Physician’s Guide To Teaching Clinical Skills To Medical Students

Why Should I Teach Medical Students?

The physician shortage is growing. The AAMC now predicts a deficiency of up to 139,000 physicians by 2033. Meanwhile, the number of medical student applications increased by 20% between 2019 and 2020.

Yet many current students are limited to virtual training or groups of over a dozen trainees rounding together on the wards. The simplest solution – increase the number of preceptors.

We all start with medical school. We all understand the struggles associated with it. And many want to work actively to improve the learning environment for those who follow. Perhaps this is why up to 45% of medical students display a “high desire” to go into academic medicine and teaching.

When it comes to clinical rotations, there have traditionally been limited opportunities for students. They either stay within their universities’ limited schedules and restricted electives options or seek away rotations. Few outside of academic medicine have advocated for more diverse educational experiences. Now, that is changing.

The persistent effects of the COVID-19 pandemic and consistent increases in international and foreign medical graduates and leading to changes. Technology has allowed a greater number of community physicians to accept mentees in-person and virtually. Even specialties routinely associated with hospitals are now opening up external private practices. And this is only the beginning.

Why Do Students Need My Help?

Medical students are facing a faculty shortage crisis. According to the AAMC, there are approximately 155,000 individuals enrolled on the national Faculty Roster. Physicians in academic medicine only make up approximately 15% of the total physician population. Additionally, 38% of them leave academia within 10 years.

When each practitioner’s research, professional and personal time constraints are added, there is a lack of available resources targeted at education. As the physician shortage concerns continue to rise, we must find more training options for our future health professionals.

Besides the limited resources in academia, there is also increased competition between different healthcare fields for clinical education sites. Students may find themselves rotating with a dozen or more other peers and residents. This may limit the experiential learning and knowledge acquisition that each future physician may attain.

MD and DO students are now also competing with NP and PA students for the same clinical rotations. All healthcare trainees require adequate training to provide the best possible patient care. Internal struggles between disciplines doesn’t provide better services to patients or increase health outcomes. So what options do we have?

Instead of interdisciplinary fighting, why not take advantage of existing resources? The 85% of non-academic physicians actively practicing in the U.S. could be that resource.

In the past, it was difficult for community practitioners to find students, schedule clinical rotations, sign all appropriate documentation, and receive compensation for their efforts. However, now this work is being crowdsourced and automated.

Using MedTech in MedEd, we can now utilize this bountiful resource. Preceptors no longer need to worry about the marketing or the bureaucratic side of clerkships. They can focus on teaching and patient care, as it should be.

We can provide a wider range of clinical sites and demographics, better educational environments, and improved patient care. But this is only the tip of the iceberg. We can shape the future of medicine by educating the next generation in new and innovative ways.

Career counseling: Medical students have so many options for their future specialty or profession. Like entering Starbucks for the first time, it can be daunting to make a decision! How can the student know what they will be best at in the long-term? What if their current preferred specialty will lead them to burnout? Without proper experience and mentorship, we may do what we tell our patients not to do: make an uninformed decision.

Developing professionalism and personal growth: The word “professionalism” is used frequently in course curriculum, hospital manuals, and in verbal communication without actually explaining what it means! The best way to demonstrate professionalism to a new student is by instructional scaffolding. Preceptors can demonstrate how to act, what ethical situations may arise, and encourage growth in their students. Be the change you want to see!

Increasing interest in the unknown: Student participation is not limited to patient care. Student mentors can guide trainees into new fields and ways of thinking. They can encourage creative thinking academically and professionally. Inspiration for new research topics and public health concerns often arises from a preceptor’s advocacy. How can you inspire your trainees?

How Do I Start Precepting Students?

If you are considering adding precepting to your current activities, consider your needs and desires. Make sure that this is not only a good fit for you, but also for the students you will educate. Here are some questions you may want to ask:

We will come back to these in a moment.

If you are in academic medicine, you probably have a clear understanding of how your institution handles academic appointments. However, for those in community medicine, there are a few ways to approach this.

Some physicians have the time to set up their websites and landing pages, contact students, and schedule appointments. Others opt to use a service for these administrative concerns. Luckily, the pathway has just become much easier.

We’ve all seen AirBnB revolutionize travel and Lyft reform public transportation. Now, we have FindARotation. The first-ever crowdsourced system for clinical experience. The efficiency is in its simplicity.

By allowing physicians to tap into a marketplace that greatly needs their expertise, the field of medical education can now interconnect in ways previously impossible. How do you determine if entering into, or rejoining, medical education is the right choice for you? Let’s take a closer look at those questions above.

Learning Environment

Depending on your facilities, time-constraints, and personal comfort level the actual design of your future clinical rotations can follow a few paths. Some clinical educators prefer a one-on-one experience with their mentees. Others may require limiting it to 2-3 students consecutively. Still, others wish to allow larger groups of trainees to rotate at the same time.

There is no direct right or wrong way to approach this topic. Try whatever feels comfortable. You can always add or subtract available spots later on! The focus should be proper mentorship. If the students are not able to adequately learn with the current design, consider decreasing the number of seats available.

Patient Care

Students bring great benefits to patient care. They may have been trained with different educational, demographic, or even technological backgrounds. This can facilitate better understanding by mentors of certain patient populations. A deeper understanding of those from different upbringings can lead to better communication and better health outcomes.

Your patients are also likely active online. Whether through internet browsing or social media, medical learners may be able to add new perspectives to your outreach. Developing a greater insight into how your patients view you (or your website and social media presence) may allow for a greater connection with the community in which you serve. See other potential physician benefits below.

Preceptor Administrative Tasks

Even if you do have time to market to students or schools, set up schedules, and determine if and how payment should be received, do you really want to do it? These tasks can take hours each week per student. School affiliate agreements, creating student expectations, and completing letters of recommendation and student evaluations can be burdensome.

You can perform this task with your office manager or hire a virtual assistant. That will likely cost you several hundred dollars per week. You can also decide to use a marketplace with specific knowledge in this arena. That will allow these tasks to be streamlined, automated, and monitored for you.

Giving back to the community and advancing medical education is a great reward. Those with intrinsic motivation to educate future physicians provide unmatchable value to the healthcare system. However, other extrinsic motivators may act as icing on the cake! Let’s next take a look at some of the rewards and perks of being a preceptor.

Benefits of Mentorship in Healthcare Education

Strong mentorship benefits healthcare students, mentors, and healthcare institutions that support them. Training is not limited to acquisition or knowledge and skill development, but also the financial and personal development of the learner. Preceptors can increase their student’s ability to learn effectively, synthesize research materials, and gain confidence in their skills as clinical professionals. All of which, hopefully, improve future patient care.

Mentors can also benefit greatly from their mentees. Bridging the gap between cultures, generations, or technology leads to greater understanding and empathy. Students may also act as advocates for your practice, both to their student peers and to friends and family looking for health services. Preceptors can learn a lot from their mentees within and outside of medicine.

The medical field is also blessed with countless physicians that are willing to donate their time and services to teach their pupils. However, sometimes it is not feasible to take on the responsibility of new office personnel without compensation. Fortunately, for those wishing to join clinical education, this may come in several forms. I’ve written on this subject in the past for Physician on FIRE, and here are some important highlights.

Academic Awards

Preceptors are eligible for CME in many specialties, as well as CV-boosting educational awards. Anyone can sit in a class or watch a video series and gain didactic continuing medical education. However, most studies show that interactive, not didactic, CME improves physician performance.

The AMA, AAFM, ABFM, and several other medical societies provide CME credit for precepting medical students. As a certain level of continuing education is mandated anyway, why not fulfill this educational requirement in a way that benefits you and your trainees the most?

Additionally, there is an increasing number of teaching awards that preceptors may apply for or be nominated for. The Outstanding Volunteer Clinical Teacher Award and the Herbert S. Waxman Award for Outstanding Medical Student Educator are both offered by the ACP. AMA also offers the Physician’s Recognition Award.

These are only a few of the many opportunities that exist. Having other forms of recognition can be a great way to build your credentials for academic work or research. They prove a level of dedication to the field of medicine that can increase your status in the eyes of your colleagues.

Indirect Financial Compensation

In addition to academic achievements, precepting medical students can also open up the door to little-known financial benefits. Many states now allow tax breaks to physician educators. This can range from a few hundred dollars to up to $10,000 in a fiscal year!

Seeing states appreciate their medical trainers gives hope. However, more advocacy is needed to assure more states join this mindset and add appropriate legislation as well. At the time of this writing, several states offer tax incentives to teach medical learners.

AZ through HB 2137
CO (HB16-1142)
GA (PTIP; HB 287)
HA (HI SB2298)
OH (FQHC)
ME (HP0917)
MD (Senate Bill 411 / House Bill 1474)
and SC (Senate Bill 314)

Things may change quickly depending on the state of politics. There are also bills in New York, Rhode Island, North Carolina, and Massachusetts, but it is too soon to know where things will fall.

Precepting should always be about education and patient care. Focusing on extrinsic rewards is likely to lead to a poor teaching environment. These incentives are best thought of as showing appreciation for your hard work. Although we are sure that anyone reading to this point has already made up their mind on becoming a preceptor or not, there is one last topic to discuss.

Direct Financial Compensation

Let’s discuss the elephant in the room: money. As stated above, many physicians believe in the Hippocratic Oath. Namely, the part that states, “…and I shall teach them this art – if they desire to learn it – without fee and covenant.” Our hats are off to you! Students suffer from unmanageable debt as it is, and we should do everything we can to reduce this burden.

On the other hand, there are potentially significant obstacles that may arise while teaching in our current system. Potential preceptors must dedicate adequate time to teaching and acquire the skills to do so. Studies show that when mentors are forced to teach, the outcomes are often poor.

At FindARotation, we have seen everything from voluntary precepting to charging students $4,000/week! If nothing else, this displays how severe the demand is for more clinical training sites in the U.S.

Physicians that utilize our marketplace can set their prices, create different prices for different learning environments (shadowing, observerships, hand-on, student type), and change them as they please. They can also alter the number of seats available per rotation type as required.

Whatever reason, you decide what is right for you. We hope you will consider adding precepting to your curriculum. On the surface, teaching medical students may appear a daunting and overwhelming task. However, we have demonstrated many ways to do this easily and efficiently.

From community benefits to personal development to generational knowledge sharing, there is something in it for nearly everyone. If you do decide to take the plunge, there is one more bit of information we’d like to leave you with. If you want to teach, do it the right way

What Makes a Great Student Mentor?

All preceptors should consider themselves educators as well as clinical practitioners. Doctors are, by definition, educators. As such, it’s important to keep up with the latest tips and strategies for teaching students in the most effective ways. Unfortunately, those external to a University hospital setting is less likely to have continued faculty development resources available to them.

Teaching effectively requires leading by example, understanding how learning occurs, and giving immediate feedback. To be an effective instructor in clinical practice, an educational supervisor must be a lifelong learner not only in medicine but in education. Presentations, performance evaluations for clinical exams, and a demonstration of skills outside of patient interactions should be assessed regularly.

Resources for teaching effectively remain relatively rare for a profession as integral to society as medicine. We’ve developed a few simple guidelines that may improve communication with trainees and increase their academic performance. If you would like to know what other preceptors are doing, consider listening to the interviews conducted in the Rounds to Residency podcast!

Set Expectations Early On

Clinical teaching is most effective when all parties know exactly what to expect and how to excel in their training. Clinicians should prepare a list of learning objectives, student roles, and non-clinical expectations before the first day of a student’s rotation. These can be re-emphasized and clarified during orientation.

Student expectations should also be assessed early on. What do they wish to gain from this experience? What is their level of education and what gaps in their knowledge exist? Do they plan to pursue your specialty for residency or is it a core curriculum requirement?

Understanding the different perspectives and goals of your learner will make it infinitely easier to teach to their level.

Engage Student Learning and Interest

Most of us have completed externships where the majority of our time was utilized filling out charts and completing other grunt work. While this may be a mandatory aspect of your educational setting, be sure to also engage your mentees in a way that is enticing and interesting.

Keep in mind that students may have shelf or board exams to prepare for, research to conduct, and personal lives outside of the hospital. All of which can greatly distract them from committing their full attention to rounds. An effective preceptor may attempt to find ways to limit such distractions with presentations, games, or other activities when on the wards.

Teaching clinical skills not only helps the learner develop critical thinking skills, but it also influences their academic achievement and career choices. Stronger mentor relationships may increase the trainee’s interest in that particular specialty.

Understanding Learning Theories

Research on “learning styles”, such as visual-auditory-reading-kinesthetic (VARK), have been widely discredited in modern studies. All types of learning can be beneficial. Some styles are preferred in one scenario and others in another. However, when all are used together it can provide a synergistic effect.

Providing a demonstration of clinical skills, concrete examples of challenging concepts, and immediate feedback may help structure deeper understanding and retention of the material. Performance evaluations, when used properly, can quantify a learner’s grasp of their current level of proficiency. Peer teaching also allows for synthesizing information and recognizes gaps in knowledge.

Understanding not only what tools may be used but also the goal of using each technique allows a clinical educator to have goal-oriented tasks for student learning. Another recommended resource for greater mentorship skills development is the Faculty Factory Podcast.

Simulated Training and Technology

Every year, education technologies advance. Adoption of these technologies may seem like a lot of unnecessary work for the busy physician. However, with a small investment in time, these tools can be used to significantly increase conceptual and skills-based learning.

Limiting clinical teaching to presentations and lectures may fail to engage student interests. Consider implementing interactive quizzes, asynchronous videos, or gamified learning designs. Premade resources can often be used just as effectively as self-made, and requires little time to organize.

YouTube videos, Anki flashcard decks, medical-based card games, and even mobile apps can help add variety into the clinical environment. Patient simulators also allow for patient training in settings that may not otherwise be available to the learner in-person.

No matter your reasoning for becoming a clinical preceptor, we hope these resources help to provide guidance. Your role in the future of medicine and medical education can not be understated. To see a significant change in the future, we must give future physicians the tools and knowledge they will need to enact progress.

Creating future doctors is the first step. However, we can also do much more. By enhancing advocacy, creating physician-entrepreneurs, and teaching physician-leadership we provide a voice for patient care and healthcare improvements. Be a part of that change!