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Bowen J and Irby D, Assessing the quality and costs of Education in the ambulatory setting. Acad Med. 2002;77:621-680 Brief review by Steve Miller, Columbia University


Bowen J and Irby D, Assessing the quality and costs of Education in the ambulatory setting. Acad Med. 2002;77:621-680

Brief review by Steve Miller, Columbia University

This is an amazing comprehensive review of the literature. Issues that are addressed include:

  1. Sites conducive to learning must include active patient care and participation by the students - an increase in passive observation is a warning sign of increasing faculty burden

(Has the amount of passive observation been increasing for your students? Steve Miller)

  1. Excellent teachers are those who provide clear explanations, set expectations and provide feedback, show enthusiasm for the topic and the learner, and role model excellent care and communication. Most preceptors feel deficient in the setting expectations and providing feedback skills.

(Do you provide faculty development for your ambulatory preceptors on giving effective feedback? Steve Miller)

  1. Little is known about the impact of education on patient care outcomes and on the utility of computer aided instruction - that is generalizable.

There is also extensive review of issues related to evaluation tools, impact on career choice and the cost of education - it costs 30% more to educate a student - either in time - or money.

(Do you reimburse faculty who teach in ambulatory settings? If yes, how much? SM)

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