Preceptor Bias? - EMS Student Perceptions of Preceptor Interactions Based on Age, Gender, and Ethnicity

Page, David I; Martin, Melisa EMT-P, MHS; Hubble, Michael W., PhD, MBA, NREMTP, Mortenson, Jesse BA

IntroductionPrevious research in allied health clinical education indicates that preceptor relationships play a key role in student success.  EMS program accreditation requires students to evaluate their preceptors.  Anecdotal reports indicate EMS preceptors may not be as welcoming of diverse and female students as their Caucasian male counterparts. 

Hypothesis: Student perceptions of Preceptor interactions vary based on gender, age, and ethnicity.

Methods: Between September 2007 to January 2013 EMS students participating in FISDAP, a national computerized online EMS student tracking system prospectively completed a Preceptor Evaluation survey.  The survey consisted of 14 items adapted from the Committee on Accreditation of EMS Programs Resource Survey (Part C).  Using a 5-point Likert scale students rated their preceptors on each of the following dimensions:  Communication of expectations, welcoming and orientation of the student, facilitating student involvement in patient care, allowing interaction with patients and family, providing useful feedback and fair evaluations, demonstrating an enthusiasm for teaching, and the degree of comfort working with the same preceptor during a future rotation.   All completed surveys were retrospectively reviewed and aggregated for analysis based on gender, age, and ethnicity using t-test, Pearson correlation, and ANOVA procedures.  Statistical significance was established at p≤0.05.

ResultsA total of 1,666 students participated representing 16,075 clinical shifts.  Compared to males, females rated their preceptors significantly lower in the dimensions of welcoming behavior, communication of expectations, orientation, allowing patient interaction, and fair evaluation  (p<0.05). Similarly, compared to their Caucasian counterparts, minorities reported lower levels of satisfaction with their preceptors on all of these dimensions plus enthusiasm for teaching and comfort level for future rotations (p<0.05).  In addition, increasing age was negatively correlated with all of the above dimensions of student-preceptor interaction (p<0.05). 

ConclusionMinority, female and older EMS students reported significantly lower preceptor performance ratings on most dimensions compared to their Caucasian male counterparts.  The causes, practical significance and effect on student success of these differences warrant further investigation.