Active precepting in the residency clinic: a pilot study of a new model.

OBJECTIVE This study's objective was to develop and implement a model of "active precepting" as a teaching and patient care quality improvement project at a community-based family medicine residency program. METHODS The Prepare, Orchestrate, Educate, Review (POwER) model was developed with input from faculty, students, residents, and staff. Five measures of conformance to the model were monitored with daily feedback cards from November 2001 to February 2002. Faculty, residents, and clinic staff were surveyed and interviewed after the intervention for perceptions about active precepting. Two follow-up patient flow studies were completed for concomitant quality improvement efforts, and those findings were reviewed along with intervention findings. RESULTS Preceptors reported reviewing resident schedules prior to clinic sessions more often after the model was put in place, and clinic staff reported that residents and faculty were more willing to help solve problems. Concurrent flow studies showed that patient time in clinic decreased from 110 minutes before the intervention to < 70 minutes after, while resident time with patients, including precepting time, decreased from 44 minutes to < 30 minutes. CONCLUSIONS Our results point to the potential of the POwER model of active precepting to contribute to improved patient care, teaching, stakeholder satisfaction, and better flow in the family medicine teaching clinic.