Information for Current Preceptors
Best Practices for Preceptors in the Department of Family and Community Medicine
Thank You to Our Preceptors Heading link
The entire medical student education team here at the University of Illinois, at Chicago, Department of Family Medicine would like to thank you, the community physicians, office and residency personnel who help in teaching UIC College of Medicine students, who make this family medicine clerkship a wonderful experience.
We know that you are incredibly busy and pulled in many directions. Because we recognize the challenges, we want you to know that your efforts are appreciated. Because of you:
- The students with whom you work are exposed to empathy in a way they have never seen.
- They see continuity in a whole new light.
- They realize the value of full spectrum primary care through the example that you set.
Preceptor Handbook Heading link
You should be very familiar with the student’s responsibilities for the M3 Clerkship. In order to help you, as a Preceptor, excel within your role, we offer the following guidance.
Follow these four guidelines
- Preceptors should emphasize the importance of and the approaches which facilitate patient-centered medicine.
- Preceptors should understand and actively support the principles of evidence-based medicine.
- Preceptors should relate the principles of behavioral medicine and how these principles affect their practice. Through exposure, students, will further appreciate how the principles of behavioral medicine apply to their everyday patient interactions.
- Preceptors are encouraged to role model how a physician can balance work and personal life. Students should understand how personal issues can affect his or her delivery of patient care. Students should be shown the positive aspects of life as a family physician.
Required duties
Feedback
You should employ feedback techniques to promote resident self-awareness and improvement.
Signing patient logs
Students are required to record the types of patients they see. Preceptors are to review the student’s list and sign their log sheet on a weekly basis.
Direct observation
Direct observation is a central tool in the ongoing evaluation of a student’s progress. Residents should be directly observed on a regular basis. The form, Modified Mini-CEX Learner Rating Instrument, available online, will give your student the opportunity to receive direct feedback from you through assessment ratings of History OR Physical OR both during patient interactions that you directly observe.
Midterm feedback
Students will prompt you to provide for them a midterm evaluation. This can be done online or on a hardcopy form. We encourage direct discussion with the students for this activity. Please fill this out and discuss your thoughts and possible concerns verbally with your students to allow them a chance to improve before the end of the rotation.
Final Evaluation
You are, as well, requested to complete a final evaluation. This can be done online or on a hardcopy form. We encourage direct discussion with the students for this activity, as well.
Completion of evaluations in a timely fashion is importnat. Please complete the evaluations in a timely manner. A delay in completion of the evaluations can delay the student’s grade which can affect their advancement in medical school and their timing of graduation.
Evaluations can be done on paper, if you prefer. For information please call Cheron Zei, our medical student education coordinator, at (312) 996-9116 or you can email her at cbuckl2@uic.edu.
Please take note of the following
- Assure that there is always adequate faculty and support staff, including site director, to respond to the students’ needs.
- Communicate problems, issues or concerns to the Clerkship Director as soon as possible.
- Respond to identified problems and feedback.
- Provide a space for students to see patients, do procedures, do chart work, and consult reference material. This area may be shared with other doctors or staff and need not be exclusive to the student. It is important the student not feel he or she is imposing on others by using this space. The student will need to have high-speed internet access available for reference materials, communications and evaluation.
- Introduce the student to his/her colleagues and office staff and orient the resident to the medical and non-medical community.
- Make patients aware that the office is a teaching site and seeing students is usual. Patients should understand the rationale of having learners in the practice. All patients should be encouraged to interact with the student. Each teaching site must decide how to deal with patients who are uncomfortable having the student involved in their care.
- Provide accessible parking or be available by public transportation.
- Ensure that appropriate security systems are in place.
Please take note of these expecations
UIC DFM will coordinate all medical student activities and will provide opportunities for faculty development. In addition, a Clerkship Director and Associate Director will be available to respond to questions or concerns and provide guidance to the community preceptors.
Best Practices in Teaching Manual Heading link
This is a manual of best practices as it relates to the multiple components of interfacing with students in the role of a teaching clinician within the field of Family Medicine. Topics covered include:
- Teaching in the Ambulatory Setting
- Building Effective Lecture based Educational Sessions and Clerkship Selectives
This manual is meant to grow and adapt over time. Your feedback and input are greatly appreciated
Teaching in the Ambulatory Setting Heading link
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Expectations
Self Defined Expectations
Ask the student every day what he or she wants or needs to learn on that day. This will empower the student and provide you, as the preceptor, the opportunity to best meet his or her needs. Ask the student, “What are your learning objectives for today?”
Applied Expectations
Inform the student that you expect him or her to BE the physician. Require them to “step to the next level.” By informing them that you have high expectations of their performance, you are providing them the opportunity to succeed at this higher level. In doing so, you may want to give them permission to “make mistakes.” Reassure the student that it is OK to be wrong, the most important thing at this stage in their training is to engage in active learning. You, the preceptor, are there to correct the errors and assure quality care. Committing oneself to an answer or particular stance is the best way to learn, though sometimes taking these chances means making mistakes. That is OK.
Emphasizing the Assessment and Plan
It is important to emphasize that the learner progress beyond their previous expectations of gathering information to the practice of applying that information. One should encourage the student to focus in on the Assessment and Plan and develop this fully and in as much detail as is possible. This will force the student to act as the physician, holding themselves accountable, and, thus, enforcing learning.
Evidence Based
Give your students 5 or 10 minutes prior to presenting the patient to “research” their assessment and plan and assure themselves, through evidence, that they are considering this case appropriately. This helps the student build the skills of identifying evidence and interpreting this evidence for individual patients at the point of care.
What Is / What Isn’t
Emphasize to the students that as they are providing their Assessment and Plan, they may not always be able to provide a definitive answer or diagnosis. In this case, they may consider providing information as to what has been ruled up or ruled down in their differential. If they are not, in essence, able to say what it is, they should comment on what it is not. This will help them broaden their differential and illustrate to their precepting physician that they are using the appropriate logic and critical evaluation.
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Details
Medical Education / Knowledge Base
Engaging the Student through mini-lecture
At the beginning of the first session with each student, one might give a standard mini lecture on a particular topic such as heart sounds. One practitioner who employs this technique has found that this serves two purposes: 1) this engages the student immediately and puts them in the mindset of learning and 2) this helps him understand the level of knowledge of the student with whom he will be working thus facilitating targeted and appropriated learning.
Approach to the patient
Model Patient Care. Don’t simply do something in front of the student. Prompt their attention. Be an active demonstrator by stating up front, “Watch what I am going to do.” Prime the student. Encourage the student to “Watch / listen to my interaction with the patient and let me know how what I am doing is different than what you just did.”
Patient Follow-up
Encourage longitudinal care by informing the student how you would like him or her to follow up on the labs, diagnostics, and consultations for the patients whom you saw together in clinic. Encourage the student (after touching base with you) to document the findings / results, and contact the patient.
Readings and Student Preparation
Engage in active, point-of-care learning by having the student look things up. Point of care learning is an excellent way to learn. Demonstrate life-long learning by illustrating that you, as an attending, ALSO regularly looks things up. This is an important component of being a responsible physician.
Personal Organization / Efficiency
Share your productivity tips and practices with the students. How do you keep track of to do’s? How do you advance through your day? How do you assure that things don’t “get missed?” How do you use technology to help you achieve this productivity?
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How to guide
Student Presentations
Have the student present in the room with the patient. This is a great opportunity to engage the patients in student learning. Listen and refrain from teaching until the student is done presenting. Many times they may get around to what you are noting they have missed.
Giving Feedback
Use the Feedback Model. See this article.
J Gen Intern Med. 1998 February; 13(2): 111–116. doi: 10.1046/j.1525-1497.1998.00027.xTell the student to remind you to give them feedback
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Details
Composure
Be positive in control: Don’t be flustered. You are most influential in the manner in which you handle yourself under pressure.
Be up front with the student
“Flow is always a challenge in the ambulatory setting. Take note of some of the strategies that we use on a daily basis to deal with this issue.”
Family Medicine is a busy specialty and oftentimes unpredictable. this is due to patient issues primarily. It creates challenges and we deal with them in these ways…Other thoughts
- Challenge is good. Students like to grow.
- Have the student hold his or her questions until the end of the session and then you can respond to the most pertinent. This helps with flow.
- If the preceptor sees the first patient him or herself, this will also help with flow.
- Having multiple students in the same session can be challenging but oftentimes can also be value added. Have the third year student help teach the first year student. The both often enjoy and get a lot out of this type of arrangement.
- Ask open ended questions
- Teaching Acronym: METRC
- Make a commitment. What do you think is going on?
- Explore Reasoning. Why do you think this? How did you come to this conclusion? Why?
- Teach to the Gap
- Reinforce what was done well.
- Correct mistakes.
- Ask the student to summarize the take home point
Building Effective Lecture based Educational Sessions and Clerkship Electives Heading link
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Details on this strategy
It is easy to not participate if one is in the corner. Set up the chairs in a circle or horseshoe arrangement. Use the structure to encourage all to participate. Go around the circle for input. This will help to involve all the students equally.
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Details on this strategy
At the beginning of the session, go around the room and ask for names, something interesting, and input on what they are hoping to learn. This helps to engage everyone from the start.
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Details on this strategy
Disclosure
Reassure the students that there are no wrong answers.
Whip around
Go around the room and get input from everyone.
Take Risks
Inform the students that it is OK to make mistakes. This is one of the best ways to learn, in fact.
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Details on this strategy
If you have a personal interest in the material that you are teaching and you are continually committed to learning yourself, keeping up on the literature, reading the latest publications, you are much more likely to be enthusiastic in the way that you teach.
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Details on this strategy
Allow for (or even encourage) the discussion to wander and meander at times. This gives students the opportunity to explore and be engaged. This is often when the best learning occurs. You may want to have an outline of the salient points and as the discussion moves in that direction, you can bring out those points. You may not hit them all in the same order every time, but this type of discussion can be a lot more exciting and fun to follow – encouraging learning.
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Ways to innovate
Experiential Learning
As you are planning and preparing your selectives, try to incorporate experiential learning into your plan. Combine your selective with a trip into the community to do some education and have the students lead the discussion, as an example. This type of active learning is very valuable.
Student Led Discussions
Give the students the opportunity to lead the discussions and present information to their colleagues.