Clinical scholarship among preceptors supervising longitudinal integrated medical clerkships in regional and rural communities of practice

OBJECTIVE: All senior medical students at the University of Wollongong undertake a longitudinal integrated community-based clerkship, supervised by experienced general practitioners in a regional or rural community. This study investigates the influence of the longitudinal integrated clerkship model of medical education on scholarship among preceptors in these practice communities. DESIGN: General practitioner preceptors were interviewed after the first student cohort had completed their 38-week placements. Analysis of transcripts identified themes supporting clinical scholarship among preceptors. The entire transcript for each preceptor was analysed, permitting a quantitative determination of each theme. Quotations supporting the themes were selected. SETTING: The setting was the primary health care practices supervising the longitudinal integrated clerkship medical students. PARTICIPANTS: Twenty-six preceptors who supervised longitudinal integrated clerkship medical students in rural and regional New South Wales participated. None had previously been involved in this model of medical education. MAIN OUTCOME MEASURE: The study looked for evidence of clinical scholarship among preceptors supervising students in the longitudinal medical student clerkship. RESULTS: Thematic analysis of interview transcripts revealed evidence of clinical scholarship in regional/rural clinical medicine. The 'practice' was validated as a place where scholarship occurs, an 'academy of learning' and part of the university. About half of the preceptors believed the longitudinal integrated clerkship gave students a deeper link with the community. Two thirds of participants perceived an improved quality of care in their practice. CONCLUSION: Longitudinal integrated clerkships in teaching communities of practice provide the opportunity for emergence of clinical scholarship among preceptors supporting the learning needs of medical students.Kathryn M. Weston, Judith N. Hudso