The
Modeling and Role-Modeling paradigm, originally derived by
Helen Erickson from a practice model (later labeled
the APAM model), was developed over several years of clinical
practice. Related concepts and their relations were further
elaborated, labeled and articulated during the early 1970’s when
Erickson began a prolonged collaboration with Mary Ann Swain.
During this period of time, the APAM model was tested, needs and
developmental taxonomies elaborated, and linkages hypothesized.
In
the mid 1970’s, while enrolled in graduate school at The
University of Michigan-Ann Arbor (UM), Erickson and Tomlin
discovered one another. Interested in the promotion of person
centered care, they spent many hours discussing the essence of
nursing, the importance of patient-centered care, and other
philosophical assumptions that provide the bases of MRM. Swain,
Principal Investigator of a NIH funded research project, invited
Erickson to test the efficacy of MRM interventions with people
who had hypertension. Swain followed her project with one
focused on persons with diabetes; Erickson requested that Tomlin
join the research team. By the early 1980’s the original
practice model derived from practice, expanded and tested
through research, took on a distinctive life of its own.
Erickson accepted invitations to present the model both instate
and out, Tomlin wrote about it, calling it Erickson’s self-care model, and
Swain continued to support and encourage further elaboration and
testing. Klienbeck (1977) replicated Erickson’s work on the APAM
for her master’s thesis and other graduate students used the
framework as the bases of their graduate work. Finally, by the
early 1980’s it became apparent that sufficient interest existed
to take the work to the next level. The first book, Modeling
and Role-Modeling: A Theory and Paradigm for Nursing, was
written.
The
Fundamentals Department faculty in the School of Nursing used it
as the bases for clinical practice. Jenny James, Clinical
Director of the Medical-Surgical units in the University of
Michigan, Medical Center observing significant changes in
student’s attitudes and nursing actions, contacted Erickson for
consultation. Soon after, MRM was adopted as a framework for the
Medical-Surgical units under the direction of James. Debra
Finch, then head nurse on one of the units, adopted the entire
model and initiated implementation. Finch concurrently enrolled
in graduate school, developed a clinical tool designed to assess
developmental residual and tested it for her master’s thesis.
Simultaneously, courses in MRM offered to graduate students,
served as a stimulus for expansion and testing of various
concepts; several graduate students
adopted the model as the bases for their theses and
dissertations. A cohort of faculty, students and clinical
personnel met weekly to discuss clinical, research and
educational issues as they related to MRM.
During the fall of 1985, two things occurred that influenced the
future of MRM. First, the “MRM Cohort” decided to offer a
conference on the theory and paradigm; and second, Carolyn
Kinney (one of the U of M faculty) decided that the “MRM Cohort”
should organize a Society for the Advancement of MRM. The
outcome of these decisions were the establishment of The Society
for the Advancement of Modeling and Role-Modeling (SAMRM) and
the First National Conference on
Modeling and Role-Modeling sponsored by SAMRM.
In
the fall of 1986 Erickson moved to the University of South
Carolina as Associate Dean, Academic Affairs Kinney moved to The
University of Texas-Austin as faculty. Tomlin continued to teach
Fundamentals at U of M for a few years and then retired, moving
to Illinois. By the late 1980’s, Swain had moved into
Administration at U of M, and soon after moved on to New York to
assume the position of Provost and Vice President for Academic
Affairs, the New York State University System. In 1986 Erickson
moved to Austin TX, as Professor of Nursing and Chair of Adult
Health.
During the late 1980’s MRM continued to grow and spread as
Erickson and Kinney worked together to advance the work of SAMRM;
Jenny James implemented the model in various health care
agencies, and other Charter members including Janet Barnfather,
Nancy Kline-Leidy, and Margaret Erickson continued to test
hypotheses and publish findings. Doctoral students at The
University of Texas also adopted MRM. Susan Bowman and
colleagues adopted the model as the bases for their curriculum
at Humboldt State University. Their school became the first
School of Nursing to fully implement the model and become
nationally accredited with a MRM based nursing curriculum. Other schools and health care agencies
followed.
Today, MRM serves as one of the extant theories for holistic
nursing, recognized by ANA as a
specialty in nursing. It has provided the framework for numerous
dissertation, several research
studies, and clinical practice.