P A Masters1, C Nester. 1. Division of General Internal Medicine, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA. pmasters@psu.edu
Abstract
OBJECTIVE: To compare teaching activity and content between academic and community-based practices used in third year medical student primary care training. SETTING: Academic and community-based primary care practices participating in third-year internal medicine, family medicine, and primary care core clerkships. PARTICIPANTS: Five-hundred thirteen preceptor-student encounters involving 32 preceptors and 26 third-year medical students were evaluated. DESIGN: Student-preceptor pairs collected a convenience sample of data from shared patient encounters. Preceptors recorded the content of teaching interventions, and students independently documented learning points received for each clinical encounter. MEASUREMENTS AND MAIN RESULTS: Comparison of problem exposure, frequency and content of teaching interventions, and the effect of patient complexity and patient care workload on teaching frequency was made between the academic and community-based practices. Several small differences were found in the frequency of clinical problem exposure between the 2 settings. The frequency and focus of teaching interventions did not differ by practice type. Teaching by community-based preceptors tended to decrease with increased patient care workload, but increased in academically based practices. CONCLUSIONS: Although several differences exist between educational experiences in community- and academically based primary care practices, they appear to be minor and of minimal educational significance.
OBJECTIVE: To compare teaching activity and content between academic and community-based practices used in third year medical student primary care training. SETTING: Academic and community-based primary care practices participating in third-year internal medicine, family medicine, and primary care core clerkships. PARTICIPANTS: Five-hundred thirteen preceptor-student encounters involving 32 preceptors and 26 third-year medical students were evaluated. DESIGN: Student-preceptor pairs collected a convenience sample of data from shared patient encounters. Preceptors recorded the content of teaching interventions, and students independently documented learning points received for each clinical encounter. MEASUREMENTS AND MAIN RESULTS: Comparison of problem exposure, frequency and content of teaching interventions, and the effect of patient complexity and patient care workload on teaching frequency was made between the academic and community-based practices. Several small differences were found in the frequency of clinical problem exposure between the 2 settings. The frequency and focus of teaching interventions did not differ by practice type. Teaching by community-based preceptors tended to decrease with increased patient care workload, but increased in academically based practices. CONCLUSIONS: Although several differences exist between educational experiences in community- and academically based primary care practices, they appear to be minor and of minimal educational significance.