Role modelling in medical education
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Role Modelling Attributes of Trainers and
the Potential Impact on Learners
Dr Andrew Ferguson
MEd FRCA FFICM MAcadMEd
Consultant in ICM and Anaesthetics
College Tutor, Anaesthetics
GOAL CONTAGION
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Explore the concept of role-modelling
Look at positive and negative attributes
Think about the opportunities
Look in the mirror
Think about what could be better
Change!
Why are we here?
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“Always On”
Teaching
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Q: How many of you have actively
considered your impact as a
role-model?
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Q: What is a role model?
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“A person considered to demonstrate a
standard of excellence to be imitated”
Implicit observational learning
The “hidden” curriculum
A boring definition…
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proximate living examples of what he/she may
aspire to become…their very existence is
confirmation of possibilities one may have every
reason to doubt, saying, 'Yes, someone like me
can do this’.
Sonia Sotomayer
A more enthusiastic one…
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How do you cope when the day just sucks?
What do you look for in a day that shines?
How do you keep hold of the “buzz”?
How well do you teach these???
Is that us?
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We teach what we are…
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And it’s catching…
GOAL CONTAGION
“The automatic (unconscious) adoption of a goal
upon perceiving another’s goal-directed action”
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The aims of training
Competence
Professionalism
High-quality care
Explicit learning
Implicit learning Role modeling
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Learners become like us…
They see how we act:
• - as clinicians & professionals
– - as trainers
– - as human beings
They imitate consciously and/or subconsciously
They need to learn to sift the good from bad
We need to learn what aspects have an impact
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Apperception
A key process in learning from role models
– Making sense by assimilating (perceived) ideas
into the body of ideas already possessed
– PERCEPTION IS KEY
Does not prevent assimilation of the bad
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Q: What makes for a NEGATIVE
ROLE MODEL?
Professional
Personal
Educational
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Attributes of a negative role model
Professional/clinical Uncaring
Poor communicator
Poor relationships with patients
One-dimensional view of patients
Uncooperative with colleagues
Unprofessional attitudes
Unethical behaviour
Not up to date in their knowledge
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Attributes of a negative role model
Teaching qualities (trainer) Poor support for learners
Teaches wrong clinical approach
Rarely gives feedback
Sink or swim approach to learners
Disinterested
Difficult remembering names and faces (!)
Leaves learners feeling they know more than trainer
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Attributes of a negative role model
Personal qualities Cynical
Sexist
Impatient and/or inflexible
Over-opinionated
Nit-picking and harsh
Lacks self-confidence
Lacks leadership skills
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Q: What makes for a POSITIVE
ROLE MODEL?
Professional
Personal
Educational
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Patient care attributes
Competent with up-to-date knowledge
Committed to high-quality care
Effective diagnostic and therapeutic skills
Sound clinical reasoning
Compassionate, caring, empathic
Good communicator
Respect for colleagues
Assumes responsibility in difficult scenarios
Enthusiastic about work
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Teaching qualities
Rapport with learners
Tailors teaching to learner’s needs
Creates safe learning environment
Gives learners autonomy for decision-making
Provides room to practice independently
Enthusiasm for teaching
Positive attitude towards learners
Accessible and open to questions
Stimulates critical thinking and reflection
Aware of role model status and adapts behaviour to this
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Personal qualities
Self-confident
Shows honesty and integrity
Easy to work with and cooperative
Shows leadership ability
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Q: How can/do we know what sort of
role-model we are?
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Q: What are the barriers to us being
better as role-models?
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Isn’t this just more edu-babble?
NO!
The unspoken atmosphere of the department
Central to motivating trainees
Poor role models…
– undermine other teaching
– undermine department feedback (GMC etc.)
– can scar trainees and impede/reverse their progress
– let down other +ve aspects of their own performance
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Optimising trainee benefits
Realise it’s happening
– Both trainees AND trainers
Understand positive and negative attributes
Emphasise the good in practice
Change behaviour to minimise the bad
Get feedback to ensure this is happening
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It’s tough…
It takes serious effort…
Now for the good news…
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You don’t have to….
Be the boss
Have a national/international reputation
Have numerous publications
Be attractive (or even be ugly!)
Conduct a lot of research
Offer loads of didactic teaching
Conduct regular teaching rounds
Have similar outside interests to trainees
Be overly interested in trainees’ life outside work
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So what next?
Get feedback, review your feedback, and “reflect”
Approach trainee interactions consciously
– Be self-aware and adapt behaviour accordingly
Make the implicit explicit
– Don’t just show it.…explain it (the why and why not)
Discuss thought processes and decision-making
Discuss awkward patient or relative interactions
– Don’t just think it….say it
Give feedback to trainees on their performance at the time
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Questions and/or comments?
Challenged?
Do you consider RM important?
Barriers to improvement in yourself?
Barriers to improvement in your dept?
Is trainee feedback available to you?
Is the thought of trainee feedback uncomfortable?
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If you can't be a good example,
then you'll just have to be a
horrible warning…
Catherine Aird
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References
Jochemsen-van der Leeuw HG, et al. The attributes of a clinical trainer as a role model: a
systematic review. Acad Med 2013; 88: 26-34.
Park J, et al. Observation, reflection, and reinforcement: surgery faculty members’ and
residents’ perceptions of how they learned professionalism. Acad Med 2010; 85: 134-139.
Wear D, et al. Hidden in plain sight: the formal, informal, and hidden curricula of a
psychiatric clerkship. Acad Med 2009; 84: 451-458.
Cruess SR, at al. Role-modelling – making the most of a powerful teaching strategy. BMJ
2008; 336: 718-721.