Ambulatory Medicine

Ambulatory settings are a great place for medical education, and tons of potential to facilitate teaching. However, it does require some preparations in advance to ensure that learners get the best experience and patient care isn't disrupted.

When preceptors aren't aware of incoming learners, many issues can arise. The clinic may be too busy for the preceptor to balance teaching vs. service, causing a lot of tension. There may not be enough space for the student to use to perform their own examinations. Patients may be less than welcoming of the sudden learner, especially if they're in a hurry and weren't informed. Other staff may be disoriented because of the extra personnel, and not being familiar with their roles as part of the team. Likely, the preceptor and student would not have had a chance to go through learning objectives and determine expectations for the experience.

However, when proper preparations can be made, students can have a great learning experience. Health care is moving away from hospitals and towards ambulatory and community settings, so it will be helpful for students to learn within the setting to better reflect what they'll be practicing. Ambulatory settings also provide a broad range of patients for students to see, and often undifferentiated symptoms to challenge problem solving and medical knowledge. If a preceptor can be informed in advance of a learner they will be taking on, along with their medical background, they can ensure that there is adequate space for the learner to see patients and research medical information. By informing staff of the student and their roles on the team, the student may be able to have more experiences working with different team members, and find themselves in a more welcoming environment. Having staff gain patient consent to have a medical learner ahead of time, or having informational sheets in the waiting areas, can allow the learner to have a more productive encounter with patients. Clinic days with a learner can also be scheduled so that time will be available for case discussions and teaching, as well as regular feedback.

These are not the only ways, but just a few ways in which ambulatory learning experiences can be optimized for learners. Hopefully, ambulatory teaching settings can be continuously improved to help learners become competent physicians.

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