Clinical teachers as positive and negative role models: an explanatory sequential mixed method design

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Abstract

Today, role modeling is an essential component of medical education that facilitates the students' learning and affects their attitudes and behaviors. Hence, this study aimed to examine the characteristics of positive and negative role models using a mixed method approach. In the quantitative part, data were collected using a questionnaire with 24 items. The research population included medical students who were in their clinical period between May 2017 and December 2018 at Shiraz University of Medical Sciences (n = 750). A total of 282 questionnaires were completed by these students, and in the qualitative part, 26 semi-structured interviews were conducted with them.

The most important components of role modeling for students included: individual characteristics, clinical skills and competence, teaching skills and professionalism, in that order. The qualitative analysis confirmed the results of the quantitative analysis. The findings showed that the characteristics of a negative role model can also be classified in four main components. The results demonstrated that 46.8% of the students identified one or more medical teachers as negative models.

Students paid attention to not only the positive characteristics of their teachers, but also their negative features, stating that they had been influenced by both. Therefore, it can be concluded that clinical teachers should improve their performance as positive role models through reducing these negative effects and reinforcing positive characteristics.

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What makes a good clinical teacher in medicine? A review of the literature.

Randolph Schiffer, Gary Sutkin, Elizabeth Wagner … (2008)

The authors perform a review of the literature pertinent to the question, "What makes a good clinical teacher in medicine?" After framing the question, based on discussions of their own experiences with clinical teachers, the authors performed a search of the literature pertinent to the question, "What are the qualities of a good clinical teacher in medicine?" Between July and December, 2006, they reviewed titles from Index Medicus (1909-1966), PubMed (1966 to the present), PubMed Related Articles, and referenced articles. The initial selections were chosen by scanning pre-1966 Index Medicus title lists and post-1966 abstracts. Chosen articles were then read in their entirety, and those which described specific characteristics of clinical teachers were selected for inclusion. Qualitative analysis was used to identify themes. From 4,914 titles, 68 articles were selected for analysis-26 published before 1966, and 42 published after 1966. Four hundred eighty descriptors were identified and grouped into 49 themes, which were clustered into three main categories: physician, teacher, and human characteristics. Echoing the authors' intuitive descriptions, noncognitive characteristics dominated the descriptions and themes. Excellent clinical teaching, although multifactorial, transcends ordinary teaching and is characterized by inspiring, supporting, actively involving, and communicating with students. Faculty development programs and future research should focus on development of the noncognitive attributes of clinical teachers, as well as the knowledge and skills associated with effective teaching.

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Role modeling in physicians' professional formation: reconsidering an essential but untapped educational strategy.

Heather MacLeod, N Kenny, V Mann (2003)

Forming technically proficient, professional, and humanistic physicians for the 21st century is no easy task. Mountains of biomedical knowledge must be acquired, diagnostic competence achieved, effective communication skills developed, and a solid and applicable understanding of the practice and role of physicians in society today must be reached. The central experience for learners in this complex and challenging terrain is the "modeling of" and "learning how to be" a caregiver and health professional. Role modeling remains one crucial area where standards are elusive and where repeated negative learning experiences may adversely impact the development of professionalism in medical students and residents. The literature is mainly descriptive, defining the attributes of good role models from both learners and practitioners' perspectives. Because physicians are not "playing a role" as an actor might, but "embodying" different types of roles, the cognitive and behavioral processes associated with successfully internalizing roles (e.g., the good doctor/medical educator) are important. In this article, the authors identify foundational questions regarding role models and professional character formation; describe major social and historical reasons for inattention to character formation in new physicians; draw insights about this important area from ethics and education theory (philosophical inquiry, apprenticeship, situated learning, observational learning, reflective practice); and suggest the practical consequences of this work for faculty recruitment, affirmation, and development.

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Attributes of excellent attending-physician role models.

S. Wright, K B Kolodner, Francesco Brancati … (1998)

Although effective role models are important in medical education, little is known about the characteristics of physicians who serve as excellent clinical role models. We therefore conducted a case-control study to identify attributes that distinguish such physicians from their colleagues. We asked members of the internal-medicine house staff at four teaching hospitals to name physicians whom they considered to be excellent role models. A total of 165 physicians named by one or more house-staff members were classified as excellent role models (these served as the case physicians in our study). A questionnaire was sent to them as well as to 246 physicians who had residency-level teaching responsibilities but who were not named (controls). Of these 411 physicians, 341 (83 percent) completed questionnaires while unaware of their case-control status. Of the 341 attending physicians who responded, 144 (42 percent) had been identified as excellent role models. Having greater assigned teaching responsibilities was strongly associated with being identified as an excellent role model. In the multivariate analysis, five attributes were independently associated with being named as an excellent role model: spending more than 25 percent of one's time teaching (odds ratio, 5.12; 95 percent confidence interval, 1.81 to 14.47), spending 25 or more hours per week teaching and conducting rounds when serving as an attending physician (odds ratio, 2.48; 95 percent confidence interval, 1.15 to 5.37), stressing the importance of the doctor-patient relationship in one's teaching (odds ratio, 2.58; 95 percent confidence interval, 1.03 to 6.43), teaching the psychosocial aspects of medicine (odds ratio, 2.31; 95 percent confidence interval, 1.23 to 4.35), and having served as a chief resident (odds ratio, 2.07; 95 percent confidence interval, 1.07 to 3.98). These data suggest that many of the attributes associated with being an excellent role model are related to skills that can be acquired and to modifiable behavior.

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Author and article information

Journal

Journal ID (nlm-ta): J Med Ethics Hist Med

Journal ID (iso-abbrev): J Med Ethics Hist Med

Journal ID (publisher-id): JMEHM

Title: Journal of Medical Ethics and History of Medicine

Publisher: Tehran University of Medical Sciences (Tehran, Iran )

ISSN (Electronic): 2008-0387

Publication date Collection: 2019

Publication date (Electronic): 4 September 2019

Volume: 12

Electronic Location Identifier: 11

Affiliations

[1 ] Assistant Professor, Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

[2 ] Professor, Department of Medical Ethics and Philosophy in Health Care, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

[3 ] Researcher, Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Author notes

[* ]Corresponding Author: Ali Asghar Hayat. Sina-Sadra Halls Complex, Neshat Ave., Shiraz, Iran. Tel: (+98) 0713 23 33 064. Email: ali.hayat63@ 123456gmail.com

Article

Publisher ID: JMEHM-12-11

DOI: 10.18502/jmehm.v12i11.1448

PMC ID: 7166239

PubMed ID: 32328224

SO-VID: 3e976479-dcc1-4c8a-a857-bade20834f9e

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Clinical teachers as positive and negative role models: an explanatory sequential mixed method design

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Most cited references 32

What makes a good clinical teacher in medicine? A review of the literature.

Role modeling in physicians' professional formation: reconsidering an essential but untapped educational strategy.

Attributes of excellent attending-physician role models.

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