title: The impact of the location and structure of an ambulatory rotation on cognitive knowledge and performance.
abstract: With the increasing shift to community-based ambulatory education, it is essential to gain a better understanding of the impact of these changes. To assess the impact of the location and structure of an ambulatory internal medicine clerkship rotation on cognitive knowledge and clinical performance, students were assigned to one of the following: (a) a multidisciplinary ambulatory clerkship (MAC), (b) the office of a community-based general internist, or (c) a university-based internal medicine ambulatory clinic. The groups were compared on the internal medicine clerkship examination and preceptor ratings controlling for introduction to clinical medicine course performance via analysis of covariance. MAC students were rated lower than the other two groups by their preceptors. There were no other statistically significant differences. The structure and location of the rotation had little impact on cognitive knowledge. The impact of the structure of the rotation on clinical performance is less clear suggesting that further research is needed.
authors.affiliation: University of Texas Medical Branch, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Solomon
authors.forename: C J
authors.initials: CJ
authors.lastname: Rosebraugh
authors.forename: A J
authors.initials: AJ
authors.lastname: Speer
authors.forename: M D
authors.initials: MD
authors.lastname: Holden
authors.forename: K M
authors.initials: KM
authors.lastname: Szauter
mesh_terms: D000553:Ambulatory Care; D000704:Analysis of Variance; D002982:Clinical Clerkship / Q000379:methods*; D002983:Clinical Competence; D003071:Cognition; D003153:Community Health Services; D003479:Curriculum; D004521:Educational Measurement; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D010044:Outpatient Clinics, Hospital