Preceptor Expectations and Experiences in a Longitudinal Integrated Clerkship

The Longitudinal Integrated Clerkship (LIC) as a pedagogical model in medical education is a burgeoning area of interest as an alternative to a traditional, rotation- (block) based curriculum and presents a distinct set of considerations. A large number of studies examine the impact on students participating in LIC programs, but fewer assessments exist for the preceptors involved. This study sought to understand changes in expectations and experiences following LIC program participation.

We conducted a survey-based prospective cohort study of preceptors before and after first-time LIC program participation. Five-point Likert-type questions were grouped into four subscales determined by areas of practice and preceptor role: clinical, administrative, professional, and educational. For statistical analyses of the nonmatched responses we used Pearson Chi-Square measures of association and independent t-tests.

Forty-seven of 84 (56%) preceptors responded to the presurvey and 42% responded to the postsurvey (35/84), totaling 82 unique responses. Thirty-nine (48%) were female, 64 (79%) had over 5 years teaching experience, and 61 (74%) had prior rotation-based clerkship experience. Only the clinical subscale (evaluating aspects of physical exam, history taking, and patient relationship with physician and student) was significantly different pre- (M1= 3.09[SD=0.40]) to post-LIC (M2= 3.47[SD=0.29]) showing a positive change at post-LIC participation (P=0.03).

For first-time LIC preceptors in a new LIC program, participation led to improvements in clinical practice without detriment to administrative, professional, or educational roles. Future research should examine changes among individual preceptors over time as well as assessments of students, including knowledge, skills, and attitude outcomes.