Skip to main content
SpringerLink
Log in

Learning outcomes of an ambulatory care rotation in internal medicine for junior medical students

  • Original Articles
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

Objective: To assess the educational outcomes of training junior medical students in an eight-week combined ambulatory/inpatient rotation compared with those of training exclusively on inpatient services.

Design: Participants were randomly assigned to one of three groups: those who volunteered for the ambulatory/inpatient rotation and were randomly selected; those who volunteered and were not selected; and those who did not volunteer.

Setting: University-based internal medicine (IM) inpatient services and community-based clinics and private practices.

Participants: Seventy-five third-year medical students taking the required eight-week IM clerkship.

Intervention: Assessment included both pre- and posttest measurement of students’ knowledge of general internal medicine and a profile of the types of patient problems seen by students in ambulatory settings.

Results: While students’ general medicine knowledge scores increased significantly from pre- to posttest (p<0.001), there was no significant difference in scores between the ambulatory/inpatient and exclusive inpatient groups. Patient log data indicated notable differences in the diagnostic compositions of students’ patient loads. For instance, 38% of the ambulatory diagnoses were infectious disease, neurologic, endocrine, rheumatologic, or dermatologic problems, and another 15% were non-IM (e.g., obstetric/gynecologic; ear, eye, nose, and throat) problems. Only 24% of the inpatient diagnoses reflected these specialty areas.

Conclusions: Ambulatory training did not significantly affect students’ knowledge gain compared with that for exclusive inpatient training, but student evaluations of the rotation plus patient log data suggested that ambulatory training can provide a more complete view of general medicine practice than can exclusive inpatient training.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Schroeder SA. Expanding the site of clinical education: moving beyond the hospital walls. J Gen Intern Med. 1988;3(M/A suppl):S5-S14.

    PubMed  CAS  Google Scholar 

  2. Gruppen LD, Wisdom K, Anderson DS, Woolliscroft JO. An assessment of the impact of ambulatory care education of third-year medical students. Acad Med. 1991;66(Sept suppl):S55-S57.

    Article  PubMed  CAS  Google Scholar 

  3. Woolliscroft JO, Schwenk TL. Teaching and learning in the ambulatory setting. Acad Med. 1989;64:644–8.

    Article  PubMed  CAS  Google Scholar 

  4. Perkoff GT. Teaching clinical medicine in the ambulatory setting: an idea whose time may have finally come. N Engl J Med. 1986;314:27–31.

    Article  PubMed  CAS  Google Scholar 

  5. Muller S (chairman). Physicians for the Twenty-first Century: Report of the Project Panel on the General Professional Education of the Physician and College Preparation for Medicine. J Med Educ. 1984;59(Part 2).

  6. Schwartz MD, Linzer M, Babbott D, et al. Medical student interest in internal medicine: initial report of the Society of General Internal Medicine Interest Group Survey on factors influencing career choice in internal medicine. Ann Intern Med. 1991;114:6–15.

    PubMed  CAS  Google Scholar 

  7. Abbott AV, Lee PV. Medical student education in ambulatory care. Acad Med. 1989;64(suppl 2):S9-S15.

    Article  PubMed  CAS  Google Scholar 

  8. Petersdorf RG. Restructuring clinical education. Acad Med. 1990;65:558.

    Google Scholar 

  9. Harris IB, Watson K, Howe R. Development and evaluation of a required ambulatory medicine clerkship. Acad Med. 1991;66:511–2.

    Article  PubMed  CAS  Google Scholar 

  10. Carmines EG, Zeller RA. Reliability and validity assessment. Beverly Hills, CA: Sage Publications, 1979.

    Google Scholar 

  11. New challenges in resident education. Proceedings of a symposium sponsored by the Society of General Internal Medicine. J Gen Intern Med. 1990;5(J/F suppl).

  12. Graettinger JS. Internal Medicine in the National Resident Matching Program 1987: the Ides of March. Ann Intern Med. 1988;108:101–15.

    PubMed  CAS  Google Scholar 

  13. Feltovich J, Mast TA, Soler NG. Teaching medical students in ambulatory settings in departments of internal medicine. Acad Med. 1989;64:36–41.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. the Department of Medical Education, Doctors Hospital, Columbus, Ohio

    Paula S. Butterfield PhD

  2. the Department of Internal Medicine, The Ohio State University, Columbus, Ohio

    Andrew G. Libertin MD

Authors
  1. Paula S. Butterfield PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrew G. Libertin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

The results of this study were briefly reviewed as part of an invited roundtable discussion at the American Educational Research Association’s annual meeting, April 1991, Chicago, Illinois.

Supported by a grant from the Region V Ohio Area Health Education Center.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Butterfield, P.S., Libertin, A.G. Learning outcomes of an ambulatory care rotation in internal medicine for junior medical students. J Gen Intern Med 8, 189–192 (1993). https://doi.org/10.1007/BF02599265

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02599265

Key words

Search

Navigation