FM Residency Program: Guidelines for Selection of Primary Preceptors

Background

Primary Preceptor practices are the residents’ home base and the main educational exposure to family practice.  It is important to select preceptors and practice settings providing excellent role models with the necessary educational exposures.  The CFPC ‘Medical Home’ serves as our model practice outline.  It is understood that ‘no practice is perfect’ but we hope to identify practices that share this philosophy, and are committed to the ongoing process of review and improvement.  Where educational gaps arise, it is expected that preceptors are committed to assist residents in achieving the necessary exposure.

Practice Selection Criteria

Based on the CFPC Medical Home model, the key features to consider when considering a preceptor practice includes the following:

Practice Feature	Program Standard
Personal Family Physician	Provision of coordinated and comprehensive care across life span to an identified population of patients. Ideally, a patient roster is in place as evidence of a commitment to this model of practice.
Patient Centred	Embraces a patient-centred philosophy of care manifesting in practice as a commitment to patients and families as active participants in their care, access to medical records, patient education and self-management approaches, and active attempts to receive patient feedback.
Comprehensive Care	Comprehensiveness is a practice-based concept and is described according to five domains: ·        Care of patients across the life cycle (maternal/newborn, child and adolescent, adult, elderly, palliative) ·        Care across clinical settings (office, home, LTC, hospital) ·        Spectrum of clinical responsibilities ·        Care of marginalized/disadvantaged patients ·        Procedural medicine
Team-Based	The practice supports a collaborative care approach to care and the resident will have an opportunity to practice in an inter-professional environment in the office and/or community setting. Shared-care with family physicians with special interests or skills, along with other medical specialists is encouraged and may be necessary for the provision of comprehensive care.
Access	The practice will model accessible care, including after-hours coverage and the resident will participate in this arrangement. Practice has a strategy for access to same-day appointments with the patient’s personal family physician or other appropriate team members.  Practice size should be appropriate to ensure timely access to appointments and safe, high-quality care for each patient and the practice population being served.
Continuity	Residents are able to follow a group of same patients over time and the practice is committed able to support their continuous involvement.
EMR and Health Information	An electronic medical records (EMR) is in use
Effective Governance	The practice is well organized and residents will have opportunities to be involved in managing the practice
Evaluation	The practice conducts ongoing evaluation of the effectiveness of its services as part of its commitment to continuous quality improvement (CQI). There will be opportunities for a resident to engage in practice-based CQI activities.

Preceptor Selection Criteria

To be considered for the role of Primary preceptor, the following must apply:

• Is a certificant of the College of Family Physicians holding an active membership (CCFP)
• Has, or is eligible and willing to obtain a McMaster University faculty appointment
• In practice for at least 3-5  years unless functioning as a co-preceptor with experienced faculty
• Is an experienced clinical teacher with strong student/resident evaluations
• Willing and able to attend required meetings and faculty development activities
• Is able to install viewing equipment in the practice (with financial support from the Department)

Selection Process

Primary preceptors will be considered based on a recommendation from their local family medicine (FM) Site Director.  Prospective preceptors will be asked to complete a Preceptor Information Form and to make themselves available for a site visit.  In determining the readiness of a family physician to serve in the role of a PG Primary Preceptor there will be an initial assessment of the preceptor’s educational track record and a review of their practice arrangements and location.  The final determination will be based on the following sources of information:

• Consultation with the local FM Site Director and Education Associate
• Review of available teacher evaluations
• Review of Preceptor Information Form (completed in advance of site visit)
• Practice site visit typically conducted by the Site Director and/or delegate. The site visit will include a tour of the practice and a meeting with the proposed preceptor, typically requiring at least one hour. The site visit will also serve as a starting point to identify preceptor interests, areas of expertise, and faculty development planning.

The Site Director will make the final determination, based on consultation with the site Education Committee and/or the Program Director when required.

We would also strongly encourage these preceptors/supervisor to continue to take pre-clerkship, clerkship and elective learners as there is a “resident as teaching” component to the resident’s curriculum and they will need to have access/exposure to other learners during their tenure in your practice.

 

Approved by REC:  January 20, 2015

Draft:  July, 2016