Medical Education Amidst Conflict: A National Assessment of Sudanese Medical Students’ Perceptions Using the DREEM Tool

Background The ongoing conflict in Sudan has severely disrupted medical education, urging the need to assess the educational environment experienced by medical students across the country. Methods A cross-sectional study was conducted between December 2024 and February 2025, involving 2,714 medical students from 46 Sudanese universities. A convenience sampling method was implemented. Data were collected via a self-administered online questionnaire comprising demographic items and the Dundee Ready Education Environment Measure (DREEM) scale. The 50-item DREEM assesses five domains: perceptions of learning, teachers, academic self-perception, atmosphere, and social self-perception. Reliability was assessed using Cronbach’s alpha, and data were analyzed using SPSS v29. Independent t-tests and ANOVA were performed to explore associations between DREEM scores and demographic variables. Results The sample was predominantly female (70.1%), with a median age of 22 years. The overall mean DREEM score was 125.99, indicating an environment that was more positive than negative. Among the subdomains, perceptions of atmosphere (M = 30.23) and learning (M = 29.83) scored highest, while social self-perception was lowest (M = 17.36). Reliability analysis demonstrated good internal consistency for the total scale (α = 0.882), with acceptable reliability across most subscales except social self-perception (α = 0.495). Gender and academic level significantly influenced subscale scores. Clinical students and those residing in dormitories also reported more favorable perceptions (p < 0.05). Conclusion Despite the ongoing conflict, medical students in Sudan reported generally positive perceptions of their educational environment, but major concerns centered on academic stress, passive teaching, and weak institutional support were highlighted. These results point to urgent priorities for strengthening medical education during crises to maintain its quality and continuity. Clinical trial number: Not applicable