EFFECTIVE TEACHING BEHAVIORS OF RURAL FAMILY MEDICINE PRECEPTORS

Objective: To describe effective teaching behaviours of rural family m edicine preceptors. Design: Descriptive qualitative study using the cr itical incident technique. Setting: Rural Manitoba community practices affiliated with the University of Manitoba's 8-week family medicine/c ommunity medicine rotation (clinical clerkship). Participants: All fam ily medicine preceptors and fourth-year medical students involved in t wo family medicine rotations from Mar. 11 to June 14, 1991. During the first rotation all 12 students and 21 preceptors participated. During the second rotation 12 of the 13 students and 20 of the 21 preceptors participated. The overall response rate was 97%. Outcome measures: Ef fective and less effective preceptor teaching behaviours. Results: Dur ing 120 telephone interviews (48 with the students and 72 with the pre ceptors) 275 critical teaching incidents were elicited. Over 800 teach ing behaviours were identified, and seven main categories describing e ffective teaching behaviours of preceptors were formed: (a) actively i nvolves the student, providing adequate supervision and appropriate in dependence, (b) develops and fosters a supportive interpersonal relati onship with the student to facilitate learning, (c) emphasizes problem solving and the understanding of general principles, (d) balances cli nical and teaching responsibilities, (e) demonstrates clinical and pro fessional competence, (f) uses an organized approach, including goal s etting and summation, and (g) provides the student with ongoing feedba ck, assessments and evaluations. Conclusion: The teaching behaviours d escribed in this study augment and corroborate findings from previous studies on clinical teaching and provide a better understanding of eff ective teaching behaviours. The findings suggest a curriculum for a fa culty-development program for rural family medicine preceptors.