Background: The University of Washington School of Medicine (UWSOM) and other medical schools utilize a distributed medical education (DME) model to train medical students in real-world community settings. An inherent challenge in this model is maintaining high-quality teaching across large geographic areas and clinical settings. This study compares student perceptions of rural and nonrural preceptor teaching in the UWSOM-required clerkships.
Methods: Our study analyzed 41,684 medical student evaluations of preceptors from six required clerkships and over 4 clerkship school years. Using the Rural-Urban Commuting Area definitions, we categorized individual evaluations as either "rural" or "nonrural". We used Welch's unpaired t tests and descriptive statistics to compare rural and nonrural evaluation results.
Results: The evaluation data showed high ratings of preceptor teaching across all nine teaching evaluation categories for both rural and nonrural preceptors, with mean scores of 5.5 or higher on a 6-point Likert scale. Rural preceptors slightly outperformed their nonrural counterparts in seven out of nine teaching categories, including three categories reaching statistical significance.
Conclusions: Results suggest that Liaison Committee on Medical Education standards for comparable educational experiences are being met across distributed sites. We recommend a thematic analysis of student evaluation comments to contextualize the findings reported in our study.
© 2025 by the Society of Teachers of Family Medicine.