Academic Medicine · 1997 · 56 citations · 0 references
NursingTeacher EducationTeacher EnhancementPrimary CareEducational MissionTeachingAmerican Health CareAmbulatory CareTeaching MethodEducationAllied Health ProfessionsContinuing Medical EducationHealth Profession TrainingMedicineCurriculumEmergency MedicineCurrent Drive
The push for clinical efficiency in academic medical centers has reduced protected teaching time, threatening the quality of physician education and potentially creating a national crisis. This article examines the time demands and unique challenges of outpatient teaching and proposes strategies to safeguard high‑quality education. The authors recommend that institutions recognize teaching as a core mission and allocate sufficient time for planning, instruction, and reflection to preserve comprehensive education.
The current drive for efficient clinical teaching threatens the educational mission of academic medical centers. With pressures to increase clinical productivity, protected time and compensation for teaching have become scarce resources for clinical teachers in all settings. Although it may yield new approaches to education, the push for efficiency may ultimately result in insufficient time for teaching and may cause some clinical preceptors to stop teaching completely. Further, it may lead to the illusion that comprehensive teaching truly requires little time. Since the future of American health care depends upon the provision of high-quality clinical education to young physicians, this situation presents a potential national crisis. In this article, the authors discuss the complex nature of teaching, its time requirements, and the special challenges of teaching in outpatient settings. To avoid overemphasizing efficiency to the detriment of education they recommend adhering to two principles: (1) academic medical centers are educational as well as training institutions, and therefore should provide a broad-based education as well as training in clinical skills; and (2) the clinical teaching process is complex and adequate time must be provided for its many phases, including planning, instructing, and reflecting. Finally, the authors make recommendations for ensuring the delivery of high-quality education in ambulatory care settings.