Influence of community preceptor specialty and method of assignment in an early clinical experience course

Objectives: Although early clinical experience courses are often the purview of family medicine faculty, students may receive training with community physicians from varying specialties. Little is known about the influence of preceptor specialty and method of assignment on students' performance and course satisfaction. Methods: Second-year medical students spent one half day per month with a preceptor to practice clinical skills. Preceptors were either assigned randomly or assigned by student recruitment or specialty request. We analyzed whether preceptor specialty, method of assignment, and practice site (the independent variables) were associated with the dependent variables of course evaluation ratings and student performance on objective structured clinical examinations (OSCEs). Results: Analyses found no differences in students' overall course satisfaction or OSCE scores and little difference in satisfaction with specific course components. There was a positive relationship between overall course rating and the rating of the preceptor experience and between the preceptor experience and more time spent in ambulatory clinics and direct patient interaction. Conclusions: Because students were equally satisfied and performed comparably regardless of specialty or matching method, early clinical exposure may be accomplished equally well using specialist or generalist physicians, potentially giving primary care educators greater latitude to focus their efforts on teaching students in clinical clerkships and those interested in primary care.