Perspectives of final-year medical students in Singapore on clinical role models: a mixed methods study

Clinical role modelling is an essential part of medicine's "hidden curriculum", which deeply influences trainees' professional development. Yet, learners' perspectives of both positive and negative clinical role models remain less well-known.

We surveyed a cohort of final-year medical students in Singapore with a comprehensive questionnaire on role model profile, impact, and key attributes, with face and content validation performed as required. Specifically, our study adopted a mixed-methods approach, with collection of quantitative data on respondents' perceptions of positive and negative role models, and qualitative thematic analysis from free-text survey responses.

Majority of role model encounters were with senior clinicians (registrar and above). Most students (> 75%) reported positive role model encounters in clinical settings, although one-third and one-half reported negative role model encounters in medical and surgical rotations respectively. Students highly rated the importance of role models across surveyed domains of personal/professional development. Core role model attributes identified largely pertained to interpersonal skills and professional conduct. Qualitative free-text thematic analysis revealed three major themes: (1) Role modelling humanity: compassion, patience and empathy, (2) Teaching as moral leadership: grounded confidence and professionalism in action, and (3) Negative role modelling: disrespect, humiliation, and their impact.

Medical students placed great value on relational/interpersonal attributes (e.g. empathy, compassion, and professional conduct) in role modeling that forms an integral part of medicine's enduring hidden curriculum. Further qualitative studies to interrogate personal and real-world contextual factors that influence role modeling behaviors would be helpful to inform pedagogical and workplace-based interventions that foster positive clinical role modeling.