AMEE Guide No 26: clinical teaching in ambulatory care settings: making the most of learning opportunities with outpatients.

Increasing student numbers and changes in healthcare delivery are making inpatient settings less ideal for teaching undergraduate students. As the focus of healthcare provision shifts towards ambulatory care, increasing attention must now be given to developing opportunities for clinical teaching in this setting. This Education Guide describes the opportunities to be made available by introducing clinical teaching into ambulatory care venues not usually used for undergraduate teaching as well as different models for maximizing student/patient interaction in traditional outpatient clinics. In general there has been only a limited development of teaching initiatives in such ambulatory care areas as accident and emergency departments, clinical investigation units, radiology and imaging suites or the departments of professions allied to medicine. Each of these venues provides different resources suitable for clinical teaching and has its own advantages and disadvantages. A variety of models for facilitating student groups in these venues can be used. Practical advice is provided for the clinical tutor about to supervise clinical teaching in any of these ambulatory care settings. In contrast the development of a dedicated Ambulatory Care Teaching Centre allows the use of specific instructional strategies and can focus teaching on specific body systems illustrated by clinical volunteers invited to attend from a 'bank' of previous patients with stable clinical conditions. Finally, a teaching programme based on the day surgery unit is described as a way of achieving a variety of educational objectives in a busy resource that may not previously have been used for teaching.