It's all about relationships : Aqualitative study of family physicians' teaching experiences in rural longitudinal clerkships.

Cary Cuncic,Heather Frost,Joanna Bates,Glenn Regehr

doi:10.1007/s40037-018-0416-y

Abstract

IntroductionThe relationship between preceptor and trainee is becoming recognized as a critical component of teaching, in particular in the negotiation of feedback and in the formation of professional identity. This paper elaborates on the nature of the relationships between preceptor and student that evolve in the context of rural longitudinal integrated clerkships (LICs).MethodsWe drew on constructivist grounded theory for the research approach. We interviewed nine LIC family practice preceptors from three sites at one educational institution. We adapted the interview framework based on early findings. We analyzed the data through a constant comparative process. We then drew on concepts of relationship-based learning as sensitizing concepts in a secondary analysis.ResultsWe constructed three themes from the data. First, preceptors developed trusting professional and personal relationships with students over time. These relationships expanded to include friendship, advocacy, and ongoing contact beyond the clerkship year. Second, preceptors’ approach to teaching was anchored in the relationship with an understanding of the individual student. Third, preceptors set learning goals collaboratively with their students, based not only on program objectives, but also with the student as a future physician in mind.DiscussionOur findings suggest that rural family medicine preceptors developed engaged and trusting relationships with their students over time. These relationships imbued all activities of teaching and learning with an individual and personal focus. This orientation may be a key factor in supporting the learning outcomes demonstrated for students studying in rural LICs.

Highlights

The relationship between preceptor and trainee is becoming recognized as a critical component of teaching, in particular in the negotiation of feedback and in the formation of professional identity
Our findings suggest that rural family medicine preceptors develop engaged and trusting professional and personal relationships with their students over time
In one common model of longitudinal integrated clerkships (LICs), students are placed in small rural communities during their principal clinical year, where they engage in an extended learning relationship with a family practice preceptor and participate in the comprehensive care of that preceptor’s patients over time

Summary

Introduction

The relationship between preceptor and trainee is becoming recognized as a critical component of teaching, in particular in the negotiation of feedback and in the formation of professional identity. In one common model of LICs, students are placed in small rural communities during their principal clinical year, where they engage in an extended learning relationship with a family practice preceptor and participate in the comprehensive care of that preceptor’s patients over time. Through this extended, integrated experience, they meet the majority of the year’s core clinical competencies across multiple disciplines simultaneously [3]. The many benefits of LICs for students include positive learning experiences, development of professional identity, patient-centredness and at least equal academic performance. These features are well described in the literature [4, 5]

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