Abstract

Background

Students’ perceptions of their learning environment are important for continuous improvement of the educational environments and curriculum by defining their strengths and weaknesses. Therefore, this study aims to explore medical students’ perceptions of their learning environment at the Jazan Faculty of medicine in Jazan City, Saudi Arabia. Different aspects of the educational environment were compared across year levels and gender.

Methods

This cross-sectional study was conducted at the Faculty of Medicine, Jazan University. A total of 400 medical students participated in this study, with a response rate of 83.5%. Data were analyzed using the Statistical Package for the Social Sciences (SPSS). Comparisons of the mean score of Dundee Ready Education Environment Measure (DREEM) subscales were calculated.

Results

From 334 students who submitted the questionnaire, almost equal participation of male (50.6%) and female (49.4%) students was observed. The mean total sum for each individual in all subscales is 104.9 (SD = 26.353), with male students having a mean of 100.36 (SD = 26.078), and for female students, the mean was 109.54 (SD = 25.897). The highest mean was observed among third-year female students (Mean = 115.57), and the lowest mean value was observed among fifth-year male students (Mean = 92). An examination of each of the 50 items in the DREEM inventory revealed that 26 items scored between 2.00 and 3.00, while 22 items scored less than 2.00. Those with a score of 2.00 or less were identified as problem areas in this medical school and are therefore addressed in this study. The overall score showed that the medical students’ perceptions were low. The students’ perceptions of the educational environment were not impressive for all five DREEM subscales.

Conclusion

According to the findings of the study, student perceptions of their learning environment are generally lower than expected from the faculty's perspective. Based on these findings, the study was able to identify areas that were found to be particularly problematic and, as a result, should be prioritized for improvement.

Key Messages

1. Current Students’ perceptions are part of future curriculum.
2. Planning of teaching activities in the institute should be practiced and reviewed frequently.
3. More opportunities should be provided to enhance clinical skills.

Background

The College of Medicine in the Jazan region was established in 2001 in Jazan city and adopted the traditional system of education. However, in 2005, the new Integrated Medical Curriculum was initiated, and students embarked on their medical training under a new curriculum. The traditional discipline-based, lecture-intensive coursework is replaced by this Integrated Medical School Curriculum. The faculty of medicine program at Jazan University is divided into three stages: basic sciences, basic medicine, and clerkships. Students are expected to learn any body system in an integrated manner across all departments under the new curriculum(El-Naggar et al., 2007).

DREEM:

The Dundee Ready Education Environment Measure (DREEM) was published in 1997 as a tool to evaluate educational environments of medical schools and other health training settings. A recent review concluded that it was the most suitable instrument.(Miles et al., 2012)

Curriculum

Although not the final step, curriculum evaluation is the starting point for the public to know whether the curriculum implemented has achieved its aims and objectives; teachers to know whether what they are doing in the classroom is effective, and the developer or planner to know how to improve the curriculum product. Dealing with curriculum means there is a subject, student, teacher, and a process. 

Research Question

For this study, the research question is "What are the perceptions of medical students at Jazan University about the learning environment in Jazan medical school in Saudi Arabia?"

Study Design:

The present study employs an observational cross-sectional study design, which is suitable for this study since the investigator collected the information from respondents with the purpose of investigating their perceptions about the ongoing training programs. The student’s perceptions are the dependent variable, whereas a set of independent variables were collected; student class level and student gender were investigated as independent variables.

Target Group:

Students of Jazan University – Faculty of Medicine – inclusion criteria are students who registered for the academic year 2017 - 2018.

Study Area: 

The study was conducted at Jazan University’s College of Medicine, the leading educational institution in the Jazan region. Jazan is one of the 13 regions in Saudi Arabia. It lies in the country's southwest corner, directly in the north of the border with Yemen. This region is situated on the coast of the Red Sea and serves as a large agricultural heartland with a population of 1.5 million, according to the 2010 census.

Sample Size and Design:

Following Cochran (Cochran et al., 1977), the suitable sample size was determined based on the standard formula given by:

Where:

n:         is the sample size.

p:         is an anticipated proportion of levels (here refers to DREEM response). 

Z:         is the standardized variable that corresponds to a 95% confidence level.

d:         is the desired marginal error.

Since no prior knowledge of student perceptions is available, 50% of the total DREEM scores provided the maximum sample size. Based on the values p = 0.5, the desired marginal error, d = 0.05 and z = 1.96. Using finite sample correction factor and non-response rate of 10%, the required sample size was approximately 400 students. The sample size distribution in the different study levels and the two genders was proportionate to the total population size.

Methods of Data Collection:

Data was collected from the students using structured, standardized questionnaire DREEM, which has been frequently used in similar studies. A Professional English/Arabic translator translated the questionnaire into Arabic, and piloting of the questionnaire was carried out. The questionnaire was delivered to the students electronically online using "Monkey Survey," a web-based program. The students received the questionnaire by email, and they were instructed to fill it online.

Informed consent

informed consent has been requested before beginning the online survey in digital form.

Student Instruments:

As mentioned before, DREEM was used to explore students’ perspectives of their learning environment. DREEM is suitable since it has been used internationally for different purposes and is regarded as a useful tool by users. The DREEM questionnaire has been found to have universal face validity and high reliability in different geographical areas.

The DREEM inventory involves 50 items divided into five subscales:

1. Students’ perceptions of learning (SPoL); 12 items; maximum score is 48.
2. Students’ perceptions of teachers (SPoT); 11 items; maximum score is 44.
3. Students’ academic self-perceptions (SASP); 8 items; maximum score is 32.
4. Students’ perceptions of atmosphere (SPoA); 12 items; maximum score is 48.
5. Students’ social self-perceptions (SSSP); 7 items; maximum score is 28.

The students were asked to read all of the statements and respond on a five-point Likert scale ranging from “strongly agree” to “strongly disagree.” The scoring of items was as follows: 4 = strongly agree, 3 = agree, 2 = uncertain, 1 = disagree, and 0 = strongly disagree.

The total score for all subscales is 200. Each item is scored from 0 to 4 with 4¼ strongly agree, 3¼ agree, 2¼ unsure, 1¼disagree, and 0¼strongly disagree. Nine negative items are scored in reverse for analysis (4, 8, 9, 17, 25, 35, 39, 48, and 50). A higher score indicates a more positive evaluation – in the original version, the DREEM (50 items) has a maximum score of 200, demonstrating the perfect educational environment (Roff et al., 1997). According to literature, when evaluating individual items, individual items with a mean score of ≥ 3.5 are particularly strong areas, items with a mean score of ≤ 2.0 need particular attention, and items with mean scores between 2 and 3 are areas of the educational environment that could be improved (Roff et al., 2001).

Data Analysis & Interpretation:

To ensure data collection quality, all questionnaire items were filled electronically through “Survey Monkey," so any missed item prevents the submission of participants questionnaire. The data entry and analysis were performed using SPSS. 

The data analysis involves descriptive statistics as well as inferential statistics. Simple tabulation and frequency tests were used to evaluate the difference in mean scores between groups. Mean scores for subgroups were also compared.

Ethical Consideration:

Ethical clearance and permission were obtained from IRB Jazan University. Before the data collection, authorization was granted from His Excellency, Vice-Chancellor of Jazan University, and the Dean of Faculty of Medicine. Students were informed during the questionnaire distribution that the information collected would be kept anonymous and participation is voluntary.

Results

Data were analyzed using SPSS version 20 (IBM Corp, Armonk, NY, USA). Comparisons of the mean scores of males and females were included for the total sample and each class level. 

Participation

A total of 334 students completed the online questionnaire through “Survey Monkey, and almost equal participation was observed between male (50.6) and female (49.4) participants.  Table 1 shows student participation according to class and gender

General Result:

The mean score of the total sum for each individual in all subscales is 104.9 (SD=26.353), with male students having a mean score of 100.36 (SD=26.078) and for female students having a mean score of 109.54 (SD=25.897). Tables 2 and 3 show the mean for each group of students according to their class and gender. It is sorted by the mean value, with third-year female students having the highest mean (Mean=115.57) and fifth-year students having the lowest (Mean=92).

Students’ Perceptions of Learning Subscale (SPoL) (Items: 1, 7, 13, 16, 20, 22, 24, 25, 38, 44, 47, 48)

This subscale comprises 12 items with 48 as the maximum score. As per the main objective of the integrated curriculum, the author of the present study expect more enjoyment in the learning subscale. Out of 48, the mean of the total sample is 22.98, which is less than the mean for female students (24.24) and greater than the mean for male students (19.35). Except for second-year students, the mean of all female classes is above the mean of the total sample, whereas the mean of all male classes is lower than the mean of the total sample. Table 4 shows the mean sum of the SPoL subscale, sorted according to the value for each group; male group, female group, and total sample.

Students’ Perceptions of Teachers (SPoT) (Items: 2, 6, 8, 9, 18, 29, 32, 37, 39, 40, 50)

This subscale comprises 11 items with 44 as the maximum score. The mean of the total sample is 23.81/44, with third-year female students having the highest score and sixth-year male students having the lowest. Except for fourth-year male students, all male subgroups have a mean score below the mean of the total sample. All of the female subgroups have mean scores above the mean score of the total sample. Table 5 shows the mean sum of the SPoT subscale, sorted according to the value for each group; male group, female group, and total sample.

Students’ Academic Self-Perception (SASP) (Items: 2, 10, 22, 26, 27, 31, 41, 45)

This sub-scale comprises eight items with 32 as the maximum score. Fifth-year male students and third-year female students have the lowest score in the SASP subscale (the mean scores are16.68 and 17.82, respectively). Although students in the same level have the same learning context, the author of the present study found that the mean score for fifth-year is extremely different for male and female students, with male students having the lowest mean score and female students having the highest. The representation for male and female students in fifth-year is almost equal. The total mean score is 19.14. Table 6 shows the mean sum of the SASP subscale, sorted according to the value for each group; male group, female group, and total sample. 

Students’ Perceptions of Atmosphere (SSPA) (Items: 11, 12, 17, 23, 30, 33, 34, 35, 36, 42, 43, 50)

This subscale comprises 12 items with 48 as the maximum score. The mean score of the total sample is 24.24/48, which is equal to the 50% of the total score. Second-year female students and fifth-year male students (mean scores are 21.91 and 20.27, respectively) have the lowest score in SPoA as compared to others, while third-year female students have the highest score (mean score: 27.22). Table 7 shows the mean sum of the SPoA subscale, sorted according to the value for each group: male group, female group, and total sample.

Students’ Social Self-Perception (SSSP) (items: 3, 4, 14, 15, 19, 28, 46)

This subscale comprises seven items with 28 as the maximum score. The mean of the total sample is 14.72, with the lowest score among second-year female students (mean score = 13.32). The total mean score of males (14.67) and females (14.78) in SSSP is nearly equal to the mean of the total sample (mean score = 14.72 +/- 0.05). Table 8 shows the mean sum of the SSSP subscale, sorted according to the value for each group; male group, female group, and total sample.

Discussion

Participation

Phase 1 of the curriculum is basic science, operated by the college of science. The author of the present study did not have access to the students, and they do not belong to the curriculum and study. Second-year medical students have new experiences with the research concept. Thus, notice a slight decrease in students' participation was observed in the survey (n=55) compared to other levels (n=70+/-). However, there is equal participation of students in subsequent class levels (third-year: 19.2%, fourth-year: 21.9, fifth-year: 21.6%, and sixth-year: 21%).

Although participation seems equal across the different levels, females in the third level (n=46) are more than males (n=18), and the participation of males in the fourth level (n=48) is more than females (n=25). The total number of students in third-year is 122, of which 73 of them (60%) are females, which is an unequal representation in the study’s statistics. However, in fourth-year, the total number of students is 118, of which 60 of them are males. Although they are equal, the present study still observed unequal representation in the statistics. 

General Scores

According to the literature, the following points are approximate guidelines for interpreting the overall score:

• 0-50                       Very Poor
• 51-100                   Plenty of Problems
• 101-150                 More Positive Than Negative
• 151-200                 Excellent

The mean score of the total sample is 104.9 (SD: 26.353), which, according to the literature review, is one of the lowest scores worldwide. Table 9 lists the score of different international institutes according to the value of the score.

In this study, out of 50 items, 22 items with a mean score of less than 2 need attention. Two items with a mean score ≥3 demonstrate strong area, and 26 items with a mean score between 2-3 need improvement in their area. Observing the items again for each gender, it was found that males had more items with low mean scores (30 items) compared to females (19 items), and more strong items among females (4 Items) compared to males (2 items). It was found that in Saudi Arabia, 82% (18 out of 22 ) of items that have lower scores (<2) are also a problematic area in other Medical schools in Saudi Arabia, including King Abdulaziz University and Umm Alqura University (Al-Hazimi, Zaini, et al., 2004)  

Students’ Perceptions of Learning (SPoL) 

The total sample mean score for SPoL is 22.98 (SD: 6.83), which is lesser than 50% of the maximum score. Male students have a lesser score (mean score: 21.75) than females (mean score: 24.24). In comparison with other studies in Saudi Arabia, the SPoL result for this study is almost the same for other schools except for King Saud Bin Abdulaziz University, which has the highest score in Saudi Arabia (SPoL mean score: 36.44) (Zawawi & Elzubeir, 2012). Other schools share almost the same results, ranging between 20 and 26. Table 10 summarizes the DREEM results in different local medical schools. Observing the individual items in the SPoL subscale, it was found that seven items with mean scores less than 2 (items: 48, 25, 44, 16, 47, 20, 1) need attention. No single item demonstrated a strong area with a mean score ≥ 3, and 5 items demonstrate a need for improvement (items: 24,7, 13, 38, 22), with a mean score range between 2-3.

Looking at item No. 1, "I am encouraged to participate during teaching sessions," and item No. 7, "The teaching is often stimulating," with the exception of second-year students, it was found that all female subgroups have mean scores of more than 2, and all male subgroups have mean scores below 2. 

Although the main objective of the curriculum is to improve the competency of graduates, students still did not find an appropriate effect of the teaching in improving their competency, as in item No. 16, "The teaching helps to develop my competence," with a mean score of 1.84.

It was also found that, according to item No. 20, "The teaching is well-focused," the total sample agrees that the teaching processes in the school are not focused. In addition to that, senior male students have lower scores (fifth-year mean: 1.46; sixth-year mean: 1.55) compared to senior female students' subgroup (fifth-year mean score: 1.94 and sixth-year mean score:2.00), although male and female students are supposed to have the same learning context, especially in the same level.

When asked about item 25, "The teaching over-emphasizes factual learning," it was found that the total sample score for this item is not acceptable (mean score: 1.57), and there is obvious score deference among fifth-year students, with female students having the highest score (1.89) and lowest for male (1.31).

As a higher education institute, the curriculum is supposed to engage students in adult learning activities. For item 44, "The teaching encourages me to be an active learner," mean score was 1.83; the mean score was 1.85 for item 47, "Long-term learning is emphasized over short-term learning"; and 1.55 for item 48, "The teaching is too teacher-centered," which reflect mainly the adult learning principles, demonstrate a failure of the curriculum to support learning principles of adult learning, according to Knowles (Craig 1996). 

Please see Appendix II and III for individual scores for each item of the SPoL subscale, sorted by the total sample mean score. 

Students’ Perceptions of Teachers (SPoT)

Looking at the second subscale, Students’ Perceptions of Teachers, which included eleven items, the same findings were obtained as the first subscale: a low total sample mean score of 23.81 out of 44 (SD: 7.094) and a lack of strong items. 

In comparison to SPoT results from other studies in Saudi Arabia, it could be seen that this study has almost the same SPoT score as other schools in Saudi Arabia. Saudi Arabian studies revealed that this study was almost identical to other Saudi Arabian schools, with mean SPoT scores ranging between 21 and 25. Table 10 summarizes DREEM results from various local medical schools.

Negative items, including item 9, which asked whether “The teachers are authoritative,” item 39, which asked whether “The teachers get angry while teaching,” and item 8, which asked whether “The teachers ridicule the students,” have mean scores of 1.66 (SD 1.12), 1.7 (SD 1.09), and 1.84 (SD 1.29), respectively. These scores indicate the students’ agreement with these items, meaning they are problem areas that need further investigation. The other items in this subscale have mean scores between 2 and 3, indicating the need for improvement.

Generally, in all SPoT subscales, female students are happier than male students. Females had mean scores of more than 2 on eight items, while males had mean scores of more than 5 on only 5 items. 

Feedback is an integral and important part of the teaching and learning environment in the medical field, as it improves the learners' knowledge, skills, and other competencies. Unfortunately, item 29, "The teachers are good at providing feedback to students," shows that all students are not satisfied with feedback quality and quantity (total sample mean score = 1.92; SD = 1.098). In addition to that, teachers still gave more feedback for female students (Mean score = 2.13) compared with males (Mean score = 1.7). 

Please see Appendix II & III for individual scores for each item of the SPoT subscale, sorted by the mean score for the entire sample.

Students’ Academic Self-Perception (SASP)

Compared to other subscales, the students have a reasonable general mean score for the SASP subscale as 19.14 out of 32 for eight items, which is nearly equal for males (mean score: 18.49) and females (mean score:19.81). 

Compared to SASP results from other Saudi Arabian studies, it could be seen that the school's mean score (19.14) is almost equal to the mean score of King Saud bin Abdulaziz University (19.81), which has the highest total DREEM score in Saudi Arabia (total mean score: 131). Table 10 summarizes DREEM results from various local medical schools.

Looking at individual items in the SASP subscale, the results revealed that items 5, 21, and 27 have mean scores less than 2 and thus require attention, there are no items that demonstrate a strong area with a score of 3, and items 26,41,31,45, and 10 items have a mean score range of 2-3 and thus require improvement in their area.

Although the score for item 10, "I am confident about my success this year," is 2.97 (SD 0.94), female students show a mean score of 3.12 (SD 0.86), and 2.83 (SD 0.99) for male students. This is in accordance with the percentage of pass in exams, which indicated a higher success rate among female students than male students. 

Item 21, "I feel I am being well prepared for my profession," denotes that these juniors (second-level mean score: 1.9; third-level mean score: 2.08) are more optimistic compared to senior students (fifth-level mean score: 1.57; sixth-level mean score: 1.74).

The students have difficulty memorizing all they need as per item 27. This agreement among all students is mainly, as I expect, due to subjects contents, which is more than what they need to learn.

Please see Appendices II and III for individual scores for each SASP subscale item, sorted by the total sample mean score.

Students’ Perceptions of Atmosphere (SPoA)

The mean score for the total sample is 24.42 out of 48, with a total score of 12 items. Male and female students are almost the same as the mean of the total sample (mean score: 23.17 and 25.33, respectively). The educational environment in the medical field is novel for junior students, particularly junior students. Previously, female students had their academic activities conducted solely by female staff. Due to a shortage of female faculty in the second year, female students must deal with the new experience of being taught by male faculty. This could explain why second-year female students have the lowest mean score in this subscale (mean score: 21.91). In comparison to SPoA results from other studies in Saudi Arabia, this study can be viewed as almost identical to other schools, with the exception of King Saud Bin Abdulaziz University, which has the highest score in Saudi Arabia (SPoA Mean: 32.77) (Zawawi and Elzubeir 2012b). Other schools share almost the same results, ranging between 21 and 26. Table 10 summarizes DREEM results in different local medical schools.

Looking at individual items in the SASP subscale, items 11, 12, 42, 43, and 23 have mean scores less than 2 and need attention. No single item demonstrated a strong area with mean scores ≥ 3. Items 49, 34, 30, 17, 33, 35, and 36 demonstrate a mean score of 2-3, which indicates a need for improvement in their areas. Again, most female student groups have a mean score above the total sample mean score for all subscale items in contrast with the male students, except for item 11, where students asked about the atmosphere of ward teaching.

The academic atmosphere during teaching activity; ward teaching, lectures class, seminars, and tutorials are negatively assigned with a total agreement between male and female (item 11, 23, and 34), which has a great consequence on item 42, "The enjoyment outweighs the stress of the course," which also has a low mean score (mean: 1.48). This indicates a decrease in the atmosphere's motivation and a decrease in the mean score of item 43, "The atmosphere motivates me as a learner" (mean score: 1.74). Item 12, "This school is well time-tabled" with a mean score of 1.45, could explain some of the results of the low SASP subscale scores, which affect the overall atmosphere of teaching and learning.

Although junior students participate in some academic activity in the hospital, bedside teaching takes place mainly in the hospital and is restricted to fourth, fifth, and sixth-year students. As a result, the author of the current study must consider students' scores for senior students. When item 11, "The atmosphere is relaxed during ward teaching," was analyzed, the result was very depressive, with a mean score of 0.85 and 1.23 for the fifth and sixth levels, respectively. 

Please see Appendices II and III for individual scores for each item of the SPoA subscale, sorted by a mean score for the total sample.

Students’ Social Self-Perception (SSSP)

The SSSP comprises seven items with 28 maximum possible scores. This study's total sample mean score is 14.72, almost 50% of the maximum score. In comparison to SSSP results from other studies in Saudi Arabia, it could be seen that this study has almost identical results to those from other schools, ranging between 12.9 and 16.8. Table 10 summarizes DREEM results from various local medical schools.

Items in the SSSP subscale were classified into three categories; 

1. Social items closely related to the school, item 3, "There is a good support system for students who get stressed," item 4, "I am too tired to enjoy the course," and item 14, “I am rarely bored on this course.” Those items have very low scores among all inventory items; mean scores = 1.02, 1.08, and 1.2, respectively. Surprisingly, except for one item, two different schools in Saudi Arabia, Umm Al-Qura University and King Abdulaziz University, have the same student perception of those items, with mean scores ranging from 0.92 to 1.2 (mean score for item 14 is 1.5 in Umm Al-Qura University)
2. Items partially related to the school environment; item 28, "I seldom feel lonely," and item 19, "My social life is good." Those items with a mean score range of 2-3 indicate a need for improvement in that area.
3. Items that are independent of the school environment: item 46, "My accommodation is pleasant," and item 15, "I have good friends in this school." These items demonstrate a strong point with a mean score of ≥ 3. In addition to that, it was discovered that the study’s results in those items matched the results of similar items in deferent Saudi Arabia DREEM (King Abdulaziz University and Umm Al-Qura University), and they are the only items that demonstrate a strong point with a score more than 3, which almost equal to the study’s result. Table 11 shows the results of various schools for items 15 and 46.

Looking at this subscale with regard to the subgroups, it could be seen that second-year students have the lowest score (mean 13.71), and among them, females have the lowest mean score (mean 13.32). These students usually face new changes and challenges in their lives, including a new academic environment, new colleagues, new culture; the study anticipates some social difficulties that they could face. Item 15, "I have good friends in this course," shows a good score for all subgroups; however, male and female second-year students show the lowest score (mean: 3.29) and again the lowest score for female students (mean: 3.18). Please see Appendix II & III for individual scores for each SSSP subscale question, sorted by the total sample mean score.

Conclusion and recommendations

Conclusion

Regardless of the primary objective of this study, this study showed many points that should be paid attention to seriously, especially as they relate to the main objective of the existence of such an educational institution, the College of Medicine. Therefore, we can take advantage of the previous results above. We need to look carefully at the study's overall results and the results of the internal sections of the questionnaire. Despite the items raised in each section to measure the amount of each section, the elements mentioned in it give the impression of student feedback about its content. In order to figure out the problem details for each negative element in the resolution, To figure out the problem details for each negative element in the resolution, additional study of those elements would be required, whether to take to the field and communicate with officials from students and teachers, to get the information that might contribute to the understanding of the problem and to find appropriate solutions.

This study is considered an integral part of the evaluation process of the curriculum, so it is an effort to contribute to the progress of the evaluation process. Every person involved in the college's development process should incorporate the findings of this study into the college's strategic plan. 

Recommendations:

There are many points that can contribute to the reform of the educational environment and reaching the desired level, in addition to the results of raw numbers, which can be presented as recommendations in this research. 

The result of the present study prompted the author to make the following recommendations in order to address the issues that students in the field of medical education face.

1. We need to increase the awareness among students for active participation in research activity and realize its importance for improving the institute's standard.
2. Great attention needs to be paid to the total score as all standard educational institutes focus on accreditation, students’ satisfaction, a reference point for improvement, and repetition of the same inventory to measure the improvement in accreditation standards. 
3. There is a great necessity to review the institute's learning and teaching strategies and methods.
4. Course objectives, learning content, teaching strategies, and evaluation process must comply with each other during the whole learning process.
5. Planning of teaching activities in the institute should be practiced and reviewed frequently.
6. Teachers should be motivated to apply innovative teaching strategies to promote self-learning among the students.
7. More opportunities should be provided to enhance clinical skills. 
8. It is considerable to develop, encourage, and boost critical thinking among students by applying modern teaching techniques.
9. Teachers should be trained in both large and small group classroom management techniques.
10. For effective teaching, learning and teaching resources should be revised and updated, as well as appropriate materials.
11. Teaching behavior and skills among the staff must be evaluated recursively.
12. Active feedback from students and teachers is valuable to improve both the teaching and learning environment.
13. Equal learning opportunities for both males and females should be ensured. 
14. Course content must be revised frequently to meet the challenges of the changing educational scenario.
15. Advisory and mentoring systems for students should be well organized to facilitate all the students.
16. Seminars, workshops, and awareness programs should be organized to develop students' character, instill disciplinary behavior, and encourage independent learning.
17. To enhance inter and intrapersonal skills and multiple intelligences, student-teaching should be practiced. 
18. Student-teacher relationship should be strengthened by integrating curricular and co-curricular activities.

Finally, because curriculum evaluation is an ongoing process with no end, this study, which is a point of curriculum evaluation, can be relied upon as part of the curriculum development.

Declarations

Methods Declaration

The author confirm that all methods were carried out in accordance with relevant guidelines and regulations. 

Data availability:

The authors confirm that the data supporting the findings of this study are available within the article and its Supplementary material. Raw data that support the findings of this study are available from the corresponding author, upon reasonable request.

Author contributions

An author of a paper is an individual who made a significant intellectual contribution to the work described in the paper (in contrast, for example, to a monetary contribution); made a contribution to drafting, reviewing and/or revising the paper for its intellectual contribution (in contrast, for example, to spell checking or typesetting); and approved the final version of the paper including references.

Declaration of funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Disclosure of interest

There are no conflicts of interest to disclose

Ethical Approval 

 The research involved human participants and was ethically approved by the Jazan University Scientific Research Ethics Committee. All procedures performed in our study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Consent for participation

The author confirm that informed consent was obtained from all subjects and/or their legal guardian prior to data collection.

Consent for publication

 the author confirming that informed consent was obtained from all subjects before starting data collection.

Authors' contributions

The author of this paper is individual who made a significant intellectual contribution to the work described in the paper and were involved in the conception and design, analysis and interpretation of the data; the drafting of the paper, revising it critically for intellectual content; and the final approval of the version to be published; and the author agree to be accountable for all aspects of the work and approved the final version of the paper including references.

References

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