Teaching models for outpatient medicine

A third-year student in your busy ambulatory care clinic presents a case of a 34-year-old woman with a 3-day history of acute cough and fever. On physical examination, she has notably a temperature of 100.4°F (1) and crackles in the right lower lobe on lung examination. How do you decide what to teach this student?

Ambulatory care for outpatients in clinic settings poses unique challenges to preceptors (teachers) and learners as a result of the pace of patient care and the limited time available for teaching. In addition to providing high-quality patient care, preceptors must integrate learners into patient care delivery, teach efficiently, provide feedback in real time and evaluate learners performances.¹ At the same time, they must engage in clinical instructional reasoning: diagnosing patients problems, assessing learners needs and using teaching scripts to provide targeted instruction.^1,2 This reasoning process is enacted through a variety of teaching/pedagogic strategies. In this article, we describe three teaching models: the traditional, One Minute Preceptor (OMP)³ and SNAPPS⁴ models.