In recent years, there has been a shift in emphasis of undergraduate medical education from the inpatient to outpatient/primary care-based settings (1
). As a result, almost all medical schools in the United States and Canada provide an office-based primary care experience as a part of their core clerkships (4
). Medical students benefit greatly from this experience as they are provided the opportunity to expand not only their knowledge of patient care, but also formulate an understanding of the healthcare delivery system including the medical home model and the business of medicine (2
). Accordingly, community-based, outpatient experiences have been identified as a requirement of several accreditation and professional organizations, such as the Association of American Medical Colleges (AAMC) (7
), Liaison Committee on Medical Education (LCME) (8
), and the Council on Medical Student Education in Pediatrics (COMSEP) (9
Although there is pressure from the AAMC, LCME, and COMSEP to provide community-based rotations for medical students, there are several challenges to overcome. Among the greatest challenges are recruitment and retention of faculty preceptors within the community (9
). Specific barriers include changes in the healthcare system and impediments to clinical productivity resulting in the potential for reduced reimbursement (11
). With the high demands on community-based physicians, preceptors struggle with finding time for teaching because of the constraints related to managed care and lack of flexibility in scheduling (9
). Because of these barriers, previous studies have attempted to identify motivations of community faculty in an attempt to assist in future recruitment and retention.
Previous literature has identified intrinsic and extrinsic motivators that encourage physicians to serve as preceptors. Intrinsic motivators include satisfaction from sharing knowledge, demonstrating the primary care model, interacting with other volunteer faculty, and directly participating in the education of future physicians (4
). Extrinsic motivators include direct financial compensation, awards, recognition, and access to university resources (22
). Several studies have demonstrated the superiority of intrinsic over extrinsic motivators in the recruitment and retention of community preceptors (4
While prior studies have identified reasons why active preceptors (APs) choose to volunteer their time (11
), there is only one study which explicitly surveyed inactive preceptors (IPs) to identify barriers and compare this group to their active peers (26
). That study surveyed family medicine physicians in Canada and identified practice-related constraints and unawareness of teaching opportunities as important barriers and found that graduates of the local medical school and/or residency program were more likely to volunteer their time. To date, no previous studies have sought to identify differences in preferred incentives among currently active and currently IPs.
The purpose of this study was to survey all community-based pediatric physicians surrounding an urban academic center in the United States to determine why some pediatric physicians volunteer to work with medical students and others do not. Our research question was; what differences exist between APs and IPs of third-year medical students rotating through pediatrics? We sought to specifically identify differences between the two groups in terms of (1
) demographic variables (2
), teaching responsibilities, and (3
) incentives/rewards. We also sought to identify perceived barriers among IPs. For the purpose of this study, we defined APs as those who had precepted at least one M3 student over the preceding 12 months.