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An efficient and effective teaching model for ambulatory education.

Martha Regan-Smith1, William W Young, Adam M Keller

  • 1Center for Clinical Evaluative Sciences, Health Care Improvement Leadership Development, Darmouth Medical School, Hanover, NH 03755, USA. regan-smith@dartmouth.edu

Academic Medicine : Journal of the Association of American Medical Colleges
|July 13, 2002
PubMed
Summary

This study presents an integrated ambulatory teaching model that enhances learner roles and patient care efficiency. The model improved preceptor productivity and satisfaction for all involved, despite some implementation barriers.

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Area of Science:

  • Medical Education
  • Ambulatory Care
  • Healthcare Systems

Background:

  • Traditional ambulatory teaching is often inefficient, variable, and unpredictable.
  • Learners are not fully integrated into patient care teams.
  • Existing models limit learner participation and preceptor efficiency.

Purpose of the Study:

  • To present and evaluate an integrated model for ambulatory teaching.
  • To enhance learner roles and patient care within outpatient settings.
  • To improve efficiency and satisfaction in medical education.

Main Methods:

  • Piloted an integrated education and patient care model in three outpatient settings.
  • Redesigned practice to include learners in patient intake, histories, education, and monitoring.

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  • Implemented pre-rotation learning and competence certification for immediate learner contribution.
  • Utilized parallel patient scheduling for learners and preceptors to ensure dedicated teaching time.

    • Main Results:

    • Learners provided care in roles traditionally held by physicians and nurses.
    • The model maintained or improved preceptor productivity and on-time efficiency.
    • Learners reported satisfaction with time spent with patients, observation, and case discussions.
    • Increased satisfaction was reported by learners, teachers, clinic staff, and patients.

    Conclusions:

    • An integrated ambulatory teaching model can effectively incorporate learners into patient care teams.
    • This model enhances efficiency and satisfaction for learners, educators, and patients.
    • Barriers such as limited rooms and scheduling inflexibility need to be addressed for wider implementation.