The Worksheet for Ambulatory Medicine (WAM) was designed to enhance te
aching and learning outpatient general internal medicine. It contains
a set of explicit learning objectives, promotes important teaching str
ategies, and carefully structures educational and patient care activit
ies. WAM may help students by: (1) demonstrating methods for more focu
sed history-taking, physical examination, and case-presentation; (2) i
ncreasing preceptor feed-back; (3) making performance expectations exp
licit; (4) facilitating and encouraging self-directed learning and ref
lective, evidence-based, practice; (5) promoting autonomous evaluation
and management of outpatient problems; and (6) demonstrating an appro
ach to evaluating undifferentiated clinical problems. WAM may help tea
chers by: (I) identifying student learning needs; (2) increasing struc
ture and control of teaching sessions; and (3) helping demonstrate ste
ps in the clinical reasoning process. WAM has been pilot-tested with t
hird- and fourth-year medical students. Informal feedback has been fav
orable, and formal evaluation of the worksheet is underway.