The roles of experience and reflection in ambulatory care education.

While ambulatory care education typically does not provide much direct instruction, supervision, or feedback, experiential learning occurs. Using experiential learning theory, the authors describe how this process of learning works. the process is characterized by a cycle of having a concrete experience (e.g., an encounter with a patient), reflecting on that experience as it unfolds, formulating conceptualizations and generalizations from the experience, and testing those generalizations and concepts in other situations. With this model in mind, the authors make four recommendations for improving ambulatory care education for both medical students and residents: (1) plan for experiences in carefully selected ambulatory care settings; (2) facilitate reflective observation; (3) encourage conceptual thinking and inquiry; and (4) promote feedback and testing of insights from experiences. The authors discuss the rationale behind each recommendation and offer guidelines for how each might be implemented.