Cabin Fever: an innovation in faculty development for rural preceptors

Context and setting A new rural family medicine residency programme was established in Alberta, Canada in 2000. This group of 20 rural-based residents, in addition to the urban-based residents, are being trained in 21 rural and regional sites in Alberta over a 2-year period. One early challenge was that of faculty development (FD) for the 140 family medicine and specialty preceptors, most of whom were new to their roles as clinical teachers. Why the idea was necessary Traditional urban-based FD was neither congruent with the location and philosophy of the rural-based programme, nor appropriate, given the programme FD goals. The Cabin Fever retreat was established with the overarching goal of supporting the recruitment and retention efforts of the Alberta Rural Physician Action Plan as support from the main academic centres has been shown to stabilise manpower in underserviced areas. Each FD retreat has had 2 focused objectives: context-specific preparation of preceptors for their new roles in both teaching and evaluation of clinical skills, and networking among rural preceptors and their families. What was done The retreat was organised in a winter recreational setting. In a co-operative manner, the timing of other FD opportunities in the province were considered. This format was chosen as interruptions from the demands of practice were minimised, and opportunities for networking and social activities were readily available. The attendance of family members was explicitly encouraged – and funded – because of their crucial contribution to successful rural practice. The FD retreat is held each year on the same weekend in February. It takes place over 3 days, with mornings focused on educational activities and afternoons left unstructured. Participants and their families reconvene for an evening meal in which exemplars are honoured and the contribution of families to programme success acknowledged. The formal educational programme consists of 1 plenary speaker on the first day, followed by small group workshops. The workshop topics are based on a needs assessment coupled with feedback and suggestions from participants and residents from the previous year. The workshops are divided into 3 streams, with 1 for novice teachers, another for experienced teachers and a third for those interested in the theoretical foundations of education. Preceptors self-select into each stream and are allowed to cross over streams if they wish. Rural preceptors are actively sought to facilitate or co-facilitate workshops. Workshop facilitators are encouraged to use an interactive format with practice-enhancing strategies where appropriate (i.e. role play, videotape review and Internet access). Evaluation of results and impact Participants rate the retreat format, content and practice applicability very highly. There are numerous comments each year on the positive impact of actively including family members. Preceptors are asked to commit to specific teaching changes for each workshop they attend and the majority of participants do so. Next steps will include ensuring that each rural teaching site is represented at the retreat and that participants are supported in sharing the knowledge and skills gained with their site co-preceptors. A final step will involve the transfer of the retreat planning and delivery entirely to the rural preceptors.

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