An observational study of precepting encounters in a family practice residency program

Family practice residents spend substantial time in their family health centers. Little is known about the area of focus of discussions between preceptors and residents. In this study, we describe the percentages of time that preceptors spent in various focus areas in one family practice residency program.

We conducted a direct observational study of four purposefully selected half-day sessions, one at each of four continuity sites, which included 80 precepted encounters and 451 minutes. Percentages of precepting time were calculated by overall, by common or uncommon diagnoses, by postgraduate level, and by clinical or academic faculty.

Preceptors discussed diagnosis or management 90% of the time; use of consultants and tests 6%; pathophysiology, pharmacology, other basic science 2%; and psychosocial factors 2%. There were no significant differences between percentage of time spent in each of the focus areas when comparing clinical to academic faculty or postgraduate year (PGY)-1, PGY-2, and PGY-3. Precepting about common problems had a higher percentage of time devoted to psychosocial issues than did precepting about uncommon problems (3.8% versus .4%).

Preceptors focused on diagnosis and management in this family practice residency program. Further study is needed to determine if this unbalanced focus is a problem or is present in other programs.