title: Faculty verbal evaluations reveal strategies used to promote medical student performance.
abstract: BACKGROUND
  Preceptors rarely follow medical students' developing clinical performance over time and across disciplines. This study analyzes preceptors' descriptions of longitudinal integrated clerkship (LIC) students' clinical development and their identification of strategies to guide students' progress.
  
  
  METHODS
  We used a common evaluation framework, reporter-interpreter-manager-educator, to guide multidisciplinary LIC preceptors' discussions of students' progress. We conducted thematic analysis of transcripts from preceptors' (seven longitudinal ambulatory preceptors per student) quarterly group discussions of 15 students' performance over one year.
  
  
  RESULTS
  All students' clinical development progressed, although most experienced obstacles. Lack of structure in the history and physical exam commonly obstructed progression. Preceptors used templates for data gathering, and modeling or experiences in the inpatient setting to provide time and solidify structure. To advance students' knowledge acquisition, many preceptors identified focused learning topics with their students; to promote application of knowledge, preceptors used reasoning strategies to teach the steps involved in synthesizing clinical data. Preceptors shared accountability for helping students advance as the LIC allowed them to follow students' response to teaching strategies.
  
  
  CONCLUSIONS
  These results depict preceptors' perceptions of LIC students' developmental continuum and illustrate how multidisciplinary preceptors can use a common evaluation framework to identify strategies to improve performance and follow students' performance longitudinally.
authors.affiliation: Department of Medicine, University of California San Francisco, CA 94143-0120, USA. karen.hauer@ucsf.edu
authors.forename: Karen E
authors.initials: KE
authors.lastname: Hauer
authors.forename: Lindsay
authors.initials: L
authors.lastname: Mazotti
authors.forename: Bridget
authors.initials: B
authors.lastname: O'Brien
authors.forename: Paul A
authors.initials: PA
authors.lastname: Hemmer
authors.forename: Lowell
authors.initials: L
authors.lastname: Tong
mesh_terms: D002982:Clinical Clerkship; D002983:Clinical Competence; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods*; D004522:Educational Status; D005180:Faculty, Medical; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007858:Learning; D010865:Pilot Projects; D011231:Preceptorship; D036301:Qualitative Research; D013337:Students, Medical; D013637:Tape Recording; D013647:Task Performance and Analysis; D013663:Teaching / Q000379:methods*; D014705:Verbal Behavior