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Educ Health (Abingdon). 2019 May-Aug;32(2):87-90. doi: 10.4103/efh.EfH_206_16.

Checking in on check-out: Survey of Learning Priorities in Primary Care Residency Teaching Clinics.

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Department of Internal Medicine, Division of General and Hospital Medicine, UT Health San Antonio, San Antonio, Texas, USA.
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Internal Medicine, Division of General Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.



Despite focus on increasing the quality of ambulatory education training, few studies have examined residents' perceptions of learning during case discussions with their preceptors (i.e., "check-out"). The objective of this study was to assess the difference between residents' and preceptors' perceptions of behaviors that should occur during check-out discussions.


We conducted a cross-sectional survey of categorical internal medicine and family medicine residents and preceptors. The survey was distributed electronically and assessed 20 components of the check-out discussion.


Of 38 preceptors, 22 (61%) completed the survey. Of 172 residents, 82 (48%) completed the survey. For residents, we identified discrepancies in desired and perceived check-out behaviors. Specifically, utilizing a dependent sample t-test, residents felt that all 20 areas needed additional teaching during check-out (P < 0.05). Preceptors believed that demonstrating physical examination skills in the patient room during check-out was significantly more important than did residents (P = 0.01). Increasing years of preceptor experience did not statistically relate to their valuation of components important to residents.


Our research highlighted a major deficiency in training in the check-out process, with residents desiring more patient management education in all components. Moreover, faculty and residents do not necessarily agree with what is an important focus in the "teachable moment." Our results serve as a training needs assessment for future faculty development seminars and highlight the need to consider resident learning needs in general.


Ambulatory care; graduate medical education; patient care management; preceptorship; primary health care

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