What Do Residents Want From Clinical Supervision in Primary Care Practice? Identifying Desired Behaviors for Outpatient Precepting.

Abstract

Feedback to clinical supervisors of residents (preceptors) is critical to ensure quality teaching. Most feedback tools are based on theoretical models or expert opinion. No research has asked residents their thoughts on teaching practices. Our objective was to identify desired precepting practices by analyzing written feedback provided to preceptors by residents. This project was conducted in a family medicine residency training program, analyzing feedback to preceptors from residents collected over 5 years. We used the nonviolent communication format, which identifies a request to a preceptor to continue an existing teaching behavior or change to a new one. The request statements were qualitatively analyzed by coders, aligning them when possible to categories of the Mayo Outpatient Precepting Evaluation Tool. Using content analysis, we coalesced all codes into categories from which we derived behaviorally based desired practices for precepting. Most (66.49%) of the requests were to continue a teaching behavior. We identified 26 desired practices in the following categories: setting the learning climate (n=5); preprecepting (n=2); preceptor presence (n=1); conveying clinical knowledge (n=4); decision-making (n=5); time management (n=4); and feedback on performance (n=5). We identified precepting practices that residents desire. Some of these desired behaviors are not reflected in existing preceptor evaluation tools.