Time Efficient Preceptorship
“I really liked that one of my preceptors, especially with new patients, would scribe while I was doing the interview, which I felt was helpful because it didn’t make the patient go through everything twice.”
— Student
“My students are definitely really good at prepping for patients in advance and looking at my schedule. Sometimes at the end of a session, I look with my student at the next week’s patients and identify in advance people for them to read about.”
— Preceptor
We review tips for balancing the primary goal of patient care while teaching medical students in an LIC. On average, working with students adds 30 minutes to a clinical session early in the year, while later in the year many preceptors find efficiency in clinic improves and quality of patient care is enhanced with students present. Listed are key tips on managing busy clinics with a LIC student.
Structured plan for clinical teaching:
When possible, select patients for the following week at the end of the previous session. If not done in the prior session, identify patients at beginning of current session.
Strategically select patients for students spaced out over the session.
Limit the number of patients the student sees. 1-2 patients per half-day at the beginning of the year is appropriate. By the end of the year, they will likely be seeing 3-4 per session.
Students can spend time with patients that need to share their story and need more attention. This will allow you to see other patients independently while student is in another visit.
Direct observations need only be brief. For example, observe the students focused physical exam, or observe them telling the patient the plan.
If observing students while taking a history, you can begin note writing as scribe and place orders.
When in a patient room with a student, think out loud: narrate PE findings or clinical reasoning for student to follow.
Encourage students to reflect clinical reasoning in the note, especially when there is little time for a more comprehensive presentation.
Encourage students to focus on 1-2 key/pressing issues for complex patients and go into detail on these.
It’s ok to teach less during busy sessions and acknowledge this.
Encourage Self-Directed Learning:
Encourage students to review charts ahead of session to prepare for clinic or surgery.
Utilize intersession time to teach more.
Provide learning opportunities by encouraging students to engage in lab follow-up and patient phone calls in between sessions. Forward admission notifications and consultant communication to students and email interesting articles to student.
Identify topic for student to review and share what they learned the following week.
Advocating for and Empowering Student Role:
Briefly huddle before clinic starts with student and MA and review schedule.
Connect students directly to the care team to empower them to be pro-active in their work which can help improve efficiency.
