The Decline in Community Preceptor Teaching Activity: Exploring the Perspectives of Pediatricians Who No Longer Teach Medical Students

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.

Training interns in nutrition and dietetics: a cross-sectional study of the barriers and motivators to being a Registered Dietitian Nutritionist preceptor

“…This national random sample survey with RDN and NDTR professionals identified differences by preceptor experience category in attitudes and perceptions of the dietetic internship preceptor role, institutional support, intern value, and preferred incentives to precept. Despite the important role preceptors perform by supervising dietetic interns during their experiential learning, little research has been conducted examining these aspects of the precepting experience for the dietetics profession [12][13][14][15][16][17][18], although other health professions have explored the precepting experience [6][7][8][9][10][11]20]. If the dietetics profession hopes to address the imbalance between didactic program graduates and available internship positions [3,4], and address the needs of the workforce by keeping up with the growth rate of the number of jobs for RDNs [1], additional preceptors will be needed to increase experiential learning opportunities.…”

“…More current preceptors compared to former preceptors or those who had never precepted felt that their immediate supervisor was supportive of their preceptor role. However, employer support and recognition of the importance of the precepting role beyond the immediate supervisor is vital, and has been recognized as both a benefit and a barrier to precepting by other healthcare professions [ 6 , 8 – 10 ] Encouraging employers to recognize the increased workload associated with precepting and provide workload adjustments or recognition or incentives on annual evaluations to encourage precepting could be helpful when recruiting more preceptors [ 24 , 25 ].…”

“…However, the only statistically significant difference was current preceptors agreeing that interns conducted themselves in a professional manner. Consequently, the preceptors’ attitudes toward and perceptions of interns appear to be assets, rather than barriers, to precepting, a theme that is also reported in the medical and nursing health professions [ 6 , 9 , 10 ].…”

“…In contrast, a reason some pediatrician preceptors reduced their time precepting or stopped serving as a preceptor was inadequate monetary compensation for their time [6,10], indicating that desired benefits vary across different health professions. Studies also report that benefits of satisfaction and altruism were greater in preceptors than non-preceptors [6,10,12,13] and compensation was greater in non-preceptors [6,10,13].…”

“…While other health professions have explored the attitudes and perceptions associated with precepting, including the desired benefits and perceived barriers associated with the role [6][7][8][9][10][11], limited research has been conducted in the area of nutrition and dietetics despite the critical role preceptors play in the education and training of future RDNs and NDTRs [12][13][14][15][16][17][18]. Understanding what motivates practitioners to not only become preceptors, but to continue precepting, as well as the barriers to serving as a preceptor, is important if the dietetic profession is to successfully recruit sufficient preceptors now and in the future.…”