The theories of adult learning have the potential to apply well to resident education
in the ambulatory setting. Many of the teaching strategies discussed above
are compatible with concepts of Adult Learning Theory. Application of teaching
methods that are based on these theories should increase the effectiveness of
teaching and learning. Yet we have little evidence that this is true. To date few
empirical studies have evaluated teaching methods explicitly based on Adult
Learning Theory.
Skeff and colleagues evaluated an intensive training course in clinical teaching,
using pre/post self-assessments (Skeff et al., 1992). We identified only one other
published paper examining the application of Adult Learning Theory to general
ambulatory resident education (Tibbles, 1985). In this study family medicine residents
were asked to identify their most common learning needs by categorical
topic. Faculty preceptors from the same clinics were asked to identify residentperceived
learning needs from the same list. Mismatches between residents and
preceptors regarding perceptions of educational needs were common in this study
(Tibbles, 1985). None of the other approaches to ambulatory teaching presented
in this paper has been rigorously evaluated. These techniques may be too time
intensive for extremely busy teaching settings; however, time efficiency of teaching
has never been evaluated. The lack of extensive and substantive evaluation of these
theory-based approaches represents an important deficit in our understanding of
effective teaching methods for ambulatory resident education.