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Development and Implementation of a Novel Learner-driven Precepting Model for Pulmonary Fellowship.

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|April 19, 2021
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Summary

Pulmonary and critical care medicine (PCCM) fellowship training needs better ambulatory education. A new learner-driven precepting model, STEP-UP, improved training perceptions but faced implementation challenges.

Keywords:
ambulatory educationclinical reasoningfellowship educationoutpatientprecepting

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Area of Science:

  • Medical Education
  • Pulmonary and Critical Care Medicine

Background:

  • Ambulatory education is currently underemphasized in pulmonary and critical care medicine (PCCM) fellowship training.
  • Existing clinic precepting models do not meet the unique needs of fellow-level trainees.

Purpose of the Study:

  • To develop and implement a novel fellow-led precepting model to improve ambulatory education for PCCM trainees.

Main Methods:

  • A mixed-methods needs assessment (surveys, focus groups, observations) was performed.
  • A novel, learner-driven precepting model (STEP-UP) was developed and implemented.

Main Results:

  • Current precepting practices did not meet fellows' needs for graduated autonomy, skill development, and self-directed learning.
  • Implementation of the STEP-UP model improved perceptions of outpatient training and precepting.
  • Barriers to uptake included increased cognitive burden.

Conclusions:

  • A needs assessment identified a need to align precepting processes with advanced trainee goals.
  • A learner-driven model (STEP-UP) focused on clinical reasoning and self-directed learning was developed.
  • Further study is warranted to refine and test the model in different settings.