Preceptor Retention: Impact of Curriculum Reform and Competency-Based Assessment on Preceptor Reward and Burden

Sustaining clerkship preceptors is increasingly challenging, leading to interest in preceptor retention and incentive strategies. Guided by self-determination theory (SDT), this study examined preceptor retention and factors associated with retention after a large-scale curriculum reform including transition to an all-longitudinal integrated clerkship (LIC) curriculum.

A survey was administered to 1164 LIC preceptors at a single institution. Questions focused on intention to precept the next year, reasons for continuing or leaving and incentives to motivate teaching. Descriptive and comparative statistics were performed.

An 83% response rate was achieved (n = 965), with a preceptor retention rate of 84.5% (816/968). The most common reasons cited for leaving precepting roles were as follows: needing a break (n = 46, 30.1%), leaving clinical practice (n = 31, 20.1%) and decreased clinical time (n = 29, 19.3%). Specialty, participation in faculty development and perceived ease/difficulty of assessment forms were not associated with retention; only being a first-year preceptor was shown to have significant negative association (p = 0.006). Most preceptors leaving teaching cited personal reasons (n = 74, 46.7%). For those planning to return to precepting, the most common reason cited was the longitudinal relationship with students (n = 536, 66%).

Faculty decisions to continue or discontinue precepting were driven primarily by personal or structural factors rather than dissatisfaction with the curriculum. Consistent with SDT, the longitudinal relationship with students was the strongest motivator to precept, suggesting the LIC model itself may support faculty recruitment and retention. First-year faculty are at greatest risk for attrition and represent a key target for intervention and support aimed at retention.