Caroline R Paul1, Chad Vercio, Rebecca Tenney-Soeiro, Chris Peltier, Michael S Ryan, Elizabeth R Van Opstal, Anton Alerte, Cynthia Christy, Julie L Kantor, William A Mills, Patricia B Patterson, Jean Petershack, Andrew Wai, Gary L Beck Dallaghan. 1. C.R. Paul is associate professor of pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. C. Vercio is assistant professor of pediatrics, Loma Linda University School of Medicine, Loma Linda, California. R. Tenney-Soeiro is associate professor of clinical pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. C. Peltier is associate professor of clinical pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio. M.S. Ryan is associate professor of pediatrics and assistant dean for clinical medical education, Virginia Commonwealth University School of Medicine, Richmond, Virginia. E.R. Van Opstal is assistant professor of pediatrics and internal medicine, Rush Medical College, Chicago, Illinois. A. Alerte is professor of pediatrics, University of Connecticut Health Center, Hartford, Connecticut. C. Christy is professor of pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York. J.L. Kantor is associate clerkship director, International University College of Medicine, Miami, Florida. W.A. Mills Jr is associate professor of pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina. P.B. Patterson is assistant professor of pediatrics, Tufts University School of Medicine, Boston, Massachusetts, and Maine Medical Center, Portland, Maine. J. Petershack is professor of pediatrics, The Long School of Medicine at UT Health San Antonio, San Antonio, Texas. A. Wai is assistant professor of pediatrics and internal medicine, Loma Linda University School of Medicine, Loma Linda, California. G.L. Beck Dallaghan is director of educational scholarship, University of North Carolina School of Medicine, Chapel Hill, North Carolina; ORCID: https://orcid.org/0000-0002-8539-6969.
Abstract
PURPOSE: Difficulty in recruiting and retaining community preceptors for medical student education has been described in the literature. Yet little, if any, information is known about community outpatient preceptors who have stopped or decreased teaching time with students. This study aimed to examine these preceptors' perspectives about this phenomenon. METHOD: Using a phenomenology framework, this multi-institutional qualitative study used semistructured interviews with community pediatric preceptors who had stopped or reduced teaching time with medical students. Interviews were conducted between October 2017 and January 2018 and transcribed verbatim. Interviews explored factors for engaging in teaching, or decreasing or ceasing teaching, that would enable future teaching. An initial code book was developed and refined as data were analyzed to generate themes. RESULTS: Twenty-seven community pediatricians affiliated with 10 institutions participated. Thirty-seven codes resulted in 4 organizing themes: evolution of health care, personal barriers, educational system, and ideal situations to recruit and retain preceptors, each with subthemes. CONCLUSIONS: From the viewpoints of physicians who had decreased or stopped teaching students, this study more deeply explores previously described reasons contributing to the decline of community preceptors, adds newly described barriers, and offers strategies to help counter this phenomenon based on preceptors' perceptions. These findings appear to be manifestations of deeper issues including the professional identify of clinical educators. Understanding the barriers and strategies and how they relate to preceptors themselves should better inform education leaders to more effectively halt the decline of community precepting and enhance the clinical precepting environment for medical students.
PURPOSE: Difficulty in recruiting and retaining community preceptors for medical student education has been described in the literature. Yet little, if any, information is known about community outpatient preceptors who have stopped or decreased teaching time with students. This study aimed to examine these preceptors' perspectives about this phenomenon. METHOD: Using a phenomenology framework, this multi-institutional qualitative study used semistructured interviews with community pediatric preceptors who had stopped or reduced teaching time with medical students. Interviews were conducted between October 2017 and January 2018 and transcribed verbatim. Interviews explored factors for engaging in teaching, or decreasing or ceasing teaching, that would enable future teaching. An initial code book was developed and refined as data were analyzed to generate themes. RESULTS: Twenty-seven community pediatricians affiliated with 10 institutions participated. Thirty-seven codes resulted in 4 organizing themes: evolution of health care, personal barriers, educational system, and ideal situations to recruit and retain preceptors, each with subthemes. CONCLUSIONS: From the viewpoints of physicians who had decreased or stopped teaching students, this study more deeply explores previously described reasons contributing to the decline of community preceptors, adds newly described barriers, and offers strategies to help counter this phenomenon based on preceptors' perceptions. These findings appear to be manifestations of deeper issues including the professional identify of clinical educators. Understanding the barriers and strategies and how they relate to preceptors themselves should better inform education leaders to more effectively halt the decline of community precepting and enhance the clinical precepting environment for medical students.