Beck Dallaghan Gary L, Alerte Anton M, Ryan Michael S, Patterson Patricia B, Petershack Jean, Christy Cynthia, Mills William A, Paul Caroline R, Peltier Chris, Stamos Julie K, Tenney-Soeiro Rebecca, Vercio Chad
G.L. Beck Dallaghan is assistant dean for medical education, University of Nebraska College of Medicine, Omaha, Nebraska. A.M. Alerte is associate professor of pediatrics, University of Connecticut Health Center, Hartford, Connecticut. M.S. Ryan is assistant dean for clinical medical education, Virginia Commonwealth University School of Medicine, Richmond, Virginia. P.B. Patterson is assistant professor of pediatrics, Maine Medical Center, Portland, Maine. J. Petershack is professor of pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas. C. Christy is professor of pediatrics, University of Rochester School of Medicine, Rochester, New York. W.A. Mills Jr is associate professor of pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina. C.R. Paul is assistant professor of pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. C. Peltier is associate professor of clinical pediatrics, University of Cincinnati School of Medicine, Cincinnati, Ohio. J.K. Stamos is associate professor of pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois. R. Tenney-Soeiro is associate professor of clinical pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. C. Vercio is assistant professor of pediatrics, Loma Linda University School of Medicine, Loma Linda, California.
Acad Med. 2017 Aug;92(8):1168-1174. doi: 10.1097/ACM.0000000000001667.
The recruitment and retention of community preceptors to teach medical students is difficult. The authors sought to characterize the underlying motivational factors for becoming a preceptor and to identify strategies for recruiting and retaining community-based pediatric preceptors.
This multicenter qualitative action study included semistructured interviews with community-based pediatric preceptors affiliated with 12 institutions from August to December 2015. Only active preceptors were included, and participating institutions were diverse with respect to geographic location and class size. Interviews were conducted over the telephone and transcribed verbatim. Six investigators used deidentified transcripts to develop a codebook. Through a constant comparative method, codes were revised as data were analyzed and disagreements were resolved through discussion. All investigators organized the themes into dimensions.
Fifty-one preceptors were interviewed. Forty-one themes coalesced into four dimensions: (1) least liked aspects of teaching, (2) preparation to teach, (3) inspiration to teach, and (4) ways to improve recruitment and retention. Time constraints and patient care demands were the most commonly cited deterrents to teaching. Successful preceptors balanced their clinical demands with their desire to teach using creative scheduling. External rewards (e.g., recognition, continuing medical education credit) served as incentives. Internal motivation inspired participants to share their enthusiasm for pediatrics and to develop longitudinal relationships with their learners.
Changes in health care delivery have imposed more time constraints on community-based preceptors. However, this study identified underlying factors motivating physicians to volunteer as preceptors. Strategies to recruit new and retain current preceptors must be collaborative.
招募和留住社区带教老师来指导医学生是一项困难的任务。作者试图明确成为带教老师的潜在动机因素，并确定招募和留住社区儿科带教老师的策略。
这项多中心定性行动研究包括在2015年8月至12月期间对隶属于12家机构的社区儿科带教老师进行半结构化访谈。仅纳入在职带教老师，参与机构在地理位置和班级规模方面具有多样性。访谈通过电话进行，并逐字转录。六位研究人员使用去识别化的转录本制定了一个编码手册。通过持续比较法，随着数据分析对编码进行修订，并通过讨论解决分歧。所有研究人员将主题组织成不同维度。
对51位带教老师进行了访谈。41个主题合并为四个维度：（1）教学中最不喜欢的方面，（2）教学准备，（3）教学动力，以及（4）改善招募和留住带教老师的方法。时间限制和患者护理需求是最常被提及的教学阻碍因素。成功的带教老师通过创造性的日程安排，在临床需求和教学愿望之间取得平衡。外部奖励（如认可、继续医学教育学分）起到了激励作用。内在动力促使参与者分享他们对儿科的热情，并与学生建立长期关系。
医疗服务的变化给社区带教老师带来了更多时间限制。然而，本研究确定了激励医生自愿成为带教老师的潜在因素。招募新带教老师和留住现有带教老师的策略必须具有协作性。
