Classification of Professionalism Concerns

The FoMD's Office of Professionalism has set a classification of professionalism concerns, modified with permission from J. Bolton, Office of Professionalism, University of Mexico.

Misunderstanding/ Miscommunication

"Oops" (knowledge of social rules, bad day, stressors)

  • Person knows the rules and follows them
  • Insight is demonstrated, is usually remorseful
  • Rare relapse

"Can't" (doesn't know or understand social rules)

  • Person can't fulfil role/expectations
  • Do not know or don't have skills
  • May or may not be insight and/or remorse
  • New to the "culture"

"Won't" (doesn't believe in social rules)

  • Person knows the rules of the role, but chooses not to act
  • Lack of regret, insight or remorse
  • Rules do not apply
  • Often repeated events

Levels of professionalism intervention

The FoMD's Office of Professionalism has a standardized approach to professionalism interventions, allowing for professionalism lapses while still identifying problematic professionalism behaviours. These standards are derived from the Vanderbilt Graduated Intervention (Hickson et al, Acad Med 2007) & Health Quality Council of Alberta Guidelines).

Cup of Coffee Conversations

  • Isolated/one-time events

Pattern "Awareness" Interventions

  • Apparent patterns of incidents/​behaviours

Professionalism/​Teaching Coaching Plans

  • Persistent patterns of incidents/​behaviours
  • Remediation/​coaching

Duty to Report — Investigation + Disciplinary Processes

  • Report to other professional bodies and/​or organizations
  • Often involves teaching suspension during investigation

In the instance of a potential egregious professionalism concern (see above for full definition), where there is concern for serious potential impact to others (i.e., colleagues, peers, learners, public, patients) with regards to safety, mistreatment, or harassment, these will be dealt with on a case-by-case basis. This may include but is not restricted to:

  • Harassment (sexual, racial)
  • Discrimination
  • "Won't" professionalism behaviour as per above classification with failure of remediation/leader-developed action plans
  • Level 3 or 4 disruptive behaviour (Health Quality Council of Alberta)

Appropriate formal bodies will be consulted, preserving confidentiality. Intervention will be guided by consultations with the appropriate formal bodies, with accelerated levels of intervention as appropriate. The Office is not responsible for managing investigations.

Formal investigations through these institutions include:

  • University of Alberta Faculty Agreement
  • University of Alberta Accommodation Policy and the Discrimination and Harassment Policy
  • College of Physicians & Surgeons of Alberta (CPSA) Health Professions Act, Province of Alberta
  • Alberta Health Services Policy: Workplace Violence Prevention and Response Policy
  • Medical Laboratory Technologists of Alberta, Complaints and Discipline
  • College of Registered Dental Hygienists of Alberta
  • Alberta College of Medical Diagnostic and Therapeutic Technologists
  • Alberta Dentistry College (ADC), Health Professions Act