An Academic Medical Center: a Customized Strategy to Overcome the Shortcomings of Interns’ Ambulatory Education

Purpose: This study aims at evaluating the medical faculty Interns' skills in ambulatory area both from their own perspectives and researchers’ observations, in order to diag-nose the causes of the problems and to recommend the right solution

Method: In this study (2010), 4 researchers and 45 Interns of the Imam Reza Academic Medical Center (IRAMC), Tabriz- Iran measured the Interns' abilities in ambulatory care setting from 9 disciplines based on 1335 patients visited and using a well-structured questionnaire covered those abilities based on the MD2000 curriculum of the Brown University. Ambulatory teaching process in each clinic was described according to various items and based on researchers’ direct observations of 45 sessions.

Results: forty six faculties visited 10293 patients during two-hour sessions in an ex-tremely varied range -two to five times- per week for a period of five months (439 ses-sions) in 9 visit rooms with about 160 square feet area. The teaching model in all clinics was Grand Stand model, and some important reasons of the Interns' imperfect ambula-tory education were distinguished: attending in a resident-centered venue just to observe those mostly follow-up, complex and referral cases; lack of engagement in the patients' visit process and not receiving any feedback. The level of the Interns' abilities was mostly low both from their points of view and researchers' observations. Significant differences upon 4 items were found.

Conclusions: We found "frenetic and chaotic pace “of patient visit in IRAMC as the key constraint on ambulatory teaching, and in order to augment the Interns' unsatisfactory skill level, several customized recommendations would be presented