Concern Processing

Professionalism Concern Reporting Process

There is "No Wrong Door" to reporting a professionalism concern.

1. A concern is submitted by a Reporter (Anonymous or Named—on behalf of self or others), either online, through Office of Advocacy & Wellbeing, an education lead, Chief Wellness Officer or other route
2. The concern is received and assigned a status by a FoMD professionalism triage office (a small group of faculty members within FoMD with signed confidentiality agreement for the role)

Anonymous Submission of Professionalism Concern

Where the concern is placed anonymously:

1. The professionalism triage officer will be unable to contact the anonymous Reporter
2. The concern is shared with members of the professionalism triage committee who decide on whether to send the concern to the individual's Supervisor (e.g., Chair, Program Director, Human Resources, Other), based upon:
   • Ensuring the anonymity of Reporter when moving forward with the concern
   • Constructive messaging within the concern
3. Ask the Supervisor to report back to us with the action they’ve taken
4. Where relevant, the concern is shared with AHS/Covenant (e.g., if occurring in a clinical environment)
5. The concern is logged as a way of tracking recurring behaviors and professionalism themed-behaviours

Confidential Named Reporter Concern

Where a Reporter includes their name and email address as a part of the submission:

1. Concern can be placed on behalf of one’s own experience, or on behalf of others (3^rd party concern). An example of a 3^rd party concern would be a program director submitting on behalf of a learner or a group of learners
2. The triage officer will contact the Reporter in as timely a fashion as possible (with or without a support person, as selected by the Reporter in the concern submission)
3. At the meeting with Reporter, the triage officer will:
   
   • Review supports for the Reporter and Reporter’s wellness
   • Review the concern from the Reporter’s point of view & summarize themes/concerns arising from the experience
   • Explore what would be ideal outcomes/goals from the Reporter’s point of view
   • Review possible options on how to deal with the concern
4. Approaches to addressing concerns are done on a case-by-case basis and may include:
   • Logging the concern as a way of tracking behaviour, if the Reporter does not wish to take further action

If the reporter wishes to take further action we will send the concern and summary on behalf of the reporter to the appropriate individual/organization. This may include:

1. • Submit concern to Individual’s Supervisor (e.g.: Chair, Program Director, Human Resources, Other)
   • Forward to UGME or PGME
   • Forward to Alberta Health Services/Covenant Health
   • Submit concern to Health Professions Colleges of Alberta (e.g.: CPSA)
   • If there is a group or environment concern, this would be forwarded to FoMD Chief Wellness Officer
2. The Supervisor receives the concern, meets with named person, and sets out interventions regarding the Individual/Individuals, as per the Graduated Approach to Professionalism set out by Vanderbilt (Hickson et al, Academic Medicine 2007)
3. A summary of actions/outcomes are sent to the Office of Professionalism from Supervisor
4. Professionalism triage officer communicates with Reporter to close the loop on concern

Note:  If the concern is felt to be egregious (i.e., patient or learner safety is at risk), there is leader discussion with Faculty Affairs, Dean/Deputy Dean, and/or Faculty Relations regarding immediate next steps for safety of learners with consideration of non-disciplinary suspension, while the concern is looked into and/or reported to formal disciplinary bodies for investigation and conclusion (case by case basis).

Note: If the concern is not deemed to be a professionalism concern or is outside the jurisdiction of the Professionalism Triage Committee, then other pathways to address the concern will be offered.

The Professionalism Triage Committee reviews submitted concerns, ongoing concern, and outcomes every 8 weeks, closing concluded concerns by consensus. There is a target timeline of 6 months from submission of concern to outcomes and closure.

Records of concerns are retained in the same fashion and for the same time period, as for all Human Resource Records at the University of Alberta. Anonymized summaries are posted annually on the FoMD professionalism website for institutional transparency and accountability.

This process was updated August 2024

Summary of the Reporting Process

This table has headers along the first column. The first column lists the basic steps. The second and third columns are the process for anonymous submission. The fourth and fifth columns are the process for submission with a name. Those cells that span columns apply to multiple segments of the process. For a more detailed description of the process, see the section above.

1. You submit a concern	Reporter submits a professionalism concern
• Ways to submit	Anonymously		Through a named report (either on behalf of yourself or others)
2. Triage committee decides how to proceed	Triage committee votes to send concern to the individual's supervisor		Triage officer meets with the reporter for support and determine outcomes.
• Committee notifies individual's supervisor or not	Triage committee does not notify the supervisor	Triage committee forwards the concern to the supervisor	Reporter wishes to continue the process and supervisor is notified	Reporter does not wish to continue the process
3. Supervisor deals with the concern	Proceed to step 5	Concern is addressed based on guided levels of intervention and lapse classification		Proceed to step 5
4. Supervisor reports back to the committee		Supervisor reports to triage committee on actions taken and outcomes
• Committee reports back to you		Proceed to step 5	Triage officer reports back to the reporter
5. Committee logs the concern	Triage committee logs the concern and any outcomes for tracking
6. Committee posts an annual anonymized report	Committee anonymizes all logged concerns annually in a public report

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Classification of FoMD Professionalism Concerns

Complete information on the classification of concerns and responses »

Levels of Response to Professionalism Concerns

The University of Alberta uses the following levels of response (derived from the Vanderbilt Graduated Intervention (Hickson et al, Acad Med 2007).

• Level 1: "Cup of Coffee" conversations for single, isolated incidents.
• Level 2: Non-punitive "awareness" interventions for apparent patterns of behaviour or incidents.
• Level 3: Remediation at the department or program level if the pattern persists.
• Level 4: Investigation and disciplinary processes if the plans above have failed or there is immediate concern for harm to others. This will often involve a teaching suspension during the investigation. The Triage Committee has a duty to report possible egregious concern to our formal institutions for formal investigations and disciplinary sanctions.

Definition of "egregious" professionalism concern**

• Any one of:
  • Multiple previous professionalism concerns raised or did not successfully remediate previous concerns of professionalism (x2 remediations/leader developed action plans) and/or
  • Egregious, or potential for egregious, harm to others (faculty, learners, patients, public or institutions) and/or
  • Behaviour inconsistent with a future career in medicine
• This may include but is not restricted to:
  • Harassment (sexual, racial)
  • Discrimination
• "Won't" professionalism behaviour as per above classification and/or (iv) failure of remediation/leader-developed action plans
• Level 3 or 4 disruptive behaviour (Health Quality Council of Alberta)***

** Student Professionalism Policy, Undergraduate Medical Education, Queen's University*** Health Quality Council of Alberta Disruptive Behaviour Framework (Provincial Framework, March 2013)

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Professional Apology Template

When applicable, one may refer to this apology template when developing an appropriate response to an incident.