Being an effective role model Drs Margaret Kingston & Leena Patel

You ARE a role model, but are you always a good one? Being a positive role model is:  A key attribute of a successful doctor  A requirement of all UK registered doctors by the General Medical Council Education is an integral part of medical practice & learning form role models is an important aspect of medical education because:  It teaches the application of knowledge and skills  Influences career choices  Is how our students and trainees develop professionalism

Students & trainees are aware of their role models - good & bad! “I think a role model is the single best way to learn… if you can see someone do it and understand how and why they do it, I think that’s when you’ll get it” “ Enthusiastic about her discipline, involved students actively in the work, excellent knowledge and practical skills, nice to patients, staff and students” “I’ve found my first rotation was very stressful, humiliating, I worked and read because of fear…”

Personal considerations…  Who are / were your role models?  What was their influence on your learning and career choices?  Who are you a role model for?  What are your good and bad attributes as a role model?

ILOs for this workshop “Research indicates that being a positive role model is a set of skills, attitudes and behaviours which may be taught and acquired by doctors…”  Define positive and negative attributes of a role model  Understand how learning from role models happens  How you can effectively teach through role modelling

Studies have established the attributes reported in medical role models: Individuals who:  Excel in their clinical knowledge and skills  Through communication skills they maintain good professional relationships  Are effective and enthusiastic teachers A tall order!  Students & trainees have multiple role models, learning different things from different individuals; the “composite” role model

How learning from role models happens  This is a complex process! Aspects have been explained through various learning theories:  Individuals learn “to talk, from talk”  Students & trainees learn professionalism through the “Hidden Curriculum” :  This is a process of assimilation into a community of practice, not only by possession of shared expertise, but also the development of professional values and standards

Cruess, 2008

Video clip (cardiac arrest, first episode, see youtube!) For those you consider to be acting as a role model in these scenarios: –What positive attributes of a role model are they displaying? –Are they demonstrating any negative role model attributes? –How could learning through role modelling be improved in this situation?

Positive role model attributes Personal characteristics Compassion Caring Empathic Patient-centred approach Excellent communication skills Good inter-professional relationships Respectful Good team player Demonstrates leadership Integrity Honesty Good sense of humour Calm Positive attitude Clinical skill Practically skilful Demonstrates clinical competence Knowledgeable Sound clinical reasoning Ability to reach the correct diagnosis Strives for excellence Presentation skills Aware of own strengths and weaknesses

Positive role model attributes Teaching abilities Taking an interest in students and trainees Spending time with students and trainees Enthusiasm Patience Provide clear explanations Versatile, learner centred teaching style Constructive feedback Demonstrating clinical reasoning Facilitation patient interaction and learning opportunities Identifying opportunities for reflection

Negative role model attributes Personal characteristics Making derogatory comments about patients or fellow professionals Inappropriate humour directed at patients or colleagues Lack of empathy Unfriendliness Complaining Expressing anger or frustration Bitterness and cynicism Opinionated Lack of confidence Un co-operative Clinical skill Lack of knowledge Teaching abilities Forgetting names and faces Excessive criticism Frightening or humiliating students or trainees Promoting unnecessary competition between students or trainees

How to MAXIMISE learning through role modelling 1.Attention: Drawn attention to the behaviour or skill being modelled by: I. Physically emphasising it II.Asking them relevant questions III.Providing an enthusiastic narrative IV.Subdividing and explaining specific aspects of a complex skill. 2.Retention: This may be enhanced by adoption of the following strategies: I.Repetition of a skill or relaying of an important fact II.Symbolic representation to create visual memory III.Drawing appropriate parallels or realistic exemplification of possible harmful effects (e.g. giving telling examples) IV.Relating new to existing knowledge 3.Production: Provide experience with appropriate autonomy 4.Motivation: I.Awareness of motivators for learners including personal rewards such as enjoyment, enthusiasm and dedication, financial gains or social status, professional autonomy or influence. II.Increasing frequency and magnitude of observed rewards & concurrence with the trainee’s own aspirations increases the effect.

How to MAXIMISE learning through role modelling Wright & Caresse, 2002

How to MAXIMISE learning through role modelling Blue sky thinking…. 1.Remember – you are a role model! 2.Make time for teaching 3.Explicitly model skills & behaviours 4.Recognise & use seminal events 5.Provide experience & feedback 6.Creating a positive learning environment and culture 7.Providing learner centred teaching 8.Show you love it! When it gets tough…. 1.Time for teaching: – “Teaching when time is limited – Irby BMJ 2008; 336: 384 ” 2.Competing priorities: – Demonstrate how these are managed, including work-life balance/merge 3.Adverse work related pressures: – Explicitly model effectively dealing with these

Time to have a quick go?

Feedback from role pay 1.The scenario 2.Positive role modelling skills to be utilised 3.Barriers to learning

Scenario one Positive role modelling skills to be utilised Barriers to learning from effective role modelling You are the tutor of a Problem Based Learning (PBL) group and during a case discussion one member of the group expresses homophobic and racist attitudes; how do you handle this?  Patient centred approach  Excellent communication skills  Respectful  Positive attitude  Constructive feedback  Versatile learner centred teaching  Personal opinions  Attitudes of other students  Inappropriate humour  Excessive criticism  Humiliating or frightening approach  Patience  Clear explanation

Scenario two Positive role modelling skills to be utilised Barriers to learning from effective role modelling You are in a busy clinic and a patient who has recently received a serious diagnosis is very distressed. You have a student sitting in. How do you handle the patient and effectively teach the student?  Compassion  Caring  Patient centred approach  Excellent communication skills  Calm  Hot review  Identifying opportunities for reflection  Lack of empathy  Time pressure

Scenario three Positive role modelling skills to be utilised Barriers to learning from effective role modelling You are undertaking a procedure with a student in attendance, how do you effectively teach the student to do this?  Patient centred approach  Practically skilful  Facilitating patient interaction and opportunity for learning  Patience  Explicitly demonstrating skills  Lack of confidence  Time pressure

So, in summary, being a good role model is important! Because, being a positive role model is  A key attribute of a successful doctor  A requirement of all UK registered doctors by the General Medical Council Furthermore, our students and trainees learn important skills and make important choices because of this:  Through it they learn the application of knowledge and skills  We influence their career choices  It is how our students and trainees develop professionalism – which has never been more important than it is now!

You ARE a role model; how can you be a good one (nearly) all the time? 1.Remember that you are a role model 2.Actively demonstrate your positive role model characteristics and skills 3.Actively demonstrate dealing with challenges 4.Create opportunities for authentic learner centred experiences with constructive feedback 5.Enjoy yourself!

ILOs for this workshop  Define positive and negative attributes of a role model  Understand how learning from role models happens  How you can effectively teach through role modelling

Thank you for your participation  Any last questions or comments?