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Senior Residents' Perspectives and Intentions to Teach in Outpatient Primary Care Settings.

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Title: Senior Residents' Perspectives and Intentions to Teach in Outpatient Primary Care Settings.
Authors: Ma L; University of California, San Diego, San Diego, USA.; Veterans Affairs Palo Alto, Palo Alto, USA.; Stanford University, Stanford, USA., Vercio C; Loma Linda University, Loma Linda, USA., Peltier C; University of Cincinnati College of Medicine, Cincinnati, USA., Paul CR; NYU Grossman School of Medicine, NYU Langone Health, New York City, USA.; University of Kentucky College of Medicine, Lexington, USA., Jassal SK; University of California, San Diego, San Diego, USA., Dallaghan GB; University of Texas at Tyler, Tyler, USA.; University of Illinois Urbana-Champaign, Champaign, USA., Wang HC; University of California, San Diego, San Diego, USA. hew004@stanford.edu.; Department of Pediatrics, Stanford University, 3351 El Camino Real Suite 100, Atherton, CA, 94027, USA. hew004@stanford.edu.
Source: Journal of general internal medicine [J Gen Intern Med] 2025 Nov; Vol. 40 (15), pp. 3549-3559. Date of Electronic Publication: 2025 Aug 13.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Springer Country of Publication: United States NLM ID: 8605834 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1525-1497 (Electronic) Linking ISSN: 08848734 NLM ISO Abbreviation: J Gen Intern Med Subsets: MEDLINE
Imprint Name(s): Publication: Secaucus, NJ : Springer
Original Publication: [Philadelphia, PA] : Hanley & Belfus, [c1986-
MeSH Terms: Internship and Residency*/methods , Primary Health Care* , Preceptorship*/methods , Attitude of Health Personnel* , Ambulatory Care*/methods , Intention*, Humans ; Female ; Male ; Qualitative Research ; Adult ; Internal Medicine/education
Abstract: Competing Interests: Declarations:. Ethics Approval and Consent to Participate:: This research was approved by the UCSD Institutional Review Board as exempt (Protocol #801881). Conflict of Interest:: The authors declare that they do not have a conflict of interest.
Background: Primary care is pivotal to delivering effective healthcare. However, interest in primary care continues to decline; this is compounded by difficulties recruiting and retaining community-based preceptors to train and inspire trainees to enter primary care. Prior research explored the perspectives of community preceptors, but more concerted efforts across primary care specialties need to be directed upstream to understanding residents' perceptions on becoming future preceptors.
Objective: We aimed to understand the experiences and factors that shape graduating residents' attitudes about and desire to serve as outpatient preceptors.
Design: This was a qualitative study, using a narrative inquiry approach, based on semi-structured interviews.
Participants: Graduating Internal Medicine, Pediatric, and Internal Medicine-Pediatric residents at a single institution were interviewed.
Approach: We developed an interview guide based on researchers' own experiences as medical educators and a pilot interview. Applying inductive analysis, we identified common themes that influenced participants' perspectives on outpatient precepting. With the derived themes, we identified an existing theory that best explained the results.
Key Results: After interviewing 13 residents, four themes were constructed that influence participants' perspectives on becoming outpatient preceptors. The Theory of Planned Behavior, where one's intention is informed by one's behavioral beliefs, normative beliefs, and control beliefs, conceptualized the themes. Witnessed advantages and disadvantages of precepting informed participants' behavioral beliefs, preparedness to practice medicine and teach informed their control beliefs, physicians' responsibility to teach contributed to their normative beliefs, and clinical demands were a secondary determinant that influenced all three beliefs.
Conclusions: Using identified themes and the Theory of Planned Behavior, we propose the following recommendations to improve resident outpatient training with the goal of improving long-term community preceptor recruitment: (1) enrich the outpatient learning experience, (2) reinforce the teacher identity, (3) advocate for structural and cultural changes to address current clinical barriers to teaching.
(© 2025. The Author(s).)
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Contributed Indexing: Keywords: community preceptors; primary care; qualitative research; workforce
Entry Date(s): Date Created: 20250813 Date Completed: 20251113 Latest Revision: 20251115
Update Code: 20251115
PubMed Central ID: PMC12612470
DOI: 10.1007/s11606-025-09809-8
PMID: 40804562
Database: MEDLINE
Description
Abstract:Competing Interests: Declarations:. Ethics Approval and Consent to Participate:: This research was approved by the UCSD Institutional Review Board as exempt (Protocol #801881). Conflict of Interest:: The authors declare that they do not have a conflict of interest.<br />Background: Primary care is pivotal to delivering effective healthcare. However, interest in primary care continues to decline; this is compounded by difficulties recruiting and retaining community-based preceptors to train and inspire trainees to enter primary care. Prior research explored the perspectives of community preceptors, but more concerted efforts across primary care specialties need to be directed upstream to understanding residents' perceptions on becoming future preceptors.<br />Objective: We aimed to understand the experiences and factors that shape graduating residents' attitudes about and desire to serve as outpatient preceptors.<br />Design: This was a qualitative study, using a narrative inquiry approach, based on semi-structured interviews.<br />Participants: Graduating Internal Medicine, Pediatric, and Internal Medicine-Pediatric residents at a single institution were interviewed.<br />Approach: We developed an interview guide based on researchers' own experiences as medical educators and a pilot interview. Applying inductive analysis, we identified common themes that influenced participants' perspectives on outpatient precepting. With the derived themes, we identified an existing theory that best explained the results.<br />Key Results: After interviewing 13 residents, four themes were constructed that influence participants' perspectives on becoming outpatient preceptors. The Theory of Planned Behavior, where one's intention is informed by one's behavioral beliefs, normative beliefs, and control beliefs, conceptualized the themes. Witnessed advantages and disadvantages of precepting informed participants' behavioral beliefs, preparedness to practice medicine and teach informed their control beliefs, physicians' responsibility to teach contributed to their normative beliefs, and clinical demands were a secondary determinant that influenced all three beliefs.<br />Conclusions: Using identified themes and the Theory of Planned Behavior, we propose the following recommendations to improve resident outpatient training with the goal of improving long-term community preceptor recruitment: (1) enrich the outpatient learning experience, (2) reinforce the teacher identity, (3) advocate for structural and cultural changes to address current clinical barriers to teaching.<br /> (© 2025. The Author(s).)
ISSN:1525-1497
DOI:10.1007/s11606-025-09809-8