Steven L. Lawrence

Using standardized ambulatory teaching situations for faculty development

The challenges of teaching in the ambulatory setting have been well documented. This article describes a method for developing faculty teaching skills in the ambulatory setting through the use of standardized ambulatory teaching situations (SA TS). Adapted from methods for using simulated or standardized patients, SA TS uses trained individuals to simulate medical students who then interact with faculty in a variety of teaching encounters common to the ambulatory setting. Preliminary results indicate that these high‐fidelity teaching simulations can be effectively used to provide opportunities for faculty to observe, practice, and receive feedback on clinical teaching skills.

A Comparison of Problem‐Based and Didactic Approaches to Learning on an Ambulatory Medicine Clerkship

Teaching in the ambulatory setting is limited by the lack of time for in‐depth discussion of common ambulatory problems. This study was designed to compare the effectiveness of a problem‐based versus didactic approach to teaching common ambulatory problems during a senior ambulatory clerkship. Three outcome measures were examined: (a) student knowledge, measured objectively and by self‐report; (b) student satisfaction; and (c) student self‐directed learning. No significant differences by method were obtained for either student knowledge or student satisfaction. Students in the problem‐based approach demonstrated greater self‐direction in learning as measured by resource utilization and number of hours studied. Conclusions related to learning outcomes, utilization of faculty time, and implications for future student learning are discussed.

An analysis of ambulatory teaching situations for faculty development

Economic, social, and medical trends are forcing medical educators to look to the ambulatory care setting as a training site for medical students and residents. The purpose of this study was to identify the variables that clinical faculty perceive to influence the ease or difficulty of teaching in the ambulatory setting. Faculty having teaching responsibilities in the ambulatory setting were asked to complete teaching situation cards related to either an “easy teaching situation”; or a “difficult teaching situation.”; Faculty identified several major characteristics that contributed to easy teaching situations including the medical student or resident and the patient. The variables that faculty perceived as contributing to difficult teaching situations included the medical students or residents lack of receptiveness to feedback from the instructor, lack of interest, and incompetence. Implications of the findings for faculty development efforts to improve teaching in the ambulatory setting are reported.