Assessing Quality and Costs of Education in the Ambulatory Setting

Abstract

This review identifies many gaps in our knowledge of effective clinical teaching practices, and of learning environments in which that teaching takes place. The predominance of single-institution studies limits generalizability of current findings. A prioritized research agenda should be established and funded, focusing on improving the efficiency and effectiveness of teaching and learning in ambulatory settings.

Solutions to Common Problems in Training Learners in General Internal Medicine Ambulatory Settings

“…Clerkship directors should communicate clear expectations to the student regarding time allotted for taking the patient's history, extent of the physical examination possible given the time constraints, use of EMR, and degree of responsibility. (8) This orientation will help ensure that students are considered part of the health care team with specific roles and responsibilities while minimizing the impact on faculty preceptor productivity and workflow.…”

“…Medical students should be encouraged to participate actively in patient care and make diagnostic and management decisions under supervision (12). Participatory learning with real patients confers a sense of legitimate involvement and facilitates identity formation (8,12,13). In addition to independent interview, examination and discussion of patient care, measuring and documenting vital signs, teaching device usage (e.g.…”

“…Before the advent of PCMH, the ambulatory teaching setting cost about 24-36% more to operate than nonteaching settings. (8,28) Current funding models for graduate medical education (GME) encourage residents to provide mainly inpatient care, and the funding does not always clearly and equitably flow through the hospital to the training program. Federal GME funding should be restructured to incentivize programs to explore innovation in ambulatory training.…”

Réponses et cadres conceptuels des cliniciens enseignants lors de discussions de cas avec des internes en psychiatrie

“…Contraints par le temps, puisqu'ils ne disposent généralement que de cinq à neuf minutes pour la discussion en contexte ambulatoire [9,10] , ils doivent gérer le cas, évaluer les besoins d'apprentissage des étudiants en fonction du cas et échanger une Abstract -Background: The development of clinical expertise is highly influenced by the quality of constructive feedback provided during clinical training. However, much of the research and literature on clinical supervision focuses on "how" to provide feedback and much less on the content of feedback.…”

Nonverbal Communication between Veterinary Students and their Teachers in Food Animal Practice

“…The learning environment, important for the quality of education, contains integrating elements such as educational culture and instructional strategies [1], defining the behavior of the participants, the teaching behavior of teachers and the learning strategies adopted by students. However, there are many gaps in the educators' knowledge of effective clinical teaching practice and learning environments [1].…”