Ignoffo Robert, Chan Lucinda, Knapp Katherine, Chan Emily, Ip Eric, Bandy Jason, Besinque Kathleen, Colbert James, Duby Jeremiah J, Galanto Joseph S, Gloudeman Mark, Havard Patty, Lackey Grant, Lozano Eric, Scott James, Stewart Tania L
Touro University California College of Pharmacy, Vallejo, CA.
Lifelong Medical Care-East Oakland, Oakland, CA.
Am J Health Syst Pharm. 2017 Oct 1;74(19):1570-1578. doi: 10.2146/ajhp170181. Epub 2017 Aug 22.
Using the Delphi process, a panel of experienced preceptors achieved consensus on best practices to increase preceptor efficiency and effectiveness.
The Delphi panelists completed 3 survey rounds and a face-to-face meeting. Survey questions covered several topics, including preparation of students for rotations, preceptor efficiency and effectiveness, potential resident contributions to precepting, methods of developing critical-thinking skills and providing assessment and feedback, precepting time metrics, and barriers to preceptor effectiveness. Panel consensus was defined as agreement of ≥80%.
Fifteen of 36 invited preceptors (42%) completed all 3 survey rounds. The expert panel reached consensus on 6 essentials for effective rotations, 8 precepting contributions that could be made by appropriately trained residents, precepting barriers, 4 strategies for teaching critical thinking, and 5 valuable characteristics of the One Minute Preceptor model. Panelists reported on time spent with students presenting new patient cases (median, 10 minutes per case), time devoted to assessment of students' clinical performance (median, 22 minutes per student weekly), and time dedicated to student professional development (median, 20 minutes per student weekly).
Important strategies for preceptors identified by the panel included (1) a thorough orientation to logistics, expectations, and scheduling of activities, (2) using appropriately trained residents in student training, (3) providing opportunities for critical thinking and therapeutic decision-making, (4) giving frequent, quality feedback on clinical activities, and (5) giving feedback to learners on a regular basis.
通过德尔菲法，一组经验丰富的带教老师就提高带教效率和效果的最佳实践达成了共识。
德尔菲小组成员完成了三轮调查和一次面对面会议。调查问题涵盖多个主题，包括学生轮转准备、带教老师的效率和效果、住院医师对带教的潜在贡献、培养批判性思维技能以及提供评估和反馈的方法、带教时间指标以及带教效果的障碍。小组共识定义为≥80%的一致意见。
36名受邀带教老师中有15名（42%）完成了所有三轮调查。专家小组就有效轮转的6项要点、经过适当培训的住院医师可做出的8项带教贡献、带教障碍、4项培养批判性思维的策略以及“一分钟带教”模式的5项有价值特征达成了共识。小组成员报告了与学生讨论新患者病例所花费的时间（中位数为每个病例10分钟）、用于评估学生临床表现的时间（中位数为每周每个学生22分钟）以及用于学生专业发展的时间（中位数为每周每个学生20分钟）。
小组确定的带教老师的重要策略包括：（1）对后勤、期望和活动安排进行全面介绍；（2）在学生培训中使用经过适当培训的住院医师；（3）提供批判性思维和治疗决策的机会；（4）对临床活动给予频繁、高质量的反馈；（5）定期向学习者提供反馈。
