title: A prospective study to assess the effect of ambulatory teaching on patient satisfaction.
abstract: OBJECTIVE
  To assess the effect of ambulatory teaching on patients' satisfaction.
  
  
  METHODS
  In 1996, 103 adult patients presenting to the Walter Reed General Medicine Walk-in Clinic completed a patient-satisfaction questionnaire immediately following their visits, during which they were initially seen by a trainee (third-year medical student or intern) and then seen by a faculty preceptor. The questionnaire included five items from the validated Medical Outcomes Study (MOS)-9 questionnaire as well as two open-ended questions. Fourteen staff physicians, 13 students (49% of the visits), and 11 interns (51% of the visits) participated in the study. Satisfaction was analyzed by level of training, and the responses from the study patients were compared with the responses from 372 usual-care (i.e., non-teaching) patients from the same clinic, using the chi-squared test.
  
  
  RESULTS
  The study patients were typically pleased with their encounters, rating their overall satisfaction as excellent (61%), very good (29%), or good (9%). Nearly two thirds of the patients rated their satisfaction with waiting time to be very good or excellent. Compared with the usual-care patients, the study patients reported equal or greater satisfaction for all five MOS-9 items. Ninety-five percent of the study patients said they would be willing to be seen by a trainee-staff team on future visits. There was no difference in patient satisfaction by trainee level. The study patients cited enhanced interaction (45%), enhanced education (34%), and improved care (26%) as benefits of trainee-involved care, and increased waiting time (18%) and worse care (5%) as drawbacks.
  
  
  CONCLUSIONS
  The results of this study suggest that ambulatory teaching does not adversely affect patient satisfaction, regardless of trainee level, and that patients who have been seen by trainee-staff teams are willing to experience such encounters again.
authors.affiliation: Department of Medicine, Uniformed Services University of the Health Services, F. Edward Hébert School of Medicine, Bethesda, MD 20814-4799, USA. pjomalley@msn.com
authors.forename: P G
authors.initials: PG
authors.lastname: O'Malley
authors.forename: D M
authors.initials: DM
authors.lastname: Omori
authors.forename: F J
authors.initials: FJ
authors.lastname: Landry
authors.forename: J
authors.initials: J
authors.lastname: Jackson
authors.forename: K
authors.initials: K
authors.lastname: Kroenke
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D004504:Education, Medical, Undergraduate; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008396:Maryland; D017063:Outcome Assessment, Health Care; D010044:Outpatient Clinics, Hospital / Q000592:standards*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011446:Prospective Studies; D013663:Teaching / Q000379:methods*; D000078329:Workforce