CREATING AND EVALUATING AN INDEPENDENT AMBULATORY INTERNAL-MEDICINE CLERKSHIP

Patient care is shifting from an inpatient setting to an ambulatory se tting. Despite this shift, most internal medicine clerkships provide t he majority of medical student training in inpatient settings or in un iversity tertiary care clinics, which are not representative of patien t care in a community setting. We created a separate ambulatory clerks hip that used volunteer community faculty at local and distant sites. The steps involved are described here, including finding time within t he clerkship, reaching consensus within the department, defining the c urriculum, identifying sites, and developing preceptors. Various param eters were measured to ensure quality in educational design. Compariso ns of the 1-year pilot program, the full implementation program, and t he inpatient program revealed that use of community sites does not aff ect cognitive knowledge acquisition but does in fluence students' sati sfaction level.