Modeling and Role Modeling Theory in Modern Nursing

Introduction to Modeling and Role Modeling Theory

The Modeling and Role Modeling Theory was developed by Helen Erickson, Evelyn M. Tomlin, and Mary Anne P. Swain. It was first published in 1983 in their book Modeling and Role Modeling: A Theory and Paradigm for Nursing. This theory is highly pertinent to the changing dynamics of healthcare currently underway. New healthcare laws and regulations have created access to care for a more diverse and unique set of individuals. Many of these individuals were previously uninsured or had very limited coverage. Due primarily to new regulation, many of these individuals can now access healthcare. The theory enables nurses to care for and nurture each patient with an awareness of and respect for the individual patient's uniqueness.

This concept is critical because individual patients, more than at any time in history, will now have unique attributes that need attention. This exemplifies theory-based clinical practice that focuses on the patient's needs—a focus that has become central to healthcare legislation. The theory draws concepts from a variety of sources, including Maslow's Theory of Hierarchy of Needs, Erikson's Theory of Psychosocial Stages, Piaget's Theory of Cognitive Development, and Selye and Lazarus's General Adaptation Syndrome. Among these, Piaget's and Maslow's theories are arguably the most fundamental, offering universal appeal to diverse patient populations.

Professional and Demographic Context for Theory Development

The nursing profession plays an integral role in a globalized society, particularly in developed nations such as the United States and Japan. The nursing profession has undergone fundamental change reflecting shifting dynamics within the industry. In America specifically, consumers are becoming older and living longer. The baby boomer population in particular has experienced dramatic change in the transition from work to retirement. The nursing profession has therefore needed to evolve in order to accommodate the changing needs of society, with particular emphasis on the baby boomer population. As this demographic ages, individuals typically become more prone to sickness and other forms of serious illness. As such, the importance of nursing in the coming years will be even more profound. Nursing theories have been impacted due to the changing occurrences within the profession (Butts & Rich, 2010).

Legislation in particular has had a profound impact on the nursing profession overall. Due to the Affordable Care Act of 2010, the nursing profession is undergoing a fundamental shift in how it approaches patient experience. As the theory describes, patients will now demand a more individualized experience, catering to their specific needs. A "one-size-fits-all" approach will no longer be tolerated by consumers. This is particularly true for minority patients who now have healthcare access but possess differing needs based primarily on hereditary characteristics rather than behavioral ones. For instance, African Americans are more prone to sickle cell anemia. However, the African American population has historically had the highest rates of uninsured individuals. The U.S. healthcare system is now shifting its focus from acute and specialty care to primary care, which requires a shift in business operations.

Additionally, due to the aging of the baby boomer generation mentioned above, the need for primary care overall is shifting toward individualized care models. The last ten years in particular has seen an increasing influx of retiring baby boomers requiring care. A positive impact of the Affordable Care Act is that more individuals are now insured. Consequently, the need for primary care will increase over subsequent years, particularly within minority populations (Draper, LaDou, & Tennenhouse, 2011). The legislation has fundamentally reshaped how nurses approach patient populations, making theories like Modeling and Role Modeling essential to contemporary practice.

Foundational Theories and Supporting Evidence

The theorists cite many existing theories to support their framework. These theories stem primarily from two sources: Maslow's Hierarchy of Needs and Piaget's Theory of Cognitive Development. Of these two, Maslow's theory is the most fundamental. Maslow proposed that human beings have basic needs that must be satisfied to ensure a high quality of life. These needs form the foundation for the Modeling and Role Modeling theory for numerous reasons. First, Maslow's hierarchy proposes that humans have a basic need for safety and security, which incorporates healthcare. Humans want to feel healthy in order to live productive lives. As such, aspects such as social needs, esteem, and self-actualization cannot be achieved, in theory, unless individuals have a healthy body and mind. Healthcare therefore allows the individual to achieve many of their basic needs of life through proper medication, diet, and overall treatments.

The theorists also cite Piaget's theory regarding the overall development of individuals with access to proper healthcare. Lifespan development and its subsequent occurrences are very important to human growth. Through biological and chemical changes, the body constantly evolves and changes. Consequently, the inability to properly care for individuals inhibits this growth. Piaget's theory pertains mainly to the gradual acquisition of knowledge from conception throughout life. As his theory describes, cognition is the essence of any organism. Piaget believed that reality is a dynamic system of continuous change, with life constantly evolving. Therefore, the Modeling and Role Modeling theory proposes that if families establish the importance of healthcare early and consistently, it will have rippling effects throughout society. Through the development of cognition, society will be better able to handle diseases that were once unique to certain uninsured demographic groups. By allowing everyone to be exposed to healthcare, society benefits through the use of less costly resources, overall efficiency, and a healthier population.

The motivation of the theorists was two-fold. First, the theorists recognized the changing demographic needs of the developed world. Globalization, along with worldwide economic development, has altered the need for healthcare. Second, the theorists were motivated by rising costs of healthcare. In many instances, particularly in America, healthcare costs—if not diminished—have the potential to create serious economic strain. To mitigate this effect on society, the theory allows for costs to be lowered through increased efficiency, an individualized approach, and a more robust healthcare system overall. By emphasizing patient-centered, culturally aware nursing practice, the Modeling and Role Modeling Theory addresses both the practical challenges and ethical imperatives facing contemporary healthcare.