Disagreement Between Students and Preceptors Regarding the Value of Teaching Behaviors for Ambulatory Care Settings

Abstract

Background: Medical students and preceptors commonly disagree on methods of clinical instruction in ambulatory care, although the extent of the problem is not documented. Purpose: The purpose is to identify disagreement and concordance between students and preceptors for teaching behaviors in ambulatory care. Methods: We surveyed students and preceptors at 4 U.S. schools. Respondents rated 58 behaviors on two scales. Disagreement was recognized when the percentage of students and preceptors who recommended a behavior and rated it important differed by over 15% (p < .01). Results: Disagreement was identified for 8 behaviors (14%). Six were valued less by students, including “watch the student perform critical tasks in history taking and other communication” (59% compared with 82%). Two behaviors were valued more by students, including “delegate responsibility to the student for the wrap up discussion with the patient” (82% compared with 61%). Conclusions: Students and preceptors disagree regarding the value of a minority of teaching behaviors. Because some are potentially important, however, early negotiation regarding their use may enhance teaching effectiveness and mutual satisfaction with learning.

Supported by an anonymous gift by an individual to the Department of Medicine at Yale. We acknowledge the many medical students and preceptors who gave generously of their time to make this research possible.

Notes

^a N = 163.

^b N = 138.

^c For students, practice type refers to the main teaching site to which he or she was assigned. Practice type was missing for one faculty member.

^a N = 163.

^b N = 138.

^c Item was identified only during faculty focus groups.

^d Identical or very similar items were identified as valued by students in a previous survey. ¹⁰

^e Identical or very similar to items that were identified as not valued by students in a previous survey. ¹⁰

^a N = 163.

^b N = 138.

^c Item was identified only during faculty focus groups.

^d Identical or very similar to items that were identified as not valued by students in a previous survey. ¹⁰

^e Identical or very similar items were identified as valued by students in a previous survey. ¹⁰

^a N = 163.

^b N = 138.

^c Identical or very similar items were identified as valued by students in a previous survey. ¹⁰

^d Item was identified only during faculty focus groups.

^e Identical or very similar to items that were identified as not valued by students in a previous survey. ¹⁰