October 1990

Strategies to Improve Teaching in the Ambulatory Medicine Setting

Author Affiliations

From the Division of Clinical Epidemiology and the Division of General Medicine and Primary Care, Beth Israel Hospital and Harvard Medical School (Dr Lesky), and from the Renal Section, Department of Medicine, Boston City Hospital and Boston University School of Medicine (Dr Borkan), Boston, Mass.

Arch Intern Med. 1990;150(10):2133-2137. doi:10.1001/archinte.1990.00390210099022

• Expansion of resident training in ambulatory medicine has created new challenges for faculty preceptors. Outpatient teaching is hampered by inadequate time and a reliance on methods of instruction that are more useful for the inpatient setting. Effective outpatient teaching requires an understanding of the objectives of ambulatory medical training and improved facility with teaching methods that accommodate the brief, impromptu nature of ambulatory teaching. In a hypothetical outpatient teaching encounter, the interactions between the patient, resident, and attending physician are dissected to reveal missed opportunities to teach and to explore alternative approaches to the educational process. These approaches include promoting the resident's role as the primary provider, developing a limited teaching agenda for each teaching encounter, focusing on the learner rather than on the diagnostic dilemma posed by the patient, and using questions, role modeling and observation with feedback to promote learning.

(Arch Intern Med. 1990;150:2133-2137)