One-Minute Preceptor Improves Clinical Competence in Pediatric Clerkships: A Cluster Randomized Trial

Objective Clinical teaching in busy pediatric clerkships requires brief strategies that make learner reasoning visible and provide timely feedback. We assessed whether training pediatric resident preceptors to use the One-Minute Preceptor (OMP), a five-microskills teaching model, improved directly observed student performance and learner satisfaction without a statistically significant increase in assessment-related time. Methods We conducted a single-center, stratified cluster randomized controlled trial with pediatric resident preceptors as the unit of randomization. Thirty preceptor clusters were allocated 1:1 to OMP or usual teaching (15 per arm), with 450 fourth-year medical students included in the analysis (225 per arm). The primary outcome was performance across seven Mini-Clinical Evaluation Exercise (Mini-CEX) domains. Secondary outcomes included student satisfaction, formal observation duration, and post-encounter feedback duration. Primary analyses used generalized estimating equations adjusted for case difficulty with Holm correction; prespecified sensitivity analyses assessed robustness. Results OMP significantly improved Mini-CEX scores in medical interviewing (adjusted mean difference [MD] 1.12, 95% CI 0.82–1.42; Holm-adjusted P < .001), counseling (MD 1.20, 95% CI 0.85–1.55; Holm-adjusted P < .001), and clinical reasoning (MD 1.28, 95% CI 1.01–1.55; Holm-adjusted P < .001), whereas the remaining domains were not significant after multiplicity adjustment. OMP also increased student satisfaction (MD 0.63, 95% CI 0.25–1.01; P < .001). Formal observation and post-encounter feedback durations were numerically longer but not statistically significant. Findings were consistent in sensitivity analyses. Conclusions In pediatric clerkships, OMP improved selected domains of workplace-based clinical competence and learner satisfaction, with modest, statistically nonsignificant increases in assessment-related time. © 2026 Academic Pediatric Association.