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      The Heroic and the Villainous: a qualitative study characterising the role models that shaped senior doctors’ professional identity

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          Abstract

          Background

          The successful development and sustaining of professional identity is critical to being a successful doctor. This study explores the enduring impact of significant early role models on the professional identity formation of senior doctors.

          Methods

          Personal Interview Narratives were derived from the stories told by twelve senior doctors as they recalled accounts of people and events from the past that shaped their notions of being a doctor. Narrative inquiry methodology was used to explore and analyse video recording and transcript data from interviews.

          Results

          Role models were frequently characterised as heroic, or villainous depending on whether they were perceived as good or bad influences respectively. The degree of sophistication in participants’ characterisations appeared to correspond with the stage of life of the participant at the time of the encounter. Heroes were characterised as attractive, altruistic, caring and clever, often in exaggerated terms. Conversely, villains were typically characterised as direct or covert bullies. Everyday events were surprisingly powerful, emotionally charged and persisted in participants’ memories much longer than expected. In particular, unresolved emotions dating from encounters where bullying behaviour had been witnessed or experienced were still apparent decades after the event.

          Conclusion

          The characterisation of role models is an important part of the professional identity and socialisation of senior doctors. The enduring impact of what role models say and do means that all doctors, need to consistently reflect on how their own behaviour impacts the development of appropriate professional behaviours in both students and training doctors. This is especially important where problematic behaviours occur as, if not dealt with, they have the potential for long-lasting undesirable effects. The importance of small acts of caring in building a nurturing and supportive learning atmosphere at all stages of medical education cannot be underestimated.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12909-016-0731-0) contains supplementary material, which is available to authorized users.

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          Most cited references53

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          GENDER ROLES AND WOMEN'S ACHIEVEMENT-RELATED DECISIONS

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            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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              Narrative Analysis

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                Author and article information

                Contributors
                +612 9926 4658 , kirsty.foster@sydney.edu.au
                christopher.roberts@sydney.edu.au
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                16 August 2016
                16 August 2016
                2016
                : 16
                : 206
                Affiliations
                [1 ]Medical Education and International Health, Sydney Medical School - Northern, Kolling Institute and Office for Global Health, University of Sydney, Level 7 Kolling Building, Royal North Shore Hospital, St Leonards, Sydney, New South Wales 2065 Australia
                [2 ]Medical Education and Primary Care, Sydney Medical School- Northern, Kolling Institute, University of Sydney, Sydney, Australia
                Article
                731
                10.1186/s12909-016-0731-0
                4986406
                27530252
                add52ef0-30e9-40e6-88b7-f4d5047e9a52
                © Foster and Roberts. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 4 May 2015
                : 9 August 2016
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Education
                professional identity,role model,narrative analysis,emotion,clinical education,reflection on behaviour

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