Keep a Place for Colleagues in Rural Faculty Development

Moving faculty development online can remove a journey. It still leaves a design choice: what should a rural preceptor study independently, and what is worth arranging time with colleagues to do?

ACGME's August 17 announcement asked current and potential faculty in rural and underserved communities about their development needs. The assessment was intended to inform a virtual program in teaching, supervision, assessment, and learner support. It announced a planning process, not findings about what those faculty need or evidence that a particular format works.

For a CME team building faculty development across clinical sites, the useful question is how to divide the work. A recording can introduce a teaching method. A conversation can let preceptors examine what happens when they try it with their own learners. Filling both spaces with the same presentation spends shared time without giving it a distinct job.

An older program made that division explicit

The University of Calgary's FM POD pilot, published in May 2014, combined an initial face-to-face meeting with individual preparation and subsequent virtual workshops for rural family-medicine preceptors. Preparatory narrated presentations introduced material before the online meetings. The workshops used scenarios and problem-solving activities to help participants compare experiences and apply the material together.

That sequence offers a design example, not a requirement to reproduce its software or timetable. Its distinction between preparation and collaboration is useful when clinical colleagues are geographically dispersed.

The evaluation was small: 13 preceptors signed up, seven completed the whole program, and evaluation responses declined over time. Participants reported increased comfort with teaching skills; objective improvement in teaching was not established. The program also included an in-person start, so it cannot show that a wholly virtual course would produce the same experience.

Give shared time something to accomplish

Suppose the development topic is feedback. Individual preparation might introduce a feedback approach and ask each preceptor to identify a teaching situation they want help with. In the shared session, colleagues could examine why the conversation is difficult, compare possible approaches, and rehearse a response. Use constructed or appropriately deidentified situations; identifiable learner difficulties do not belong in a casual cross-site discussion.

This is a proposed use of the format, not a tested intervention. The design test is simple: what can participants gain from one another that they would not get by replaying the material alone? If the answer is unclear, revise the shared activity before filling the calendar.

The opposite choice can also be reasonable. If a task is to learn a defined process and faculty do not need discussion to understand it, an accessible individual resource may be sufficient. Save scarce synchronous time for the questions that benefit from another person's reasoning, experience, or feedback. The rural setting does not make every topic a group task.

Our earlier discussion of how local conditions shape faculty development treated context as part of the intervention. For distributed faculty, apply that principle to both parts of the sequence: can participants prepare, and can they actually join the exchange?

A link does not allocate time

An Oregon rural-preceptor project published online in April 2018 based each educational session on interviews about local training needs. Its qualitative account identified dedicated development time, communication with the academic center, and billing-revenue concerns as important conditions. The preceptors were volunteers in a convenience sample; this was not a controlled comparison of delivery formats.

Before offering a shared session, ask local clinical leaders and preceptors when participation can fit around patient care and what support it requires. Count preparation as part of the workload too. A virtual invitation should not quietly assume that both tasks will happen in personal time.

Preserve the part of faculty development that requires colleagues, while making the rest usable independently. A distributed program should explain why people are coming together—and make that time possible.