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Medical Education  |   October 2008
Supporting and Promoting Osteopathic Medicine Through Community-Based Family Practice Preceptorships: A Survey-Based Study
Author Notes
  • From the Michigan State University College of Osteopathic Medicine (Drs Aguwa, Monson, and Liechty) and its Division of University Relations (Ms Fowler) in East Lansing, and Western Michigan University (Ms Kost) in Kalamazoo. 
  • Address correspondence to Margaret I. Aguwa, DO, MPH, Professor and Associate Dean, Community Outreach and Clinical Research, Michigan State University College of Osteopathic Medicine, A322 E Fee Hall, East Lansing, MI 48824-1316. E-mail: aguwa@msu.edu 
Article Information
Medical Education
Medical Education   |   October 2008
Supporting and Promoting Osteopathic Medicine Through Community-Based Family Practice Preceptorships: A Survey-Based Study
The Journal of the American Osteopathic Association, October 2008, Vol. 108, 606-614. doi:10.7556/jaoa.2008.108.10.606
The Journal of the American Osteopathic Association, October 2008, Vol. 108, 606-614. doi:10.7556/jaoa.2008.108.10.606
Abstract

Context: Michigan State University College of Osteopathic Medicine (MSUCOM) has long maintained a preceptorship program involving community-based osteopathic physicians who voluntarily provide osteopathic medical students with early clinical experiences in family practice.

Objective: To investigate the factors that influence osteopathic physicians to participate in the MSUCOM Family Medicine Preceptorship Program.

Methods: A self-administered survey consisting of 28 questions in five categories was mailed to all 177 osteopathic physicians participating in the MSUCOM Family Medicine Preceptorship Program.

Results: A total of 168 surveys reached potential respondents. Eighty-nine completed, legible surveys were returned, for a response rate of 53%. The most common reasons given for program participation were the desire to contribute to the medical education of students (99%), to provide “real-life” clinical experiences to students (78%), to share knowledge (72%), and to “give back” to the osteopathic medical profession (71%). A majority of respondents agreed that the preceptorship program would influence students' specialty (96%) and internship choices (79%). Respondents also reported an expectation that their participation would lead to continuing medical education (CME) credit for clinical teaching (65%), opportunities for faculty development (28%) or research collaboration (17%), and professional recognition (12%).

Conclusion: The primary motivations for osteopathic physicians to participate in the MSUCOM Family Medicine Preceptorship Program are related to a personal sense of “giving back” to the osteopathic medical profession by contributing to the education of future physicians. In addition, the integrated relationship between volunteer preceptors and MSUCOM enriches professional opportunities for CME credit, faculty development, and other academic-related benefits.

What motivates osteopathic physicians in family practice to volunteer their time and expertise for community-based teaching of undergraduate osteopathic medical students in the clinical setting? There is a dearth of research related to the motivations and expectations that underlie volunteer participation by community-based osteopathic physicians in preceptorship programs. 
Ullian et al1 analyzed the motivations of preceptors involved with the Interdisciplinary Generalist Curriculum (IGC) Project, a national demonstration project developed in the 1990s by the Bureau of Health Professions to encourage medical schools to implement interdisciplinary generalist curricula in preclinical education. This analysis classified the rewards of 2400 community-based faculty members serving with the IGC Project into three main categories: affective, cognitive, and tangible.1 Many community-based preceptors noted such “affective” rewards as enjoying teaching; being an important part of training the next generation of physicians; and increasing their identification with the school. Cognitive rewards included the rejuvenating influence of students' knowledge. Tangible rewards included hassle-free on-campus parking, access to university libraries, and free or reduced-fee access to programs for continuing medical education (CME) credit.1 
From their observations of the service of 250 osteopathic physician preceptors at the University of North Texas Health Science Center—Texas College of Osteopathic Medicine (UNTHSC/TCOM) in Fort Worth, Zachary and Smith-Barbaro2 concluded, “The specialty that students ultimately pursue and the type of community in which they choose to practice may be a direct result of valuable experiences gained through a preceptor/clerkship.” 
The present study examined the preceptorship program administered by the Department of Family and Community Medicine (FCM) at the Michigan State University College of Osteopathic Medicine (MSUCOM). Although we analyzed the impact of the preceptorship program on the career choices of osteopathic medical students—as in the UNTHSC/TCOM study2—the main focus of our investigation was to determine what motivates osteopathic physicians in family practice to serve as volunteers in the MSUCOM Family Medicine Preceptorship Program. 
History of the MSUCOM Family Medicine Preceptorship Program
The Michigan College of Osteopathic Medicine (MCOM) opened as a private college in Pontiac, Mich, in 1969.3 In 1971, MCOM was moved to East Lansing and became MSUCOM, the first COM to be part of a major university.3 According to Myron S. Magen, DO,4 founding dean of MCOM, the two major objectives for establishing MCOM were “to prepare osteopathic family physicians qualified to provide high-quality comprehensive healthcare services to the whole family” and “to introduce [osteopathic] medical students to patient contact as early as possible.” From its founding, MCOM emphasized training in early clinical experience for osteopathic medical students—an emphasis that has remained constant through the years (R.C. Ward, DO, oral communication, January 2003). 
As one of the main clinical departments at MSUCOM, FCM has the responsibility of coordinating and managing the community-based family medicine clinical rotations (ie, the Family Medicine Preceptorship Program), in which second-year osteopathic medical students are assigned to osteopathic physicians (ie, volunteer preceptors) in family practice settings throughout the state. Undertaken on a weekly basis throughout each academic semester, these early clinical rotations allow students to gain valuable experiences in ambulatory clinical settings with a variety of patients. 
The MSUCOM Family Medicine Preceptorship Program has a course structure with multiple components for the preceptors and the students. Any community-based osteopathic physician interested in becoming a preceptor is required to complete an application and to receive a briefing and on-site evaluation by the director of the Family Medicine Preceptorship Program before receiving assigned student. When a preceptor is appointed and assigned students, he or she is provided with program protocols, including objectives, expectations, course requirements, other policies and guidelines, and instruments for student and program evaluation. Subsequently, annual, biannual, or triennial reappointments of the preceptor within MSUCOM are based on reviews of the preceptor's applications and evaluations.5 
Each osteopathic medical student participating in the MSUCOM Family Medicine Preceptorship Program must have successfully completed all first-year courses, including a course on integrated clinical skills, before being assigned to a preceptor. Students are briefed in a classroom setting before the preceptorship rotation begins. At that time, they are provided with course protocol packets that are nearly identical to those received by preceptors. Student packets also include preceptor evaluation forms as well as form-based assignments for recording clinical cases.6 Likewise, preceptor packets include student evaluation forms. At the end of each rotation, students are debriefed as a group. Some students are also debriefed individually by the program director on an as needed basis (ie, by student request or in response to evaluation comments). 
All student and preceptor evaluations are reviewed individually, analyzed collectively, and used for ongoing monitoring of the quality and effectiveness of the Family Medicine Preceptorship Program. Modifications to the program are implemented based on the analyses of these evaluations and of any other relevant information. For example, an unfavorable student evaluation of a preceptor might compel the program director to visit the preceptor and, depending on the findings of that visit, withhold future assignments of students from the preceptor or deny the preceptor's reappointment. On rare occasions, a student may be immediately withdrawn from a preceptor if the student's educational experience in the program is deemed to be suboptimal. It is more common, however, for preceptors to receive favorable evaluations from students and to be formally recognized and given commendations and awards, such as certificates of recognition, by FCM administrators. In our experience with the Family Medicine Preceptorship Program, the majority of preceptors have continued to provide MSUCOM students with valuable clinical training, professional mentoring, and collegiality. 
Adaptive modifications are continually being made to the program. Such modifications are based on a variety of factors, including student and preceptor evaluations of the program, evolving expectations in osteopathic medical education, advancements in evidence-based clinical medicine, changes in core competency requirements, and internal monitoring of program and education activities. Such changes have resulted in the tightening of curriculum structure and standardized criteria for recruitment and approval of community-based preceptors. Internal records of the MSUCOM Family Medicine Preceptorship Program reveal that, in recent years, an increasing number of osteopathic physicians are volunteering their time and resources to participate in the program.6 Currently, more than 250 osteopathic family physicians practicing in Michigan serve as community-based faculty within FCM at MSUCOM. However, depending on any given semester, a lesser number of these individuals may participate as active preceptors with assigned osteopathic medical students. 
Despite the ongoing monitoring and evaluations of the MSUCOM Family Medicine Preceptorship Program, the present study represents the first time that an investigation of the motivations and expectations of program participants has been carried out. The objectives of this study were to investigate the factors that influence osteopathic physicians to participate in the Family Medicine Preceptorship Program, including their motivations, their understanding of MSUCOM's expectations, their perceptions of the impact of the program on students' career choices, their expectations of MSUCOM, and their desired rewards for participation. Under the auspices of its Division of Research, staff in the FCM undertook this study with the hypothesis that the motivations and expectations of preceptors would be more altruistic than financial or tangible in nature. 
Methods
In 2001, the FCM developed and pretested a survey instrument specifically designed for preceptors in the MSUCOM Family Medicine Preceptorship Program. The 28-item instrument was divided into five sections: demographic and general information, academic affiliations, motivations to serve in the program, perceptions regarding the impact of the program on students' career choices, and professional interests and expectations (including expectations of rewards). The University Committee on Research Involving Human Subjects approved the survey instrument and research protocol in March 2002. 
The survey instrument, a self-administered questionnaire, was mailed to all osteopathic physicians who were currently serving as preceptors in the Family Medicine Preceptorship Program and who had active clinical FCM faculty appointments (N=177). The initial mailing of surveys was sent to the target group in June 2002, with two follow-up mailings occurring in July and November. 
Results
Demographics
Of the 177 surveys that were mailed, 168 reached the target group. Ninety-one of the 168 survey instruments were returned, two of which were not usable because of incomplete or illegible responses. The response rate was thus 53% (89 of 168). Appropriate descriptive statistics were generated from the response data using SPSS statistical software (Version 11.0; SPSS Inc, Chicago, Ill). 
Table 1 shows the demographic characteristics and other general findings regarding the survey participants. The majority of respondents were white (84 [94%]), men (70 [79%]), and between the ages of 40 and 59 years (69 [78%]). Fewer than 10% of respondents were of other racial or ethnic backgrounds. 
Table 1
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Characteristics of Respondents (N=89)

Characteristic

No. (%)*
Age, y
□ 30-39 3 (3.4)
□ 40-4935 (39.3)
□ 50-59 34 (38.2)
□ ≥6017 (19.1)
Sex
□ Men70 (78.7)
□ Women 19 (21.3)
Race
□ African American 1 (1.1)
□ Asian American1 (1.1)
□ White 84 (94.4)
□ East Indian/Caribbean1 (1.1)
□ Hispanic 1 (1.1)
□ Native American1 (1.1)
Graduation Year
□ Before 19602 (2.2)
□ 1960-1969 17 (19.1)
□ 1970-197927 (30.3)
□ 1980-1989 37 (41.6)
□ 1990-19996 (6.7)
Years in Practice
□ 0-94 (4.5)
□ 10-19 34 (38.2)
□ 20-2929 (32.6)
□ 30-39 18 (20.2)
□ ≥404 (4.5)
Practice Setting
□ Community health service1 (1.1)
□ Group 27 (30.3)
□ Hospital9 (10.1)
□ Partnership 6 (6.7)
□ Private46 (51.7)
Practice Location
□ Inner city5 (5.6)
□ Metropolitan 11 (12.3)
□ Rural25 (28.1)
□ Suburban 48 (53.9)
Practice in Underserved Area
□ Yes 14 (15.7)
□ No72 (80.9)
□ Uncertain/varies
3 (3.4)
 *Some percentages do not total 100 because of rounding.
Table 1
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Characteristics of Respondents (N=89)

Characteristic

No. (%)*
Age, y
□ 30-39 3 (3.4)
□ 40-4935 (39.3)
□ 50-59 34 (38.2)
□ ≥6017 (19.1)
Sex
□ Men70 (78.7)
□ Women 19 (21.3)
Race
□ African American 1 (1.1)
□ Asian American1 (1.1)
□ White 84 (94.4)
□ East Indian/Caribbean1 (1.1)
□ Hispanic 1 (1.1)
□ Native American1 (1.1)
Graduation Year
□ Before 19602 (2.2)
□ 1960-1969 17 (19.1)
□ 1970-197927 (30.3)
□ 1980-1989 37 (41.6)
□ 1990-19996 (6.7)
Years in Practice
□ 0-94 (4.5)
□ 10-19 34 (38.2)
□ 20-2929 (32.6)
□ 30-39 18 (20.2)
□ ≥404 (4.5)
Practice Setting
□ Community health service1 (1.1)
□ Group 27 (30.3)
□ Hospital9 (10.1)
□ Partnership 6 (6.7)
□ Private46 (51.7)
Practice Location
□ Inner city5 (5.6)
□ Metropolitan 11 (12.3)
□ Rural25 (28.1)
□ Suburban 48 (53.9)
Practice in Underserved Area
□ Yes 14 (15.7)
□ No72 (80.9)
□ Uncertain/varies
3 (3.4)
 *Some percentages do not total 100 because of rounding.
×
Seventy respondents (79%) reported graduating from colleges of osteopathic medicine (COMs) after 1970. Forty-six survey participants (52%) were graduates of MSUCOM. Fifty-one preceptors (57%) reported being in practice for 20 years or more, and 73 preceptors (82%) were in either private or group practice. Practice locations were predominantly in suburban or rural areas (73 [82%]), with only 16 respondents (18%) reporting practicing in metropolitan or inner-city settings. Fourteen responding physicians (16%) reported that their practices were located in medically underserved communities. 
Most survey respondents reported that they held assistant clinical professorships (49 [49%]) or associate clinical professorships (31 [35%]) at MSUCOM, while 8 respondents (9%) held MSUCOM clinical instructor (ie, intern or resident) positions (Table 2). Most responding preceptors (60 [67%]) had served as MSUCOM clinical faculty for between 6 and 20 years. Fifty-four respondents (61%) indicated that they typically accepted between two and four students per year in their preceptorships. 
Table 2
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Academic Credentials of Respondents (N=89)

Academic Credentials

No. (%)*
Clinical Faculty Title
□ Assistant clinical professor 44 (49.4)
□ Associate clinical professor31 (34.8)
□ Clinical instructor 8 (9.0)
□ Clinical professor2 (2.2)
□ Unspecified 4 (4.5)
Time in Clinical Faculty, y
□ 0-5 10 (11.2)
□ 6-1031 (34.8)
□ 11-15 16 (18.0)
□ 16-2013 (14.6)
□ 21-25 4 (4.5)
□ 26-308 (9.0)
□ ≥31 1 (1.1)
□ Unspecified6 (6.7)
Students Trained, Mean No. per Year
□ 05 (5.6)
□ 1 8 (9.0)
□ 216 (18.0)
□ 3 14 (15.7)
□ 424 (26.9)
□ 5 6 (6.7)
□ 68 (9.0)
□ ≥7
8 (9.0)
 *Percentages do not total 100 because of rounding.
 All interns and residents in the Michigan State University College of Osteopathic Medicine Statewide Campus System/Osteopathic Postdoctoral Training Institution are given the rank of clinical instructor within their specialty departments.
Table 2
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Academic Credentials of Respondents (N=89)

Academic Credentials

No. (%)*
Clinical Faculty Title
□ Assistant clinical professor 44 (49.4)
□ Associate clinical professor31 (34.8)
□ Clinical instructor 8 (9.0)
□ Clinical professor2 (2.2)
□ Unspecified 4 (4.5)
Time in Clinical Faculty, y
□ 0-5 10 (11.2)
□ 6-1031 (34.8)
□ 11-15 16 (18.0)
□ 16-2013 (14.6)
□ 21-25 4 (4.5)
□ 26-308 (9.0)
□ ≥31 1 (1.1)
□ Unspecified6 (6.7)
Students Trained, Mean No. per Year
□ 05 (5.6)
□ 1 8 (9.0)
□ 216 (18.0)
□ 3 14 (15.7)
□ 424 (26.9)
□ 5 6 (6.7)
□ 68 (9.0)
□ ≥7
8 (9.0)
 *Percentages do not total 100 because of rounding.
 All interns and residents in the Michigan State University College of Osteopathic Medicine Statewide Campus System/Osteopathic Postdoctoral Training Institution are given the rank of clinical instructor within their specialty departments.
×
Motivations
Table 3 summarizes our survey findings regarding the motivations of osteopathic physicians for volunteering in the MSUCOM Family Medicine Preceptorship Program. The top five responses suggest that “giving back” to the osteopathic medical profession and perpetuating the profession in its historical form were powerful incentives for survey respondents. Almost all preceptors (88 [99%]) noted that they desired to contribute to the medical education of osteopathic medical students. Sixty-nine respondents (78%) indicated their desire to provide “real-life” clinical experiences to students; 64 (72%), to share knowledge; 63 (71%), to “give back” for their own training; and 49 (55%), to maintain osteopathic medicine's model of clinical training. 
Table 3
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Responses to “What Motivated You to Become a Clinical Faculty Member for MSUCOM?” (N=89)

Response

Preceptors, No. (%)*
Contribute to Medical Education of Students88 (98.8)
Provide “Real-Life” Clinical Experiences to Students 69 (78.0)
Share Knowledge64 (72.0)
“Give Back” for My Training 63 (70.8)
Maintain the Osteopathic Medical Model of Clinical Training49 (55.1)
Obtain CME Credits for Teaching 31 (34.8)
Be Affiliated With MSU23 (25.8)
Obtain an Academic Title 8 (9.0)
Obtain Financial Rewards2 (2.2)
Other
□ Incentive to continue to learn and grow2 (2.2)
□ Enjoy camaraderie/company of students 1 (1.1)
□ Ensure survival of osteopathic physicians1 (1.1)
□ “Entice” students toward primary care 1 (1.1)
□ Obtain teaching tools for family practice residency1 (1.1)
□ Stay in touch with MSUCOM 1 (1.1)
□ Transitioning from private practice to academic medicine1 (1.1)
 Abbreviation: CME, continuing medical education.
 *Percentages total greater than 100 because respondents were allowed to give multiple answers.
 “Other” responses were written on survey forms by respondents.
Table 3
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Responses to “What Motivated You to Become a Clinical Faculty Member for MSUCOM?” (N=89)

Response

Preceptors, No. (%)*
Contribute to Medical Education of Students88 (98.8)
Provide “Real-Life” Clinical Experiences to Students 69 (78.0)
Share Knowledge64 (72.0)
“Give Back” for My Training 63 (70.8)
Maintain the Osteopathic Medical Model of Clinical Training49 (55.1)
Obtain CME Credits for Teaching 31 (34.8)
Be Affiliated With MSU23 (25.8)
Obtain an Academic Title 8 (9.0)
Obtain Financial Rewards2 (2.2)
Other
□ Incentive to continue to learn and grow2 (2.2)
□ Enjoy camaraderie/company of students 1 (1.1)
□ Ensure survival of osteopathic physicians1 (1.1)
□ “Entice” students toward primary care 1 (1.1)
□ Obtain teaching tools for family practice residency1 (1.1)
□ Stay in touch with MSUCOM 1 (1.1)
□ Transitioning from private practice to academic medicine1 (1.1)
 Abbreviation: CME, continuing medical education.
 *Percentages total greater than 100 because respondents were allowed to give multiple answers.
 “Other” responses were written on survey forms by respondents.
×
Although preceptors are not financially compensated for their participation in the MSUCOM Family Medicine Preceptorship Program, they do receive certain benefits, including clinical faculty appointments, free access to MSU e-mail services, and MSU library privileges. They also receive Category 1-A CME credit for preceptoring, in accordance with the American Osteopathic Association's (AOA) CME Guide for Osteopathic Physicians.7 Although these benefits are clearly important to some preceptors—31 respondents (35%) noted that they value the CME credits and 23 (26%) noted that they value affiliation with MSUCOM—these motivations were clearly secondary to their desire to support and promote the osteopathic medical profession. 
A small number of survey respondents provided other reasons for program participation, including a desire to “entice osteopathic medical students toward primary care” and to “ensure survival of osteopathic physicians.” Such factors appear to overlap with the primary motivation factors given by the preceptors. The various motivating factors indicated by respondents were neither an exhaustive nor mutually exclusive list. 
Expectations, Impacts, and Rewards
Table 4 outlines the respondents' perceptions of what was expected of them by MSUCOM for participating in the preceptorship program. All 89 respondents (100%) reported believing that MSUCOM expected them to provide constructive learning opportunities for students, and a vast majority also believed that they were expected to use the philosophy of osteopathic medicine in patient care (81 [91%]) and to allow students to interact with a diverse patient population (78 [88%]). Other important perceptions of expectations included conducting timely evaluations of students (67 [75%]), following MSUCOM educational guidelines (63 [71%]), and abiding by MSUCOM bylaws and policies (54 [61%]). 
Table 4
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Responses to “What Do You Consider to be MSUCOM's Expectations of You as a Clinical Faculty Member?” (N=89)

Response

Preceptors, No. (%)*
Provide Constructive Learning Opportunities for Students89 (100.0)
Mentor Students in Osteopathic Medicine's Philosophy of Patient Care 81 (91.0)
Allow Students to Interact With Diverse Patient Populations78 (87.6)
Conduct a Timely Constructive Evaluation of Each Student 67 (75.3)
Follow Education Guidelines Set by MSUCOM63 (70.8)
Abide by MSU Bylaws and Policies 54 (60.7)
Participate in Collaborative Clinical Research23 (25.8)
Other
□ Be a role model for students in human relations
1 (1.1)
 *Percentages total greater than 100 because respondents were allowed to give multiple answers.
 “Other” responses were written on survey forms by respondents.
Table 4
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Responses to “What Do You Consider to be MSUCOM's Expectations of You as a Clinical Faculty Member?” (N=89)

Response

Preceptors, No. (%)*
Provide Constructive Learning Opportunities for Students89 (100.0)
Mentor Students in Osteopathic Medicine's Philosophy of Patient Care 81 (91.0)
Allow Students to Interact With Diverse Patient Populations78 (87.6)
Conduct a Timely Constructive Evaluation of Each Student 67 (75.3)
Follow Education Guidelines Set by MSUCOM63 (70.8)
Abide by MSU Bylaws and Policies 54 (60.7)
Participate in Collaborative Clinical Research23 (25.8)
Other
□ Be a role model for students in human relations
1 (1.1)
 *Percentages total greater than 100 because respondents were allowed to give multiple answers.
 “Other” responses were written on survey forms by respondents.
×
As shown in Table 5, preceptors responding to the survey overwhelmingly agreed that program participation would have an impact on students' choice of medical specialties (85 [96%]). Furthermore, 70 preceptors (79%) agreed that this participation would later have an impact on students' decisions to take an AOA-approved osteopathic internship. Finally, 52 respondents (60%) agreed that participation in community-based rotations would later influence student decisions to provide healthcare in underserved populations. However, the present study did not investigate the reasons underlying these perceptions regarding students' career choices. Therefore, future research may wish to explore these perceptions. In particular, researchers may wish to investigate whether osteopathic medical students share their preceptors' opinions. 
Table 5
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Responses to Statements About Influence of Community-Based Rotations on Osteopathic Medical Students' Choices (N=89)

Statement/Response

Preceptors, No. (%)*
Rotations Will Influence Students' Choices of Specialties
□ Strongly agree 46 (51.7)
□ Agree39 (43.8)
□ Disagree 0 (0)
□ Undecided4 (4.5)
Rotations Will Influence Students' Decisions to Undertake Osteopathic Internships
□ Strongly agree37 (41.5)
□ Agree 33 (37.1)
□ Disagree1 (1.1)
□ Undecided 18 (20.2)
Rotations Will Influence Students' Decisions to Provide Care for Underserved Populations
□ Strongly agree 23 (25.8)
□ Agree30 (33.7)
□ Disagree 6 (6.7)
□ Undecided
31 (34.8)
 *Percentages do not total 100 because of rounding.
Table 5
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Responses to Statements About Influence of Community-Based Rotations on Osteopathic Medical Students' Choices (N=89)

Statement/Response

Preceptors, No. (%)*
Rotations Will Influence Students' Choices of Specialties
□ Strongly agree 46 (51.7)
□ Agree39 (43.8)
□ Disagree 0 (0)
□ Undecided4 (4.5)
Rotations Will Influence Students' Decisions to Undertake Osteopathic Internships
□ Strongly agree37 (41.5)
□ Agree 33 (37.1)
□ Disagree1 (1.1)
□ Undecided 18 (20.2)
Rotations Will Influence Students' Decisions to Provide Care for Underserved Populations
□ Strongly agree 23 (25.8)
□ Agree30 (33.7)
□ Disagree 6 (6.7)
□ Undecided
31 (34.8)
 *Percentages do not total 100 because of rounding.
×
The expectations that preceptors had for the MSUCOM Family Medicine Preceptorship Program are reported in Table 6. These responses reveal a mixture of expectations regarding the academic and clinical preparation of MSUCOM students, as well as expected professional benefits. 
Table 6
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Responses to “What Expectations Do You Have of MSUCOM?” (N=89)

Response

Preceptors, No. (%)*
▪ Adequate Preclinical Preparation of Students79 (88.8)
▪ CME Credit for Clinical Teaching 58 (65.2)
▪ Timely Feedback Regarding Student Evaluations31 (34.8)
▪ Faculty Development Opportunities 25 (28.1)
▪ Easy Access to Appropriate Program Staff23 (25.8)
▪ Free Access to Lecture Programs for CME Credit 23 (25.8)
▪ Standardization of Students' Experiences in Clinical Settings22 (24.7)
▪ Opportunities for Research Collaboration 15 (16.8)
▪ Professional Recognition/Awards11 (12.3)
▪ Financial Remuneration 4 (4.5)
▪ Other
□ Consideration if full-time professorship becomes available 1 (1.1)
□ E-mail access and use of MSU outdoor pool1 (1.1)
□ Help in advancing to associate clinical professor 1 (1.1)
□ More flexibility in scheduling1 (1.1)
□ More information regarding expectations of preceptors 1 (1.1)
 Abbreviation: CME, continuing medical education.
 *Percentages total greater than 100 because respondents were allowed to give multiple answers.
 “Other” responses were written on survey forms by respondents.
Table 6
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Responses to “What Expectations Do You Have of MSUCOM?” (N=89)

Response

Preceptors, No. (%)*
▪ Adequate Preclinical Preparation of Students79 (88.8)
▪ CME Credit for Clinical Teaching 58 (65.2)
▪ Timely Feedback Regarding Student Evaluations31 (34.8)
▪ Faculty Development Opportunities 25 (28.1)
▪ Easy Access to Appropriate Program Staff23 (25.8)
▪ Free Access to Lecture Programs for CME Credit 23 (25.8)
▪ Standardization of Students' Experiences in Clinical Settings22 (24.7)
▪ Opportunities for Research Collaboration 15 (16.8)
▪ Professional Recognition/Awards11 (12.3)
▪ Financial Remuneration 4 (4.5)
▪ Other
□ Consideration if full-time professorship becomes available 1 (1.1)
□ E-mail access and use of MSU outdoor pool1 (1.1)
□ Help in advancing to associate clinical professor 1 (1.1)
□ More flexibility in scheduling1 (1.1)
□ More information regarding expectations of preceptors 1 (1.1)
 Abbreviation: CME, continuing medical education.
 *Percentages total greater than 100 because respondents were allowed to give multiple answers.
 “Other” responses were written on survey forms by respondents.
×
Seventy-nine survey respondents (89%) expected that MSUCOM would provide them with students who had adequate preclinical preparation. Smaller numbers of respondents expected timely feedback regarding student evaluations (31 [35%]) and standardization of students' experiences in clinical settings (22 [25%]). 
Eighty-one responding preceptors (91%) noted that they expected to be provided with CME credit for clinical teaching or free access to lecture programs that provide additional CME credit. Twenty-five respondents (28%) expected to have faculty-development opportunities offered to them, and 23 (26%) expected easy access to program staff. Few of the respondents expected to receive opportunities for research collaboration (15 [17%]), to receive professional recognition or awards (11 [12%]), or to be financially remunerated (4 [5%]). 
Comment
For more than 30 years, FCM at MSUCOM has administered the Family Medicine Preceptorship Program, the required first set of core clinical experiences for all MSUCOM students. These experiences take place in community-based clinical settings within the state. The MSUCOM Family Medicine Preceptorship Program spans both semesters of the academic year, with each student assigned to one preceptor during each semester.6 
The MSUCOM Family Medicine Preceptorship Program is reflective of traditions within the osteopathic medical profession. Since the establishment of the first school of osteopathic medicine (the American School of Osteopathy in Kirksville, Mo) by Andrew Taylor Still, MD, DO, in 1892, the profession has been characterized by a large proportion of osteopathic physicians practicing primary care medicine, engaging in community-based clinical training of future physicians, and caring for medically underserved populations.8-10 
Every year since 1999, in the annual rankings of medical schools by US News & World Report,11 MSUCOM has been among the top 10 medical schools for primary care medicine—the only COM to receive this distinction. We, most of whom are faculty members at MSUCOM, attribute this national recognition to a number of factors representative of the philosophy of osteopathic medicine, including MSUCOM's leadership in providing osteopathic medical students with training in primary care and with outstanding graduate medical education in osteopathic hospitals.12,13 In addition, a high percentage of MSUCOM alumni are committed to the importance of primary care in medically underserved communities (Table 7).12,13 
Table 7
Michigan State University College of Osteopathic Medicine Family Medicine Graduates in American Osteopathic Association–Approved Osteopathic Internships and Residencies and in Medically Underserved Communities *


Graduation Year

Internship/Residency Category
1999
2000
2001
2002
2003
2004
2005
Annual Mean
Graduation Class Size, No.131107120120125139125124
Graduates, No. (%)
□ Osteopathic family practice internships63 (48.1)56 (52.3)66 (55.0)54 (45.0)40 (32.0)31 (22.3)44 (35.0)51 (41.4)
□ Osteopathic rotating internships 42 (32.0) 24 (22.4) 30 (25.3) 38 (31.7) 41 (32.8) 66 (47.5) 32 (26.0) 38 (31.1)
□ Osteopathic special-emphasis/specialty-tracked internships13 (10.0)11 (10.6)18 (15.2)20 (16.5)39 (31.2)21 (15.0)40 (31.7)23 (18.6)
□ Osteopathic residencies 118 (90.1) 99 (92.4) 112 (93.6) 113 (94.2) 120 (96.0) 127 (91.7) 116 (92.7) 115 (93.0)
□ Practice in medically underserved communities
14 (10.7)
21 (19.6)
9 (7.4)
12 (10.0)
19 (14.9)
15 (10.5)
28 (22.4)
17 (13.6)
 *Table based largely on data obtained by the Michigan State University College of Osteopathic Medicine (MSUCOM) Office of Student Affairs, Office of External and Alumnae Programs, and Office of the Statewide Campus System, and the American Osteopathic Association's Intern/Resident Registration Program (AOA “Match”).
 Data based on self-reported information from MSUCOM graduates.
 Data obtained by cross-referencing residency locations with United States Census Bureau tract numbers for medically underserved communities.
Table 7
Michigan State University College of Osteopathic Medicine Family Medicine Graduates in American Osteopathic Association–Approved Osteopathic Internships and Residencies and in Medically Underserved Communities *


Graduation Year

Internship/Residency Category
1999
2000
2001
2002
2003
2004
2005
Annual Mean
Graduation Class Size, No.131107120120125139125124
Graduates, No. (%)
□ Osteopathic family practice internships63 (48.1)56 (52.3)66 (55.0)54 (45.0)40 (32.0)31 (22.3)44 (35.0)51 (41.4)
□ Osteopathic rotating internships 42 (32.0) 24 (22.4) 30 (25.3) 38 (31.7) 41 (32.8) 66 (47.5) 32 (26.0) 38 (31.1)
□ Osteopathic special-emphasis/specialty-tracked internships13 (10.0)11 (10.6)18 (15.2)20 (16.5)39 (31.2)21 (15.0)40 (31.7)23 (18.6)
□ Osteopathic residencies 118 (90.1) 99 (92.4) 112 (93.6) 113 (94.2) 120 (96.0) 127 (91.7) 116 (92.7) 115 (93.0)
□ Practice in medically underserved communities
14 (10.7)
21 (19.6)
9 (7.4)
12 (10.0)
19 (14.9)
15 (10.5)
28 (22.4)
17 (13.6)
 *Table based largely on data obtained by the Michigan State University College of Osteopathic Medicine (MSUCOM) Office of Student Affairs, Office of External and Alumnae Programs, and Office of the Statewide Campus System, and the American Osteopathic Association's Intern/Resident Registration Program (AOA “Match”).
 Data based on self-reported information from MSUCOM graduates.
 Data obtained by cross-referencing residency locations with United States Census Bureau tract numbers for medically underserved communities.
×
The present study was initiated in 2001 to gain greater insight into the motivations, expectations, and other factors that influence community-based osteopathic physicians in family practice to serve as volunteer preceptors. We also examined the influence of participation in community-based rotations on the career choices of osteopathic medical students. Our findings regarding students' choices are similar to those previously identified at UNTHSC/TCOM. At that institution, researchers2 concluded that the specialties pursued by osteopathic medical students may be the result of experiences gained during their participation in the program. 
The present study did not analyze why MSUCOM and the osteopathic medical profession produce large numbers of primary care physicians. Nevertheless, we did find that MSUCOM community-based faculty members believe that their roles are integral to this self-selection process. A future research project could further validate this observation. Our findings also suggest that this belief motivates MSUCOM preceptors to volunteer their time and resources to provide outstanding clinical experiences for future generations of osteopathic physicians. In so doing, osteopathic physicians perpetuate a culture of community service within the profession. 
Although there have been few other studies focusing on community-based osteopathic physicians' participation in preceptorship programs, a number of previous studies have examined community-based clinical rotations, the roles and responsibilities of volunteer preceptors, and preceptors' contributions to the training and professional growth of medical students within the wider healthcare field.1,10,14-17 
In 1999, Single et al14 reported on their survey of 184 community-based family practice physicians, internists, obstetrician/gynecologists, and pediatricians affiliated with a large public teaching hospital. The purpose of that survey was to determine the factors that may influence physicians' decisions to serve as preceptors. Single et al14 suggested that survey respondents preferred nonmonetary compensation, rating the receipt of CME credit as the most favorable incentive for functioning as preceptors. 
A study reported in 1996 by Foley et al15 included a survey of physicians who were part of the 320-preceptor Longitudinal Primary Care Program at the University of Illinois College of Medicine at Chicago. Their study found that the predominant motivations given by preceptors for participating in the program related to contributing to the development of young medical professionals, encouraging students to choose their specialties, and giving something back to the medical profession. These findings are supported by the results of the IGC Project,1 as previously discussed. 
The present study can be compared with the IGC Project1 in a number of ways. Like the IGC Project,1 which classified the rewards of community-based faculty into affective, cognitive, and tangible categories, the present study also suggests that affective rewards are important to community-based preceptors. As noted in Table 3, far more survey respondents were motivated to participate in the program by a belief that they were contributing to the training of future osteopathic physicians (99%) than by any other reason given. 
Similarly, in his analysis of the state of primary care medicine in 2002, Schroeder18 concluded that many physicians have a sense of responsibility to prepare future physicians, and that academic medicine has an important stake in what he described as the “imperiled state of generalism.” He further maintained that “... academic medicine's implicit social contract to educate the physicians of tomorrow carries with it the obligation to train generalist physicians.”18 
The cognitive rewards valued by more than half the IGC Project preceptors included the “refreshing” influence of students on physician knowledge and current standards of practice.1 By contrast, a small percentage (2%) of respondents in the present MSUCOM survey noted this particular incentive for participation (Table 3). Although 72% of respondents acknowledged a motivation to participate in the program to “share knowledge,” this response was not indicative of a two-way exchange as in the IGC Project report.1 Furthermore, though all of the MSUCOM respondents reported their belief that the college expects them to “provide constructive learning opportunities for students” (Table 4), they did not report this factor as a cognitive reward or motivation for their participation in the program. 
Silverberg19 concluded in 1998 that volunteer clinical faculty are involved in preceptorship programs for a number of cognitive reasons, including gaining exposure to current concepts being taught in medical schools about family practice and the basic sciences. Preceptors have motivations, according to Silverberg,19 to improve their professional skills and to stay current regarding medicine and science—factors listed in the study as physician benefits of the office-based preceptorship. These conclusions were similar to those reported in the IGC Project.1 
In a final comparison between the IGC Project1 and the present survey, the tangible rewards reported by preceptors in the IGC Project (eg, hassle-free on-campus parking, library privileges, CME credit) appeared to be less important motivations for the MSUCOM preceptors, though these rewards were still expected. For example, findings reported in Table 6 show that 65% of MSUCOM respondents expected CME credits for clinical teaching, while 26% expected free access to lecture programs that provide CME credits. Only 1 respondent indicated an expectation that MSUCOM would provide free access to e-mail and outdoor pool facilities. 
Studies that survey allopathic physician preceptors are useful for comparison. In 1997, Levy et al20 reported on a survey of 130 family practice physicians serving as preceptors with the University of Iowa College of Medicine in Iowa City. In 2003, Starr et al21 reported on a survey of 35 experienced community-based preceptors. According to both research teams,20,21 though many community-based faculty members associated with allopathic medical schools are paid for their teaching services, the preceptors responding to these surveys still considered nonmonetary rewards to be important. 
In a survey of 112 community-based family practice preceptors with the University of North Carolina at Chapel Hill, Langlois22 reported that these physicians ranked CME credits for teaching, financial stipends, and free textbooks as highest in value for participation in the university's preceptorship program. These findings, noted Langlois,22 support the concept of assigning financial value to preceptors' participation. 
Fulkerson and Wang-Cheng23 reported that 84% of 120 community-based physicians in a network of preceptors in Milwaukee, Wis, indicated that the rewards they preferred most were clinical faculty status, CME credit, bookstore discounts, computer networking, and workshops for improving skills in clinical teaching.23 These findings validate the concepts of institutional involvement, academic respect, and recognition as rewards to preceptors for voluntary participation. 
Finally, an Australian study of 134 nurse preceptors involved in an undergraduate nursing course by Usher et al24 found that some of the same affective, cognitive, and tangible rewards that motivate physician preceptors1 were also motivations for the nurses to volunteer their time and resources. Usher et al24 reported that intrinsic and extrinsic rewards for nurse preceptors included the opportunity to teach students and influence the practice of nursing, to increase their own knowledge of nursing, and to stimulate their thinking. These observations are consistent with our findings for osteopathic physician preceptors at MSUCOM. 
The results of the present study indicate the importance of recognizing that the training of future osteopathic physicians needs to be a collaborative effort between COMs and community-based professional resources that are available to osteopathic medical students, including preceptors in family practice settings. The value of the contributions of such preceptors to MSUCOM are reflected in the rates at which MSUCOM graduates select primary care specialties (58%), undertake graduate medical education in Michigan (86%), and establish private medical practices in Michigan (64%).12,13 
Conclusions
Many studies of physician preceptorships—including the present study of osteopathic physicians in the MSUCOM Family Medicine Preceptorship Program—reveal that, the majority of physicians are motivated to participate in preceptorships by intrinsic, altruistic factors rather than extrinsic, self-concerned factors. In fact, an overwhelming majority of preceptors surveyed for our study expressed a preference for nonmonetary rewards, such as the opportunity to promote the philosophy of osteopathic medicine, instead of direct financial compensation or other professional gains. 
The importance of “giving back” from one generation to the next has long been cited anecdotally as a common feature of the osteopathic medical profession. This commonly held perception is worthy of future investigation so that it might be empirically verified. We believe that a major mechanism by which osteopathic physicians can give back to their profession is by serving as volunteer community-based faculty for COMs, either as preceptors or as unpaid adjunct clinical faculty members. 
The training of future osteopathic physicians should be a collaborative effort between academic institutions and community-based professional resources, including support and instruction from preceptors in family practice clinical settings. 
 This study was financially supported by a contract from the Michigan Department of Community Health and a grant from the US Department of Health and Human Services (HHS), Health Resources and Services Administration, Academic Administrative Units in Primary Care (HHS Grant No. 2D54 HP 00101-06).
 
We thank Dean Emeritus Myron S. Magen, DO, and Robert C. Ward, DO, for their gracious support of this project in providing an oral history of the MSUCOM Family Medicine Preceptorship Program. We also thank the MSUCOM Office of Student Affairs, Office of External and Alumnae Programs, and Office of the Statewide Campus System for providing data on recent graduating classes of MSUCOM. 
Ullian JA, Shore WB, First LR. What did we learn about the impact on community-based faculty? Recommendations for recruitment, retention, and rewards. Acad Med. 2001;76(4 suppl):S78-S85.
Zachary TE, Smith-Barbaro P. Values of a family medicine preceptorship/clerkship to students, preceptors, and communities: observations from a 25-year-old program. Fam Med. 2001;33:500-501.
Brief History of the Michigan State University College of Osteopathic Medicine page. Michigan State University College of Osteopathic Medicine Web site. July 14, 2008. Available at: http://www.com.msu.edu/osteomed/history.html. Accessed September 22, 2008.
Magen MS, Kabara J, Brooker F. Application to the Division of Educational and Research Facilities for a Federal Construction Grant [grant application]. Pontiac, Mich: Michigan College of Osteopathic Medicine; 1970.
Department of Family and Community Medicine, Michigan State University College of Osteopathic Medicine. Departmental Criteria for Preceptor/Senior Partner Appointment (Assistant Clinical Professor). East Lansing, Mich: Michigan State University College of Osteopathic Medicine; 1999.
Department of Family and Community Medicine, Michigan State University College of Osteopathic Medicine. Department of Family and Community Medicine Preceptorship Program Policies, Regulations, Evaluations, and Records. East Lansing, Mich: Michigan State University College of Osteopathic Medicine; 1999.
American Osteopathic Association. Continuing Medical Education Guide for Osteopathic Physicians—2007-2009. Chicago, Ill: American Osteopathic Association; December 2006. Available at: https://www.do-online.org/pdf/cme_guidemain07-09.pdf. Accessed September 22, 2008.
Teitelbaum HS. Osteopathic Medical Education in the United States: Improving the Future of Medicine. A report jointly sponsored by the American Association of Colleges of Osteopathic Medicine and the American Osteopathic Association. Washington, DC; June 2005. Available at: http://osteopathicresearch.net/data/special-report.pdf. Accessed January 2, 2008.
American Osteopathic Association Commission on Osteopathic College Accreditation—Executive Committee and the Subcommittee on Osteopathic Educational Elements. Report of the AOA Commission on Osteopathic College Accreditation—Executive Committee and the Subcommittee on Osteopathic Educational Elements: Resolution 274 (A/2004) Match participation and rotations with osteopathic physicians, proposed requirements for osteopathic. Paper adopted at: Annual Meeting of the AOA House of Delegates; July 15-17 , 2005; Chicago, Ill.
Peters AS, Clark-Chiarelli N, Block SD. Comparison of osteopathic and allopathic medical schools' support for primary care. J Gen Intern Med. 1999;14:730-739. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=10632817. Accessed September 22, 2008.
Complete guide to medical schools; 2007. US News & World Report Web site. Available at: http://grad-schools.usnews.rankingsandreviews.com/usnews/edu/grad/rankings/med/medindex_brief.php. Accessed January 2, 2008.
Kilbourn, S. Self-Report of MSUCOM Alumnae (1999-2006) on Their Practice Types and Locations. East Lansing, Mich: Office of External and Alumnae Programs, Michigan State University College of Osteopathic Medicine; January 2006.
Cummings M. Profiles of the Statewide Campus System Internship and Residency Programs 2000-2006. East Lansing, Mich: Office of the Statewide Campus System, Michigan State University College of Osteopathic Medicine; January 2006.
Single PB, Jaffe A, Schwartz R. Evaluating programs for recruiting and retaining community faculty. Fam Med. 1999;31:114-121.
Foley R, Yonke A, Smith J, Roe B, Vance J. Recruiting and retaining volunteer community preceptors. Acad Med. 1996;71:460-463.
Mann KV, Holmes DB, Hayes VM, Burge FI, Viscount PW. Community family medicine teachers' perceptions of their teaching role. Med Educ. 2001;35:278-285.
Usatine RP, Hodgson CS, Marshall ET, Whitman DW, Slavin SJ, Wilkes MS. Reactions of family medicine community preceptors to teaching medical students. Fam Med. 1995;27:566-570.
Schroeder SA. Primary care at a crossroads. Acad Med. 2002;77:767-773.
Silverberg LI. Office-based preceptorship: a creative approach to a learning and growth experience. J Am Osteopath Assoc. 1998;98:642-646.
Levy BT, Gjerde CL, Albrecht LA. The effects of precepting on and the support desired by community-based preceptors in Iowa. Acad Med. 1997;72:382-384.
Starr S, Ferguson WJ, Haley HL, Quirk M. Community preceptors' views of their identities as teachers. Acad Med. 2003;78:820-825.
Langlois JP. Support of community preceptors: what do they need? Fam Med. 1995;27:641-645.
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Table 1
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Characteristics of Respondents (N=89)

Characteristic

No. (%)*
Age, y
□ 30-39 3 (3.4)
□ 40-4935 (39.3)
□ 50-59 34 (38.2)
□ ≥6017 (19.1)
Sex
□ Men70 (78.7)
□ Women 19 (21.3)
Race
□ African American 1 (1.1)
□ Asian American1 (1.1)
□ White 84 (94.4)
□ East Indian/Caribbean1 (1.1)
□ Hispanic 1 (1.1)
□ Native American1 (1.1)
Graduation Year
□ Before 19602 (2.2)
□ 1960-1969 17 (19.1)
□ 1970-197927 (30.3)
□ 1980-1989 37 (41.6)
□ 1990-19996 (6.7)
Years in Practice
□ 0-94 (4.5)
□ 10-19 34 (38.2)
□ 20-2929 (32.6)
□ 30-39 18 (20.2)
□ ≥404 (4.5)
Practice Setting
□ Community health service1 (1.1)
□ Group 27 (30.3)
□ Hospital9 (10.1)
□ Partnership 6 (6.7)
□ Private46 (51.7)
Practice Location
□ Inner city5 (5.6)
□ Metropolitan 11 (12.3)
□ Rural25 (28.1)
□ Suburban 48 (53.9)
Practice in Underserved Area
□ Yes 14 (15.7)
□ No72 (80.9)
□ Uncertain/varies
3 (3.4)
 *Some percentages do not total 100 because of rounding.
Table 1
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Characteristics of Respondents (N=89)

Characteristic

No. (%)*
Age, y
□ 30-39 3 (3.4)
□ 40-4935 (39.3)
□ 50-59 34 (38.2)
□ ≥6017 (19.1)
Sex
□ Men70 (78.7)
□ Women 19 (21.3)
Race
□ African American 1 (1.1)
□ Asian American1 (1.1)
□ White 84 (94.4)
□ East Indian/Caribbean1 (1.1)
□ Hispanic 1 (1.1)
□ Native American1 (1.1)
Graduation Year
□ Before 19602 (2.2)
□ 1960-1969 17 (19.1)
□ 1970-197927 (30.3)
□ 1980-1989 37 (41.6)
□ 1990-19996 (6.7)
Years in Practice
□ 0-94 (4.5)
□ 10-19 34 (38.2)
□ 20-2929 (32.6)
□ 30-39 18 (20.2)
□ ≥404 (4.5)
Practice Setting
□ Community health service1 (1.1)
□ Group 27 (30.3)
□ Hospital9 (10.1)
□ Partnership 6 (6.7)
□ Private46 (51.7)
Practice Location
□ Inner city5 (5.6)
□ Metropolitan 11 (12.3)
□ Rural25 (28.1)
□ Suburban 48 (53.9)
Practice in Underserved Area
□ Yes 14 (15.7)
□ No72 (80.9)
□ Uncertain/varies
3 (3.4)
 *Some percentages do not total 100 because of rounding.
×
Table 2
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Academic Credentials of Respondents (N=89)

Academic Credentials

No. (%)*
Clinical Faculty Title
□ Assistant clinical professor 44 (49.4)
□ Associate clinical professor31 (34.8)
□ Clinical instructor 8 (9.0)
□ Clinical professor2 (2.2)
□ Unspecified 4 (4.5)
Time in Clinical Faculty, y
□ 0-5 10 (11.2)
□ 6-1031 (34.8)
□ 11-15 16 (18.0)
□ 16-2013 (14.6)
□ 21-25 4 (4.5)
□ 26-308 (9.0)
□ ≥31 1 (1.1)
□ Unspecified6 (6.7)
Students Trained, Mean No. per Year
□ 05 (5.6)
□ 1 8 (9.0)
□ 216 (18.0)
□ 3 14 (15.7)
□ 424 (26.9)
□ 5 6 (6.7)
□ 68 (9.0)
□ ≥7
8 (9.0)
 *Percentages do not total 100 because of rounding.
 All interns and residents in the Michigan State University College of Osteopathic Medicine Statewide Campus System/Osteopathic Postdoctoral Training Institution are given the rank of clinical instructor within their specialty departments.
Table 2
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Academic Credentials of Respondents (N=89)

Academic Credentials

No. (%)*
Clinical Faculty Title
□ Assistant clinical professor 44 (49.4)
□ Associate clinical professor31 (34.8)
□ Clinical instructor 8 (9.0)
□ Clinical professor2 (2.2)
□ Unspecified 4 (4.5)
Time in Clinical Faculty, y
□ 0-5 10 (11.2)
□ 6-1031 (34.8)
□ 11-15 16 (18.0)
□ 16-2013 (14.6)
□ 21-25 4 (4.5)
□ 26-308 (9.0)
□ ≥31 1 (1.1)
□ Unspecified6 (6.7)
Students Trained, Mean No. per Year
□ 05 (5.6)
□ 1 8 (9.0)
□ 216 (18.0)
□ 3 14 (15.7)
□ 424 (26.9)
□ 5 6 (6.7)
□ 68 (9.0)
□ ≥7
8 (9.0)
 *Percentages do not total 100 because of rounding.
 All interns and residents in the Michigan State University College of Osteopathic Medicine Statewide Campus System/Osteopathic Postdoctoral Training Institution are given the rank of clinical instructor within their specialty departments.
×
Table 3
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Responses to “What Motivated You to Become a Clinical Faculty Member for MSUCOM?” (N=89)

Response

Preceptors, No. (%)*
Contribute to Medical Education of Students88 (98.8)
Provide “Real-Life” Clinical Experiences to Students 69 (78.0)
Share Knowledge64 (72.0)
“Give Back” for My Training 63 (70.8)
Maintain the Osteopathic Medical Model of Clinical Training49 (55.1)
Obtain CME Credits for Teaching 31 (34.8)
Be Affiliated With MSU23 (25.8)
Obtain an Academic Title 8 (9.0)
Obtain Financial Rewards2 (2.2)
Other
□ Incentive to continue to learn and grow2 (2.2)
□ Enjoy camaraderie/company of students 1 (1.1)
□ Ensure survival of osteopathic physicians1 (1.1)
□ “Entice” students toward primary care 1 (1.1)
□ Obtain teaching tools for family practice residency1 (1.1)
□ Stay in touch with MSUCOM 1 (1.1)
□ Transitioning from private practice to academic medicine1 (1.1)
 Abbreviation: CME, continuing medical education.
 *Percentages total greater than 100 because respondents were allowed to give multiple answers.
 “Other” responses were written on survey forms by respondents.
Table 3
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Responses to “What Motivated You to Become a Clinical Faculty Member for MSUCOM?” (N=89)

Response

Preceptors, No. (%)*
Contribute to Medical Education of Students88 (98.8)
Provide “Real-Life” Clinical Experiences to Students 69 (78.0)
Share Knowledge64 (72.0)
“Give Back” for My Training 63 (70.8)
Maintain the Osteopathic Medical Model of Clinical Training49 (55.1)
Obtain CME Credits for Teaching 31 (34.8)
Be Affiliated With MSU23 (25.8)
Obtain an Academic Title 8 (9.0)
Obtain Financial Rewards2 (2.2)
Other
□ Incentive to continue to learn and grow2 (2.2)
□ Enjoy camaraderie/company of students 1 (1.1)
□ Ensure survival of osteopathic physicians1 (1.1)
□ “Entice” students toward primary care 1 (1.1)
□ Obtain teaching tools for family practice residency1 (1.1)
□ Stay in touch with MSUCOM 1 (1.1)
□ Transitioning from private practice to academic medicine1 (1.1)
 Abbreviation: CME, continuing medical education.
 *Percentages total greater than 100 because respondents were allowed to give multiple answers.
 “Other” responses were written on survey forms by respondents.
×
Table 4
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Responses to “What Do You Consider to be MSUCOM's Expectations of You as a Clinical Faculty Member?” (N=89)

Response

Preceptors, No. (%)*
Provide Constructive Learning Opportunities for Students89 (100.0)
Mentor Students in Osteopathic Medicine's Philosophy of Patient Care 81 (91.0)
Allow Students to Interact With Diverse Patient Populations78 (87.6)
Conduct a Timely Constructive Evaluation of Each Student 67 (75.3)
Follow Education Guidelines Set by MSUCOM63 (70.8)
Abide by MSU Bylaws and Policies 54 (60.7)
Participate in Collaborative Clinical Research23 (25.8)
Other
□ Be a role model for students in human relations
1 (1.1)
 *Percentages total greater than 100 because respondents were allowed to give multiple answers.
 “Other” responses were written on survey forms by respondents.
Table 4
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Responses to “What Do You Consider to be MSUCOM's Expectations of You as a Clinical Faculty Member?” (N=89)

Response

Preceptors, No. (%)*
Provide Constructive Learning Opportunities for Students89 (100.0)
Mentor Students in Osteopathic Medicine's Philosophy of Patient Care 81 (91.0)
Allow Students to Interact With Diverse Patient Populations78 (87.6)
Conduct a Timely Constructive Evaluation of Each Student 67 (75.3)
Follow Education Guidelines Set by MSUCOM63 (70.8)
Abide by MSU Bylaws and Policies 54 (60.7)
Participate in Collaborative Clinical Research23 (25.8)
Other
□ Be a role model for students in human relations
1 (1.1)
 *Percentages total greater than 100 because respondents were allowed to give multiple answers.
 “Other” responses were written on survey forms by respondents.
×
Table 5
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Responses to Statements About Influence of Community-Based Rotations on Osteopathic Medical Students' Choices (N=89)

Statement/Response

Preceptors, No. (%)*
Rotations Will Influence Students' Choices of Specialties
□ Strongly agree 46 (51.7)
□ Agree39 (43.8)
□ Disagree 0 (0)
□ Undecided4 (4.5)
Rotations Will Influence Students' Decisions to Undertake Osteopathic Internships
□ Strongly agree37 (41.5)
□ Agree 33 (37.1)
□ Disagree1 (1.1)
□ Undecided 18 (20.2)
Rotations Will Influence Students' Decisions to Provide Care for Underserved Populations
□ Strongly agree 23 (25.8)
□ Agree30 (33.7)
□ Disagree 6 (6.7)
□ Undecided
31 (34.8)
 *Percentages do not total 100 because of rounding.
Table 5
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Responses to Statements About Influence of Community-Based Rotations on Osteopathic Medical Students' Choices (N=89)

Statement/Response

Preceptors, No. (%)*
Rotations Will Influence Students' Choices of Specialties
□ Strongly agree 46 (51.7)
□ Agree39 (43.8)
□ Disagree 0 (0)
□ Undecided4 (4.5)
Rotations Will Influence Students' Decisions to Undertake Osteopathic Internships
□ Strongly agree37 (41.5)
□ Agree 33 (37.1)
□ Disagree1 (1.1)
□ Undecided 18 (20.2)
Rotations Will Influence Students' Decisions to Provide Care for Underserved Populations
□ Strongly agree 23 (25.8)
□ Agree30 (33.7)
□ Disagree 6 (6.7)
□ Undecided
31 (34.8)
 *Percentages do not total 100 because of rounding.
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Table 6
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Responses to “What Expectations Do You Have of MSUCOM?” (N=89)

Response

Preceptors, No. (%)*
▪ Adequate Preclinical Preparation of Students79 (88.8)
▪ CME Credit for Clinical Teaching 58 (65.2)
▪ Timely Feedback Regarding Student Evaluations31 (34.8)
▪ Faculty Development Opportunities 25 (28.1)
▪ Easy Access to Appropriate Program Staff23 (25.8)
▪ Free Access to Lecture Programs for CME Credit 23 (25.8)
▪ Standardization of Students' Experiences in Clinical Settings22 (24.7)
▪ Opportunities for Research Collaboration 15 (16.8)
▪ Professional Recognition/Awards11 (12.3)
▪ Financial Remuneration 4 (4.5)
▪ Other
□ Consideration if full-time professorship becomes available 1 (1.1)
□ E-mail access and use of MSU outdoor pool1 (1.1)
□ Help in advancing to associate clinical professor 1 (1.1)
□ More flexibility in scheduling1 (1.1)
□ More information regarding expectations of preceptors 1 (1.1)
 Abbreviation: CME, continuing medical education.
 *Percentages total greater than 100 because respondents were allowed to give multiple answers.
 “Other” responses were written on survey forms by respondents.
Table 6
Michigan State University College of Osteopathic Medicine Family Medicine Preceptorship Program Survey: Responses to “What Expectations Do You Have of MSUCOM?” (N=89)

Response

Preceptors, No. (%)*
▪ Adequate Preclinical Preparation of Students79 (88.8)
▪ CME Credit for Clinical Teaching 58 (65.2)
▪ Timely Feedback Regarding Student Evaluations31 (34.8)
▪ Faculty Development Opportunities 25 (28.1)
▪ Easy Access to Appropriate Program Staff23 (25.8)
▪ Free Access to Lecture Programs for CME Credit 23 (25.8)
▪ Standardization of Students' Experiences in Clinical Settings22 (24.7)
▪ Opportunities for Research Collaboration 15 (16.8)
▪ Professional Recognition/Awards11 (12.3)
▪ Financial Remuneration 4 (4.5)
▪ Other
□ Consideration if full-time professorship becomes available 1 (1.1)
□ E-mail access and use of MSU outdoor pool1 (1.1)
□ Help in advancing to associate clinical professor 1 (1.1)
□ More flexibility in scheduling1 (1.1)
□ More information regarding expectations of preceptors 1 (1.1)
 Abbreviation: CME, continuing medical education.
 *Percentages total greater than 100 because respondents were allowed to give multiple answers.
 “Other” responses were written on survey forms by respondents.
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Table 7
Michigan State University College of Osteopathic Medicine Family Medicine Graduates in American Osteopathic Association–Approved Osteopathic Internships and Residencies and in Medically Underserved Communities *


Graduation Year

Internship/Residency Category
1999
2000
2001
2002
2003
2004
2005
Annual Mean
Graduation Class Size, No.131107120120125139125124
Graduates, No. (%)
□ Osteopathic family practice internships63 (48.1)56 (52.3)66 (55.0)54 (45.0)40 (32.0)31 (22.3)44 (35.0)51 (41.4)
□ Osteopathic rotating internships 42 (32.0) 24 (22.4) 30 (25.3) 38 (31.7) 41 (32.8) 66 (47.5) 32 (26.0) 38 (31.1)
□ Osteopathic special-emphasis/specialty-tracked internships13 (10.0)11 (10.6)18 (15.2)20 (16.5)39 (31.2)21 (15.0)40 (31.7)23 (18.6)
□ Osteopathic residencies 118 (90.1) 99 (92.4) 112 (93.6) 113 (94.2) 120 (96.0) 127 (91.7) 116 (92.7) 115 (93.0)
□ Practice in medically underserved communities
14 (10.7)
21 (19.6)
9 (7.4)
12 (10.0)
19 (14.9)
15 (10.5)
28 (22.4)
17 (13.6)
 *Table based largely on data obtained by the Michigan State University College of Osteopathic Medicine (MSUCOM) Office of Student Affairs, Office of External and Alumnae Programs, and Office of the Statewide Campus System, and the American Osteopathic Association's Intern/Resident Registration Program (AOA “Match”).
 Data based on self-reported information from MSUCOM graduates.
 Data obtained by cross-referencing residency locations with United States Census Bureau tract numbers for medically underserved communities.
Table 7
Michigan State University College of Osteopathic Medicine Family Medicine Graduates in American Osteopathic Association–Approved Osteopathic Internships and Residencies and in Medically Underserved Communities *


Graduation Year

Internship/Residency Category
1999
2000
2001
2002
2003
2004
2005
Annual Mean
Graduation Class Size, No.131107120120125139125124
Graduates, No. (%)
□ Osteopathic family practice internships63 (48.1)56 (52.3)66 (55.0)54 (45.0)40 (32.0)31 (22.3)44 (35.0)51 (41.4)
□ Osteopathic rotating internships 42 (32.0) 24 (22.4) 30 (25.3) 38 (31.7) 41 (32.8) 66 (47.5) 32 (26.0) 38 (31.1)
□ Osteopathic special-emphasis/specialty-tracked internships13 (10.0)11 (10.6)18 (15.2)20 (16.5)39 (31.2)21 (15.0)40 (31.7)23 (18.6)
□ Osteopathic residencies 118 (90.1) 99 (92.4) 112 (93.6) 113 (94.2) 120 (96.0) 127 (91.7) 116 (92.7) 115 (93.0)
□ Practice in medically underserved communities
14 (10.7)
21 (19.6)
9 (7.4)
12 (10.0)
19 (14.9)
15 (10.5)
28 (22.4)
17 (13.6)
 *Table based largely on data obtained by the Michigan State University College of Osteopathic Medicine (MSUCOM) Office of Student Affairs, Office of External and Alumnae Programs, and Office of the Statewide Campus System, and the American Osteopathic Association's Intern/Resident Registration Program (AOA “Match”).
 Data based on self-reported information from MSUCOM graduates.
 Data obtained by cross-referencing residency locations with United States Census Bureau tract numbers for medically underserved communities.
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