Role modelling in medical education

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  • 1. GOAL CONTAGION 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
  • 2. Why are we here?  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!
  • 3. “Always On” Teaching
  • 4. Q: How many of you have actively considered your impact as a role-model?
  • 5. Q: What is a role model?
  • 6. A boring definition… “A person considered to demonstrate a standard of excellence to be imitated” Implicit observational learning The “hidden” curriculum
  • 7. A more enthusiastic one… 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
  • 8. Is that us? 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???
  • 9. We teach what we are…
  • 10. And it’s catching… GOAL CONTAGION “The automatic (unconscious) adoption of a goal upon perceiving another’s goal-directed action”
  • 11. The aims of training Explicit learning Competence High-quality care Professionalism Implicit learning Role modeling
  • 12. 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
  • 13. 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
  • 14. Q: What makes for a NEGATIVE ROLE MODEL? Professional Personal Educational
  • 15. 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
  • 16. 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
  • 17. 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
  • 18. Q: What makes for a POSITIVE ROLE MODEL? Professional Personal Educational
  • 19. 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
  • 20. 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
  • 21. Personal qualities     Self-confident Shows honesty and integrity Easy to work with and cooperative Shows leadership ability
  • 22. Q: How can/do we know what sort of role-model we are?
  • 23. Q: What are the barriers to us being better as role-models?
  • 24. 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
  • 25. 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  
  • 26. It’s tough… It takes serious effort… Now for the good news…
  • 27. 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
  • 28. 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
  • 29. 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?
  • 30. If you can't be a good example, then you'll just have to be a horrible warning… Catherine Aird
  • 31. 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.