The impact of the location and structure of an ambulatory rotation on cognitive knowledge and performance

With the increasing shift to community-based ambulatory education, it is es sential to gain a better understanding of the impact of these changes. To a ssess the impact of the location and structure of an ambulatory internal me dicine clerkship rotation on cognitive knowledge and clinical performance, students were assigned to one of the following: (a) a multidisciplinary amb ulatory clerkship (MAC), (b) the office of a community-based general intern ist, or (c) a university-based internal medicine ambulatory clinic. The gro ups were compared on the internal medicine clerkship examination and precep tor ratings controlling for introduction to clinical medicine course perfor mance via analysis of covariance. MAC students were rated lower than the ot her two groups by their preceptors. There were no other statistically signi ficant differences. The structure and location of the rotation had little i mpact on cognitive knowledge. The impact of the structure of the rotation o n clinical performance is less clear suggesting that further research is ne eded.