Background

The impact of role models and clinical supervisors is known to be significant in the development of professionalism. My doctoral research looked at factors influencing notions of professionalism, in particular the nature of the relationship between doctors and significant role models encountered during their training. 

Methods

In-depth interviews were conducted with twelve senior clinicians asking them to reflect on factors they felt had influenced the their own notion of the meaning of professionalism. Three separate analyses were conducted within a constructivist interpretive framework: a thematic analysis; an analysis of the characterisation of protagonists in the narratives; and a metaphorical analysis (not reported here)

Results

Three main groups of factors were found to contribute to understanding of professionalism: environmental factors such as medical culture and societal expectations; personal factors such as identity, self-esteem, gender and social status; and people factors including doctor role models and teaching and learning relationships. Role model clinicians were almost entirely characterised as heroes or as villains, and strong emotions evoked within interpersonal interactions impacted on learning. For example, feedback on a job well done builds self-esteem and reinforces good practice while working in an atmosphere of fear and humiliation inhibits learning and destroys self-esteem. The impact of both positive and negative experiences was persisted for many years.  

Conclusion

The quality of the interpersonal relationships between medical students and postgraduate trainees and their supervisors contributes to developing notions of professionalism. Emotional tone is especially influential in creating an atmosphere which may be conducive or aversive to learning depending on the nature of the evoked emotion. These findings are likely to be transferable to the efficacy of the relationship between higher degree research student and their supervisor with resultant impact on the quality of work.