Role models and Troll models - September 2025

Links

'Role Model Moments' and 'Troll Model Moments' in Surgical Residency: How Do They Influence Professional Identity Formation? - PubMed 

The session was centred on the concepts of 'Role Models and Troll Models', which offer a perspective on learning through observation. 

Core Concepts of the Workshop

The workshop presented a framework derived from recent research in medical education, designed to move beyond simplistic notions of professional exemplars.

• 'Role Model Moments': These are defined as specific instances where an observed behaviour is perceived as inspirational. Such moments are characterised by the learner feeling engaged, trusted, and supported, and they often lead to the positive adoption of a behaviour through subsequent reflection.

• 'Troll Model Moments': These are instances where a witnessed behaviour is perceived as unprofessional or misaligned with professional values. The learner typically feels distant or unsupported, and the experience prompts a conscious and immediate rejection of the behaviour ("I will not emulate that conduct").

A distinction was drawn between these observable moments and the individuals who exhibit them. The framework posits that any individual can be the source of both types of moments. This encourages trainees to engage in a sophisticated process of selectively adopting and rejecting specific behaviours, rather than uncritically idolising or dismissing colleagues. These interactions are a primary mechanism through which the Hidden Curriculum—the unwritten norms and values of a profession—is transmitted.

Discussions

• Systemic Pressures and Professional Behaviour: It was widely acknowledged that 'troll moments' are often not a result of individual malice but a symptom of a stressed system. The term 'Goblin Mode' was used by participants to describe a state wherein professional standards may lapse due to extreme pressure. This highlighted that context, such as the COVID-19 pandemic, can alter perceived norms of acceptable behaviour.

• The Role of Reflection: A consensus emerged that reflection is of of the mechanism that transforms a negative observational experience into a valuable learning opportunity. Without structured reflection, there is a risk that learners may normalise unprofessional conduct, a phenomenon described as the 'Schweitzer effect'.

• Psychological Safety as a Prerequisite: For reflection and open discussion to occur, the learning environment needs to be psychological safe. 

• The Erosion of the 'Community of Practice': Tutors discussed the decline of informal collegiate spaces, such as the doctors' mess or scheduled coffee breaks. These environments have historically served as the natural habitat for a Community of Practice, allowing for the informal debriefing and processing of challenging clinical moments.

Ideas for Educational Practice

• Employ a Shared Lexicon: Educators should use the language of 'role' and 'troll' moments to facilitate discussions. This vocabulary depersonalises feedback and allows for a more objective analysis of behaviour.

• Develop Observational Acuity: Educators should cultivate the skill of observing their trainees' reactions to clinical events. A non-verbal cue, or 'flinch', can be an indication that a significant moment has occurred and may warrant a follow-up conversation.

• Foster a Culture of Openness: Creating psychological safety requires educators to model vulnerability. By sharing their own 'troll moments' and demonstrating an openness to feedback, they can encourage trainees to do the same.

• Protect Time for Informal Interaction: Where possible, educators should champion the protection of time for informal team connection. These moments are vital for maintaining the health of the 'Community of Practice' and providing opportunities for peer support.