Clinical experiences during preclinical training: the function of modeled behavior and the evidence of professionalism principles

Objectives: Following the fundamental tenets of Bandura's social learning theory, this study examines the functions of modeled behavior during clinical experiences in the first two years of medical training from the students' perspective, and explores the potential presence of professionalism principles in students' narratives. Methods: Data were gathered through in-depth interviews with ten first year and ten second year medical students. Data were analyzed utilizing a subset of deductive codes extracted from previous literature, as well as inductive codes and particular categories and themes that followed from subsequent analysis procedures. Results: Although not explicitly prompted during inter-views, students offered basic principles of professionalism through their descriptions of behaviors and attributes exhibited by shadowed physicians and preceptors as characteristics that they found appealing and desirable to emulate. Also, students not only actively distinguish between role models and anti-models, but the data suggests that antimodels may even serve as effective mechanisms of social learning processes during these early clinical experiences. Furthermore, the data point to the probable influence of anticipatory socialization processes prior to medical training in that students present, as early as their first week of training, conceptions of how a doctor should act towards patients and other health care professionals. Conclusions: Students actively engage in the social learning process, and early clinical exposure provides opportunities for students to refine their understandings and perceptions of their future role through analysis of the attitudes and behaviors displayed by physicians they deem as positive and negative models of the physician role.