Abstract Manager

Oral

OH1-2-2

Accept

I declare I have no actual or potential conflict of interest in relation to this program.

yes

General Call (Workshop, Oral Presentation, Poster Presentation)

Oral

Education Innovation

Other

yes

Residents as Teachers in the Ambulatory Setting: a possible solution for fragmented learning?

Historically, medical students have learned internal medicine on well-established inpatient clinical teaching units, including significant learning from residents. In contrast, teaching medical students in the outpatient setting is less well-described but just as necessary, given the scope of ambulatory care. Our undergraduate ambulatory structure had relied on a clinical preceptors volunteering for half days when they were able, resulting in a fragmented curriculum for students.

We created a "junior attending" rotation where a PGY-4/5 resident was added to the third year medical students' 2-week internal medicine ambulatory rotation. Nine residents completed this 4 week rotation between February 2018-June 2019. They provided the bulk of teaching and clinical supervision to the students. Two clinical faculty members served as the preceptors. Patients were given a "Who is my Doctor" handout to describe the structure of the teaching clinic. Semi-structured interviews were conducted with both preceptors, all nine fellows, and 13 medical student focus groups. Interviews were analyzed in an iterative manner to explore the educational implications.

The major themes identified emerging from the initial analysis of the interviews included: 1) increased time, focus and individualized attention to the students' learning than compared to the inpatient setting, 2) unique teaching and feedback skills acquired by the residents 3) increased job satisfaction for faculty preceptors 4) creation of a supportive learning environment for all. We propose that the junior attending role be expanded from the inpatient clinical teaching unit to the ambulatory setting given the benefits to all stakeholders.

ambulatory teaching

positive learning environment

individualized learning

General

Teaching and learning

Undergraduate

Postgraduate

Physician & Medical Student Health and Well-being

Yes

Yes

Yes

Yes

Yes