BUILDING BETTER CLINICAL TRAINING EXPERIENCES: A LEARNING COLLABORATIVE

Mary Theobald

doi:10.1370/afm.2344

The Society of Teachers of Family Medicine (STFM) continues to invest in strategies to increase the pool of community-based preceptors and the quality of training at ambulatory sites. Five interprofessional teams are implementing these tactics:

Tactic 1: Work with the Centers for Medicare and Medicaid Services (CMS) to revise student documentation guidelines
Tactic 2: Integrate interprofessional/interdisciplinary education into ambulatory primary care settings through integrated clinical clerkships
Tactic 3: Develop standardized onboarding process for students and preceptors & integrate students into the work of ambulatory primary care settings in useful and authentic ways
Tactic 4: Develop educational collaboratives across departments, specialties, professions, and institutions to improve administrative efficiencies
Tactic 5: Promote productivity incentive plans that include teaching and develop a culture of teaching in clinical settings

The Tactic 4 team has launched a multiyear pilot, funded by the American Board of Family Medicine, called Building Better Clinical Training Experiences: A Learning Collaborative. During the pilot, family medicine departments will participate in 1 of 3 projects to implement, evaluate, and disseminate innovative approaches to standardize the onboarding of students and to engage community preceptors.

Project 1: Family medicine departments, ideally in collaboration with other specialties and professions, will pilot student onboarding resources and processes

Goals

Ease the administrative burden on community preceptors by standardizing documentation
Help preceptors integrate students more easily into practices
Increase student value to practices
Aid teaching programs in administering clinical clerkship experiences

Onboarding materials/processes will include

A passport that captures a student’s background and training. For the preceptor, the form includes a professional bio, clinical rotation background (graduation date, previous rotations, procedures learned), and objectives for the current rotation. For the practice administration, the form includes contact details and evidence that the student is ready for clinical work (proof of HIPAA training, background check, immunizations, etc).
Education for students on how to hit the ground running at their clerkship site.
Online training for students on “How to Create a High-Quality Note in the Medical Record,” “How to Perform Medication Reconciliations,” and “Motivational Interviewing.”
Self-developed, pre-clinical curriculum to meet goals and objectives outlined in the appendix of the AAMC’s 2008 Recommendations for Preclerkship Clinical Skills Education for Undergraduate Medical Education.

Project 2: Family medicine departments, ideally in collaboration with other specialties and professions, will pilot standardized preceptor onboarding and engagement resources

Goals

Ease the administrative burden on community preceptors by standardizing documentation
Engage community preceptors
Encourage and reward teaching
Enhance the quality of training at ambulatory sites

Standardized onboarding and engagement materials will include

A faculty appointment onboarding process where administrative personnel at the institution assist new preceptors in developing and formatting CVs during a phone interview
Participation in the ABFM Precepting Performance Improvement Program, using:
- An online self-assessment of developmental competencies for preceptors
- TeachingPhysician.org assigned readings, based on self-assessment
An online course on giving feedback
A new preceptor recognition program
A new teaching practice recognition program

Project 3: Family medicine departments, ideally in collaboration with other specialties and professions, will pilot student onboarding resources and processes outlined in Project 1 and will pilot standardized preceptor onboarding and engagement resources outlined in Project 2

Five family medicine departments for each of the 3 projects were selected through a competitive application process. Preference was given to departments collaborating with 2 or more other specialties/departments/professions. Over the next 2 years, departments and their collaborators will participate in online and in-person learning communities to share/learn about intervention approaches; conduct standardized pre/post measurement; and disseminate their findings.

The pilot is being led by tactic team leader Jim Ballard, PhD and project manager Melissa Abuel. Evaluation will be managed by the Robert Graham Center, which will measure the impact of the interventions on preceptors’ administrative burden, and the learning experience for students.