An Ambulatory Care Teaching Centre (ACTC) has provided an opportunity to de
velop an integrated teaching programme in a supervised environment which li
nks students' initial clinical experiences in the skills centre with patien
t-contact in other teaching settings. Second-year students attended 2-h ses
sions in the ACTC during each block of a systems-based course. Two 'system-
sensitive' patients invited from a patient bank enabled students to develop
clinical skills previously practised on mannequins and simulated patients
and to integrate theoretical material with clinical practice. A programme c
o-ordinator timetabled student, patient and tutor attendances. Students par
ticularly appreciated the protected environment where they could practice c
linical skills under supervision before interviewing other patients in pati
ent-centred clinical settings. Tutors appreciated an environment which elim
inated tensions often present between teaching and service delivery. They e
njoyed focussed teaching sessions especially if details of invited patients
were known in advance and 'backup' resources were available. Patients enjo
yed opportunities to contribute to clinical teaching.