Caroline R. Paul, MD, Gwen C. McIntosh, MD, MPH, University of Wisconsin School of Medicine and Public Health, Madison, WI
There is a need to establish objective and rigorous measurable outcomes in learners’ routine clinical settings with real patients. Our aim was to assess preceptor perceptions of use of an evaluation instrument in their encounters with medical students. A curriculum for pediatric otoscopy was implemented during a pediatric clerkship. A key outcome measure was use by the preceptor of a pre- and post-intervention checklist. The preceptors were assigned as the student’s preceptor for 3 weeks. Preceptors were asked to complete the checklist during routine clinical encounters with real patients before and then following the curriculum intervention, during specific periods. The 12-item checklist adapted from ePROM focused on 5 domains of the pediatric ear exam: discussion with caregiver, equipment, distraction techniques, holding positions, and exam. Preceptors were not able to alter the checklist content. Eight core preceptors participated in this evaluation component. After participation in the study for 17 months, preceptors were asked to complete a web-based 12-item Likert-type survey. 100% of the preceptors completed the survey. 63% of preceptors liked using the checklist with their students and the majority reported the checklist was easy to implement during clinic time (88%) and was of the appropriate length (100%). While 50% of preceptors reported that their method of performing otoscopy varied from that described in the checklist, use of the checklist did not interfere with their teaching style (100%) or with patient care (100%). 25% of preceptors reported checklist use interfered with their clinic flow and efficiency. Checklist use enhanced the teaching experience (50%) and encouraged greater preceptor observation of students (63%). 88% of preceptors recognized potential for similar checklist use for other clinical topics including the neurological exam and focused musculoskeletal exams. Preceptors perceived that use of an evaluation tool in students’ routine clinical encounters with real patients enhanced their teaching experience and did not interfere with patient care. Similar efforts to systematize evaluation of medical student and resident performance in real clinical settings by their preceptors should be considered for other clinical areas.