Purpose. With increasing amounts of medical education occurring in ambulatory care and managed care settings, time-efficient and educationally effective teaching methods are in high demand. To identify such methods, four exemplary preceptors who taught in a family medicine clerkship in the context of their managed care clinics were observed in two consecutive years. The purpose of this second observational case study was to look at the teaching and practice strategies of these four exemplary preceptors in more detail and to directly measure the use of strategies that have previously been identified. Method. Observation of 44 patient encounters by four exemplary preceptors in ambulatory managed-care settings. Results. On average, these preceptors spent one minute per patient more when the student was involved. With students present, the preceptors saved 3.3 minutes per patient in charting time, while spending 2.2 minutes more listening to student presentations and 1.6 minutes more in pure teaching time. The preceptors spent half a minute less time in direct contact with each patient when a student was present. However, the patients received 12.4 additional minutes from the health-care team. Conclusion. Time savings from student charting may allow preceptors to teach and care for patients without losing valuable practice time.
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