The role of preceptorship in the training of family and community doctors: challenges, competencies and impact on the quality of care in primary health care

Abstract

The present article analyzes preceptorship as a formative axis of residency training in Family and Community Medicine within the context of Primary Health Care, articulating three dimensions: challenges encountered in the daily practice of service-based education, competencies expected of preceptors to sustain clinical and pedagogical supervision, and impacts associated with the quality of care. Methodologically, the study adopts an integrative literature review covering the last five years, based on searches conducted in databases relevant to primary care and medical education, such as SciELO, PubMed/MEDLINE, BVS/LILACS, and DOAJ. Defined inclusion criteria were applied to select studies that explicitly address preceptorship/supervision in ambulatory settings linked to Primary Health Care, describing barriers, practices, competencies, organizational models, and formative or care-related outcomes. The selection process was described in a traceable manner, resulting in the inclusion of eight studies. The results converged in showing that preceptorship is a situated practice, strongly conditioned by service organization, in which high clinical workload, lack of protected time, infrastructure gaps, weaknesses in the integration between education and service, and limited institutional recognition constitute recurring obstacles. At the same time, the literature highlights competencies that can be described as observable and trainable behaviors, such as direct observation, structured feedback, expectation setting, support for clinical decision-making, and calibration of supervised autonomy, with particular relevance in the primary care outpatient setting, characterized by limited time and high demand. In addition, discussions regarding models of preceptorship and evaluation and monitoring tools are evident, making it clear that quality depends on the alignment between supervision arrangements, program governance, and institutional support.