Teaching and learning in the ambulatory setting.

Changes in how and where health care is delivered have had an adverse effect on the traditional inpatient-based clinical education of medical students. Increasingly, medical educators are turning to ambulatory-based educational experiences as viable and useful adjuncts to the inpatient wards. However, when planning and developing an ambulatory clerkship, careful attention must be paid to the desired outcomes from the experience, the appropriate site, and instructional model to use to best meet the objectives. This report explores (1) the major differences between ambulatory and inpatient educational settings, (2) potential educational outcomes of clinical teaching in the ambulatory setting, (3) instructional models that can be used to meet educational objectives, (4) the potential barriers and critical issues that must be considered when implementing ambulatory educational experiences, and (5) evaluation strategies for measuring the educational outcome.