Exploring motivators and challenges for preceptors to teach in the clinical settings: a survey-based study | BMC Medical Education

This study was conducted to identify factors that play a role in motivating or inhibiting preceptors to teach in the clinical settings. We established that most preceptors endorsed intrinsic motivators as having a higher impact on their willingness to teach than extrinsic motivators. This aligned with a previous report about job satisfaction coming from intrinsic factors [7,8,9]. The major challenges to teach were related to time and heavy clinical workload, a redemonstration of one of the common challenges encountered during literature search [7].

Motivators

The study reveals a strong intrinsic motivation among medical educators, with 64% of participants placing high value on sharing knowledge and expertise. This is closely followed by 63% who are motivated by the opportunity to educate the next generation of doctors. These findings underscore the deep sense of professional identity and personal fulfillment that medical educators derive from their work, consistent with Kumar et al.’s findings, where personal satisfaction from sharing knowledge was also noted as a key motivator. This reflects the educators’ desire to impact the medical field positively, contributing to a legacy of well-trained professionals [3]. A recent systematic review demonstrated that intrinsic factors dominated when it came to motivators to teach, were sense of fulfillment, enjoyment and connectedness were the core drivers to teach [10].

Furthermore, 43.4% of your study’s participants value faculty development opportunities, highlighting the importance of continuous learning and growth in maintaining job satisfaction and effectiveness. This aligns with the educational initiative in Saudi Arabia, where the Saudi Commission for Health Specialties offers a mandatory free Train of Trainers Workshop, emphasizing both practical skills and institutional support for medical educators [11, 12]. Furthermore, in the study by Kumar et al., faculty ranked sponsorship of scientific activities, travel and registration reimbursement high [3].

Interestingly, extrinsic factors such as financial gain were ranked low among motivational factors by your study’s participants, with direct financial rewards like tuition payment, support for business activities, and recognition events scoring between 9.7% and 20%. This might reflect a professional norm where intrinsic rewards are more valued than extrinsic ones. However, contrasting evidence a study from Harvard faculty suggests a complex relationship with financial compensation, they found that their faculty were (2.66) times more likely to return to teach when the financial compensation was raised from 900$ to 2500$, with faculty receiving direct payment more likely to continue teaching than those who are receiving indirect payments [5]. Interestingly, another study found that physicians were motivated to teach when financial compensation was added, despite that when asked about the factors that motivated them to continue to teach, they stated that reimbursement was least significant [4]. This suggests a complex relationship with financial compensation, indicating that while not a primary motivator, it remains an important factor, particularly when substantial and direct.

Moreover, the high importance placed on student preparedness in our study where (45.5%) stated that having a well-prepared student is crucial for a positive teaching experience, reducing stress and enhancing educational effectiveness. These results align with the study by Peters et al. where preceptors rated having good students with 73% as a factor for continuing to teach and in 92% this was the primary source of satisfaction [5]. In a similar study by Hanson et al. and Orsini et al. they reported that student autonomous motivation led to their psychological satisfaction [2, 9]. Therefore, as an intervention attention to hospital-based orientation is important to support learners’ transition and engagement from academic to clinical environment [13].

Challenges

The findings from this study underscore significant challenges faced by medical preceptors, primarily a heavy clinical workload and a lack of time, which were reported by 31.3% and 28% of participants respectively. These challnges are consistent with the study by Peters et al., which also identified extended working hours and slower patient turnover when a student is present as critical challenges [5]. Furthermore, Ryan et al. found that a substantial 71% of preceptors ranked time challenges as the most significant barrier to teaching [4]. Additional studies indicating that patient encounter times can double with the presence of a student [14, 15]. This consistency across various studies highlights a systemic issue in clinical education that necessitates strategic interventions. Addressing these challenges could involve several approaches, including adjusting clinical workloads, enhancing educational resources, and providing specific support for time management, which could collectively improve the efficiency and effectiveness of medical preceptors in their educational roles while maintaining quality patient care [16].

Another perceived limitation by our preceptors was lack of space to accommodate the students’ numbers. This was also a problem in other regions of the world where the clinical education of medical students is challenged by increased enrollment and insufficient clerkship spots due to factors such as hospital closures, healthcare mergers, and a shift to outpatient care. Additionally, competition from offshore medical schools exacerbates the shortage of available training opportunities. These issues are compounded by a healthcare industry that prioritizes productivity over education, necessitating strategies to expand clinical training and support for medical preceptors [16].

Subsequently, other issues that were perceived as challenges by our preceptors were workplace that does not allow for medical students to be at the facility as well as patients unwillingness to be seen by a medical student. This issue can be ameliorated by optimizing the use of simulation and virtual reality in education [16].

Feedback to the preceptors about their performance was among the least fearsome challenges in our study further making feedback a desirable outcome from this mutual relationship. Student feedback offers valuable opportunities for preceptors to enhance their teaching methods by providing insights into the effectiveness of their instructional approaches. Additionally, receiving positive feedback can validate preceptors’ efforts, reinforcing their sense of efficacy and motivating them to continue dedicating time and energy to teaching. This cycle of feedback and improvement not only benefits preceptors but also enhances the overall educational experience for students [17].

In examining the motivators and challenges faced by medical educators, it’s clear that intrinsic factors such as the desire to share knowledge, educate future doctors, and achieve personal fulfillment is the drive for our preceptors. These intrinsic motivations highlight the authentic professional identity and satisfaction derived from their educational roles. Furthermore, the challenges they face, such as heavy clinical workloads, lack of time, and inadequate resources, present significant challenges that can inhibit their ability to effectively teach and engage with students. Despite the presence of extrinsic motivators like financial compensation, which can influence faculty retention to some extent, the intrinsic rewards are more valued. Thus, addressing these challenges through institutional level interventions and support systems is critical to utelise the full potential of educators’ and enhance the quality of medical education.

Limitations

Our study has several limitations. First, the cross-sectional design restricts our ability to infer causality between variables. Second, the use of convenience sampling may limit the external validity of the findings, as the sample may not fully represent the broader population. Additionally, low response rates and missing data introduce potential bias and reduce the generalizability of the results. Future studies should aim for larger, more representative samples to improve the robustness and applicability of the findings.