How good is the ambulatory care clinic for learning clinical skills? Students' and residents' perceptions differ

Abstract

The objective of this study was to compare learner perceptions of the educational value of patient interactions in an ambulatory care medical clinic (AMC) with those on a clinical teaching unit (CTU) and to discern whether there is a difference in the perceptions of residents and students. During a six-month period a research assistant interviewed residents and students following their patient encounters in an AMC and on a CTU. Using a clinical skills log she collected information on trainee perceptions of the relevance of each patient encounter for learning 16 important clinical skills. The study was carried out in the AMC and on the medical CTUs of a major teaching hospital of McGill University in Montreal, Quebec, Canada. All residents and students assigned to the two teaching sites during the six-month study were asked to volunteer for the interview. Comparisons between the relevance ratings of the 16 clinical skills revealed that mean ratings of CTU experiences were similar for the two groups while students accorded higher relevance ratings to AMC interactions for eight of the 16 skills. Students rated more highly the 'educational value' of ambulatory care patients than did residents.