A skill to be worked at: Using social learning theory to explore the process of learning from role models in clinical settings

Abstract

Background: Role modelling is widely accepted as being a highly influential teaching and learning method in medical education but little attention is given to understanding how students learn from role models. This study focuses on role modelling as an active, dynamic process, involving observational learning and aims to explore the process involved, including strategies that learners and medical teachers use to support this. Methods: To gain insight into medical students’ and clinical teachers’ understanding of learning through role modelling, a qualitative, interpretative methodology was adopted, using one-to-one semi-structured interviews. Six final year medical students and five clinical teachers were purposefully sampled and interviewed. Interviews were audio recorded and transcribed. The data were then analysed using open and axial coding before codes were combined to develop broader themes. Results: Students could identify ways in which they learnt from role models but acknowledged that this was complex and haphazard. They described selectively and consciously paying attention, using retention strategies, reproducing observed behaviour and being motivated to imitate. Students evidenced the powerful impact of direct and vicarious reinforcement. Clinical teachers reported using strategies to help students learn, but these were not always consciously or consistently applied or informed by teachers’ understanding of their students’ cognitive processing. Conclusion Findings illustrate in what ways the process of learning from role models in clinical settings is challenging. They also support the relevancy and usefulness of Bandura’s four stage social learning model for understanding this process and informing recommendations to make learning from role modelling more systematic and effective.