Background
Shortly after appointment as dean of the Yale School of Medicine (YSM), Nancy Brown, MD, created the Office of Academic and Professional Development (OAPD) with two teams. The OAPD Faculty Affairs team manages faculty appointment, reappointment, and promotion processes as well as junior faculty development and mentorship. The OAPD Professionalism and Leadership team works to improve the climate and culture of YSM by promoting faculty professionalism, developing faculty leaders, and elevating wellness.
Developing a shared vision of faculty professionalism
The OAPD Professionalism and Leadership team, led by Dr. Robert Rohrbaugh, deputy dean for professionalism and leadership, has collected resources pertinent to fostering a shared community understanding of faculty professionalism at YSM. The School’s Core Values and pertinent University and Yale Medicine Policies and Procedures are shared on the OAPD website.
Serving as a resource for individuals who are concerned about unprofessional behavior
Individuals interested in reporting a professionalism concern about a YMS faculty member have several options, including the “Report a Concern” red button on the OAPD website. Concerns can be forwarded through a dedicated phone number, email, or by using the Yale University hotline that is managed through a third-party vendor. Each of these methods permit anonymous reporting of concerns.
In addition, OAPD receives direct emails and phone calls about professionalism concerns from members of the community, including trainees and faculty leaders. If the concern is not about a YSM faculty member, OAPD, with the permission of the individual, routes their concern to the entity charged with managing the lapse. If the concern involves sexual discrimination, harassment, or assault, OAPD is required under Title IX to report this to the University Office of Institutional Equity and Access.
Actions to address professionalism concerns
Actions taken will depend on the wishes of the individual bringing the concern. When not reported anonymously, OAPD will talk with individuals about their concern and methods to access support while addressing the concern. If the individual reporting a concern agrees, OAPD will also contact their leadership to ensure that they are provided sufficient support. For example, OAPD would connect with Dr. Illuzzi or Dr. Francis if a medical student is involved. OAPD would connect with Dr. Huot or Dr. Asnes if a resident is involved. As appropriate, these leaders would also be involved in the investigation and management of the professionalism lapse.
For less egregious concerns, faculty will be alerted about the concern and asked to reflect on their behavior; research has shown that in 90% of instances, this intervention will be sufficient to ensure the faculty member will not have another occurrence of unprofessional behavior. For more egregious lapses or for repeated concerns, further investigation may be required to understand the behavior or to determine whether others in the faculty member’s network have been treated similarly.
With more egregious or repeated concerns, OAPD will work with the faculty member’s leadership (section chief or department chair) to inform the faculty member of the concern, to develop the process to review the concern, and to craft specific interventions. Our goal is to help the faculty member remediate their behavior and to stop it from happening again. Interventions often include individualized and targeted education or coaching. Since 80% of the professionalism lapses reported to OAPD have involved some form of interpersonal communication lapse, we have developed a five-session Communication Skills Program intervention to help faculty members understand their communication style when stressed, the effect it has on others, and to develop skills to utilize alternative communication methods in the future.
If the lapse is sufficiently egregious or repeated, interventions may also include non-renewal of the faculty member’s faculty appointment or restriction or removal from clinical, teaching, research, or leadership activities.
While employment law requires keeping interventions confidential, OAPD has committed to providing follow-up to those who have filed concerns about faculty professionalism, so that they are aware that appropriate interventions have been instituted.
Addressing professionalism concerns: Confidentiality and Retaliation
OAPD will talk with the individual filing a concern about options for addressing the concerns in a confidential manner, if that is important to the individual bringing the concern. With the exception of Title IX concerns, concerns involving the safety of an individual or the community, or significant violations of law, OAPD will respect the wishes of the individual that what they report remain confidential. When possible, OAPD will describe potential processes for confidentially addressing the professionalism lapse; when the behavior has occurred in a group setting, confidentiality can often be maintained by developing a process that protects the individual bringing the complaint (“a concern has been brought to our attention”).
When confidentiality is not possible, OAPD will warn the respondent (the faculty member whose behavior has led to a professionalism concern being filed) about the serious consequences if they were to retaliate against someone bringing a concern forward. OAPD will also educate the respondent about behavior that could be construed as retaliatory.
Maintaining a record of professionalism lapses
All instances of unprofessional behavior are logged in a secure database. This database allows us to track OAPD’s performance and analyze the types of issues being brought forward in our community. For example, after our analysis demonstrated that nearly 80% of faculty professionalism issues involve interpersonal communication challenges, OAPD developed the Communication Skills program. The database also facilitates knowing whether a faculty member has had other instances of unprofessional behavior. Lastly, it allows OAPD to monitor for “hotspots,” organizational units (lab, clinical unit, section, department) where many professionalism concerns have been filed about different individuals; identifying a hotspot may indicate the need to look deeper at the climate and culture of the organization.
Summary
Promoting faculty professionalism and addressing and remediating faculty professionalism lapses is important to improving the climate and culture of YSM. We hope that this overview of the role of OAPD is helpful, and we would welcome comments, feedback, or questions via our personal email or through the OAPD telephone number and email address.
The OAPD Professionalism Team
Dr. Robert Rohrbaugh (robert.rohrbaugh@yale.edu) is a graduate of YSM, a professor of psychiatry, and serves as Deputy Dean of Professionalism and Leadership within OAPD. He has been a clerkship director and residency program director for the department of psychiatry and is familiar with the challenges and power dynamics of addressing faculty and trainee professionalism in academic settings.
Ms. Andrea Terrillion (andrea.terrillion@yale.edu) is an experienced employment attorney who has worked within the Yale University environment for the last decade and serves as the Director of Professionalism and Leadership Development within OAPD. She is familiar with investigative techniques and interventions for professionalism lapses with both faculty and staff.
Dr. Jessica Wilen (jessica.wilen@yale.edu) is an assistant professor at the Yale Child Study Center and serves as the Director of Professional Standards within OAPD and as a Deputy Title IX Coordinator. She uses her professional background to develop processes to assess and improve the professional environment within organizational entities.
Ms. Kezia Dos Santos (kezia.dossantos@yale.edu) is an experienced human resources professional who manages the intake, review, and intervention processes to ensure that concerns are addressed in a timely manner. She analyses professionalism data to identify areas of concern and disseminates accurate and pertinent information about the work of OAPD.