Wilcock (1999) describes being as the process of being true to our nature, as the contemplation and enjoyment of life, being true to what is distinctive about us. In terms of our professional identity being means being true to our professional values and this begins with recognising what those values look like in practice. Preceptorship does this through the use of the preceptor, the preceptors' skills and abilities and how these are perceived by the preceptees, otherwise known as role modelling. Wilcock also describes how this process requires time and preceptorship offers a dedicated year to this process. Wilcock (1999) goes on to consider being as a fundamental ontological notion, and as such could become part of the ontological security that Giddens discusses as required for reflexivity (Giddens 1991).25
Role modelling is an aspect of preceptorship that is highlighted not only in the College of Occupational Therapists handbook (Morley 2012) but also in the Department of Health guidelines (DOH 2010) and describes a way social learning whereby an individual learns how to be and how to do by watching a more experienced person.
One of the participants, P2, did not experience the role modelling in a way that met her expectations and this caused her some distress. She viewed the woman who had been in the role of the preceptor as being unsupportive and unprofessional. This, despite having a negative impact in terms of her preceptorship appears to have been a reverse role modelling of a sort, one that makes the participant feel they have learnt how not to be.
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Giddens (1991) states that in order to have a stable identity we need to have ontological security; that is an unconscious sense of continuity in our life events. This ontological security he likens to the phenomenological concept of bracketing, i.e. that we accept a version of reality as true, without further question in order to function. Without this ontological security, Giddens argues that we cannot trust in abstract systems such as health care and would have no confidence in the wider social world and thereby struggle to maintain a continuous reflexive identity.
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The experiences of P2 highlight that to be a role model you do not have to be perfect, you do not have to be likeable even and people will learn how to be, or how not to be from the different aspects of the people around them. P2 learnt “how not to” be from the people she considered ‘bad’.
Although during the interviews the participants did not specifically talk about the preceptors in terms of role modelling, they did discuss the issues around role modelling including the skills of the preceptor and their relationship with their preceptors. These factors were discussed in both negative and positive terms, with the positive comments being more prevalent. Six participants made 32 comments about positive skills and relationships with the preceptor compared to four participants making 26 comments about the negative skills and relationships. These comments are made directly about the preceptor; however it is also clear from the data that in the preceptorship year learning can occur from watching the wider team at work, and how the team functions can also influence how the role of the occupational therapist is considered within the team. P3 for example states explicitly when talking about teamwork that:
“All (the) stuff I learnt on the ward, I think it’s all from watching other staff as well, because they are all very skilled.”
Occupational therapists do work primarily within multidisciplinary teams and therefore it is not surprising that other professionals can be seen as role models. P2 describes a team manager, a nurse, whose positive opinion of her is important. When asked if her team acknowledge that she gets good results in her work she replies:
“My senior band 7 (a nurse), who is hard as nails, the toughest girl on the block, she does and that means a lot.”
This not only indicates that other professionals can be a role model, but indicates some of the attributes that P2 finds exemplary in others, and aspires to herself, which is the embodiment of role modelling.
It is, therefore, interesting to look at the skills listed by the participants as being positive as these may then also indicate the skills that the participants aspire to. These were: the
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preceptors being supportive, directive, articulate, knowledgeable, nurturing, motivating, experienced and approachable. The negative skills, i.e. the ones not aspired to were: lack of interest, not caring, no guidance, not supportive and no experience with the paperwork. These negative skills are nearly the polar opposite of the positive skills mentioned, and give a very clear image of the skills that the preceptees valued in the people who were in the position of role model. Role modelling therefore, positive or negative during the preceptorship stage, can have a positive impact on the development of professional identity by allowing the participants to identify the skills in the staff around them that they either want to develop or avoid in order to develop themselves as professionals.