ROLE MODELING “The process whereby faculty members exhibit knowledge, attitudes, and skills, demonstrate and articulate expert thought processes, and manifest positive professional behaviours and characteristics” (After Irby, J Med Ed, 1986)

“being a role model is what happens when you are busy doing other things” John Lennon ROLE MODELING

WHY DO ROLE MODELS MATTER? Major Influence in the Creation of a Health Professional Part of the formal & informal curriculum (influenced by the hidden curriculum) Can affect career choice Significant influence on peers Negative role modeling is common and can be destructive

ATTRIBUTES ROLE MODEL - ATTRIBUTES expertise/clinical skillsexpertise/clinical skills humanism/self awareness, empathy, humanism/self awareness, empathy,respect communication/patient & student communication/patient & student personal qualities/lifestyle personal qualities/lifestyle collaborative practice collaborative practice advocacy advocacy

CompetenceCommitmentConfidentialityAltruismTrustworthy Integrity / Honesty Codes of ethics Morality / Ethical Behavior Behavior Responsibility to profession profession Autonomy Autonomy Self-regulation Self-regulation Associations Associations Institutions Institutions Responsibility Responsibility to society to society Team work Team work Caring/compassionInsightOpenness/transparency Respect for the healing function Respect patient dignity/autonomyPresence

What Makes a Good Role Model? What Makes a Good Role Model? CompetenceCompetence TIME: total hours & % of time spent teachingTIME: total hours & % of time spent teaching Being aware of being a role modelBeing aware of being a role model Being explicit about what is being modeled and whyBeing explicit about what is being modeled and why Communicating enthusiasmCommunicating enthusiasm (Generalist vs specialist)(Generalist vs specialist) Wright et al: NEJM,1998 Côté & Leclère: Acad Med, 2000

What Makes a Good Role Model? What Makes a Good Role Model? Demonstrating sensitivity to student’s needsDemonstrating sensitivity to student’s needs Being aware of power differenceBeing aware of power difference Giving feedbackGiving feedback Stressing importance of patient relationshipStressing importance of patient relationship Stressing psychosocial aspects of medicineStressing psychosocial aspects of medicine Reflecting and encouraging reflection in studentsReflecting and encouraging reflection in students Institutional supportInstitutional support Wright et al: NEJM,1998 Wright et al: NEJM,1998 Côté & Leclère: Acad Med, 2000 Côté & Leclère: Acad Med, 2000

What Makes a Poor Role Model? Disrespect- patients/students/team membersDisrespect- patients/students/team members Insensitivity- patients/students/team membersInsensitivity- patients/students/team members Professional dissatisfactionProfessional dissatisfaction Lack of collegialityLack of collegiality Culture accepting of poor relationshipsCulture accepting of poor relationships Lack of institutional supportLack of institutional support

Barriers to Good Role Modeling Barriers to Good Role Modeling Time/overworkTime/overwork ImpatienceImpatience Overly opinionatedOverly opinionated Hostile attitudeHostile attitude Lack of enthusiasmLack of enthusiasm Poor interpersonal skillsPoor interpersonal skills Impersonal approachImpersonal approach Too reserved/quietToo reserved/quiet

TAKE HOME MESSAGE TAKE HOME MESSAGE Attention - to the patientAttention - to the patient - to the student - to the student Retention - use Socratic methods to involve the student and promote retentionRetention - use Socratic methods to involve the student and promote retention Production - getting the student to use knowledge in order to embed itProduction - getting the student to use knowledge in order to embed it Motivation - make the event enjoyableMotivation - make the event enjoyable (Bandura: 1986 ) (Bandura: 1986 )