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      Importance of faculty role modelling for teaching professionalism to medical students: Individual versus institutional responsibility

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          Abstract

          Objective

          This study explores the perceptions of final year medical students and clinical faculty with regard to role modelling in teaching professionalism.

          Methods

          In this qualitative research design, we used the Constructivist Grounded Theory model. Six semi-structured interviews with faculty from six clinical specialties and three focus group discussions with 22 final year students were conducted. We applied initial, focused and selective coding along with a thematic analysis of the subject to develop a core category. This is the first part of a larger study that addresses the impact of positive role modelling on teaching professionalism. Findings relevant to negative role modelling are being reported in a subsequent paper.

          Results

          The results showed consensus that positive role modelling is the most important strategy for teaching professionalism to medical students. A disturbing finding was a perceived deteriorating level of inspirational positive role modelling. A lack of institutional support and weak regulatory control were pointed out as potential factors contributing towards this deterioration.

          Conclusion

          Positive role modelling was found to be the most effective way to teach professionalism to medical students. However, it cannot be truly effective unless institutions play their role which is pivotal in promoting a culture of professionalism. This can be materialized by recognizing and facilitating conscientious and explicit role modelling by the medical faculty. In addition, an effective regulatory control by the concerned authorities could play an important role.

          الملخص

          أهداف البحث

          تستكشف هذه الدراسة تصورات طلاب السنة النهائية من كلية الطب وأعضاء هيئة التدريس السريريين حول نموذج يحتذى به في تدريس المهنية الطبية.

          طرق البحث

          في هذه الدراسة البحثية النوعية، استخدمنا نموذج نظرية البنائية الأساسية. وتم إجراء ست مقابلات شبه منظمة مع أعضاء هيئة التدريس من ست تخصصات سريرية وثلاث مناقشات جماعية مركزة مع ٢٢ طالبا في السنة النهائية. لقد طبقنا ترميزا مركّزا وانتقائيا جنبا إلى جنب مع تحليل موضوعي للموضوع لتطوير فئة أساسية. وهذا هو الجزء الأول من دراسة أكبر تتناول تأثير نموذج الدور الإيجابي على تدريس المهنية الطبية.

          النتائج

          تظهر هذه الدراسة إجماعا على أن نموذج الدور الإيجابي هو أهم استراتيجية لتدريس المهنية الطبية لطلاب الطب. كانت النتيجة المزعجة هي تدهور مستوى نموذج الدور الإيجابي الملهم. تمت الإشارة إلى الافتقار إلى الدعم المؤسسي وضعف الرقابة التنظيمية كعوامل محتملة تسهم في هذا التدهور.

          الاستنتاجات

          تم العثور على نموذج الدور الإيجابي ليكون أكثر الطرق فاعلية لتعليم المهنية الطبية لطلاب الطب. ومع ذلك، لا يمكن أن تكون فاعلة حقا ما لم تلعب المؤسسات أدوارها المحورية في تعزيز ثقافة المهنية الطبية. يمكن تحقيق ذلك من خلال التعرف على نماذج الأدوار الواعية والصريحة وتسهيلها من قبل كلية الطب. يمكن أن تلعب الرقابة التنظيمية الفاعلة من قبل الجهات المعنية دورا مهما في هذا الصدد.

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          Most cited references32

          • Record: found
          • Abstract: found
          • Article: not found

          Empathy decline and its reasons: a systematic review of studies with medical students and residents.

          Empathy is a key element of patient-physician communication; it is relevant to and positively influences patients' health. The authors systematically reviewed the literature to investigate changes in trainee empathy and reasons for those changes during medical school and residency. The authors conducted a systematic search of studies concerning trainee empathy published from January 1990 to January 2010, using manual methods and the PubMed, EMBASE, and PsycINFO databases. They independently reviewed and selected quantitative and qualitative studies for inclusion. Intervention studies, those that evaluated psychometric properties of self-assessment tools, and those with a sample size <30 were excluded. Eighteen studies met the inclusion criteria: 11 on medical students and 7 on residents. Three longitudinal and six cross-sectional studies of medical students demonstrated a significant decrease in empathy during medical school; one cross-sectional study found a tendency toward a decrease, and another suggested stable scores. The five longitudinal and two cross-sectional studies of residents showed a decrease in empathy during residency. The studies pointed to the clinical practice phase of training and the distress produced by aspects of the "hidden," "formal," and "informal" curricula as main reasons for empathy decline. The results of the reviewed studies, especially those with longitudinal data, suggest that empathy decline during medical school and residency compromises striving toward professionalism and may threaten health care quality. Theory-based investigations of the factors that contribute to empathy decline among trainees and improvement of the validity of self-assessment methods are necessary for further research.
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            • Article: not found

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

            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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              Doctor role modelling in medical education: BEME Guide No. 27.

              The aim of this review is to summarise the evidence currently available on role modelling by doctors in medical education. A systematic search of electronic databases was conducted (PubMed, Psyc- Info, Embase, Education Research Complete, Web of Knowledge, ERIC and British Education Index) from January 1990 to February 2012. Data extraction was completed by two independent reviewers and included a quality assessment of each paper. A thematic analysis was conducted on all the included papers. Thirty-nine studies fulfilled the inclusion criteria for the review. Six main themes emerged from the content of high and medium quality papers: 1) the attributes of positive doctor role models; 2) the personality profiles of positive role models; 3) the influence of positive role models on students' career choice; 4) the process of positive role modelling; 5) the influence of negative role modelling; 6) the influence of culture, diversity and gender in the choice of role model. This systematic review highlights role modelling as an important process for the professional development of learners. Excellence in role modelling involves demonstration of high standards of clinical competence, excellence in clinical teaching skills and humanistic personal qualities. Positive role models not only help to shape the professional development of our future physicians, they also influence their career choices. This review has highlighted two main challenges in doctor role modelling: the first challenge lies in our lack of understanding of the complex phenomenon of role modelling. Second, the literature draws attention to negative role modelling and this negative influence requires deeper exploration to identify ways to mitigate adverse effects. This BEME review offers a preliminary guide to future discovery and progress in the area of doctor role modelling.
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                Author and article information

                Contributors
                Journal
                J Taibah Univ Med Sci
                J Taibah Univ Med Sci
                Journal of Taibah University Medical Sciences
                Taibah University
                1658-3612
                26 July 2021
                February 2022
                26 July 2021
                : 17
                : 1
                : 112-119
                Affiliations
                [a ]Department of Health Professions Education, National University of Medical Sciences, Pakistan
                [b ]Centre of Medical Education, Ninewells Hospital, University of Dundee, Scotland, United Kingdom
                Author notes
                []Corresponding address: Department of Health Professions Education, National University of Medical Sciences, The Mall, Abid Majeed Road, Rawalpindi, Punjab, 46000, Pakistan. adeela.bashir@ 123456numspak.edu.pk
                [c]

                Institution where research was conducted: CMH Lahore Medical College, Lahore, National University of Medical Sciences, Pakistan.

                Article
                S1658-3612(21)00136-0
                10.1016/j.jtumed.2021.06.009
                8802861
                35140573
                a1a7015b-cbb1-49e1-a1de-69c1a7f92d81
                © 2021 Taibah University. Production and hosting by Elsevier Ltd.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 30 April 2021
                : 25 June 2021
                : 28 June 2021
                Categories
                Original Article

                كلية السريرية,طلاب الطب,المهنية الطبية,نمذجة الدور,تعليم,clinical faculty,medical students,professionalism,role modelling,teaching

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