A worksheet to structure teaching and learning outpatient internal medicine

The Worksheet for Ambulatory Medicine (WAM) was designed to enhance teaching and learning outpatient general internal medicine. It contains a set of explicit learning objectives, promotes important teaching strategies, and carefully structures educational and patient care activities. WAM may help students by: (1) demonstrating methods for more focused history-taking, physical examination, and case-presentation; (2) increasing preceptor feedback; (3) making performance expectations explicit; (4) facilitating and encouraging self-directed learning and reflective, evidence-based, practice; (5) promoting autonomous evaluation and management of outpatient problems; and (6) demonstrating an approach to evaluating undifferentiated clinical problems. WAM may help teachers by: (1) identifying student learning needs; (2) increasing structure and control of teaching sessions; and (3) helping demonstrate steps in the clinical reasoning process. WAM has been pilot-tested with third- and fourth-year medical students. Informal feedback has been favorable, and formal evaluation of the worksheet is underway.