Your office or clinic is a busy place and becoming even busier.  At the same time, your office is an increasingly valuable site for training health professionals.  How can you integrate these learners into your practice while maintaining your sanity and your bottom line?  The following suggestions have been supplied by experienced community-based preceptors. 

Orient the Learner

• Solicit staff help in orienting the learner to your practice.
• Develop a checklist of orientation topics; if you teach a lot, write out policies & expectations.
• Go over expectations with learner at lunch on the first day or night before the rotation starts. 

Seek Patient Acceptance of the Learner

• Tell patients that you teach: put a sign in your waiting room or an article in the newspaper.
• Ask for patient permission to be seen by learner, emphasizing patients’ role as teacher.  
• Thank patients for working with learner.

Schedule for the Learner 

• Schedule 1-2 fewer patients per teaching day, OR schedule more acute “work-in” patients, OR expect your workday to be 45 minutes longer when teaching.
• Schedule some breaks: have learners spend a half-day at a time with your partner, office staff, or community agencies such as Hospice.
• Assign independent projects such as reading, a literature search, a chart audit, or development of patient education materials.

Keep Things Moving

• Have learner see every third patient: learner sees first patient as you see second; learner presents to you and you see patient together; learner writes chart while you see third patient.
• Use focused teaching techniques such as the One Minute Preceptor.
• When behind, tell learners to do some reading (warn in advance this sometimes happens).
• For learners that take a long time with patients, set time limits for each encounter.

Find Time to Teach

• Focus on brief teaching points during the day. 
• Keep notes; address larger teaching topics at specific times (end of the day or start of the next day) or “down” times (as you drive to the hospital for rounds, on call, at lunch).