Section 3: Effective Teaching and Setting Expectations

General Best Practices for Precepting Optometry Students

Preceptors and optometry programs should establish shared expectations while recognizing that individual preceptors may differ in style. Clearly distinguishing personal preferences from standards of care helps students understand what is required versus what is optional. Below are key practice areas to communicate to students.

1. Clinical Session Timing

• Provide written and verbal expectations for arrival, lunch, and end-of-day times.
  
• Clarify expectations for taking the last patient of the session, especially in clinics using a team-based departure model where everyone leaves when all patients are completed. Tracking patient counts per student can help ensure fairness.
  
• Review room setup expectations (chart review, equipment readiness) at the start of the day.
  
• If preceptors rotate daily, maintain an internal preceptor schedule accessible to staff and students.

2. Chart Review Practices

• Communicate whether you prefer pre-clinic chart review or an end-of-day case discussion / “family chat.”
  
• For evening clinics, be mindful of late-day timing when planning wrap-up discussions.
  

3. Journal Club and Research Expectations

• At the start of the semester, define what constitutes a credible source for journal club to prevent inappropriate or unreliable articles from being selected.

4. BIO Technique (Sitting vs. Supine)

• State whether your preference is sitting or lying-down BIO, and note if this choice is dictated by clinical space or clinic protocol.
• Students in earlier years may not have learned BIO yet at earlier points of the semester, so be aware of the timeline of their laboratory skills. 

5. Special Testing Expectations

• Special testing decisions can be challenging for new learners. Provide summary sheets or guides outlining expectations for:
  
  • Initial binocular vision testing
    
  • OCT scan types for common conditions
    
  • HVF settings
    
  • Glaucoma workups
    
  • Other frequently encountered testing scenarios
    

6. Timing to Dilation

• Set expectations for how long a student should take to complete the work-up prior to dilation.
  
• Adjust timing expectations based on student level, while maintaining professionalism.
  
• Tools such as a phone timer on vibrate can help students stay aware of the time.
  

7. Chart Documentation Requirements

• Review baseline documentation standards, including:
  
  • Standardized wording for chief complaints
    
  • Additional required history for conditions like diabetes or autoimmune disease
    
  • Efficient use of EHR auto-text
    
  • Importance of documenting medications and allergies
    
• Clarify the workflow for transitioning from student charting to preceptor review (e.g., how students should indicate they are finished).
  

8. Preceptor Presence During Patient Care

• Explain where you will typically be located during patient encounters, how students should reach you (e.g., knock if you’re with another patient), and if/how you may be observing their performance.
• If you may step in to speed up an exam, let the students know that this is a possibility so that patients can be prioritized.  

9. Orientation to the Clinical Rotation

• Inform students whether there is a formal orientation date set by the academic calendar or whether they are expected to begin on their first assigned day.
  

10. Requirements Prior to Clinical Privileges

• Clearly outline immunization requirements, deadlines, and consequences for non-compliance.
  
• Specify any required HR or EHR training, including dates—especially relevant for external sites.

11. Approaches to Delivering and Receiving Feedback

• Share how you prefer to communicate expectations and give feedback, and invite students to express how they best receive it.
  
• Maintain approachable body language to reinforce openness and psychological safety.

It can be difficult for interns to enter into patient care for the first time after only seeing their peers in laboratory settings.  Here are some ways that the preceptor can optimize the transition. 

• Clinical preceptor works with student in exam room for first patient encounter helping them navigate process, EHR, institutional procedures
• Reduces student anxiety: Be clear about expectations. Advise the student clinicians that they may observe for a set number of sessions, and then will be expected to gradually ramp up in participating in patient care.
• Familiarizes faculty with the student and allows for understanding of communication and learning styles.
• Can help to identify strengths and areas that require improvement.

Click here for examples of potential preceptor responses for certain situations with students in clinical setting

A useful tool to assess your own levels of teaching is the Clinician Educator Milestone project.  Preceptors can use these milestones for their own self-assessment as educators, or with a trusted peer to provide feedback and assessment. There are 20 subcompetencies, each covering a different area of professional development. Each serves as a stand-alone assessment of a specific teaching skill or method. Individuals may choose to focus on one or more of the milestones, but do not need to assess against all of them.

Resources courtesy of Dr. Neil Pence, Indiana University

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