Role modelling—making the most of a powerful teaching strategy

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What makes for an effective role model?As teachers we are capable of wide variation in our performance as role models, and we can demonstrate both positive and negative behaviours in a single encounter, as illustrated in the first vignette (box 1).Box 1 Role modelling vignettes1: In the middle of the nightA house doctor on duty in the intensive care unit at night pages the consultant on call, Dr Smith, to inform her that a postoperative patient is not doing well. The consultant is obviously annoyed at being called in the middle of the night. Although she answers the questions and finally agrees to come in, the conversation is unpleasant and filled with tension, as Dr Smith is abrupt to the point of rudeness.2: In the cafeteriaIn the cafeteria, students and their mentor overhear Dr Reed, a senior surgeon, describing a patient in derogatory terms, using the patient’s name. The mentor asks to speak to Dr Reed privately, and reminds him that he is in a public place, violating patient confidentiality and failing to show respect.3: In the clinicA final year medical student on rotation in a general practitioner’s office finds that a patient with metastatic breast cancer is extremely upset and worried about her future. The general practitioner, Dr Jones, is extremely busy, with many patients waiting. Nevertheless, he enters the consultation room with the student, sits down and takes the patient’s hand, empathises with her concerns, and explains that he is very pressed for time; he also arranges a special appointment with her at a later date when he will have time to reassure her and answer her questions.The characteristics of role models have been well documented1 3 4 8 9 10 (fig 2⇓) and can be divided into three categories:Clinical competence encompasses knowledge and skills, communication with patients and staff, and sound clinical reasoning and decision making. All of these skills must be modelled as they lie at the heart of the practice of medicine.Teaching skills are the tools required to transmit clinical competence. A student centred approach incorporating effective communication, feedback, and opportunities for reflection is essential to effective role modelling.Personal qualities include attributes that promote healing, such as compassion, honesty, and integrity. Effective interpersonal relationships, enthusiasm for practice and teaching, and an uncompromising quest for excellence are equally important.View larger version: In this window In a new window Fig 2 Characteristics of role models