Role modeling in clinical practice: A whirlpool around master and apprentice in lifestyle interventions for obesity in general practice

The overall goal of the research reported in this thesis was to gain insight into the influence of the clinical trainer as a role model for the trainee, and to find a way to improve the role model behavior of the clinical trainer in general practice.
Incorporating attributes of positive role modeling in a tool for assessing role model behavior resulted in the Role Model Apperception Tool (RoMAT). This tool can be divided into two components, namely Caring Attitude (=important for communication) and Effectiveness (=important for giving others what they need).
With an FD subject (i.e., conveying knowledge and the correct attitude as a role model) integrated in a CPD course on new guidelines on obesity, only an increase in the trainers’ knowledge could be established but no improvement in role model behavior or knowledge and attitude of the trainees.
This minimal effectiveness of the CPD/FD course, as measured in the target population, might be the result of the expectation that the competences presented to the trainers in a course, will cascade down by way of the master-apprenticeship relation to the trainees.
Adverse currents - such as interaction with the patient - function as filters, diminishing the effects of CPD/FD courses. Therefore, it is better to use a whirlpool than a cascade to visualize the effectiveness of the trainers’ amplification by way of a CPD/FD course. The currents in this whirlpool can be influenced by transforming the filters into multiple turning points that increase rather than decrease the effectiveness.