Unique learning contributions of a family medicine preceptorship

There is a belief among family medicine educators that a third-year family medicine rotation provides unique clinical learning experiences, but there is limited research to support this belief. This study identified clinical skills performed by third-year medical students only during a community-based family medicine preceptorship, even when the family medicine rotation occurs after all other required clerkships.

During 6 academic years (1990-1996), 87 third-year students completed the family medicine preceptorship as their final rotation and rated their experience with 80 clinical activities (preventive health care, clinical problem management, and procedures) after completing all required clerkships other than family medicine and again after the family medicine preceptorship. Ratings measured whether the activities occurred on the family medicine rotation, only on other rotations, or combinations of both.

More than 50% of students who performed five preventive skills (health maintenance for adolescents, young adults, middle-aged adults, or senior citizens and weight control counseling) gained that experience only during the family medicine preceptorship. The majority of students actively managed six clinical problems (acute strains and sprains, low back pain, sinusitis, strep throat, acute bronchitis, and osteoarthritis) uniquely during the family medicine preceptorship. The preceptorship offered few unique opportunities to perform procedures.

This family medicine educational experience was not merely a repeat of what is experienced on the traditional major rotations. The family medicine preceptorship provided a setting where students were able to perform several important ambulatory, primary care skills they had not performed during their core curriculum of traditional third-year rotations.