Evaluating the Texas Statewide Family Practice Preceptorship Program, 1992-2000

Purpose. Since 1979, the Texas Statewide Family Practice Preceptorship Program (TSFPPP) has conducted ambulatory preceptorships to increase the number of medical students selecting family practice residencies. The authors describe the evaluation of the TSFPPP's efficacy in terms of four evaluation questions and outcome measures identified by program users from eight Texas medical schools. Method. The authors compared the proportion of 10,081 Texas medical school students graduating from 1992-2000 who chose family practice or other primary care residencies following participation or nonparticipation in the TSFPPP's preclinical and clinical programs. Results. The proportion of students choosing family practice residencies among TSFPPP participants was significantly greater than among nonparticipants. Participation in the TSFPPP was associated with an increased choice of a family practice residency for students who were involved in the TSFPPP at the preclinical level (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.41-1.87); the clinical level (OR, 2.31; 95% CI, 1.99-2.68); and both levels (OR, 4.98; 95% CI, 3.75-6.68) compared to non-TSFPPP participation. There was a 44% increase in preceptors willing to teach medical students. Conclusions. Participation in the TSFPPP is associated with a greater likelihood of students selecting a family practice residency. The interinstitutional approach to analyzing effects of the preceptorship on students' specialty choices focuses attention on primary care issues that, in the long run, may affect an entire state's health care delivery system.