). From Curriculum Transition to Maturation: A Mixed-Methods Evaluation of the Educational Environment in Outcome-Based Medical Education. American Journal of Medical Education, 2(3), 41-49. https://doi.org/10.11648/j.mededu.20260203.11

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ACS Style

Aung, Y. P.; Naing, T. T.; Hein, T.; Phyo, Z.; Ya, S. T., et al. From Curriculum Transition to Maturation: A Mixed-Methods Evaluation of the Educational Environment in Outcome-Based Medical Education. Am. J. Med. Educ. 2026, 2(3), 41-49. doi: 10.11648/j.mededu.20260203.11

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AMA Style

Aung YP, Naing TT, Hein T, Phyo Z, Ya ST, et al. From Curriculum Transition to Maturation: A Mixed-Methods Evaluation of the Educational Environment in Outcome-Based Medical Education. Am J Med Educ. 2026;2(3):41-49. doi: 10.11648/j.mededu.20260203.11

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@article{10.11648/j.mededu.20260203.11,
  author = {Ye Phyo Aung and Tun Tun Naing and Tayzar Hein and Zaw Phyo and Soe Thu Ya and Pyi Hein Kyaw and Tin Tun and Myint Thein Naing and Lay Ko},
  title = {From Curriculum Transition to Maturation: 
A Mixed-Methods Evaluation of the Educational Environment in Outcome-Based Medical Education},
  journal = {American Journal of Medical Education},
  volume = {2},
  number = {3},
  pages = {41-49},
  doi = {10.11648/j.mededu.20260203.11},
  url = {https://doi.org/10.11648/j.mededu.20260203.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.mededu.20260203.11},
  abstract = {Background: As outcome-based medical education (OBME) becomes established, students’ experiences offer insight into strengths and unresolved implementation challenges. Earlier cohorts at the Defence Services Medical Academy (DSMA) reported broadly favourable educational environments alongside concerns about assessment, workload, faculty support and social life. Objective: To assess the educational environment of 26th Intake interns and examine experiences that contextualise their Dundee Ready Education Environment Measure (DREEM) scores. Methods: This explanatory sequential mixed-methods study surveyed 33 interns using the 50-item DREEM, followed by purposively sampled individual interviews with 10 students. Descriptive statistics summarised survey scores; interview transcripts were thematically analysed using MAXQDA. Findings were integrated through an explanatory joint display. Results: The mean overall DREEM score was 134.2/200. Domain means (mean ± standard deviation) were 32.4 ± 5.9 for Students’ Perceptions of Learning, 29.6 ± 5.2 for Students’ Perceptions of Teachers, 25.3 ± 4.4 for Students’ Academic Self-Perception, 28.2 ± 4.8 for Students’ Perceptions of Atmosphere and 18.7 ± 3.7 for Students’ Social Self-Perception. Interviews identified five themes: growing adjustment to student-directed learning; improved but inconsistent assessment clarity; the importance of accessible feedback; peer-based learning support; and tensions between academic workload and social wellbeing. Conclusion: Interns generally viewed their environment positively, but their narratives identify differences in assessment communication, access to faculty and opportunities for rest and social interaction. These descriptive, single-cohort findings can inform local quality improvement; they do not establish that curriculum maturation caused changes from prior cohorts.},
 year = {2026}
}

Copy | Download

TY  - JOUR
T1  - From Curriculum Transition to Maturation: 
A Mixed-Methods Evaluation of the Educational Environment in Outcome-Based Medical Education
AU  - Ye Phyo Aung
AU  - Tun Tun Naing
AU  - Tayzar Hein
AU  - Zaw Phyo
AU  - Soe Thu Ya
AU  - Pyi Hein Kyaw
AU  - Tin Tun
AU  - Myint Thein Naing
AU  - Lay Ko
Y1  - 2026/10/29
PY  - 2026
N1  - https://doi.org/10.11648/j.mededu.20260203.11
DO  - 10.11648/j.mededu.20260203.11
T2  - American Journal of Medical Education
JF  - American Journal of Medical Education
JO  - American Journal of Medical Education
SP  - 41
EP  - 49
PB  - Science Publishing Group
SN  - 3070-1570
UR  - https://doi.org/10.11648/j.mededu.20260203.11
AB  - Background: As outcome-based medical education (OBME) becomes established, students’ experiences offer insight into strengths and unresolved implementation challenges. Earlier cohorts at the Defence Services Medical Academy (DSMA) reported broadly favourable educational environments alongside concerns about assessment, workload, faculty support and social life. Objective: To assess the educational environment of 26th Intake interns and examine experiences that contextualise their Dundee Ready Education Environment Measure (DREEM) scores. Methods: This explanatory sequential mixed-methods study surveyed 33 interns using the 50-item DREEM, followed by purposively sampled individual interviews with 10 students. Descriptive statistics summarised survey scores; interview transcripts were thematically analysed using MAXQDA. Findings were integrated through an explanatory joint display. Results: The mean overall DREEM score was 134.2/200. Domain means (mean ± standard deviation) were 32.4 ± 5.9 for Students’ Perceptions of Learning, 29.6 ± 5.2 for Students’ Perceptions of Teachers, 25.3 ± 4.4 for Students’ Academic Self-Perception, 28.2 ± 4.8 for Students’ Perceptions of Atmosphere and 18.7 ± 3.7 for Students’ Social Self-Perception. Interviews identified five themes: growing adjustment to student-directed learning; improved but inconsistent assessment clarity; the importance of accessible feedback; peer-based learning support; and tensions between academic workload and social wellbeing. Conclusion: Interns generally viewed their environment positively, but their narratives identify differences in assessment communication, access to faculty and opportunities for rest and social interaction. These descriptive, single-cohort findings can inform local quality improvement; they do not establish that curriculum maturation caused changes from prior cohorts.
VL  - 2
IS  - 3
ER  -

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