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Background <p>In Spain, access to specialized medical training is determined through a highly competitive national examination (MIR). While the educational climate of medical schools has been associated with students’ learning outcomes and well-being, its relationship with performance in high-stakes national examinations remains unclear.</p> Methods <p>A multicenter ecological study was conducted including 31 public medical schools in Spain. Educational climate was assessed using the Dundee Ready Education Environment Measure (DREEM). Institutional MIR outcomes, including pass rates and residency placement rates, were obtained from official national data (2023–2025). Associations between DREEM scores and MIR outcomes were analyzed using Spearman’s correlation.</p> Results <p>A total of 3,632 students participated. Institutions with higher DREEM tended to show higher MIR pass and residency placement rates, however, no statistically significant correlations were observed between overall educational climate scores and MIR outcomes. Similarly, none of the DREEM subscales showed statistically significant associations with MIR indicators.</p> Conclusions <p>Educational climate showed a limited and non-significant association with MIR outcomes, suggesting that performance in high-stakes national examinations is influenced by a complex interplay of factors beyond the institutional learning environment.</p>

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Institutional educational climate and MIR examination outcomes: a multicenter ecological study in Spanish medical schools

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月28日

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  • Jesús Millán,
  • Beatriz Gal,
  • Montserrat Esquerda,
  • Joaquín García-Estañ

摘要

Background

In Spain, access to specialized medical training is determined through a highly competitive national examination (MIR). While the educational climate of medical schools has been associated with students’ learning outcomes and well-being, its relationship with performance in high-stakes national examinations remains unclear.

Methods

A multicenter ecological study was conducted including 31 public medical schools in Spain. Educational climate was assessed using the Dundee Ready Education Environment Measure (DREEM). Institutional MIR outcomes, including pass rates and residency placement rates, were obtained from official national data (2023–2025). Associations between DREEM scores and MIR outcomes were analyzed using Spearman’s correlation.

Results

A total of 3,632 students participated. Institutions with higher DREEM tended to show higher MIR pass and residency placement rates, however, no statistically significant correlations were observed between overall educational climate scores and MIR outcomes. Similarly, none of the DREEM subscales showed statistically significant associations with MIR indicators.

Conclusions

Educational climate showed a limited and non-significant association with MIR outcomes, suggesting that performance in high-stakes national examinations is influenced by a complex interplay of factors beyond the institutional learning environment.