The satisfaction, motivation, and future of community preceptors: the North Carolina experience

An Innovative, Collaborative, and Transformative Program to Enhance Off-Campus Clinical Faculty Engagement

Off-campus (volunteer, community-based) clinical faculty, upon whom medical schools heavily depend, are an integral component of medical education. However, challenges hinder their involvement in medical school governance and other activities, including inadequate communication, lack of recognition, high clinical demands that may preclude teaching, and time-consuming non-clinical tasks. While faculty appointments offer benefits like free CME, access to library resources, and email communications, faculty often prioritize potential contributions to their teaching roles over these benefits. Our medical school launched a new initiative to tackle these issues head-on. We established an Office of Faculty Engagement (OFE) that leverages engagement strategies to enhance communication, broaden access to campus resources, and provide tailored rewards for clinicians. We rebranded volunteer clinical faculty as Off-Campus Faculty (OCF) to foster a more interactive relationship and innovative measures, including personalized welcome emails, a dedicated point of contact for OCF, a user-friendly website, regular orientations, faculty development programs, recognition and appreciation events, and exclusive awards. From August 2021 to December 2023, we contacted 587 OCF members; 85 faculty members experienced improved communication. This innovative approach streamlines and personalizes interactions with OCF, enhances their satisfaction, and represents a transformative opportunity to engage and involve OCF in medical education.

Applying self-determination theory to stem medical schools' clinical teacher sustainability crisis

THE PROBLEM

Medical schools require highly skilled and committed clinical faculty to teach, assess, supervise and mentor students' clinical care. Medical education is facing a crisis in recruiting and sustaining these clinical teachers. Faced with multiple demands and responsibilities in fast-paced clinical environments, teachers may not have the time, resources or stamina to sustain these critical roles. Medical school leaders must commit to and provide structures and processes to attract, sustain and retain clinical teachers.

CONCEPTUAL FRAMEWORK

The authors use the lens of self-determination theory to frame approaches to support teacher sustainability. Self-determination theory describes sources of human motivation. The theory and its evidence base characterise three human psychological needs: autonomy, competence, and relatedness. This theory can bridge individual psychological and institutional leadership perspectives to help medical school leaders anticipate and respond to their clinical teachers' needs. The authors propose three practical steps: practices to advance employee-centredness, processes to align individual and institutional values, and restructuring education to support clinical teachers' needs alongside student and patient needs. The authors describe limitations to this relational approach that focuses on leadership actions and consider individual agency as another key factor for sustainability.

DISCUSSION

Medical school leaders can develop and apply theory-driven approaches to advance sustainability. Sustainability now and in the future requires careful attention to the needs of clinical teachers and to their relationships with and within medical schools.

What motivates GPs to train medical students in their own practice? A questionnaire survey on the motivation of medical practices to train students as an approach to acquire training practices

Background

With the new licensing regulations for doctors coming into force, medical faculties are faced with the task of recruiting and qualifying more GP colleagues to train students in their practices.

Objective

The aim of the study was to determine the motivation of GPs to train students in their own medical practices.

Method

A cross-sectional survey of Thuringian GPs was conducted from April to May 2020. 21 items on motivation, incentives and barriers were recorded and examined using univariate and multivariate analyses.

Results

The response rate was 35.8% (538/1,513). The GPs surveyed considered themselves motivated to train students in their medical practices. The motives can be described as predominantly intrinsic: the mutual exchange of knowledge, desire to share knowledge and to promote future doctors. Incentives included the opportunity to keep up to date with the latest knowledge, further training and contacts with colleagues. Barriers to teaching in the own medical practice were concerns about not being able to treat the same number of patients, a possible disruption of practice operations and lack of space. An analysis of the subgroups of GPs who were not yet teaching physicians indicated similar motives and barriers regarding training students in their practices, with a slightly lower overall motivation.

Conclusion

The results describe the facets of the motivation of Thuringian GPs to train students and can be helpful for the expansion of a sustainable network of training GP practices. It is essential to address motives, to counter difficulties with individual solutions and to create targeted incentives.

Rewards and recognition for Canadian distributed medical education preceptors: a qualitative analysis

Background: Recognition of Distributed Medical Education (DME) preceptors by medical schools ensures that important community-based training opportunities remain available to learners. Yet the literature seldom explores what rewards are meaningful to this population of teachers. The goal of our national project was to provide guidance to medical schools about the financial remuneration and non-financial rewards that are most valued by DME preceptors. Methods: In this qualitative study, we invited DME faculty members from all Canadian medical schools to participate in semi-structured interviews. Participants with a range of medical specialties, stages of career, and geographic locations were interviewed via Zoom videoconferencing. The sessions in English and French were audio-recorded and transcribed. We used line-by-line inductive coding and thematic analysis to examine participant talk about meaningful preceptor recognition. Results: Fourteen participants from multiple provinces were interviewed. Results indicated that the DME faculty are a diverse group of people with diverse needs. Most of the interviewees appreciated the rewards and recognition provided by their medical schools but felt that there are areas for improvement. Recognition is not necessarily monetary and should be tailored to the needs and the values of the recipient. Other themes included: benefits and challenges of being a preceptor, current institutional structures and supports, and the impact of the pandemic on preceptors. Conclusions: The interviews highlighted the importance placed by preceptors on personal rewards and a wide variety of forms of recognition. Based on the findings, we suggest specific steps that medical schools can take to support, engage, and recognize DME faculty.

Rewards and recognition for Canadian distributed medical education preceptors: a qualitative analysis

Background: Recognition of Distributed Medical Education (DME) preceptors by medical institutions ensures that important community-based training opportunities remain available to learners. Yet the literature seldom explores what rewards are meaningful to this population of teachers. The goal of our national project was to provide guidance to medical schools about the financial remuneration and non-financial rewards that are most valued by DME preceptors. Methods: In this qualitative study, we invited DME faculty members from all Canadian medical schools to participate in semi-structured interviews. Participants with a range of medical specialties, stages of career, and geographic locations were interviewed via Zoom videoconferencing. The sessions in English and French were audio-recorded and transcribed. We used line-by-line inductive coding and thematic analysis to examine participant talk about meaningful preceptor recognition. Results: Fourteen participants from multiple provinces were interviewed. Results indicated that the DME faculty are a diverse group of people with diverse needs. Most of the interviewees appreciated the rewards and recognition provided by their institutions but felt that there are areas for improvement. Recognition is not necessarily monetary and should be tailored to the needs and the values of the recipient. Other themes included: benefits and challenges of being a preceptor, current institutional structures and supports, and the impact of the pandemic on preceptors. Conclusions: The interviews highlighted the importance placed by preceptors on personal rewards and a wide variety of forms of recognition. Based on the findings, we suggest specific steps that medical institutions can take to support, engage, and recognize DME faculty.

Currencies of recognition: What rewards and recognition do Canadian distributed medical education preceptors value?

Background: Medical schools spend considerable time, effort, and money on recognition initiatives for rural and distributed medical education (DME) faculty. Previous literature has focused on intrinsic motivation to teach and there is little in the literature to guide institutional recognition efforts or to predict which items or types of recognition will be most appreciated. Methods: To better understand how rural and DME faculty in Canada value different forms of recognition, we asked faculty members from all Canadian medical schools to complete a bilingual, national online survey evaluating their perceptions of currently offered rewards and recognition. The survey received a robust response in both English and French, across nine Canadian provinces and one territory. Results: Our results indicated that there were three distinct ways that preceptors looked at recognition; these perspectives were consistent across geographic and demographic variables. These "clusters" or "currencies of recognition" included: i) Formal institutional recognition, ii) connections, growth and development, and iii) tokens of gratitude. Financial recognition was also found to be important but separate from the three clusters. Some preceptors did value support of intrinsic motivation most important, and for others extrinsic motivators, or a mix of both was most valued. Conclusions: Study results will help medical schools make effective choices in efforts to find impactful ways to recognize rural and DME faculty.

Longitudinal training models for entrusting students with independent patient care?: A systematic review

OBJECTIVE

The participation of students from both undergraduate medical education (UGME) and postgraduate medical education (PGME) in independent patient care contributes to the development of knowledge, skills and the professional identity of students. A continuing collaboration between students and their preceptor might contribute to opportunities for students to independently provide patient care. In this systematic review, we aim to evaluate whether longitudinal training models facilitate the independent practice of students and what characteristics of longitudinal training models contribute to this process.

METHOD

This systematic review was performed according to the PRISMA guidelines. In May 2020, we performed a search in three databases. Articles evaluating the impact of longitudinal training models on the independent practice of students from both UGME and PGME programmes were eligible for the study. A total of 68 articles were included in the study. Quality of the included studies was assessed using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD).

RESULTS

Both UGME and PGME students in longitudinal training models are more frequently allowed to provide patient care independently when compared with their block model peers, and they also feel better prepared for independent practice at the end of their training programme. Several factors related to longitudinal training models stimulate opportunities for students to work independently. The most important factors in this process are the longitudinal relationships with preceptors and with the health care team.

CONCLUSION

Due to the ongoing collaboration between students and their preceptor, they develop an intensive and supportive mutual relationship, allowing for the development of a safe learning environment. As a result, the professional development of students is fostered, and students gradually become part of the health care team, allowing them the opportunity to engage in independent patient care.

A nationwide survey of the perception of the APPE by community pharmacy preceptors in South Korea

BACKGROUND

Considering that approximately 75% of active pharmacists work in a community pharmacy globally, experiential practice in community pharmacies is a crucial part of pharmacy education. Skilled preceptors and their perceptions are integral to experiential practice. However, the perception of community pharmacy preceptors on a nationwide level is rarely studied.

OBJECTIVES

To examine the perception of community pharmacy preceptors who had undertaken the newly implemented community pharmacy experiential practice in South Korea.

METHODS

This study was based on a self-administered, nationwide, online cross-sectional survey performed by the Korean Pharmaceutical Association in 2017. Active community pharmacy preceptors undertaking experiential practice in South Korea were enrolled. The preceptor's competence, satisfaction, stress, achievement, and the likelihood of continuing preceptorship were evaluated using a 4-point Likert scale. In addition, the determinants of perception were evaluated using multivariate logistic regression analysis.

RESULTS

Of the 681 active preceptors, 390 (response rate: 57.3%) participated in this study, and the data of 385 participants were used for the final analysis. The majority of the preceptors were satisfied (83.1%), felt high achievement (85.8%), and were likely to continue with the preceptorship (85.7%). However, 52.8% reported increased stress due to the increased workload and lack of personal time. Preceptors who participated voluntarily had higher competence (odds ratio [OR] 2.050, 1.265-3.322) and exhibited lower stress (OR 0.560, 0.368-0.852). The academic degrees of preceptors and the number of preceptees trained by them were significantly related to competence. Preceptor age (>50 years) was negatively associated with stress (OR 0.635, 0.419-0.962).

CONCLUSION

Because competence is a key element associated with community pharmacy preceptors, it is necessary to create an environment in which preceptors can consider themselves competent. This nationwide study with community pharmacy preceptors will provide a basis for improving the quality of training at community pharmacies and may aid experiential practice administrators in revising the current program.

A Clinical Teaching Blended Learning Program to Enhance Registered Nurse Preceptors' Teaching Competencies: Pretest and Posttest Study

Background

Clinical nursing education provides opportunities for students to learn in multiple patient care settings, receive appropriate guidance, and foster the development of clinical competence and professionalism. Nurse preceptors guide students to integrate theory into practice, teach clinical skills, assess clinical competencies, and enhance problem-solving and critical thinking skills. Previous research has indicated that the teaching competencies of nurse preceptors can be transferred to students’ clinical learning to enhance their clinical competencies.

Objective

This study aimed to develop a clinical teaching blended learning (CTBL) program with the aid of web-based clinical pedagogy (WCP) and case-based learning for nurse preceptors and to examine the effectiveness of the CTBL program on nurse preceptors’ clinical teaching competencies, self-efficacies, attitudes toward web-based learning, and blended learning outcomes.

Methods

A quasi-experimental single-group pretest and posttest design was adopted. A total of 150 nurse preceptors participated in the CTBL program, which was conducted from September 2019 to December 2019. A set of questionnaires, including the clinical teaching competence inventory, preceptor self-efficacy questionnaire, attitudes toward web-based continuing learning survey, and e-learning experience questionnaire, was used to assess the outcomes before and after the CTBL program.

Results

Compared with the baseline, the participants had significantly higher total mean scores and subdomain scores for clinical teaching competence (mean 129.95, SD 16.38; P<.001), self-efficacy (mean 70.40, SD 9.35; P<.001), attitudes toward web-based continuing learning (mean 84.68, SD 14.76; P<.001), and blended learning outcomes (mean 122.13, SD 14.86; P<.001) after the CTBL program.

Conclusions

The CTBL program provides a comprehensive coverage of clinical teaching pedagogy and assessment strategies. The combination of the WCP and case-based approach provides a variety of learning modes to fit into the diverse learning needs of the preceptors. The CTBL program allows the preceptors to receive direct feedback from the facilitators during face-to-face sessions. Preceptors also gave feedback that the web-based workload is manageable. This study provides evidence that the CTBL program increases the clinical teaching competencies and self-efficacies of the preceptors and promotes positive attitudes toward web-based learning and better blended learning outcomes. The health care organization can consider the integration of flexible learning and intellect platforms for preceptorship education.

Physician Preceptor Satisfaction and Productivity Across Curricula: A Comparison Between Longitudinal Integrated Clerkships And Traditional Block Rotations

Phenomenon: Physicians are under intense pressure to improve clinical productivity. High clinical load, limited availability, and decreased clinical efficiency are well-documented barriers to precepting medical students and threaten clinical productivity. In an era of increasing medical student enrollment, these barriers have already led to a decreased availability of clinical teachers and training sites across the United States. Improved preceptor satisfaction could have a great impact on recruitment and retention of medical student preceptors and is likely linked to changes in productivity. Curriculum structure could impact both preceptor productivity and satisfaction. Comparing productivity and satisfaction of physician preceptors teaching in longitudinal integrated clerkships (LICs) to those teaching in traditional block rotations (TBRs), or in both settings (LIC-TBR), could lead to a better understanding of the impact of curriculum structure on preceptor productivity and satisfaction. Approach: Data were collected through a quantitative cross-sectional survey of outpatient physician preceptors in North Carolina in 2017. Preceptor satisfaction and student influence on productivity-related aspects of practice were analyzed with bivariate chi-square statistics and multivariate logistic regression. Findings: Analyses included 338 physician preceptors: 79 LIC (23%), 50 LIC-TBR (15%), and 209 TBR preceptors (62%). LIC preceptors were more likely to indicate being "very satisfied" with precepting than either their LIC-TBR or TBR counterparts. There were no differences in perceived productivity-related aspects of practice across the different curricula, such as patient flow, income, or physician working hours. Logistic regressions controlling for potential confounding variables suggested that those teaching in LICs were almost 3 times more likely to be "very satisfied" relative to those teaching in LIC-TBR and TBR settings and that the negative influence of students on patient flow and physician working hours had an adverse effect on preceptor satisfaction. Insights: Preceptor satisfaction was high overall, though satisfaction was significantly higher among preceptors who teach in LICs. The perceived impact of students on clinical productivity was stable across the different curricula. In an era of increasing need for physician preceptors, the higher satisfaction of those who teach in LICs should be considered in curricular design and for preceptor recruitment and retention.

Predictors and Motivation of Preceptors' Interest in Precepting of Pharmacy Interns-Do We Have a Useful Questionnaire?

PURPOSE

To determine the potential value of an adapted questionnaire to discover the predictors of preceptors' higher interest in precepting pharmacy interns and to evaluate preceptors' motivational factors and incentives for teaching as well as their professional satisfaction.

METHOD

A link to the survey study of adapted questionnaire (JSAMPPP) was e-mailed to all pharmacists registered with the Pharmaceutical Chamber of the Republic of Srpska. Pharmacists' demographic and work experience characteristics, their attitudes related to motivation for precepting, value of incentives for precepting, job satisfaction, and influence of interns on pharmacists' professional practice were obtained.

RESULTS

Half of the preceptors who reported feeling satisfied with their professional life also showed interest in teaching. In addition, teaching pharmacy students positively contributed to the overall job satisfaction of the preceptors. Pharmacy preceptors were found to be most motivated by intrinsic factors. The most valued incentives reported were those related to continuing education.

CONCLUSIONS

The adapted questionnaire has potential value and it revealed the following predictors of preceptors' higher interest in precepting: enjoyment of teaching, satisfaction with professional life, satisfaction as a pharmacy preceptor, and interns' influence on preceptors. These identified predictors can be emphasized to improve pharmacy students' internship experiences, thereby reinforcing the pharmacy profession.

Implementation of an educational program to improve precepting skills

BACKGROUND

Educating health care providers is dependent on developing high-quality clinical preceptors, yet preceptors face widespread challenges to precepting, such as time constraints and lack of formal preceptor training.

LOCAL PROBLEM

Our college of nursing conducted a needs assessment survey of our preceptors to better understand the barriers to and incentives for precepting. Formal preceptor training was identified as an intervention to support preceptors.

METHODS

Based on survey responses and a literature review of best practices, a preceptor training program was developed and delivered to local health care partners. Posttraining surveys were used to measure the effectiveness of the training.

INTERVENTION

We developed a one-hour formal preceptor training program. The main components included 1) orienting a student, 2) applying the Recorder/Reporter-Interpreter-Manager-Educator (RIME) framework for clinical evaluation, 3) One-Minute Preceptor (OMP) methodology for clinical teaching, 4) strategies for giving students feedback, and 5) communicating with the university.

RESULTS

Preceptor training was delivered to health care providers (N = 58) at eight clinics and one nurse practitioner (NP) professional group. Most participants (86%) had never received training in the RIME framework or OMP method (80%). The participants rated the following aspects of training as very useful or moderately useful: Orientation checklist (100%), RIME framework (96%), and OMP (100%).

CONCLUSIONS

We found that training preceptors on evidence-based, time-efficient strategies for precepting is feasible and valuable. If continued and expanded, this training may positively affect retention and recruitment of preceptors for our university's NP students. This training may be transferable to other geographical settings.

Teaching Medical Students in the Rural Setting Long Term: Physicians' Attitudes and Perceptions

OBJECTIVES

The University of Alabama School of Medicine Tuscaloosa Regional Campus conducted a 2-month block in rural family practice, but committed to expanding to an 8-month longitudinal rural curriculum. We wanted to explore how rural physicians feel about teaching students in a prolonged rural preceptorship.

METHODS

We brainstormed with colleagues, reviewed the literature, and conducted two focus groups supplemented by five interviews with rural physicians. The focus groups explored satisfaction and dissatisfaction in teaching, medical school and community support, evaluation of preceptors, and the sharing of information between students and preceptors. The analysis sought common themes among study participants and colleagues.

RESULTS

Twenty-one study participants included 19 family physicians, 15 in private practice. Eleven had taught medical students. Our key finding, combining four themes, was that a satisfactory context within which to teach medical students long term in rural sites depends on the optimization of the roles of preceptors, students, communities, and educational institutions. There were comments addressing each of these roles. This finding cannot be generalized beyond the study group because of the qualitative methodology using a convenience sample.

CONCLUSIONS

These physicians' concerns foment hypotheses about engaging rural physicians in their own unique local networks involving preceptors, students, community, and educational institutions to conduct satisfactory long-term medical education in rural sites. We recommend investigations to substantiate a prevalence among rural physicians of concern about the four roles and to describe various contexts in which these roles produce satisfactory long-term preceptorships, perhaps as best practices in different settings.

Challenges of Clinical Education

As we celebrate the 50th anniversary of the physician assistant (PA) profession and specifically PA education, think of the tens of thousands of clinical preceptors who were or currently still are involved in the education of PA students. The clinical phase of PA programs has become the rate-limiting issue in PA education. For decades, developing clinical education sites was relatively easy. Over the last decade, rapid expansion in medical, nurse practitioner, and PA education programs has resulted in greater challenges in obtaining necessary clinical training sites. This article attempts to address several of the current challenges in PA clinical education.

The North Carolina Community Preceptor Experience: Third Study of Trends Over 12 Years

PURPOSE

To measure community-based preceptors' overall satisfaction and motivations, the influence of students on preceptors' practices, and compare with 2005 and 2011 studies.

METHOD

North Carolina primary care preceptors across disciplines (physicians, pharmacists, advanced practice nurses, physician assistants) received survey invitations via e-mail, fax, postcard, and/or full paper survey. Most questions in 2017 were the same as questions used in prior years, including satisfaction with precepting, likelihood to continue precepting, perceived influence of teaching students in their practice, and incentives for precepting. A brief survey or phone interview was conducted with 62 nonresponders. Chi-square tests were used to examine differences across discipline groups and to compare group responses over time.

RESULTS

Of the 2,786 preceptors contacted, 893 (32.1%) completed questionnaires. Satisfaction (816/890; 91.7%) and likelihood of continuing to precept (778/890; 87.4%) remained unchanged from 2005 and 2011. However, more preceptors reported a negative influence for patient flow (422/888; 47.5%) in 2017 than in 2011 (452/1,266; 35.7%) and 2005 (496/1,379; 36.0%) (P < .0001), and work hours (392/889; 44.1%) in 2017 than in 2011 (416/1,268; 32.8%) and 2005 (463/1,392; 33.3%) (P < .0001). Importance of receiving payment for teaching increased from 32.2% (371/1,152) in 2011 to 46.4% (366/789) in 2017 (P < .0001).

CONCLUSIONS

This 2017 survey suggests preceptor satisfaction and likelihood to continue precepting have remained unchanged from prior years. However, increased reporting of negative influence of students on practice and growing value of receiving payment highlight growing concerns about preceptors' time and finances and present a call to action.

Stress, Satisfaction, and Competency of Hospital Pharmacy Preceptors under the New Pharmacy Program in South Korea

Objective. To evaluate hospital pharmacy preceptors' views of preceptorship and to explore the factors that might influence their stress and satisfaction after joining the newly implemented six-year pharmacy program in South Korea. Methods. A nationwide, cross-sectional, self-administered 47-item online survey was conducted for preceptors at hospital pharmacy practice sites in 2015. Results. Among 601 preceptors, 395 responded to the survey. They reported high stress and moderate role satisfaction and likelihood of continuing preceptorship. Workload was a major cause of stress and a barrier for continuing preceptorship, whereas improvement of professional knowledge and performance ability was considered the most important benefit and motivation of preceptorship. Monetary rewards were the most valuable incentive. Extra work hours used for precepting were a significant positive covariate for stress, while willingness to engage in preceptorship was a negative covariate for stress and positive covariate for satisfaction. Self-perceived assessments of preceptors' competencies showed moderate performance. Following an Importance-Performance Analysis (IPA), passion for teaching students and being a professional role model were identified as items in need of improvement. Conclusion. This study investigated relevant issues associated with hospital pharmacy preceptors in South Korea under the country's new experiential education program. The findings will help to enhance the quality of hospital pharmacy experiential education in countries that have implemented or are planning to implement a new pharmacy program.

Recruitment and Retention of Community Preceptors

BACKGROUND

Recruiting and retaining community-based pediatricians for teaching medical students has been explored through the lens of preceptors and educational leaders. The purpose of this study was to explore the perspective of pediatric department chairs, a key stakeholder group charged with maintaining teaching capacity among a faculty.

METHODS

In 2015, members of the Association of Medical School Pediatric Department Chairs and Council on Medical Student Education in Pediatrics joint task force disseminated a 20-item survey to pediatric department chairs in the United States and Canada. Topics included demographics, incentives offered to community pediatricians, and the perceived value and feasibility of such incentives. Data were analyzed using descriptive statistics and χ² to compare categorical variables.

RESULTS

Pediatric department chairs from 92 of 145 (63% response rate) medical schools returned the survey. Sixty-seven percent reported difficulty recruiting or retaining preceptors, and 51% reported high-reliance on preceptors for the ambulatory portion of the pediatrics clerkship. Almost all (92%) cited competition from other programs for the services of community preceptors. The provision of incentives was correlated with perceived feasibility (R² = 0.65) but not their perceived value (R² = 0.12). Few (21%) chairs reported providing financial compensation to preceptors. The provision of compensation was not related to reliance but did vary significantly by geographical region (P < .001).

CONCLUSIONS

Pediatric departments rely heavily on community-based pediatricians but face competition from internal and external training programs. The perspective of department chairs is valuable in weighing interventions to facilitate continued recruitment and retention of community preceptors.

Recruiting and Retaining Community-Based Preceptors: A Multicenter Qualitative Action Study of Pediatric Preceptors

PURPOSE

The recruitment and retention of community preceptors to teach medical students is difficult. The authors sought to characterize the underlying motivational factors for becoming a preceptor and to identify strategies for recruiting and retaining community-based pediatric preceptors.

METHOD

This multicenter qualitative action study included semistructured interviews with community-based pediatric preceptors affiliated with 12 institutions from August to December 2015. Only active preceptors were included, and participating institutions were diverse with respect to geographic location and class size. Interviews were conducted over the telephone and transcribed verbatim. Six investigators used deidentified transcripts to develop a codebook. Through a constant comparative method, codes were revised as data were analyzed and disagreements were resolved through discussion. All investigators organized the themes into dimensions.

RESULTS

Fifty-one preceptors were interviewed. Forty-one themes coalesced into four dimensions: (1) least liked aspects of teaching, (2) preparation to teach, (3) inspiration to teach, and (4) ways to improve recruitment and retention. Time constraints and patient care demands were the most commonly cited deterrents to teaching. Successful preceptors balanced their clinical demands with their desire to teach using creative scheduling. External rewards (e.g., recognition, continuing medical education credit) served as incentives. Internal motivation inspired participants to share their enthusiasm for pediatrics and to develop longitudinal relationships with their learners.

CONCLUSIONS

Changes in health care delivery have imposed more time constraints on community-based preceptors. However, this study identified underlying factors motivating physicians to volunteer as preceptors. Strategies to recruit new and retain current preceptors must be collaborative.

Exploration of Methods Used by Pharmacy Professional Programs to Contract with Experiential Practice Sites

Objective. To explore methods used by pharmacy programs to attract and sustain relationships with preceptors and experiential practice sites. Methods. Interviews with eight focus groups of pharmacy experiential education experts (n=35) were conducted at two national pharmacy meetings. A semi-structured interview guide was used. Focus group interviews were recorded, transcribed verbatim, and categorically coded independently by two researchers. Codes were compared, consensus was reached through discussion, and two experiential education experts assisted with interpretation of the coded data. Results. Six themes emerged consistently across focus groups: a perceived increase in preceptor compensation, intended vs actual use of payments by sites, concern over renegotiation of established compensation, costs and benefits of experiential students, territorialism, and motives. Conclusion. Fostering a culture of collaboration may counteract potentially competitive strategies to gain sites. Participants shared a common interest in providing high-quality experiential learning where sites and preceptors participated for altruistic reasons, rather than compensation.

Exploring the Teaching Motivations, Satisfaction, and Challenges of Veterinary Preceptors: A Qualitative Study

Optimization of clinical veterinary education requires an understanding of what compels veterinary preceptors in their role as clinical educators, what satisfaction they receive from the teaching experience, and what struggles they encounter while supervising students in private practice. We explored veterinary preceptors' teaching motivations, enjoyment, and challenges by undertaking a thematic content analysis of 97 questionnaires and 17 semi-structured telephone interviews. Preceptor motivations included intrinsic factors (obligation to the profession, maintenance of competence, satisfaction) and extrinsic factors (promotion of the veterinary field, recruitment). Veterinarians enjoyed observing the learner (motivation and enthusiasm, skill development) and engaging with the learner (sharing their passion for the profession, developing professional relationships). Challenges for veterinary preceptors included variability in learner interest and engagement, time management, and lack of guidance from the veterinary medicine program. We found dynamic interactions among the teaching motivations, enjoyment, and challenges for preceptors. Our findings suggest that in order to sustain the veterinary preceptor, there is a need to recognize the interplay between the incentives and disincentives for teaching, to foster the motivations and enjoyment for teaching, and to mitigate the challenges of teaching in community private practice.

Why physicians teach: giving back by paying it forward

CONTEXT

Despite the pace and intensity of the in-patient clinical setting, physicians carve out time for teaching medical students and residents.

OBJECTIVES

The goal of this study was to explore what it means for physicians to teach students and residents in the in-patient setting.

METHODS

We conducted semi-structured interviews with 15 practising physicians from the departments of internal medicine, surgery and paediatrics in three university teaching hospitals at McGill University, using an interpretive phenomenological methodology.

RESULTS

Five themes elucidated the meaning of teaching for physicians in the in-patient setting: (i) teaching was perceived as an integral part of their identity; (ii) teaching allowed them to repay former teachers for their own training; (iii) teaching gave them an opportunity to contribute to the development of the next generation of physicians; (iv) teaching enabled them to learn, and (v) teaching was experienced as personally energising and gratifying. Participants were morally and socially motivated to give time and effort through teaching (e.g. to pay forward their own privilege and thereby help to develop the next generation); teaching also gave them a sense of personal fulfilment (e.g. by allowing them to mould young minds and leave a legacy).

CONCLUSIONS

This study holds a number of implications for medical education with relevance to the recruitment and retention of clinical teachers, recognition of clinical teaching, and evidence-informed faculty development. The findings also suggest that teaching in an academic setting can bring joy and fulfilment to practising physicians.

Preceptors' and physician assistant students' views about the value of clinical site visits

PURPOSE

To determine preceptor and student views about the value of clinical site visits.

METHODS

An online survey of preceptors and students was conducted after completion of 1-year clerkships, during which each student received 2 visits from program faculty. An 11-question Likert scale (1 = strongly disagree, 5 = strongly agree) survey was administered to preceptors and students. Analysis was by descriptive statistics (percentage, mean ± SD) and theme extraction.

RESULTS

Response rate was 70% for preceptors and 77% for students. A majority of both groups agreed or strongly agreed that site visits met a need for clarifying the role of the clerkship, addressed expectations, and improved clinical experience; that visits were important, added value to education, and improved communication with the program. Visits increased preceptor self-reported confidence in faculty. Preceptor themes included "face-to-face validation," "personal touch," and "hands-on interaction." Student themes included "value of direct feedback from site visitor," "ability to improve skills between visits," and "connectedness to program."

CONCLUSION

Preceptors and students agreed on the importance and value of site visits for improving communication, clinical skills, and quality of educational experience.

Satisfaction, motivation, and future of community preceptors: what are the current trends?

PURPOSE

To measure overall satisfaction of community-based preceptors, their anticipated likelihood of continuing to teach, professional satisfaction, influence of having students, motivation for teaching, satisfaction with professional practice, and satisfaction with and value of incentives, and to compare results with those of a similar 2005 statewide survey.

METHOD

In 2011, the authors distributed a 25-item survey to all 2,359 community-based primary care preceptors (physicians, pharmacists, advanced practice nurses, physician assistants) served by the North Carolina Area Health Education Centers system's Offices of Regional Primary Care Education. The survey targeted the same items and pool of eligible respondents as did the North Carolina Area Health Education Center 2005 Preceptor Survey.

RESULTS

Of 2,359 preceptors contacted, 1,278 (54.2%) completed questionnaires. The data from 2011 did not differ significantly from the 2005 data. In 2011, respondents were satisfied with precepting (91.7%), anticipated continuing to precept for the next five years (88.7%), and were satisfied overall with their professional life (93.7%). Intrinsic reasons (e.g., enjoyment of teaching) remained an important motivation for teaching students. Physicians reported significantly lower overall satisfaction with extrinsic incentives (e.g., monetary compensation) and felt more negativity about the influence of students on their practices.

CONCLUSIONS

This study found that preceptors continue to be satisfied with teaching students. Intrinsic reasons remain an important motivation to precept, but monetary compensation may have increasing importance. Physicians responded more negatively than other health provider groups to several questions, suggesting that their needs might be better met by redesigned teaching models.

A survey to assess family physicians' motivation to teach undergraduates in their practices

Background

In Germany, family physicians (FPs) are increasingly needed to participate in undergraduate medical education. Knowledge of FPs’ motivation to teach medical students in their practices is lacking.

Purpose

To describe a novel questionnaire that assesses the motivation of FPs to teach undergraduates in their practices and to show the results of a subsequent survey using this instrument.

Methods

The questionnaire was developed based on a review of the literature. Previously used empirical instruments assessing occupational values and motivation were included. A preliminary version was pretested in a pilot study. The resulting 68-item questionnaire was sent to 691 FPs involved in undergraduate medical education. Reliability was assessed and subgroups were analyzed with regard to differences in motivation.

Results

A total of 523 physicians in n = 458 teaching practices participated (response rate 75.7%). ‘Helping others’ and ‘interest’ were revealed as the predominant motives. Responses showed a predominantly intrinsic motivation of the participating FPs. Their main incentives were an ambition to work as a medical preceptor, to generally improve undergraduate education and to share knowledge. Material compensation was of minor importance. Time restraints were indicated as a barrier by some FPs, but were not a general concern.

Conclusion

German FPs involved in medical education have altruistic attitudes towards teaching medical students in their practices. Motivational features give an important insight for the recruitment of FP preceptors as well as for their training in instructional methods.

Job and career satisfaction among pharmacy preceptors

OBJECTIVES

To examine the perceived benefit of job and career satisfaction among pharmacist preceptors and to explore other factors that might influence satisfaction.

METHODS

A cross-sectional self-administered survey instrument was mailed to pharmacists in the South Central region of the United States who had active 2010 licenses to investigate whether being a pharmacist preceptor increases job and career satisfaction.

RESULTS

Twenty-three percent of the 363 respondents were active preceptors and 62% of these reported that they had been preceptors at some point in the past. Being an active preceptor was significantly related to increased job satisfaction (p = 0.01) but not to career satisfaction. Having a perceived benefit of continuing education and being professionally challenged at work also were associated with increased job and career satisfaction (p < 0.001).

CONCLUSIONS

Pharmacist preceptors have higher levels of self-reported job satisfaction.

"They put you on your toes": Physical Therapists' Perceived Benefits from and Barriers to Supervising Students in the Clinical Setting

PURPOSE

To identify the perceived benefits of and barriers to clinical supervision of physical therapy (PT) students.

METHOD

In this qualitative descriptive study, three focus groups and six key-informant interviews were conducted with clinical physical therapists or administrators working in acute care, orthopaedic rehabilitation, or complex continuing care. Data were coded and analyzed for common ideas using a constant comparison approach.

RESULTS

Perceived barriers to supervising students tended to be extrinsic: time and space constraints, challenging or difficult students, and decreased autonomy or flexibility for the clinical physical therapists. Benefits tended to be intrinsic: teaching provided personal gratification by promoting reflective practice and exposing clinical educators to current knowledge. The culture of different health care institutions was an important factor in therapists' perceptions of student supervision.

CONCLUSIONS

Despite different disciplines and models of supervision, there is considerable synchronicity in the issues reported by physical therapists and other disciplines. Embedding the value of clinical teaching in the institution, along with strong communication links among academic partners, institutions, and potential clinical faculty, may mitigate barriers and increase the commitment and satisfaction of teaching staff.

Remote library access for pharmacy preceptors

OBJECTIVE

To institute and evaluate the response to a program providing access to electronic library resources for pharmacy preceptors.

DESIGN

The pharmacy experiential office and the library collaborated using existing programs and technology to provide and market secure remote access for preceptors.

ASSESSMENT

Preceptor participation was tracked in the experiential office, and response to the program was assessed using an online survey instrument that included questions about use of and preference for specific library resources. Three hundred thirty-four adjunct faculty members registered, representing 34% of all preceptors with active e-mail accounts.

CONCLUSION

Preceptor participation in the program exceeded expectations. Some minor flaws in the logistics of delivering the service were identified and remedied.