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Cited by 103Innovations in Medical EducationHealth and Medical EducationHospital Admissions and Outcomes

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Medical Students' and Residents' preferred site characteristics and preceptor behaviours for learning in the ambulatory setting: a cross-sectional survey

Open access
Schultz, Karen W, Kirby, John, Delva, Dianne, Godwin, Marshall, Verma, Sarita, Birtwhistle, Richard, Knapper, Chris, Seguin, Rachelle·2004·BMC Medical Education
DOI 10.1186/1472-6920-4-12PMC PMC514563
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Abstract

Background: Medical training is increasingly occurring in the ambulatory setting for final year medical students and residents. This study looks to identify if gender, school, level of training, or speciality affects learner's (final year medical students and residents) preferred site characteristics and preceptor behaviours for learning in the ambulatory setting. Methods: All final year medical students and residents at the five medical schools in Ontario (N = 3471) were surveyed about the site characteristics and preceptor behaviours most enhancing their learning in the ambulatory setting. Preferred site characteristics and preceptor behaviours were rank ordered. Factor analysis grouped the site characteristics and preceptor behaviours into themes which were then correlated with gender, school, level of training, and speciality. Results: Having an adequate number and variety of patients while being supervised by enthusiastic preceptors who give feedback and are willing to discuss their reasoning processes and delegate responsibility are site characteristics and preceptor behaviours valued by almost all learners. Some teaching strategies recently suggested to improve efficiency in the ambulatory teaching setting, such as structuring the interview for the student and teaching and reviewing the case in front of the patient, were found not to be valued by learners. There was a striking degree of similarity in what was valued by all learners but there were also some educationally significant differences, particularly between learners at different levels and in different specialities. Key findings between the different levels include preceptor interaction being most important for medical students as opposed to residents who most value issues pertaining to patient logistics. Learning resources are less valued early and late in training. Teaching and having the case reviewed in front of the patient becomes increasingly less valued as learners advance in their training. As one approaches the end of ones' training office management instruction becomes increasingly valued. Differences between specialities pertain most to the type of practice residents will ultimately end up in (ie: office based specialties particularly valuing instruction in office management and health care system interaction). Conclusions: Preceptors need to be aware of, and make efforts to provide, teaching strategies such as feedback and discussing clinical reasoning, that learners have identified as being helpful for learning. If strategies identified as not being valued for learning, such as teaching in front of the patient, must continue it will be important to explore the barriers they present to learning. Although what all learners want from their preceptors and clinic settings to enhance their learning is remarkably similar, being aware of the educationally significant differences, particularly for learners at different levels and in different specialities, will enhance teaching in the ambulatory setting.

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Crossref · 10.1186/1472-6920-4-12

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Figure 1 Gender and site characteristics
Figure 1 Gender and site characteristicsCC BY · PubMed Central
Figure 2 Gender and preceptor behaviours
Figure 2 Gender and preceptor behavioursCC BY · PubMed Central
Figure 3 School and site characteristics
Figure 3 School and site characteristicsCC BY · PubMed Central
Figure 4 School and preceptor behaviours
Figure 4 School and preceptor behavioursCC BY · PubMed Central
Figure 5 Training level and site characteristics
Figure 5 Training level and site characteristicsCC BY · PubMed Central
Figure 6 Training level and preceptor behaviours
Figure 6 Training level and preceptor behavioursCC BY · PubMed Central
Figure 7 Residency and site characteristics
Figure 7 Residency and site characteristicsCC BY · PubMed Central
Figure 8 Residency and preceptor behaviours
Figure 8 Residency and preceptor behavioursCC BY · PubMed Central

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  1. Perry WG: Intellectual and ethical development. Troy, Mo: Holt Rinehart and Winston. 1972

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Metadata

Authors
Schultz, K. W., Kirby, J., Delva, D., Godwin, M., Verma, S., Birtwhistle, R., Knapper, C., & Seguin, R.
Affiliations
Queen's University (CA)
Corresponding author
Schultz, Karen W
ORCID
Venue
BMC Medical Education
Publisher
Springer Science and Business Media LLC
Published
2004-08-06
Volume
4
Issue
1
Pages
12-12
ISSN
1472-6920 (ISSN-L)
DOI
10.1186/1472-6920-4-12
PMC
PMC514563
OpenAlex
W1607610280
Cited by
103
References
41
Citations by year
2026: 3 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 7 · 2021: 5 · 2020: 2 · 2019: 3 · 2018: 8 · 2017: 4 · 2016: 5 · 2015: 7 · 2014: 8 · 2013: 5 · 2012: 10
FWCI
3.73
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Medical Education (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Canadian Celiac Association
  • Canadian Institutes of Health Research
Topics
  • Social Sciences › Education › Innovations in Medical Education
  • Health Sciences › Health Professions › General Health Professions › Health and Medical Education
  • Health Sciences › Nursing › Leadership and Management › Hospital Admissions and Outcomes
Keywords
site conditions, medical students, residents (medical training), clinical supervision, feedback, clinical reasoning, specialty differences, training status, learner preferences
MeSH terms
Adult, Ambulatory Care Facilities, Attitude of Health Personnel, Behavior, Clinical Clerkship, Consumer Behavior, Factor Analysis, Statistical, Feedback, Female, Humans, Internship and Residency, Male, Ontario, Preceptorship, Schools, Medical, Students, Medical, Teaching, Program Evaluation

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