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If a preceptor asks you to leave early...?

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Depends on the context - but mostly it means they're being nice.  If someone tells you to leave early, say "thank you" and leave immediately.  If you really feel sketchy about it, you can say "are you sure there's nothing else I can do to help before I go?" but aside from that, just leave.

There are lots of things that we need to do that medical students are genuinely not useful for (mostly paperwork things).  It doesn't mean something bad about the medical student, it's just a fact that there are some annoying tasks that need to be done by the physician, and the yield for the medical student of standing over their shoulder while they do it is like less than zero, so if your preceptor is nice, they will allow you to have an afternoon to yourself.

Personally I'm less likely to dismiss clerks who aren't doing well early, because I will want to try to teach them something.  If I think they're doing fine, and there's nothing interesting happening, I will try to get them home.

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I have had a couple clerks over the years who thought that the best way to show interest and competence was to refuse to go home and instead sit behind me staring over my shoulder while I did very boring paperwork.  It did not impress me, I just felt very bad for them and wished I could convince them that it wasn't a trap and that I genuinely wanted them to go and enjoy themselves doing something better than what I was stuck doing.

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As ellorie said, depends. When I have clerks I love sending them home early because I loved it when my residents did that for me. Still love it when my attendings do it. 

If it’s a frustrated huff of “just go home” then you should probably ask if they have performance concerns. 

As a general rule, though, if someone says you can leave early, thank them profusely and make sure to show up on time the next day bright and ready to work. :)

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