Baker P G, Dalton L, Walker J
Discipline of General Practice, Department of Rural Health, University of Tasmania, Tasmania, Australia .
Rural Remote Health. 2003 Jan-Jun;3(1):107. Epub 2003 Mar 28.
General practitioners (GPs) as rural GP-Preceptors play an important role in medical student teaching within the Discipline of General Practice, University of Tasmania, Australia. As well a significant teaching role, they are responsible for apportioning 20% of the mark medical students receive in the General Practice examination at the end of the rotation. The contribution of the student-rural GP preceptor relationship to recruiting and retaining rural GPs has been acknowledged. Despite these important responsibilities, as honorary teaching staff rural GP preceptors receive no formal training in undergraduate education or assessment, nor did they receive formal peer support.
To address the lack of educational preparation of GP-preceptors, and in accordance with the stringent teaching and assessment standards of the Australian Medical School Accreditation, a tripartite approach was taken to educational skills development among rural GP-preceptors. The Discipline of General Practice conducted a needs-analysis of 64 rural GP-preceptors, and an evaluation by questionnaire of the teaching efficacy of those 64 rural GP-Preceptors and 76 urban GP-preceptors by 64 final-year medical students after their 3-week rural and urban GP attachments. The second intervention, based on the assessment and evaluation findings, was devised and implemented by the University Department of Rural Health. A series of workshops comprised the interdisciplinary educational and support program for GP preceptors, entitled Preceptor Onsite Preparation Program for Information Education and Support, or POPPIES.
The rural GP-preceptor needs analysis indicated that the majority of rural preceptors had no clear understanding of how what they taught fitted into the overall curriculum; they believed that their role as a clinical teacher had not been clearly defined by the program director; and also that undergraduate students had little understanding of what they needed to learn during their attachments. In contrast, preceptors believed they understood what students needed to learn; they were confident in performing the role of preceptor; and were familiar with adult learning principles, goal setting processes, effective student evaluation and the provision of appropriate performance feedback. Evaluation of feedback from students revealed that while rural GP preceptors performed well overall in regard to providing quality teaching and learning experiences, there was a significant spread of scores across all criteria, and approximately 15%-25% of students perceived various aspects of their attachment to be mediocre or poor.
The combined results of the medical student questionnaire and rural GP-preceptor survey indicated both a need and a desire for educational skills development among rural GP-preceptors. On this basis, the interdisciplinary educational and support program for GP-preceptors (POPPIES) was developed and implemented as a series of workshops throughout rural Tasmania. Although no objective data are yet available about teaching outcomes as a result of POPPIES workshops, preliminary responses from attendee GP preceptors indicated that the workshops were effective in addressing educational needs, and in providing rural clinical teachers with professional teaching development.
在澳大利亚塔斯马尼亚大学全科医学学科中，乡村全科医生（GP）作为乡村全科医学带教老师在医学生教学中发挥着重要作用。除了重要的教学角色外，他们还负责分配医学生在轮转结束时全科医学考试成绩的20%。医学生与乡村全科医学带教老师之间的关系对招募和留住乡村全科医生的贡献已得到认可。尽管承担着这些重要职责，但作为荣誉教师，乡村全科医学带教老师没有接受过本科教育或评估方面的正规培训，也没有得到正式的同行支持。
为解决全科医学带教老师教育准备不足的问题，并按照澳大利亚医学院校认证的严格教学和评估标准，对乡村全科医学带教老师采取了三方教育技能发展方法。全科医学学科对64名乡村全科医学带教老师进行了需求分析，并在64名医学专业最后一年的学生完成为期3周的乡村和城市全科医学实习后，通过问卷调查对这64名乡村全科医学带教老师和76名城市全科医学带教老师的教学效果进行了评估。第二项干预措施是根据评估和评价结果，由大学农村卫生系设计并实施的。一系列研讨会构成了针对全科医学带教老师的跨学科教育和支持项目，名为“信息教育与支持带教老师现场准备项目”，简称“罂粟花项目”。
乡村全科医学带教老师需求分析表明，大多数乡村带教老师不清楚他们所教内容如何融入整个课程；他们认为项目主任没有明确界定他们作为临床教师的角色；而且本科生对实习期间需要学习的内容了解甚少。相比之下，带教老师认为他们了解学生需要学习的内容；他们对履行带教老师的角色充满信心；并且熟悉成人学习原则、目标设定过程、有效的学生评估以及提供适当的绩效反馈。对学生反馈的评估显示，虽然乡村全科医学带教老师在提供高质量教学和学习体验方面总体表现良好，但所有标准的得分差异很大，约15%-25%的学生认为他们实习的各个方面表现平平或较差。
医学生问卷调查和乡村全科医学带教老师调查的综合结果表明，乡村全科医学带教老师既有教育技能发展的需求，也有这方面的愿望。在此基础上，针对全科医学带教老师的跨学科教育和支持项目（“罂粟花项目”）作为一系列研讨会在塔斯马尼亚农村地区开展并实施。虽然目前还没有关于“罂粟花项目”研讨会教学成果的客观数据，但参与的全科医学带教老师的初步反馈表明，这些研讨会有效地满足了教育需求，并为乡村临床教师提供了专业教学发展。
