Ambulatory education in clinics from the perspective of medical students in Iran, 2016
More details
Hide details
Assistant professor, Department of Social Medicine, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
Online publish date: 2018-07-14
Publish date: 2018-09-19
Electron J Gen Med 2018;15(5):em81
Recent years have seen a growing attention to the function and position of ambulatory care and clinical education in medical education. The present study was conducted to investigate the current status of the quality of education in major clinics from the perspective of medical students.

This cross-sectional study was conducted in 2016 on 300 medical student from Lorestan University of Medical Sciences who selected through census method. Data were collected using a researcher-made questionnaire with a confirmed face and content validity and a reliability of 0.85. The data were analyzed in SPSS-21 using descriptive and analytical statistics.

The study participants included clerkship students (65.9%) and interns (34.1%) with a mean age of 22±2.1 and 24±3.5 years respectively. Statistically significant difference was observed between teachers’ quality of teaching and other domains from the perspective of the clerkship students. From the interns’ perspective, teachers’ quality of teaching and duration of attending clinics were the domains with significant statistical differences among clinics. (P<0.05). According to the assessments by the clerkship students and interns, the mean score in obstetrics clinics, was lower than other clinics.

Given the results obtained, particularly on teachers’ quality of teaching, teachers are respectfully recommended to pay a special attention to clinical education, enthusiastically involve students in patient-associated issues and improve their skills using modern educational methods.

1. Regan-Smith M, Young WW, Keller AM. An efficient and effective teaching model for ambulatory education. Acad Med. 2002;77(7):593-9. https://doi.org/10.1097/000018....
2. Mazor KM, Stone SL, Carlin M, Alper E. What do medicine clerkship preceptors do best? Acad Med. 2002;77(8):837-40. https://doi.org/10.1097/000018....
3. Krackov Sh K. Perspectives on Ambulatory Programs: Barriers and Implementation Strategies. Teaching & Learning in Medicine. 1993;5(4):243-50. https://doi.org/10.1080/104013....
4. Delva MD, Schultz KW, Kirby JR, Godwin M. Ambulatory teaching: do approaches to learning predict the site and preceptor characteristics valued by clerks and residents in the ambulatory setting? BMC Med Educ. 2005;5:35. https://doi.org/10.1186/1472-6....
5. Dent JA. AMEE Guide No 26: clinical teaching in ambulatory care settings: making the most of learning opportunities with outpatients. Med Teach. 2005 Jun;27(4):302-15. https://doi.org/10.1080/014215....
6. Dent JA, Harden RM. A practical guide for medical teachers (2nd ed.). Edinburgh: Elsevier Churchill Livingstone. 2005.
7. Amini A, Alizadeh M, Farzaneh F. Ambulatory medical education in educational centers of Tabriz school of medicine, Intern’s point of view. Iranian Journal of Medical Education. 2002;7:19-21.
8. Shaban Yamchi N. [Attitude of Gps’ abaut ambulatory. clinics.] 9th Congress of Medical Education. Yazd: University of Medical Sciences; 2008: [In Persian].
9. Bazazi N, Falahi G, Yavari A, Houshmand B. Medical students’ viewpoints about the quality of education in outpatient clinics in Hamadan University of Medical Sciences in 2007: Iranian Journal of Medical Education, Summer 2011;11(2):167-173.
10. Avizhgan M, Farzanfar E, Najafi MR, Shams B, Ashoorion V. Ambulatory education quality in Al-Zahra Hospital clinics in Isfahan, View of clerkships students and interns. Iranian Journal of Medical Education (Special Issue on educational development). Winter 2010;10(5):896-905.
11. Shams B, Jamshidian S, Changiz T. Educational Challenges in Ambulatory Pediatrics Teaching Programs Based on the Experiences of Interns and Attends: a Qualitative Study: A qualitative study, Journal of Strides in Development of Medical Education. 2010;7(2):81-92.
12. Khorasani G, Mahmoudi M, Vahidshahi K, Shahbaznejad L, Ghafari M. Evaluation of Faculty Members’ and Students’ Attitude Towards Ambulatory Teaching Quality, School of Medicine, Mazandaran University of Medical Sciences, 2007. Journal of Mazandaran University of Medical Sciences. 2007;17(58):87-100.
13. Anbari Z, Ramezani M. The obstacles of clinical education and strategies for the improvement of quality of education at Arak University of Medical Sciences in 2008. Arak Medical University Journal (AMUJ. Summer 2010;13(2):110-118.
14. Mortazavi A, Razmara A. The satisfaction of medical clerkship students and interns with education in sectors, emergency department, outpatient centers in hospital and in the society of Isfahan University of Medical Sciences. Iranian Journal of Medical Education. 2002;3:49-52.
15. Amini M, Ghanavatipoor, Omidvari. [KAP survey regard. The most common disease, Jahrom.] Medical Education. Kerman: University of Medical Sciences. 2007:98. [In Persian].
16. Jacobson EW, Keough WL, Dalton BE, Giansiracusa DF. A comparison of inpatient and outpatient experiences during an internal medicine clerkship. Am J Med. 1998;104(2):159-62. https://doi.org/10.1016/S0002-....
17. Irby DM. Teaching and learning in ambulatory care settings: a thematic review of the literature. Acad Med. 1995;70(10):898-931. https://doi.org/10.1097/000018....
18. Masood J, Wood D, Calleary J, Wiseman O, Lane T, Barua JM. The need for supervised training in urology outpatients:A case for restructuring. BJU Int. 2006;98(6):1144-5. https://doi.org/10.1111/j.1464....
19. Zali MR, Mahdavi M S, Nobakht Haghighi A, Noroozi A, Akbari Ghamsari A. The causes of patients’ satisfaction and complaints of physicians, Abstract book of 11th international conference on Geographic Medicine and and the first conference on Ambulatory Education, Shiraz University of Medical Sciences: 105.
20. Kalet A, Pugnaire MP, Cole-Kelly K,Janicik R, Ferrara E, Schwartz MD, Lipkin M Jr, Lazare A. Teaching communication in clinical clerkships: models from the macy initiative in health communications. Acad Med. 2004;79(6):511-20. https://doi.org/10.1097/000018....
21. Sievers B, Wolf S. Achieving clinical nurse specialist competencies and outcomes through interdisciplinary education. Clin Nurse Spec. 2006;20(2):75-80. https://doi.org/10.1097/000028....
22. Scott I, Sazegar P. Why community physicians teach students (or not): barriers and opportunities for preceptor recruitment. Med Teach. 2006;28(6):563-5. https://doi.org/10.1080/014215....
23. Lesky LG, Hershman WY. Practical approaches to a major educational challenge, training students in the ambulatory settings. Arch Intern Med 1995;155(9):897-904. https://doi.org/10.1001/archin....
24. Alizade M, Sadeghi Hasan Abadi A, Tabatabii HR, Sharifi B. Opinion of general physicians of urban health center about ambulatory medical education. Abstract book of 11th International Geographic Medicine about Ambulatory education, Shiraz, Iran:116.
25. Wolpaw TM, Wolpaw DR, Papp KK, SNAPP S. A learner-centered model for outpatient education. Acad Med. 2003;78(9):893-8. https://doi.org/10.1097/000018....
26. Lubetkin EI, Krackov SK, Storey-Johnson. The use of questionnaires to assess achievement of course goals in medical students’ longitudinal community based clinical experiences. Acad Med. 1999;74:1316-9. https://doi.org/10.1097/000018....