Originally published Summer Newsletter 2024. Written by Dennis Brown, DrPH, MPH, PA-C, DFAAPA & Alec Williams, MHS, PA-C.
The future of the PA Profession is in the hands of all PAs, beyond being an active member of the professional societies that represent and champion modernization of the PA practice, we all have a professional obligation to mentor the new generation of up-and-coming PAs through precepting. The fact that only about 25% of currently practicing PAs are precepting students is not very encouraging. [1] [2] Precepting PA students is a rewarding yet challenging role that requires a blend of clinical expertise, teaching skills, and empathy. We know that in practice today PAs are being judged by their productivity and patient satisfaction, one of the primary concerns is that precepting will have an impact on both of those and potentially put the PA at risk for financial or other losses. The reassuring thing is that when done right there is no impact for either PAs or physicians who are precepting, in fact some have demonstrated increased productivity and patient satisfaction. [3] [4] [5] So, what is this magical recipe that makes one an effective and productive preceptor? The research, discussions with preceptors, and reflections of being a preceptor point to the following key areas to consider as a part of that recipe.
Establishing a Positive Learning Environment
Creating a supportive and structured environment is crucial for effective learning. This involves setting clear expectations from the outset, including goals, responsibilities, and the scope of practice. A positive learning environment encourages students to ask questions, make mistakes, and learn from them without fear of judgment. Simple actions, such as taking a few minutes to connect with the student through a personal email before the rotation begins or introducing them to each team member, substatially contribute to a positive first impression and foster a sense of strong investment from the student.
Effective Communication
Clear and constructive communication is the cornerstone of successful preceptorship. Proactive discussions regarding a student’s learning style, along with reassurance that mistakes are a natural part of the learning process, build mutual trust and facilitate an open dialogue between preceptor and student, enhancing both the learning experience and future student-patient interactions. Regular feedback sessions help students understand their strengths and areas for improvement. It’s important to provide both positive reinforcement and constructive criticism in a balanced manner. Active listening and open-ended questions can also cultivate a more interactive and engaging learning experience. [6]
Promoting Autonomy
Encouraging students to take on responsibilities and make clinical decisions under supervision helps build their confidence and independence. Sometimes this is simple, starting with the student reviewing surveys and or health prevention recommendations. Gradually increasing the complexity of tasks as the student’s competence grows can enhance their learning experience and prepare them for real-world practice.
Empathy and Support
Understanding the challenges that PA students face and providing emotional support can significantly enhance their learning experience. Empathy helps build a trusting relationship, making students feel valued and understood. This supportive environment can boost their confidence and motivation.
Continuous Learning and Professional Development
Preceptors should stay updated with the latest clinical practices and teaching methodologies. Engaging in continuous professional development not only enhances the preceptor’s skills but also sets a positive example for students. Sharing recent advancements and evidence-based practices with students can enrich their learning experience.
Addressing Common Barriers and Constraints
New or prospective preceptors are often challenged in balancing their clinical role with their teaching responsibilities. Time constraints, navigating electronic health records (EHRs), [8] combined clinical and instructional duties, and pressure to perform well in the world of productivity and patient satisfaction metrics are frequent barriers to preceptorship which need to be addressed with proper institutional support, effective time management, and ongoing training. Specifically, scheduling dedicated time for teaching and student review can help ensure that both patient care and educational needs are met. Utilizing brief, focused teaching moments during clinical practice can also be effective. The concept of a One-Minute Preceptor (OMP) has been utilized in many clinical settings, replacing the traditional teaching scripts after each patient that were long winded and often forgotten by the learner. The OMP model allows the preceptor to teach and diagnose both the patient and the student. [7] While a great tool, full discussion is beyond the brevity of this article. However, it is strongly encouraged that preceptors look at this as a solution to relieving time constraints of providing effective patient care while managing instructional obligations and evaluating the student in the process.
For Students: Preceptorship is a ‘Two-Way Street’
Of course, the ingredients to the secret sauce of a successful preceptorship do not originate solely from the preceptor. Preceptorship is a two-way street, as preceptors have many roles and tasks that they are responsible for, above and beyond just teaching. When preceptors were asked what motivates disincentives their instruction, there were specific student traits that were reflected as positive or negative influencers. Ironically, many of the same themes that make for a quality preceptor were also cited as traits which made precepting a student a more enjoyable, namely being reliable, being punctual, being self-driven with ambition to learn, being professional, maintaining a strong good work ethic, and demonstrating respect and courteousness to patients, staff, and providers. Conversely, student characteristics that had a negative influence on the desire to precept included students that had poor interpersonal communication skills, were not enthusiastic, and lacked interest, were unprepared, and disrespectful. [1]
The old cliché of “you get out what you put in” stands true. As a student it is essential to not only arrive on time but also to arrive with an active willingness to elevate your preceptorship experience. Similar to keys of a successful preceptor, a student should engage in transparent and respectful regular communication, be receptive to constructive feedback, maintain a radiating positive attitude regardless of changing medical specialties, use informed and considerate inquisition as a tool for learning, and remain dedicated to self-directed learning outside of the clinical setting. Ultimately, each student is a vital part of the medical team alongside their preceptor, working and being educated toward the shared goal of providing high-quality, patient-centered care. A successful preceptorship hinges on the student’s ability to recognize their shared accountability in patient care and approach each case, differential diagnosis, and treatment plan with the same dedication as if they were the ones pressing the ‘order’ button on the EHR.”
Conclusion
As healthcare evolves, the importance of effective preceptorship in shaping the next generation of PAs cannot be overstated. Precepting PA students is a vital role that shapes the future of the PA profession and healthcare. By creating a positive learning environment, communicating effectively, promoting autonomy, managing time efficiently, showing empathy, and engaging in continuous learning, preceptors can significantly impact the development of competent and confident healthcare professionals. The journey of preceptorship is not only about imparting knowledge but also about inspiring and nurturing the next generation of PAs.
References
- N. M. Hudak, C. G. Enking and R. Gonzalez-Colaso, “Tales from the trenches: Physician Assistant’s’ perspectives about precepting students,” J Physician Assist Educ, vol. 25, no. 1, pp. 12-19, 2014.
- R. Gonzalez-Colaso, A. Moloney-Johns and J. Sivahop, “To teach or not to teach: 2011 national survey of physician assistants and preceptor experiences,” J Physician Assist Educ, vol. 24, no. 2, pp. 12-19, 2013.
- T. C. Evans, K. H. Wick, C. H. A. Andrilla, S. A. Skaggs and T. Burgin, “A method to study the effect of physician assistant student on preceptor productivity,” J Physician Assist Educ, vol. 29, no. 4, pp. 205-210, 2018.
- J. Hatfield, G. Neal, T. Isbell and D. Dickey, “The effect of a medical student on community preceptor productivity,” Med Educ, vol. 56, no. 7, pp. 747-753, 2022.
- S. W. Zuo, N. A. Hueppchen, R. M. Salas, C. E. Galmado and S. Patel, “It’s a win-win: The effect of medical students on clinical productivity,” PRiMER, vol. 6, no. 21, 2022.
- F. E. Biagioli and K. G. Chapelle, “How to be an efficient and effective preceptor,” Fam Pract Manag, vol. 17, no. 3, pp. 18-21, 2010.
- D. M. Irby, E. Aagaard and A. Teherani, “Teaching points indetified by preceptors observing One-Minute Preceptor and traditional preceptor encounters,” Acad Med, vol. 79, no. 1, pp. 50-55, 2004.
- T. Dodge, S. M. Mazerolle and T. G. Bowman, “Challenges faced by preceptors serving in dual roles as health providers and clinical educators,” J Athletic Training Educ, vol. 9, no. 1, pp. 29-35, 2014.
Photo Credit: Photo by Lucia Navarrete on Unsplash.