Using the Ambulatory Care Teaching Centre to develop opportunities for integrated learning.

An Ambulatory Care Teaching Centre (ACTC) has provided an opportunity to develop an integrated teaching programme in a supervised environment which links students' initial clinical experiences in the skills centre with patient-contact in other teaching settings. Second-year students attended 2-h sessions in the ACTC during each block of a systems-based course. Two 'system-sensitive' patients invited from a patient bank enabled students to develop clinical skills previously practised on mannequins and simulated patients and to integrate theoretical material with clinical practice. A programme co-ordinator timetabled student, patient and tutor attendances. Students particularly appreciated the protected environment where they could practice clinical skills under supervision before interviewing other patients in patient-centred clinical settings. Tutors appreciated an environment which eliminated tensions often present between teaching and service delivery. They enjoyed focussed teaching sessions especially if details of invited patients were known in advance and 'backup' resources were available. Patients enjoyed opportunities to contribute to clinical teaching.