A study of primary care teaching comparing academic and community-based settings.
OBJECTIVE
To compare teaching activity and content between academic and community-based practices used in third year medical student primary care training.


METHODS
Academic and community-based primary care practices participating in third-year internal medicine, family medicine, and primary care core clerkships.


METHODS
Five-hundred thirteen preceptor-student encounters involving 32 preceptors and 26 third-year medical students were evaluated.


METHODS
Student-preceptor pairs collected a convenience sample of data from shared patient encounters. Preceptors recorded the content of teaching interventions, and students independently documented learning points received for each clinical encounter.


RESULTS
Comparison of problem exposure, frequency and content of teaching interventions, and the effect of patient complexity and patient care workload on teaching frequency was made between the academic and community-based practices. Several small differences were found in the frequency of clinical problem exposure between the 2 settings. The frequency and focus of teaching interventions did not differ by practice type. Teaching by community-based preceptors tended to decrease with increased patient care workload, but increased in academically based practices.


CONCLUSIONS
Although several differences exist between educational experiences in community- and academically based primary care practices, they appear to be minor and of minimal educational significance.
Division of General Internal Medicine, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA. pmasters@psu.edu
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Masters
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Nester
D004504:Education, Medical, Undergraduate / Q000458:organization & administration*; D006764:Hospitals, Community / Q000458:organization & administration*; D006784:Hospitals, Teaching / Q000458:organization & administration*; D006801:Humans; D010414:Pennsylvania; D010821:Physicians, Family / Q000458:organization & administration*; D010818:Practice Patterns, Physicians' / Q000458:organization & administration; D011231:Preceptorship; D013663:Teaching / Q000379:methods*