DEFINING AND EVALUATING QUALITY FOR AMBULATORY CARE EDUCATIONAL-PROGRAMS

As the training of medical students and residents increasingly moves t o ambulatory care settings, clerkship and program directors must find a way to use their limited resources to guide the development and eval uation of the quality of these ambulatory-based learning experiences. To evaluate quality, directors must first define, in operational and m easurable terms, what is meant by the term ''quality'' as it is applie d to ambulatory-based education. Using educational theories and the de finition of quality used by health care systems, the authors propose a n operational definition of quality for guiding the planning, implemen tation, and evaluation of ambulatory care educational programs. They a ssert that quality is achieved through the interaction of an optimal l earning environment, defined educational goals and positive outcomes, participant satisfaction, and cost-effectiveness. By describing the co mponents of quality along with examples of measurable indicators, the authors provide a foundation for the evaluation and improvement of ins tructional innovations in ambulatory care education for the benefit of teachers, learners, and patients.