Merranvo: It seems to check some property associated with the monsters, but that property seems to be reset after clearing it. Not really certain how it is actually suppose to work.
Kovi: The rules I have at my disposal say that "Ambush is applied every time when the player (thief) is attacking an NPC that isn't expecting the attack". The rules also say that "Ambush works together with Stealth".
So I guess that the game should be checking whether the monster knows about the player (because of his active Stealth) and whether it is expecting the attack or not. If not, a bonus from the Ambush skill should be applied to the attack.
The problem with stealth is that monsters seem innately aware of the player. If you use "hide in plain sight" a monster will still follow you despite your invisibility. Slowly though, indicating it is using something like sound to track you. Sneaking up while under cover often results in similar behavior (inflated skills to 20 for testing purposes), making it seem unlikely to ever get the right conditions for it to trigger.
Of course, just using a stealth check is a little overpowered as there's no delay in recasting stealth and one would expect damage from ambush to decrease with each attack until normal (on the idea that the monster should anticipate the attack the more it gets attacked).
Thanks for the information regardless.