title: Quality of student learning and preceptor productivity in urban community health centers.
abstract: OBJECTIVE
  Clinicians in community health centers find it difficult to balance the demands of increased productivity and effective teaching. We hypothesized that precepting third-year students would decrease clinical productivity and that many elements related to the quality of the learning experience (e.g., amount of patient contact, student autonomy) would be adversely affected by pressure to see increasing numbers of patients.
  
  
  METHODS
  Students and preceptors in a 6-week family medicine clerkship completed daily surveys that measured the presence of quantifiable elements of the ambulatory teaching experience. They also rated the overall quality of learning during each session.
  
  
  RESULTS
  For 62 sessions for which both students and preceptors completed evaluations, students rated the overall quality of learning more highly than preceptors. For students, the elements most positively associated with quality of learning were total teaching time and the frequency with which family issues were raised. For preceptors, the elements that predicted quality of learning were the number of patients that students saw independently and total teaching time. The clinical productivity of preceptors did not differ for sessions with and without a student.
  
  
  CONCLUSIONS
  Preceptors can be effective teachers who encourage student autonomy and who model behaviors central to family practice, without decreasing productivity.
authors.affiliation: Department of Family Medicine, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA. mckee@aecom.yu.edu
authors.forename: M D
authors.initials: MD
authors.lastname: McKee
authors.forename: P
authors.initials: P
authors.lastname: Steiner-Grossman
authors.forename: W
authors.initials: W
authors.lastname: Burton
authors.forename: M
authors.initials: M
authors.lastname: Mulvihill
mesh_terms: D002982:Clinical Clerkship / Q000458:organization & administration; D003151:Community Health Centers / Q000458:organization & administration; D017598:Efficiency, Organizational; D005194:Family Practice / Q000193:education* / Q000458:organization & administration; D005246:Feedback; D005544:Forecasting; D005610:Freedom; D006801:Humans; D007858:Learning; D015999:Multivariate Analysis; D010361:Patients; D010817:Physician-Patient Relations; D011231:Preceptorship / Q000458:organization & administration; D015397:Program Evaluation; D013337:Students, Medical; D013663:Teaching; D013997:Time Factors; D019037:Urban Health Services / Q000458:organization & administration