Building the foundation of clinical training: a mixed-methods study of pre-clerkship clinical preceptors and...

Preceptorship is a key component of medical student clinical experience. Demand for clinical preceptors is increasing. An updated understanding of why preceptors continue or discontinue these roles, particularly in pre-clerkship settings, is needed to optimize recruitment and retention. To inform recruitment and retention of pre-clerkship preceptors at a large public medical school, the authors examined preceptor motivations for precepting, reasons for leaving, and factors influencing a successful preceptorship.

The authors conducted an explanatory sequential mixed-methods study (survey followed by semi-structured interviews) between September 2024 and December 2024. Participants were current and former pre-clerkship preceptors from 57 clinical sites across 22 organizations in academic and community clinical settings. Rapid qualitative methods using templated summaries and matrix analysis were applied to identify major themes.

A total of 202 current and former pre-clerkship medical student preceptors participated in surveys characterizing their experiences: 158 current preceptors (including 36 planning to stop) and 44 former preceptors with a 70% response rate. Most preceptors cited a love of teaching as their primary motivation. Thematic analysis identified three themes: (1) Preceptors chose to precept because they love teaching-when they leave it is often related to life and work-related factors; (2) Heavy clinical workload was a barrier to a good preceptorship experience; (3) The importance of guidance flexibility, and supportive structures for preceptors.

Pre-clerkship preceptors are primarily motivated by a passion for teaching, but personal and professional pressures contribute to attrition. Addressing clinical workload and providing flexible, supportive program structures may improve preceptor retention.