Significant Primary Care Preceptor Shortage Remains One Year after the Pandemic Started

Purpose: Experiential clinical training opportunities are recognized as essential to learning clinical and critical thinking skills and are necessary to help learners become confident and competent providers. However, a shortage of clinical preceptors has driven a decline in such opportunities as providers face increasing workload expectations, time constraints, provider administrative demands, potential lower clinical productivity, and self-perceived lack of qualification by the providers. These challenges were highlighted with the spread of COVID-19 in 2020, impacting experiential experiences for health professions learners.

Methods: In February 2021, Emory Primary Care Consortium used Qualtrics to survey primary care providers (family medicine and general internal medicine only) eligible to precept medical learners to determine their current precepting status and the barriers they face to precepting during COVID-19. We used Stata to compute descriptive statistics of our results.

Results: Of 72 survey respondents, 61 were physicians and 11 were either nurse practitioners (NP) or physician assistants (PAs). Of the 41 respondents who were precepting students at the time of the survey, 29 precepted only MD students, 2 MD and PA students only, 7 NP students only, and 3 PA students only. Of the 31 respondents who were not precepting students, 4 had never precepted, 21 had precepted before March 2020 and not since, 5 precepted continuously (pre- and during COVID), and 1 had begun precepting after March 2020. Challenges to precepting that started with the COVID pandemic included low patient volume (n=12), lack of comfort teaching in a telehealth model (n=7), increased external pressure (i.e. children at home)(n=8), uncertainty of practice sustainability (n=1), and other reasons (n=11). Overall, 20 respondents were interested in receiving training on how to incorporate students into the clinical workflow and 13 in training on how to teach and provide feedback remotely.

Conclusions: Our survey illustrates potential preceptors could benefit from training on incorporating students into telehealth visits. A better understanding of precepting of medical learners will offer valuable insights into improving medical education in the future.