Bruner Lia Pierson, Jones Betsy Goebel, Trotter David R M
Department of Family and Community Medicine, Texas Tech University Health Sciences Center, TX, USA.
Fam Med. 2010 Mar;42(3):173-9.
Although early clinical experience courses are often the purview of family medicine faculty, students may receive training with community physicians from varying specialties. Little is known about the influence of preceptor specialty and method of assignment on students' performance and course satisfaction.
Second-year medical students spent one half day per month with a preceptor to practice clinical skills. Preceptors were either assigned randomly or assigned by student recruitment or specialty request. We analyzed whether preceptor specialty, method of assignment, and practice site (the independent variables) were associated with the dependent variables of course evaluation ratings and student performance on objective structured clinical examinations (OSCEs).
Analyses found no differences in students' overall course satisfaction or OSCE scores and little difference in satisfaction with specific course components. There was a positive relationship between overall course rating and the rating of the preceptor experience and between the preceptor experience and more time spent in ambulatory clinics and direct patient interaction.
Because students were equally satisfied and performed comparably regardless of specialty or matching method, early clinical exposure may be accomplished equally well using specialist or generalist physicians, potentially giving primary care educators greater latitude to focus their efforts on teaching students in clinical clerkships and those interested in primary care.
虽然早期临床经验课程通常由家庭医学教师负责，但学生可能会接受来自不同专业的社区医生的培训。关于带教教师的专业以及分配方式对学生表现和课程满意度的影响，我们知之甚少。
二年级医学生每月与一名带教教师共度半天时间来练习临床技能。带教教师要么是随机分配，要么是根据学生招募或专业需求进行分配。我们分析了带教教师的专业、分配方式和实习地点（自变量）是否与课程评估评分以及学生在客观结构化临床考试（OSCE）中的表现（因变量）相关。
分析发现，学生的总体课程满意度或OSCE成绩没有差异，对特定课程组成部分的满意度差异也很小。总体课程评分与带教教师体验评分之间以及带教教师体验与在门诊诊所花费的更多时间和与患者的直接互动之间存在正相关关系。
由于无论专业或匹配方式如何，学生的满意度相同且表现相当，因此使用专科医生或全科医生进行早期临床接触可能同样有效，这可能会让初级保健教育工作者有更大的自由度将精力集中在临床实习教学以及对初级保健感兴趣的学生身上。
