Biddle W B, Riesenberg L A, Darcy P A
State University of New York, Health Science Center at Syracuse, USA.
Fam Med. 1996 Oct;28(9):629-33.
With the increased need to establish primary care sites, we must identify the key characteristics of effective primary care training experiences.
After completing a required year-long primary care experience, third-year medical students participated in focus groups (n = 17) and completed a Q-sort exercise with three sets of items: preceptor characteristics, site characteristics, and a combination of preceptor and site characteristics (n = 59).
Thirty-eight concepts were identified by content analysis, which were grouped into six major categories: patients, preceptors' teaching behaviors, characteristics of office and staff, preceptors' personal characteristics, programmatic issues, and educational opportunities. The focus groups clearly identified preceptor teaching characteristics (35%) as the major factor that determines a good primary care teaching site. Items with the highest rankings from the Q-sort exercises related to teaching characteristics of the preceptor. The preceptor's enthusiasm, genuine interest in students, and ability to involve the student in active learning experiences with increasing levels of student responsibility were rated high.
The development of primary care experiences should focus on the selection and/or development of preceptors with the identified personal and teaching characteristics. Preceptor rather than site characteristics seem to make the vital difference in primary care educational experiences.
随着建立基层医疗服务点的需求增加，我们必须确定有效的基层医疗培训经历的关键特征。
在完成为期一年的基层医疗实习要求后，三年级医学生参加了焦点小组（n = 17），并对三组项目进行了Q分类练习：带教老师特征、实习点特征以及带教老师和实习点特征的组合（n = 59）。
通过内容分析确定了38个概念，这些概念被归为六大类：患者、带教老师的教学行为、办公室及工作人员特征、带教老师的个人特征、项目问题以及教育机会。焦点小组明确指出带教老师的教学特征（35%）是决定一个良好基层医疗教学实习点的主要因素。Q分类练习中排名最高的项目与带教老师的教学特征有关。带教老师的热情、对学生的真正兴趣以及让学生参与责任程度不断增加的主动学习经历的能力得分较高。
基层医疗实习的发展应侧重于选拔和/或培养具有已确定的个人特征和教学特征的带教老师。在基层医疗教育经历中，起关键作用的似乎是带教老师的特征而非实习点的特征。
