CHAPTER 2 THE PRINCIPLES OF BEHAVIOURIST PSYCHOLOGY 43

are around them. This will enable the nurse to firstly be aware that patients can learn from people around them and, secondly, that they themselves may be seen as a role model. Ost and Hughdahl (1985) found that 12 per cent of adult dental pho-bics can trace their dental fear back to a vicarious experience in the past, which demonstrates how individuals from a young age learn from vicarious learning. Many initiatives have manipulated observational learning, especially for a child who may have a particular fear that becomes a barrier to the care that they are receiving. For example, films can be used to reduce anxiety, since children model their behaviour on characters seen in a film. Do (2004) provides one example in which children were instructed to sit through a film where a child role model successfully endures a medical procedure that is similar to the one the patient is due to undergo. The film had many advantageous features such as demonstrating positive coping skills, deep breathing and relaxation. Do concluded from his study that children did learn and incorporate some of these behaviours during their treatment. Studies have found that children who observe a modelling film have significant reductions in disruptive behaviour when compared to children who do not observe such a film (Allan and Strokes, 1989). The opening case study also demonstrates role modelling which can be applied to a context where showing a film is not viable. The nurse in the case study used the principles of vicarious observational learning when using the dolls to demonstrate the administration of the injection. This demonstrates how the basic principles of observational learning can be incorporated into an interaction where there is no time or access to video equipment.

Role modelling and learning both for the patient and the student nurse
Looking up to role models and observing behaviour that is then emulated is equally applicable to adult patients as well as student nurses. Rosenthal and Zimmerman (1987) suggest that much of our learning occurs through observation, watching other people and analysing what happens to them. Others suggest that within nurse training, role modelling can be the most important part of early nurse education, with Driggers et al. stating that: often I learnt by watching and copying the third year student nurse or staff nurse with whom I was working. Much of my nursing socialisation and behaviour was learnt not within the school of nursing but by observing others in practice. (Driggers et al., 1993, cited in Charters, 2000, p. 27) Bandura describes four phases to the process of social learning: I. attentional phase; II. retentional phase; III. reproduction phase; IV. motivational phase.