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One-Minute Preceptor Improves Clinical Competence in Pediatric Clerkships: A Cluster Randomized Trial
Ngo C Quang1, Truong Ma Mai1, Tran D Hung2
1Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
Objective:
Clinical teaching in busy pediatric clerkships requires brief strategies that make learner reasoning visible and provide timely feedback. We assessed whether training pediatric resident preceptors to use the One-Minute Preceptor (OMP), a five-microskills teaching model, improved directly observed student performance and learner satisfaction without a statistically significant increase in assessment-related time.
Methods:
We conducted a single-center, stratified cluster randomized controlled trial with pediatric resident preceptors as the unit of randomization. Thirty preceptor clusters were allocated 1:1 to OMP or usual teaching (15 per arm), with 450 fourth-year medical students included in the analysis (225 per arm). The primary outcome was performance across seven Mini-Clinical Evaluation Exercise (Mini-CEX) domains. Secondary outcomes included student satisfaction, formal observation duration, and post-encounter feedback duration. Primary analyses used generalized estimating equations adjusted for case difficulty with Holm correction; prespecified sensitivity analyses assessed robustness.
Results:
OMP significantly improved Mini-CEX scores in medical interviewing (adjusted mean difference [MD] 1.12, 95% CI 0.82-1.42; Holm-adjusted p<0.001), counseling (MD 1.20, 95% CI 0.85-1.55; Holm-adjusted p<0.001), and clinical reasoning (MD 1.28, 95% CI 1.01-1.55; Holm-adjusted p<0.001), whereas the remaining domains were not significant after multiplicity adjustment. OMP also increased student satisfaction (MD 0.63, 95% CI 0.25-1.01; p<0.001). Formal observation and post-encounter feedback durations were numerically longer but not statistically significant. Findings were consistent in sensitivity analyses.
Conclusions:
In pediatric clerkships, OMP improved selected domains of workplace-based clinical competence and learner satisfaction, with modest, statistically nonsignificant increases in assessment-related time.
Trial Registration:
ClinicalTrials.gov, NCT07305077.
