Perception of the learning environment and its relationship with psychological distress in a cohort of preclinical medical and dental students in Nigeria: A cross-sectional study

Background

The learning environment strongly influences academic outcomes and wellbeing. This study assessed perception of the preclinical learning environment at the College of Medicine, University of Ibadan and explored associations with psychological distress.

Methods

A cross-sectional study was conducted among 187 second and third-year medical and dental students in a tertiary institution in south-western Nigeria using convenient sampling. An online structured self-administered questionnaire was adapted from the Dundee Ready Education Environment Measure (DREEM) inventory and the Kessler Psychological Distress Scale (K10). Data were analysed using descriptive statistics and non-parametric tests, and correlations were assessed with Spearman’s rho at a 95% confidence level.

Results

The overall mean DREEM score was 124.6 ± 23.7, reflecting a more positive than negative perception of the learning environment. The mean scores for the different domains were Perception of Learning 29.0 ± 7.7, Perception of Teachers 30.0 ± 5.9, Academic Self- Perception 20.7 ± 5.7, Perception of Atmosphere 29.1 ± 6.5 and Social Self-Perception 15.9 ± 4.0. The mean score on the K10 was 21.7, with 43.3% of respondents classified as likely well, 29.0% with mild distress, 13.4% with moderate distress and 13.9% with severe distress. Older students, male students and those in their third year reported higher DREEM scores, while higher academic grades were also associated with more positive perception. Psychological distress showed a negative correlation with the overall DREEM score ( r L = - 0.162; p = 0.027) and with several of its domains, suggesting that higher levels of distress were linked to less favourable perception of the learning environment.

Conclusion

Preclinical students at the University of Ibadan overall perceive their learning environment more positively, but substantial levels of psychological distress exist and are associated with poorer perception. Institutions should prioritise student wellbeing and strengthen feedback to enhance both educational climate and mental health.

Strengths and limitations of this study

• The study focuses on preclinical medical and dental students, a group often underrepresented in research on the learning environment.

• It is the first known study in Nigeria to explore the relationship between learning environment perceptions and psychological distress using validated tools.

• The use of two well-established instruments — the DREEM inventory and Kessler Psychological Distress Scale — enhances methodological validity and comparability with international research.

• The study design was cross-sectional and limited to a single institution, which may restrict generalisability to other medical schools.

• Data were self-reported and collected during a specific academic period, which may introduce response and contextual biases.