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The Modeling and Role-Modeling Theory

Table of Contents
1. Summary
2. Theorists: Education and Specialties
3. Nursing Theory, Concepts, and Propositions
4. Application of Meta-Paradigms
5. Theory's Implication on Nursing Practice, Education, and Research
6. References
1. Summary
The modeling and role-modeling theory of nursing care was developed by Helen Erickson,
Evelyn Tomlin, and Mary Swain. The three joined together in agreeance that each individual
human being is unique and has a goal to reach his or her highest potential. According to this
theory, it is the nurse's priority to assist the patient in achieving his or her goals through
replicating or modeling the patient's desired environment and world views. To apply nursing
practice under this theory, a nurse must be willing to delve into the client's world view and to
look at life and healing from the client's perspective. A nurse must display empathy and be
willing to demonstrate total individualization of care for each patient. This individualization of
care alongside complete acceptance of a client regardless of culture, socioeconomic factors, and
other distinguishing factors allows patients to recover in a timely and convenient manner.

2. Theorists: Education and Specialties
Helen Erickson
Professor Helen Lorraine (Cook) Erickson graduated from Saginaw General Hospital of
Saginaw, Michigan in 1957, after which she specialized in ER and medical-surgical nursing.
Erickson continued her education at the University of Michigan with her Bachelors of Science in
Nursing in 1974 and a Masters degree in Psychiatric Nursing in 1976 (Society for the
Advancement of Modeling an Remodeling Theory, 2011). Erickson then proceeded to develop
her career as an independent psychiatric nurse consultant prior to returning to the University of
Michigan for her Doctorate in Education Psychology in 1984 (Society for the Advancement of
Modeling an Remodeling Theory, 2011). She has since written numerous articles and studies
over nursing theories and holistic approaches to nursing.
Evelyn Tomlin
Evelyn M. Tomlin studied nursing at the University of Southern California, Los Angeles, at
which she received her baccalaureate degree prior to a masters in psychiatric nursing (1976)
from the University of Michigan (George, 2010, p. 518). Tomlin has worked in several different
areas of nursing including critical care, home care, independent practice, and staff nursing, but
currently specializes in women and childrens care with a background in Christian healing.
Tomlins focus on religion and healing has led her to publish works as to the connection between
Christian values and modeling/role-modeling theory (George, 2010, p. 518).
Mary Swain
Professor Mary Ann P. Swain graduated from DePauw University with her Bachelors of Arts in
Psychology in 1963 (University of Michigan, 1993). Swain immediately followed up with her
M.A. (1964) and Ph.D. (1969) from the University of Michigan both in psychology (University
of Michigan, 1993). Swains specialties revolved around her extensive education in psychology;
she furthered others educations by instructing psychology in nursing at the University of
Michigans School of Nursing and joining numerous higher-education committees such as the
Committee on the Status of Women in Higher Education (University of Michigan, 1993).
Professor Swain has also contributed to several different studies over nursing theories
primarily those in relation to stress adaptation and role-modeling.

3. Nursing Theory, Concepts, and Propositions
Nursing Theory
Modeling and Role-Modeling is a holistic nursing theory involving interpersonal and
interactive relationships between the nurse and client (George, 2010, p. 519). The clients view
of the world is the main focus and the nurse must adapt the plan of care to meet their individual
needs. Modeling is a process used to understand the world from the clients perspective (George,
2010, p. 519). It is both an art and a science, involving empathetic understanding of the present
circumstance within the clients context of the world (George, 2010, p. 519). The science of
modeling involves using information collected from the clients perspective and analyzing it to
adapt plans of care. Role-modeling is the facilitation of health, and is also an art and a science
(George, 2010, p. 520). The art is the individualization of care for the client and the science
requires the use of theoretical knowledge when planning and implementing that care (George
2010, p. 520). The overall goal of modeling and role-modeling is to create an environment
replicating the clients world and ensuring care is individualized for them.
Concepts
There are numerous concepts that are related to this theory. One is facilitation, which
involves making a situation easier or to help something run more smoothly (Webster, 1981, p.
812). This concept relates to nurses being able to adapt care for their clients in order to make
their world experiences better. Another concept is nurturance, relating to the act of caring for and
nurturing a patient to make them feel at ease in their environment. It is the nurses job to ensure
patients are comfortable and cared for effectively within the realm of their world. It also implies
support for growth and development, providing sustenance, and something that can predict
change over time (George, 2010, p. 528). A client who has a nurturing atmosphere will be able to
develop skills and restore health efficiently, especially in the context of their world.
Unconditional acceptance is another concept related to this theory. Acceptance is achieved when
something or someone is taken into favor or approval by something or someone else.
Unconditional means that it happens despite what they say or do. Clients who are cared for under
this theory require unconditional acceptance in order to know that their views of the world are
okay and to stimulate their growth. Without acceptance from their nurses, the clients could
possibly have their care process halted and be unable to reach their optimal level of health.
Propositions and Assumptions
The propositions and assumptions related to this theory help to connect the main ideas
and concepts while explaining how they can help clients with modeling and role modeling. An
assumption that this theory uses is that nurses have a strong theoretical foundation to use for
planning and implementing care for clients. It can be assumed that this is true based on the
educational process of nurses, and it can be linked to the concept of facilitation. In order to make
the clients care process run smoothly, the nurse has to have a theoretical background to adapt
the nursing process for individualized care. Nurses who have knowledge of nursing theory can
shape their nursing process to meet specific and individualized needs of clients and facilitate
their growth and restoration. Another assumption involved in this theory is that the whole is
greater than the sum of the parts. This is explained by the holistic approach of the theory and the
need for overall health, including physical, mental, and social well-being (George, 2010, p. 527).
This assumption is connected to the concept of nurturance because it is a nurses duty to ensure
overall care for the client. By nurturing them effectively, the client will be able to develop and
progress in a timely manner and reach overall optimal health. The last assumption related to the
modeling and role modeling theory is that individuals are unique. This assumption is related to
the concept of universal acceptance because nurses have to accept diversity and provide care
regardless of differences between clients. Each client will have different qualities, backgrounds,
cultures, and health problems that nurses must adapt to and work with. Also, relating to this
theory, each patient has his or her own individual view of the world that the nurse has to model
in order to provide the best care possible.

4. Application of Meta-paradigms in the Modeling and Role-Modeling Theory
The nursing paradigm is linked together by the person, health, environment and nursing (Potter
& Perry, 2012, p. 40). The Modeling and Role- Modeling theory has its own unique
characteristics to describe each link of the paradigm.
Person
Each person has their own subsystem that interacts with genetics, and beliefs. The interacting
subsystems include biophysical, psychological, social and cognitive (George, 2010, p. 524).
According to the Modeling and Role-Modeling theory, each person has a desire to achieve his or
her own potential even though every individual is unique (George, 2010, p. 526). The way
people achieve their self -potential varies due to different inherent behaviors, experiences and
abilities to handle stressors.
Environment
The environment is where people live internally and externally. Stressors are a daily part of life
but a person can adapt to the stressors internally and externally. External factors may be
necessary for clients who need assistance in recognizing stress and resources to adapt to stressors
in his or her life (George, 2010, p. 526).
Health
The definition of health has expanded to not only include the absence of disease, but also the
state of wellbeing which includes physical, mental and psychosocial. Health, according the
Modeling and Role-modeling theory, is described as the person adjusting to stressors in the
environment using internal and external sources (George, 2010, p. 527). While adjusting to
stressors, the person is not compromising the biophysical, psychological, social and cognitive
systems (George, 2010, p. 527).
Nursing
The goal of nursing in any theory is to help the patient achieve his or her optimum level of health
and overall well-being. The act of nursing is an interactive process that requires interpersonal
communication between the nurse and the patient (George, 2010, p. 527). The three aspects of
the Modeling and Role- Modeling theorys definition of nursing are facilitation, nurturance and
unconditional acceptance (George, 2011, p. 527). Facilitation takes the patients strengths and
build upon it with the help of the nurse (George, 2011, p. 527). Facilitation helps build the nurse-
patient relationship and allows the patient to trust his or her nurse to help make him or her better.
Nurturance is the essence of nursing; it combines the caring aspect with the cognitive,
psychological, and affective processes nurses have to help a patient achieve his or her optimal
amount of health (George, 2011, p. 527). The last aspect is acceptance off anyone. No matter
whom the patient is or what the situation is, a nurse must say with a smile that he or she would
be happy to help.

5. Theorys Implication to Nursing Practice, Education, and Research
Theorys implication to nursing practice
The theory of modeling and role modeling demands that the nurses assesses the patient,
which is modeling the patients world to understand it as the client perceives his or her world. It
demands that the nurse plans by role modeling, which is the individualization of care that draws
on the perspective the client has on the world. The nurses intervention are based on how the
client perceives the world which is obtained through the modeling and role modeling
characteristics. It is imperative that the nurse intervenes on an individualized manner because it
is based inherently on the way the client views the world. The implementations of care should be
based on all the components that go into how a client perceives the world because these all affect
views and the best measures for implement care are derived from perspectives. The nurse
assesses the client to understand their perceptions and allows the implementations to follow this
in nursing practice (George, 2011, p. 518-519).
The theory includes the five aims of interventions including building trust, promoting
positive orientation, promoting perceived control, promoting strengths, and setting mutual goals
that are health direction. These aims of interventions are based on the clients perspective of the
world. Due to the fact that all people share some common ideals, the theory is able to be
standardized to an extent (George, 2011, p. 520). For example people all share the same basic
needs as evidenced by the first tier of Maslows Hierarchy of needs. People also have
commonalities in cognitive development and psychosocial development. However, it cannot be
too narrow in scope because people differ in model of the world, stress, adaption, and self care
(Modeling and Role Modeling Theory, 2013, para 3). Building trust is essential in order to be
able to obtain information about the clients perspective. Promoting positive orientations basis
lies on promoting the clients strengths and his or her self worth. Promoting perceived control is
important because implementations rely on a clients perception of the control they have on
health situations. Promoting strengths is important because it gives clients a way to utilize
resources. Setting mutual goals that are health directed is part of the aims because it is important
for the nurse and client to have same ideas about what should happen. If a nurse has different
goals or ideas than the patient, it is a clear indicator that the nurse did not properly model the
perspective of the clients world. It is imperative to follow through with complete modeling in
order to have mutual goals in mind. Incomplete modeling will hinder this process and make it
incredibly difficult to make mutual goals (George, 2011, p. 520-521).
Self care refers to independent care that the client carries out him or herself. In the
modeling and role modeling theory self care comes from personal knowledge of how to carry out
self care, or what makes him or her be healthy. All clients are given knowledge and resources
about self care and nurse helps assist in carrying out the information they have. Self care is used
in implementation and planning of implementation for clients (George, 2011, p. 522)
The modeling and role modeling theory recognizes that the nursing process in not always
used in a step by step fashion. For example, a nurse does not assess then diagnosis, usually
nurses diagnosis while assessing. The theory liberates nurses from the linear model and thinking
of the nursing process and makes it more of a circular process. The theory considers nursing
priorities in a slightly different way than most theories. In fact, theory relies on clients concerns
being the top priority. This stems from the fact that other needs of clients will not be met until
their primary need is considered and fixed. The priority comes from what the client requests to
be measured. Assessment is controlled by what the client considers important to be able to
provide care for other issues after the client is ready. This is an important step in being able to
understand the clients perspective of the world by modeling and then role playing. It also
established a caring trust relationship right away. The nursing process is still used, however,
there are no required steps when implementing the nursing process for care. The theory views the
nursing process as interactive and ongoing while still including the scientific mode. Nurses
absolutely must use role playing while implementing care. This includes providing optimal care
while keeping consistent ideas of the clients perspective of the world (George, 2011, p. 528-
529).
Theorys implication to education
The theory is implemented in education in many ways. Overall, nurses have to learn
theories of nursing care to be able to implement care to patients in an optimal way. In the
modeling and role modeling theory nurses are taught to care for patients based on the patients
perspective of the world. This requires nurses to be able to demonstrate empathy and
understanding of a variety of patient perspectives. Nurses must also understand that all clients
are different, so implementations for care must be individualized and based fully on the clients
needs. It is important to have knowledge and education about the theory to be able to correctly
implement care (Hertz, 1997, para. 4).
Theorys implication to research

The theory considers research in many ways as well. Research must be done in order to
test the theory and consider if it works. Without research, there is no way to know if the theory
can be implemented into a method of care. Modeling and roleplaying is a grand theory that
encompasses a number of mid range theories. The parts that make up the theory have been
empirically tested. Specifically individuals ability to adapt to stress has been researched,
individuals to utilizes provided resources, and how unmet needs lead to interference with growth
and developmental processes to name a few. Some of the more broad parts of the theory that
have been researched include how basic need satisfaction and task resolution are connected, how
adaptation is related to needs to be met, and how loss resolve affects developmental process or
state. The components of the theory need to be tested and researched in order to validate that the
theory can be used in practice in a way to achieve optimal health (Hertz, 1997, para. 8).

References
George, J.B. (2010). Nursing theories: The base for professional nursing practice (6
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Philadelphia: Pearson.
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http://www.mrmnursingtheory.org/mrmoverview.html
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Nursing. Retrieved from http://nursingplanet.com/theory/modeling_and_role-
modeling_theory.html

Potter, P.A., & Perry, A.G. (2012). Fundamentals of nursing (8
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Mosby Elsevier.
Society for the Advancement of Modeling and Role Modeling, The (2011). About Helen C.
Erickson. Retrieved from http://mrmnursingtheory.org.
University of Michigan (1993). Memoir: Mary Ann P. Swain. Retrieved from
http://um2017.org/faculty-history/faculty/mary-ann-p-swain/memoir
Webster. (1981). Websters Third New International Dictionary. Massachusetts: G & C Merriam
Company Publishers.