ArticleBMC medical education2026
Institutional educational climate and MIR examination outcomes: a multicenter ecological study in Spanish medical schools.
Article in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIn 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.
methodsA 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.
resultsA 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.
conclusionsEducational 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.
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