Background: Recommendations are to increase ambulatory training in pos
tgraduate medical education. Description: We collected pre- and postro
tation measures of satisfaction in 1,500 patients. We also collected p
ostrotation ratings from 60 residents concerning (a) changes in knowle
dge and skill (b) evaluation of selected components and overall experi
ence. Evaluation: Most patients gave high ratings to their physicians
pre- and postrotation. Housestaff reported increased self-rated knowle
dge and skills for Rheumatology and Behavioral Medicine (p > .001) and
for Women's Health (p < .05). Trainees valued hands-on patient care a
nd focused clinical content. Modules with observational format, limite
d staff involvement, or fewer patients received lower ratings. Conclus
ions: We found significant increases in self-rated knowledge and skill
s, and that trainees preferred an interactive, hands-on, focused-learn
ing format. Research is needed to determine the effect of ambulatory e
xperiences on actual patient care or primary care as a career choice.