Being an effective role model Dr Margaret Kingston

Being an effective role model Dr Margaret Kingston Associate Medical Director Central Manchester Foundation Trust TPD HEENW Genitourinary Medicine

You ARE a role model, but are you always a good one? Being a positive role model is: Ø A key attribute of a successful doctor Ø Expected of all UK registered doctors by the General Medical Council Education is an integral part of medical practice & learning form role models is an important aspect of medical education because: Ø It teaches the application of knowledge and skills Ø Influences career choices Ø Is how our students and trainees develop professionalism

Students & trainees are aware of their role models - good & bad! “I think a role model is the single best way to learn… if you can see someone do it and understand how and why they do it, I think that’s when you’ll get it” “Enthusiastic about her discipline, involved students actively in the work, excellent knowledge and practical skills, nice to patients, staff and students” “I’ve found my first rotation was very stressful, humiliating, I worked and read because of fear…”

Personal considerations… Ø Who are / were your role models? Ø What was their influence on your learning and career choices? Ø Who are you a role model for? Ø What are your good and bad attributes as a role model?

ILOs for this session “Research indicates that being a positive role model is a set of skills, attitudes and behaviours which may be taught and acquired by doctors…” ØDefine positive and negative attributes of a role model ØUnderstand how learning from role models happens ØHow you can effectively teach through role modelling

Studies have established the attributes reported in medical role models: Individuals who: Ø Excel in their clinical knowledge and skills Ø Through communication skills they maintain good professional relationships Ø Are effective and enthusiastic teachers A tall order! Ø Students & trainees have multiple role models, learning different things from different individuals; the “composite” role model

How learning from role models happens Ø This is a complex process! Aspects have been explained through various learning theories: ØIndividuals learn “to talk, from talk” ØStudents & trainees learn professionalism through the “Hidden Curriculum” : ØThis is a process of assimilation into a community of practice, not only by possession of shared expertise, but also the development of professional values and standards

Cruess, 2008

Video clip • For those you consider to be acting as a role model in these scenarios: – What positive attributes of a role model are they displaying? – Are they demonstrating any negative role model attributes? – How could learning through role modelling be improved in this situation?

Positive role model attributes Personal characteristics • Caring & empathic • Patient-centred approach • Excellent communication skills • Good inter-professional relationships • Demonstrates leadership • Integrity • Good sense of humour • Calm • Positive attitude Clinical skill • Practically skilful • Knowledgeable • Sound clinical reasoning • Strives for excellence • Presentation skills • Aware of own strengths and weaknesses

Positive role model attributes Teaching abilities • Taking an interest in students and trainees • Enthusiasm & patience • Provide clear explanations • Versatile, learner centred teaching style • Constructive feedback • Demonstrating clinical reasoning • Facilitation patient interaction • Identifying opportunities for learning & reflection

Negative role model attributes Personal characteristics • Making derogatory comments • Inappropriate humour • Unfriendliness • Complaining • Expressing anger or frustration • Bitterness and cynicism • Opinionated • Lack of confidence • Un co-operative Clinical skill • Lack of knowledge Teaching abilities • • Forgetting names & faces Excessive criticism Frightening or humiliating Promoting unnecessary competition

How to MAXIMISE learning through role modelling 1. Attention Emphasise/narrative/questions/subdivide 2. Retention Repetition/parallels/relate new to existing knowledge 3. Production Experience with appropriate autonomy 4. Motivation Financial, profile, influence, enjoyment

How to MAXIMISE learning through role modelling Wright & Caresse, 2002

How to MAXIMISE learning through role modelling Blue sky thinking…. When it gets tough…. 1. Time for teaching; can be very efficient: – Appropriate techniques – Using “dead time” – Prioritisation 2. Competing priorities: – Demonstrate how these are managed, including work-life balance/merge 3. Adverse work related pressures: – Explicitly model effectively dealing with these 2. 3. 4. 5. 6. 7. 8. Remember – you are a role model! Make time for teaching Explicitly model skills & behaviours Recognise & use seminal events Provide experience & feedback Creating a positive learning environment and culture (trainees & their teachers) Providing learner centred teaching Show you love it!

Efficient teaching techniques Ø Learner centred: ü Questions; learning objectives, previous experience, pre-exiting knowledge ü Two minute observation Ø Make the implicit explicit by modelling skills, knowledge or behaviours ü Demonstrates reasoning & skills ü Effective communication ü Team working ü Communication skills

Efficient teaching techniques Ø One minute preceptor; rapid learner centred teaching & feedback ü 5 microskills: Commitment, evidence, general rules, reenforce & correct ü Highly evaluated & effective but requires training Ø Directed observation/hot review Ø “Hot seating” Ø Three- way consultation Ø SNAPPS ü Summarise, Narrow down, Analyse differential, Probe uncertainty, Plan management, Select item for selfdirected learning Ø “Aunt Minnie”

The importance of GOOD feedback Ø Feedback can modify & re Ø Feedback “sandwich” -enforce behaviour OR can cause demotivation & Ø Pendleton’s rules poorer performance Ø Reflective feedback Ø General principles: conversation ü Expected everyday ü Clear expectations ü Task specific ü Not judgemental ü Timely ü Limited ü Encourage self-appraisal ü Action plan ü RIP/PIP

Hattie and Timperley, The Power of Feedback, Review of Educational Research, March 2007, Vol. 77, No. 1, pp 81 -112

So, in summary, being a good role model is important because: Being a positive role model is: Ø A key attribute of a successful doctor Ø Expected of all UK registered doctors by the General Medical Council Education is an integral part of medical practice & learning form role models is an important aspect of medical education because: Ø It teaches the application of knowledge and skills Ø Influences career choices Ø Is how our students and trainees develop professionalism

You ARE a role model; how can you be a good one (nearly) all the time? 1. Remember that you are a role model 2. Actively demonstrate your positive role model characteristics and skills 3. Actively demonstrate dealing with challenges 4. Create opportunities for authentic learner centred experiences with constructive feedback 5. Enjoy yourself!

ILOs for this session ØDefine positive and negative attributes of a role model ØUnderstand how learning from role models happens ØHow you can effectively teach through role modelling Thank-you; any questions?