Background: This prospective randomized controlled study examined outpatient clinical teaching in the presence of the patient.
Methods: In 2006, patients in ambulatory internal medicine clinics at the University of Iowa were randomized to have faculty-learner presentations either in their presence or in the conference room. Staffing encounters were timed and faculty, learners and patients completed postencounter surveys.
Results: Participation included 254 patients and 12 faculty. Comparison of patient encounters randomized to exam room (n = 120) or conference room (n = 134) staffing demonstrated increased time spent with the patient in exam room staffing (91% vs. 54% of total staffing time; p < .0001) but no significant differences in mean total staffing time. Patients, learners, and faculty preferred exam room staffing.
Conclusions: Concerns about time efficiency and patient and learner satisfaction during exam room staffing were not supported. This approach may allow attending physicians to maximize billing levels while increasing learner/patient involvement.