Precepting Medical Students: How Did I Get

Roped Into This?!?

Disclosures• No disclosures.

Objectives• Explain how to prepare the office for teaching:

documentation, compliance, orientation• Explain how to prepare the student for teaching:

adding value to the clinical encounter• Demonstrate the preparation of the physician for

teaching: feedback and evaluations

Preparing the Office• What are the barriers to teaching in your

setting?

• What are some strategies that you have found helpful for addressing these?

Preparing the Office: Barriers• I’m not in clinic everyday

– Have student work with pharmacist, social worker, clinic manager, etc.

• EMR problems– Have student work as scribe, write note in Word

• No space– Use a laptop, de-brief at the end of the day

• No time– Have student see half of patients, call patients with

results

Indicate the VALUE you would place on the following incentives you DO NOT CURRENTLY RECEIVE

Very Great Great SomeVery little

No Value

Teachingrecognitioncertificateorplaque 2 5 13 16 12AnnualPreceptorDinner 1 5 15 14 14SiteVisit 2 7 9 17 14

Directfinancialreimbursement 2 9 9 11 16

Fall 2012 survey, n=50

Comments

“I would like to know what I can do to be a more effective preceptor. I sometimes feel as if they [students] do not seem real interested in family medicine - how can I capture their attention? I also would like to know what topics are discussed during clerkship sessions.”

Preparing the Office: Orientation• Student picture and bio for office • Orient student to the clinic: parking, lunch (bring

or buy), dress (lab coat/tie), hours, expectations

• Book urgent care visits and complex visits simultaneously

• Block 15 minutes of your schedule in the morning and afternoon for student review and teaching

• Double-book your first appointment and block your last appointment

http://www.stfm.org/Portals/49/Students%20as%20Added%20Value.pdf

Preparing the Office: Scheduling

Fam Med

Training Room

Home visits

HospitalInterprofessional

Nursing home

Preparing the Student• Determine student specific goals for day• Define how much time is available for each

patient• Discuss preferred presentation time, style and

content • Determine the level of the student

Pangaro, Louis. "A new vocabulary and other innovations for improving descriptive in-training evaluations." Academic Medicine 74.11 (1999): 1203-7.

• Hold time for questions – can batch at end of session

• Develop clinical questions and reading assignments

• Solicit and give feedback• Role model!

http://www.stfm.org/Portals/49/Students%20as%20Added%20Value.pdf

Be Prepared as a Teacher

Feedback• Ask the learner to self assess

– “How did it feel to work with an interpreter?”• Tell what you observed, both positive and

corrective, both explanation and diagnosis– “It seemed that you were speaking to the

interpreter and rarely looked at the patient.”• Ask again about understanding

– “What might you do differently next time?”

Evaluations

Resources

• Leadership theory and practice: a “case” in point, Armandi, B., Oppedisano, J., Sherman, H. Management Decision, 41 (10), 2003, 1076-1088.

• Heifetz and Linsky, Leadership on the Line, Harvard Business Review Press, First Edition (April 18, 2002)

Resources

• Peer-to-peer consultation:– https://ekstasispeerconsultations.com/

• Minnesota Medical Association Preceptor Initiative:– http://www.mnmed.org/advocacy/Key-

Issues/MMA-Preceptor-Initiative

Resources

• One Minute Preceptor (bad example): http://www.youtube.com/watch?v=937G0m5SUsI

• One Minute Preceptor (good example): http://www.youtube.com/watch?v=lCeyzpU7PMw

Resources• Giving Feedback:

https://www.youtube.com/watch?v=SYXgMobMU8U