Abstract
Background: Attributes of effective precepting of pre-clerkship medical students in community settings are not adequately described. As part of preceptor needs assessment, we conducted site visits over three consecutive years. We also measured the preceptorships’ educational quality, using students’ post-rotation data, to identify priority areas for faculty development, corroborate site visit findings, and assess functions of the site visit.
Methods: Three university faculty directly observed teaching encounters in 83 community preceptors’ offices during a 12–18-week second year (pre-clerkship) medical student rotation. Data were collected on practice demographics, teaching content, and educational quality, using multiple measures. Narrative responses to interview questions were coded for prevalent themes. Student post-rotation assessments were obtained by anonymous online evaluations.
Results: Good precepting attributes and suggestions for improvement were identified from both narrative analysis and student post-rotation evaluations in these key areas: independence in patient assessment, time spent teaching, giving feedback and orientation to the preceptor's practice. Student evaluations of preceptors’ effectiveness significantly improved from year 1 to 2 and persisted into year 3. Appropriate faculty development strategies were derived from the combined results.
Conclusions: The site visit by university faculty allows real-time observation and may itself be an effective intervention for improving teaching and learning.
Additional information
Notes on contributors
Désirée Lie
DÉSIRÉE LIE, MD, MSEd, is Director of Research and Faculty Development in the Department of Family Medicine, University of California, Irvine School of Medicine, USA.
John Boker
JOHN BOKER, PhD, is now Vice President of Academic Affairs, Geisinger Health Systems, and formerly Director of Research in Medical Education, at the University of California, Irvine School of Medicine, USA.
Emily Dow
EMILY DOW, MD, is Associate Director, Family Health Center, and Director of Student Electives, Department of Family Medicine, University of California, Irvine School of Medicine, USA.
Penny Murata
PENNY MURATA, MD, is pediatrics Clerkship Director, Department of Pediatrics, University of California, Irvine School of Medicine, USA.
Jennifer Encinas
JENNIFER ENCINAS, BA, is a research coordinator in the Department of Family Medicine, University of California, Irvine School of Medicine, USA.
David Gutierrez
DAVID GUTIERREZ, BA, is a graduate and premedical student at the University of California, Irvine, USA.
Elizabeth H. Morrison
ELIZABETH MORRISON, MD, MSEd, is Director of Research, Department of Family Medicine and Associate Dean of Clinical Science Education at the University of California, Irvine School of Medicine, USA.