Preceptor Workshop:
Teaching Medical Students and Working with Underserved Populations
May 25, 2004

The purpose of the preceptor workshop was to

• explore the challenges of teaching medical students at all levels,
• work with underserved populations and to
• generate strategies at address these issues.

Part I focused on:

• Personal experiences, personal value systems and ways to convey passion for working with the underserved to the next generation of physicians,
• Discussion of obstacles and motivations for teaching, and
• The implementation of specific, successful strategies to address the challenges of teaching and working with the underserved.

Part II brought providers together to highlight the main issues and further delineate future courses of action.

Part III on February 16, 2005 will continue and build on the efforts begun here. Please mark your calendars for Part 2 of this workshop.

Below is the summarized workshop results grouped by major themes.

Part I: Small Group Session

Participants were divided into 6 breakout groups and asked to respond to the following questions:

1. Please describe the personal value system that informs your work with the underserved. (Major themes)

a. Healthcare as a right/social justice

i. Healthcare is a right (6)

ii. The medicine we practice is also a social justice: advocacy for immigrant issues, the right thing to do, working against classism/racism (4)

b. The importance of understanding patients

i. Patients have the right to be treated with dignity and respect (3)

ii. Patients need to be understood in context: in the context of their cultures, life experiences, as a whole person (5)

iii. It is important to have a nonjudgmental attitude (2)

c. There is privilege and enjoyment

i. Working with patients is a privilege (5)

ii. There is enjoyment and reward in caring for the underserved (2)

d. There is responsibility and a need to train the next generation of physicians

i. It is important to train students to work with the underserved (3)

ii. We have a responsibility to give back (2)

2. How do you convey those values to your students?

a. Modeling

i. Transmit values through modeling: respect, "good provider," "with joy" (3)

b. Engagement

i. Engage students: getting students emotionally engaged, increasing students' sense of compassion (2)

c. Discussion

i. Discuss personal values with students (1)

 

3. Describe two challenges you encounter when you are both teaching medical students and providing patient care.

a. Time to precept/productivity demands (5)

b. Patient does not want to see student/vice versa/feel "pawned off" (5)

c. Space

d. Language (2)

e. Lack of resources: computer access/support staff (4)

f. Effective communication: with patient and student, problem of divided attentions, balancing, avoiding "patient hijacking" (4)

g. Diagnostic dilemmas: having the knowledge-based info (2)

h. Bridging the cultural language gap: treating the patient in their context/family community (2)

i. Gauging level of student responsibility

j. Lack of institutional support

 

4. Describe two strategies you have used to address those challenges.

a. Preparation (before the rotation)

i. Pre-select patients (3)

ii. Pre-select students: (2)

1. State language preferences

2. No third years

b. Scheduling

i. Give students their own schedules

ii. Allow students more independence as time goes on

c. Strategies to use on the day of teaching

i. Preemptive reframing: for patients who may not want to see students(2)

ii. Time management strategies: (4)

1. Give students a timeline

2. Leave students in room with patient

3. Allow students to interrupt and vice versa (step in more) (2)

4. Have more than one preceptor available

d. Be flexible and resourceful, aware

e. Prioritize work

 

Part II: Large Group Session

After the breakout session, the small groups came together to discuss their findings. The two part discussion centered on the challenges of teaching and working with underserved populations, as well as identifying ways to address these issues.

Challenges:

• Can clinics take on a student for all four years?
• Concern about 2 tier track--primary care vs. traditional medical student in a clinic
• Training the next generation of physicians caring for the underserved
• Address "safety net" medicine
• Finding and keeping enthusiastic preceptors

Suggested Strategies:

• Provide grant writing support to put together student and patient issues
• Adopt a student who can also give back to the community and clinic
• Project enthusiasm and enjoyment with work: no whining!
• Explore options/resources for monetary compensation
• Pursue streamlining of advancement of professorship series

 

Part III: To be continued on:

Wednesday, February 16, 2005

Teaching Medical Students and Working with Underserved Populations Part II

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