Factors associated with students' perceptions of role modelling

Exploring the Impact of a Vicarious Learning Approach on Student Pharmacists' Professional Identity Formation Using a Simulated Pharmacist-Patient Encounter

Purposefully developed professional identity formation (PIF) learning activities within the didactic curriculum provide crucial groundwork to complement PIF within authentic settings. The aim of this didactic exercise was to explore the impact upon student pharmacists' PIF after viewing, analyzing, and reflecting upon a simulated pharmacist-patient encounter (PPE). A 12 min role-play video was created, featuring a pharmacist counseling a standardized patient on a new medication regimen; foundational principles of medication safety, health literacy, social determinants of health, empathic communication, and motivational interviewing were included in the counseling, with some aspects intentionally performed well, others in need of improvement. Also included were the patient's varied reactions to the counseling. Students assumed the observer role and learned vicariously through viewing the PPE. Postactivity debriefs included justifying a foundational principle performed well by the pharmacist, and another in need of improvement, and a self-reflection essay expressing the impact of viewing the PPE on their PIF, from which extracts were thematically analyzed for impact. The main themes of the impact included increased awareness of counseling techniques, patient-friendly medical jargon, patient perspectives/empathy, positive and negative pharmacist role-modeling, and the value of the observer role. This PPE exercise enhanced PIF in terms of students thinking, acting, and feeling like a pharmacist, based on students' self-reflections, which most often referenced effective pharmacist-patient communication and enacting optimal patient care.

Teacher as role model in developing professional behavior of medical students: a qualitative study

Objectives

This study aimed to explore students' perspectives on the attributes of medical teachers as role models to students' professional behaviour in the educational process.

Methods

A phenomenological study was conducted to obtain participants' perceptions concerning the professional attributes of medical teachers. The participants were 21 final-year medical students in the School of Medicine, Universitas Gadjah Mada, who had completed and passed the national examination. The participants were recruited purposively to represent genders and performance (i.e., high-performing and average-performing students). The participants were divided into two focus groups based on their performance, each facilitated by non-teaching faculty members to avoid bias. Thematic analysis was conducted to analyze focus group transcripts by two independent coders. Codes were synthesized into themes related to the study aims.

Results

Seven themes were identified related to observed role model attributes, for instance, passionate lecturers, caring and empathetic, supportive and involving, objectivity, incompetence and compromising, poor communication and conflict, and time management. Subsequently, five themes were identified in participants' responses towards the observed role model, for instance, exemplary models, respect and motivating, confusion and inconvenience, avoiding and hate, and value collision and harmonization.

Conclusions

This study revealed a range of role model attributes and responded positively and negatively during learning encounters. As negative attributes are also prominent and observed by students, there is a need for medical schools to perform faculty development for the professional enhancement of medical teachers. Further study should be conducted to investigate the impact of role modelling on learning achievement and future medical practice.

Role modelling in professional identity formation: a systematic scoping review

BACKGROUND

Role modelling's pivotal part in the nurturing of a physician's professional identity remains poorly understood. To overcome these gaps, this review posits that as part of the mentoring spectrum, role modelling should be considered in tandem with mentoring, supervision, coaching, tutoring and advising. This provides a clinically relevant notion of role modelling whilst its effects upon a physician's thinking, practice and conduct may be visualised using the Ring Theory of Personhood (RToP).

METHODS

A Systematic Evidence Based Approach guided systematic scoping review was conducted on articles published between 1 January 2000 to 31 December 2021 in the PubMed, Scopus, Cochrane, and ERIC databases. This review focused on the experiences of medical students and physicians in training (learners) given their similar exposure to training environments and practices.

RESULTS

12,201 articles were identified, 271 articles were evaluated, and 145 articles were included. Concurrent independent thematic and content analysis revealed five domains: existing theories, definitions, indications, characteristics, and the impact of role modelling upon the four rings of the RToP. This highlights dissonance between the introduced and regnant beliefs and spotlights the influence of the learner's narratives, cognitive base, clinical insight, contextual considerations and belief system on their ability to detect, address and adapt to role modelling experiences.

CONCLUSION

Role modelling's ability to introduce and integrate beliefs, values and principles into a physician's belief system underscores its effects upon professional identity formation. Yet, these effects depend on contextual, structural, cultural and organisational influences as well as tutor and learner characteristics and the nature of their learner-tutor relationship. The RToP allows appreciation of these variations on the efficacy of role modelling and may help direct personalised and longitudinal support for learners.

The Drudgery of a Doctor's Disciple: Exploring the effects of Negative Role Modelling on medical students' professional development

INTRODUCTION

Role modelling is considered an essential component of teaching in various educational settings and impact students' professional development. Most studies found in the literature have explored the influence of positive role models and limited data is available about the negative role modelling. This study explores the effects of negative role modelling of teachers on the professional development of future doctors.

METHODS

A qualitative exploratory study was done in three medical colleges of Lahore, Pakistan. Fifteen, telephonic, semi-structured interviews were done with fifth-year MBBS students. A thematic analysis was done through manual coding of transcribed interviews.

RESULTS

A total of 374 codes were generated in the first cycle of coding, that was merged to 42 in the second cycle. These codes led to 4 subthemes that finally emerged as two themes. The first theme was "Students & patients: In the same boat" highlighting the damaging effects of negative role modelling. The second theme was "Taking the bad with the good" focusing on the ambivalent response of students towards the unprofessional behaviours of their role models.

CONCLUSION

Negative role modelling exponentially affects the attitude and behaviour of medical students especially in informal settings and have detrimental effects on patient care. Students lose some degree of humanism while unconsciously observing the unethical behaviours, to become a part of hospital culture whereas some students show determination to channelize their resentment to reforms.

South African student nurses' experiences of professional nurses' role-modelling of caring

BACKGROUND

Student nurses are expected to implement a caring practice in order to become professional nurses. Caring has remained the art and science of nursing, which student nurses learn from professional nurses during clinical practice. The South African Nursing Council mandates professional nurses to teach and supervise student nurses to master the art of caring during clinical practice. Caring is taught through role-modelling of daily nursing activities.

RESEARCH PURPOSE

This study was performed to gain an understanding of South African student nurses' experiences of professional nurses' role-modelling of caring.

METHODS

Phenomenological, qualitative research. Purposive sampling of fourth-year student nurses.

DATA COLLECTION

focus groups, observations and field notes. The data were analysed using Giorgi's modified Husserlian five-step method. Ethical principles were respected.

RESULTS

Three themes were identified. Theme 1: inconsistency in the clinical environment; Theme 2: effective and ineffective role-modelling of caring and Theme 3: carelessness cascading.

CONCLUSIONS

The study facilitated an understanding of student nurses' experiences of professional nurses' role-modelling of caring. Recommendations to facilitate professional nurses' role-modelling of caring in a public hospital were formulated: Mentorship training, recognition system for professional nurses, clinical support for student nurses, open channels of communication, random nurse leader rounds, employee wellness program, workshops and positive learning environment promotion.

Challenges and strategies of clinical rounds from the perspective of medical students: A qualitative research

INTRODUCTION

Clinical rounds provide opportunities for medical students to acquire essential skills to practice medicine in the real world. Although this kind of training is one of the most important components of medical education, it is replete with barriers in its effective implementation. This study aimed to investigate medical students' experiences concerning the barriers and strategies of clinical rounds in Kerman University of Medical Sciences (KMU).

MATERIALS AND METHODS

This qualitative research was conducted on 12 medical students in KMU in 2017. Purposive sampling was used and participants in three grades (stagers, interns, and residents) were selected, and individual semi-structured interviews were conducted until data saturation. The average of the interview time differed among the three batches (stagers, 51 min; interns, 38 min; and residents, 31 min). Content analysis using deductive approach was used for data analysis. MAXQDA version 10 was used for data analysis.

RESULTS

Data analysis yielded the identification of six themes related to the system of clinical education, fields of clinical education, clinical environment, educational program, medical teachers, and medical students concerning the barriers and five themes related to the strategies for clinical rounds.

CONCLUSIONS

Findings revealed a deeper understanding of medical students' experiences. Our investigation identified multiple challenges embedded in our context and strategies to overcome them. As teaching in clinical rounds is invaluable, there is a need to take into account the identified challenges and overcome them. Thus, more effective rounds with higher efficacy toward students' professional development can be implemented.

How do German medical students perceive role models during clinical placements ("Famulatur")? An empirical study

BACKGROUND

Studies have demonstrated the importance of role models in medical education. Medical students in Germany participate in clinical placements ("Famulatur") that last 4 months in total and represent the first real-world setting where students encounter possible role models in their clinical education. These placements are an extracurricular activity, however, and regarded as the "black box" of medical education. This study aimed to evaluate whether and how students experience role models during clinical placements, the qualities associated with potential role models and whether role model-related learning gains are relevant.

METHODS

We recruited 96 students (mean age: 23.83 years; 75% female) in their 5th to 9th semesters at the Faculty of Medicine at the University of Ulm, Germany, who were participating in a clinical placement between July and October 2015. Participants completed a questionnaire at the beginning of a 5-day working week to record sociodemographic and other information and another one at the end of the week to assess various aspects of their experiences. On each of the 5 days, they completed a structured questionnaire to record their perceived role models and self-assessed learning gains.

RESULTS

Role models and role modelling play an important role in clinical placements. The positive function of medical staff as role models predominated (88.4%) across all specialties. Junior doctors were the most frequently perceived role models (28.5%), followed by consultants (25.1%) and nursing staff (22.4%). The most commonly perceived positive quality was the interaction with students (16.5%), followed by team behaviour (13.6%), interaction with patients (13.6%) and professional expertise (13.4%). Students also had various kinds of learning gains such as knowledge or skills.

CONCLUSIONS

Although these clinical placements are extracurricular activities in Germany and their content is not regulated, they are home to a relevant amount of role modelling. Students experience the various medical professions in different roles and in a range of tasks and interactions. Defining basic learning objectives could help to increase the relevance of these placements for the medical curriculum in Germany and transfer the associated learning gains from the hidden to the open curriculum.

Strategies for teaching in clinical rounds: A systematic review of the literature

Background:

Strategies for teaching in clinical rounds are dispersed. There is a need to comprehensively collate bedside strategies to enhance teaching and learning and make clinical rounds more effective.

Materials and Methods:

A systematic review of English articles using Web of Science, PubMed, Embase, Scopus, and Cochrane library was conducted. Relevant keywords for teaching rounds/medical teachers/medical students/strategies and their synonyms were used accordingly. Additional studies were identified by searching reference lists of retrieved articles. All searches were conducted within a 10-day period from May 25, 2017, to June 3, 2017. In this systematic review, studies with any design on the subject of strategies for clinical rounds from clinical teachers’ and medical students’ perspectives were identified. Our search strategy yielded 524 articles. After removing duplicates, 337 articles remained. Based on the title and abstract review, 37 articles were obtained for further review and finally 18 entered the study. Data were extracted from the included studies. Two authors independently screened and scored the studies. We used inductive content analysis, and categories of strategies were derived from the data.

Results:

Content analysis yielded identification of strategies for clinical rounds in nine categories named: system issues, advance planning, a preround huddle, patient issues, teachable moments, teacher issues, student issues, atmosphere issues, and a postround huddle. These were classified as “before rounds,” “during rounds,” and “after rounds” activities. Quality assessment scores for the research studies ranged from 5 to 14 (possible range, 1–16). Fourteen (77.8%) studies received quality scores at or above 10, and 4 (22.2%) studies received quality scores below 10.

Conclusion:

Due to the importance of clinical rounds in students’ learning, medical teachers should divide their teaching session into activities before, during, and after rounds. These strategies on rounding practices can improve teaching and learning.

First Year Medical Student Peer Nominations of Professionalism: A Methodological Detective Story about Making Sense of Non-Sense

This article explores the assessment of professionalism within a cohort of medical students during a sequential 13-week medical school histology and anatomy course. Across seven data points, students were asked to identify a professionalism role model from amongst their peers and to score Likert-structured rationales for their decision. Based on density scores, an initial social network analysis identified six peer-nomination "stars." However, analysis of these stars revealed considerable variability and random-like "noise" in both the nomination and explanation data sets. Subsequent analyses of both data sets explored the possibility of underlying patterns in this noise using tests of reliability, principal components factor analysis, and fixed-effects regression analysis. These explorations revealed the presence of two dimensions (professional vs. supportive) in how students sought to explain their nomination decisions. Although data variability remained quite high, significantly less variability was present in the professional than in the supportive dimension, suggesting that academic helpfulness rationales are both empirically distinct and more mutable than rationales grounded in professionalism-related factors. In addition, data showed that the greater the stability in one's choice of a professionalism role model nomination over the T1-T7 data periods, the more stable one's reasons for that nomination-both for professionalism and supportive dimensions. Results indicate that while peer assessment of professionalism by first-year medical students may not be very reliable, students can differentiate between more personal and professional factors, even at this early stage in their professional development. Formal instruction within the pre-clinical curriculum should recognize and address this distinction. Anat Sci Educ. © 2018 American Association of Anatomists.

The perspective of medical students regarding the roles and characteristics of a clinical role model

Background

As medical students spend most of their time with their clinical teachers and imitate their roles and characteristics during the school year, it is important to identify the roles and characteristics that they find essential in their role models. These traits play a part in their future professions as doctors.

Objective

The aim of this study was to determine the perspective of students, interns, and residents regarding the roles and characteristics of a clinical role model.

Methods

In an analytical cross-sectional study, a structured and self-developed questionnaire was completed by 185 medical students at educational hospitals of Kerman University of Medical Sciences during April and May 2015. Participants were selected using convenience sampling method. For data analysis, we used descriptive and inferential statistics. SPSS software version 16 was used as needed.

Results

In total, 90 medical students (48.7%), 65 interns (35.1%), and 30 residents (16.2%) participated in this study. Male respondents (n=75) comprised 40.5% and female respondents (n=110) 59.5% of the study sample. The three most important roles of a clinical teacher were organizer role (99.7), teacher role (101.7), and supporter role (109.5) for students, interns, and residents respectively. On the other hand, supporter role (85.4), communicator role (86.4) and organizer role (83.4) were ranked as the least important for students, interns, and residents respectively. There was no significant association among the three batches and the roles of a clinical teacher (p>0.05). Conversely, Females rated the roles of a clinical teacher significantly higher than males (p<0.05).

Conclusions

As teachers are frequently perceived by students as role models in medical schools, great attention should be given to their roles. Teachers must be aware that their roles have an impact on students’ professional development and performance.