Building the foundation of clinical training: a mixed-methods study of pre-clerkship clinical preceptors and retention

PURPOSE: Preceptorship is a key component of medical student clinical experience. Demand for clinical preceptors is increasing. An updated understanding of why preceptors continue or discontinue these roles, particularly in pre-clerkship settings, is needed to optimize recruitment and retention. To inform recruitment and retention of pre-clerkship preceptors at a large public medical school, the authors examined preceptor motivations for precepting, reasons for leaving, and factors influencing a successful preceptorship. METHOD: The authors conducted an explanatory sequential mixed-methods study (survey followed by semi-structured interviews) between September 2024 and December 2024. Participants were current and former pre-clerkship preceptors from 57 clinical sites across 22 organizations in academic and community clinical settings. Rapid qualitative methods using templated summaries and matrix analysis were applied to identify major themes. RESULTS: A total of 202 current and former pre-clerkship medical student preceptors participated in surveys characterizing their experiences: 158 current preceptors (including 36 planning to stop) and 44 former preceptors with a 70% response rate. Most preceptors cited a love of teaching as their primary motivation. Thematic analysis identified three themes: (1) Preceptors chose to precept because they love teaching-when they leave it is often related to life and work-related factors; (2) Heavy clinical workload was a barrier to a good preceptorship experience; (3) The importance of guidance flexibility, and supportive structures for preceptors. CONCLUSIONS: Pre-clerkship preceptors are primarily motivated by a passion for teaching, but personal and professional pressures contribute to attrition. Addressing clinical workload and providing flexible, supportive program structures may improve preceptor retention.