Objectives: This study surveys medical education literature  published over the last 25 years (1993–2018) to identify the  factors scholars consider deleterious to outpatient teaching  for medical students.  

Methods: This study conducts a review of medical education  literature published between 1993 and 2018 using Medline,  Lilacs, Ibecs, Cochrane Library, and Scielo databases. The following search terms were utilized: “Education, Medical, Undergraduate” AND “Ambulatory Care” AND “Teaching/methods” OR “Clinical Clerkship” OR “Preceptorship.”  This study focuses on papers describing deleterious factors  for outpatient teaching with medical students and analyzes  their results, discussions, and conclusions sections.

Results: Of the 363 articles obtained, this study selected 33  for analysis. These papers identify numerous factors as barriers to outpatient education. For didactic purposes, these  factors are categorized into four barrier groups: environment-institution, academic staff, students, and patients. Academic staff-related teaching barrier was the most frequently  mentioned obstacle. Intense care schedule with little teaching  time was considered the most common and relevant barrier  to outpatient medical education, followed by inappropriate  teaching environment and inadequate supervision model.  

Conclusions: There is a lack of recent literature on studies  focusing on barriers to effective outpatient medical education. Factors identified as harmful to outpatient education  have been pointed out by course directors, academic staff,  and students in the literature. However, many of these factors  remain overlooked by educators, who can use these factors to  modify their academic activities for more effective results.