Leadership Views on the Barriers and Incentives to Clinical Preceptorship

Clinical education often relies on a one-to-one student-preceptor model. Recruiting and retaining quality preceptors to sustain this model has become increasingly difficult at academic institutions across the nation. While ample literature describes preceptor barriers and incentives as viewed by physician educators, few studies explore the issue from institutional leadership perspectives.

This study aimed to describe leadership perceptions across an academic institution to better understand knowledge gaps, system barriers, and proposed solutions to help institutions take action and address preceptor shortages.

Between February and July 2019, the researchers conducted one-on-one semi-structured interviews with sampled representation of Medical College of Wisconsin leadership. The researchers reviewed transcriptions of each interview verbatim and used a qualitative grounded theory approach to generate content codes and themes. Researchers iteratively refined codes using the constant comparison method until all interviews were analyzed and final themes and subthemes were defined.

Twelve institutional leaders participated, of whom 5 were clinical executives, 1 was an academic executive, 4 were academic deans, and 2 were educational directors. Analysis yielded 4 major themes: student impact, recognition, physician well-being, and leadership.

Each content theme highlighted areas to consider when addressing preceptor issues within an institution: (1) leadership knowledge gaps regarding the scope of preceptor challenges, particularly time commitments and the number of preceptors required; (2) improving career advancement or promotion criteria to recognize teaching efforts; (3) enhanced physician well-being from teaching, while important, may no longer be sufficient for participation, especially without financial compensation; (4) distributed leadership may be needed to address issues at the course, clinic, and system levels.