Applying practical preventive skills in a preclinical preceptorship

Learning primary care medicine includes learning to apply practical, preven tive medicine skills during everyday encounters with patients. The authors relate their experiences with implementing a voluntary, preventive diabetic foot-care program within the Texas Statewide Family Practice Preceptorship Program (TSFPPP). They explain the background of the TSFPPP and their rati onale for introducing prevention and selecting diabetic foot care as a firs t preventive training module. The program's structure, educational material s, and evaluations are described. Of the 158 students and 88 preceptors who were exposed to the program, the authors received, evaluations from 86 pre ceptors and 110 students. Students documented that they had screened and pr ovided foot-care education to 321 diabetic patients. On average, students s aved their preceptors 5-10 minutes each time they examined a diabetic patie nt's feet or provided foot-care education. The students said that the wide variety of preceptors' practices, the time constraints placed upon the prec eptors, and the preceptors' own guidelines for the voluntary preceptorship all posed challenges to completing the preventive activities. The preceptor s reported that preclinical students could play an important preventive rol e in their practices; however, to get optimum results from a preventive mod ule, it may he important for students and preceptors to determine which top ics are introduced. Using the preceptors' suggestions, the authors are deve loping a smoking-cessation module.