Professionalism, Professional Development, and Well-Being Resources

Transcript

• 00:00Without further ado, I'm
• 00:02I will actually turn this
• 00:04over,
• 00:05first to welcome,
• 00:08members of the,
• 00:09other side of the office
• 00:11of academic and professional development
• 00:12that Jonathan and Grauer and
• 00:14I,
• 00:14work on. And, wanted to
• 00:16welcome them in in presenting
• 00:18on professionalism, professional development, and
• 00:20well-being.
• 00:22We have,
• 00:23doctor,
• 00:24Bob Rohrbaugh
• 00:25as well as Andrea Terrillian
• 00:28and, doctor Adrian Mann. And,
• 00:30Bob or Andrea, maybe I'll,
• 00:32have you do further introductions.
• 00:36Sure.
• 00:38Hi, everyone.
• 00:41Bob Rohrbaum, the the, deputy
• 00:43dean for,
• 00:45professionalism
• 00:46and leadership development
• 00:47at the, the school of
• 00:49medicine. Andrea? I am hello,
• 00:51everyone. I'm Andrea Trilian,
• 00:53and I am the senior
• 00:55director of professionalism and leadership
• 00:56development in OAPD.
• 00:58And we're delighted to, to
• 01:00welcome Adrian Mann,
• 01:01who's an associate professor at
• 01:03the,
• 01:04University of Colorado Anschutz School
• 01:06of Medicine,
• 01:08and a certified,
• 01:10coach
• 01:11and the developer of Better
• 01:13Together,
• 01:14a program that you all
• 01:15will have access to,
• 01:17next year. And so we're
• 01:18really delighted to have, Adrianne
• 01:20join us, for this presentation.
• 01:23We're gonna talk a little
• 01:24bit about,
• 01:26three different
• 01:27programs,
• 01:29that we run,
• 01:30around professionalism,
• 01:32a little bit about leadership
• 01:33development, and then about,
• 01:35well-being. And we'll start with,
• 01:38with well-being.
• 01:39K. Let me get our
• 01:41slides here.
• 01:51K.
• 01:57Let me share.
• 01:59Sharing.
• 02:04Oops.
• 02:05There we go. So you
• 02:07already met us. So
• 02:10Hi, everyone.
• 02:12So,
• 02:14again, we have, really three
• 02:15missions, this idea of promoting
• 02:17professionalism,
• 02:18developing leaders,
• 02:19and elevating faculty well-being. And
• 02:21we're gonna start with, with
• 02:23faculty well-being.
• 02:27Excuse me. I just wanna
• 02:28make sure that we're not
• 02:30seeing two slides. Are you
• 02:32seeing two slides or one?
• 02:34One? Okay. Good.
• 02:36This is our, team.
• 02:39So in addition to, Andre
• 02:40and myself,
• 02:42Darren David works with us
• 02:43on,
• 02:44the well-being and,
• 02:48and leadership development work.
• 02:50Karen Wu works with us
• 02:52on the professionalism and leadership,
• 02:54and,
• 02:55miss Cloud and miss Enty,
• 02:57work with us around administering
• 02:59our programs, keeping keeping us
• 03:01on track.
• 03:04Great. Faculty well-being.
• 03:08You know, we have this
• 03:09really terrific,
• 03:11options for our employee assistance
• 03:13plan
• 03:15through the Optum.
• 03:17Optum is an outside group,
• 03:19that offers these
• 03:21opportunities. And
• 03:23because it's outside, it's completely
• 03:25confidential.
• 03:26So, so we wanna talk
• 03:28about,
• 03:29one program in particular, but
• 03:31you can see the the
• 03:32number of,
• 03:33of other programs that are,
• 03:35that are offered.
• 03:38So this is the one
• 03:38we wanna make sure that
• 03:39you're very aware of, and
• 03:41that's that our ability to
• 03:43offer you supportive
• 03:44counseling.
• 03:46And they'll
• 03:49Rebecca and and Amy are
• 03:50highly skilled
• 03:54mental health professionals. They've been
• 03:55in the business for twenty
• 03:57five years,
• 03:59and they know the New
• 04:01Haven community.
• 04:03Again, it's highly confidential because
• 04:05it's run through Optum. So
• 04:08so nothing is reported back
• 04:09to the, university
• 04:11about, about anything that you
• 04:13talk with them about.
• 04:15They can work on
• 04:16anxiety,
• 04:18depression management,
• 04:19but also things like,
• 04:22issues that are happening
• 04:23in your work life and
• 04:25issues,
• 04:26in your family.
• 04:27We highly recommend that you,
• 04:30consider them if, if you're,
• 04:33having any difficulties.
• 04:37We also offer, wellness webinars
• 04:39that go over some of
• 04:40the opt Optum options that
• 04:43are,
• 04:45available to you,
• 04:47both through Optum, but also
• 04:48through the university.
• 04:49These are some of the
• 04:50the things that we have,
• 04:52presentations on. We send these,
• 04:55reminders out to you, and
• 04:56you can,
• 04:57sign up. So usually at
• 04:59noontime. So we try to
• 05:00pick a time that's, optimal
• 05:02for you all.
• 05:04And they're also recorded too.
• 05:06So on the website, if
• 05:07you miss them, they're also
• 05:09recorded.
• 05:13So we were very interested
• 05:14in thinking about how to
• 05:15improve the the culture of
• 05:17the, the school. It's a
• 05:19really wonderful place to be,
• 05:20but it's also a place
• 05:21that,
• 05:23that can be can be
• 05:24improved.
• 05:25And
• 05:26we're developing this idea of
• 05:28a coaching culture within the,
• 05:30the school of medicine
• 05:31and have four specific programs
• 05:34that will,
• 05:36we wanna talk about, but
• 05:38mostly about better together coaching.
• 05:40And,
• 05:41doctor Mann is here today
• 05:43to, to talk with you
• 05:44about that.
• 05:46Incredible. I'm gonna share my
• 05:48t my screen now, I
• 05:50think. Oh, okay. You wanna
• 05:51share? Alright. Okay. Yeah. Let
• 05:53me Okay. I got it.
• 05:55Can you can you all
• 05:56see this? Okay.
• 05:58Great. Okay. Thank you for
• 06:00that introduction.
• 06:02I'm gonna continue to share.
• 06:03Okay. I'm Adrienne Mann. I'm
• 06:05from the University of Colorado.
• 06:06I'm one of the co
• 06:07directors of Better Together, and
• 06:08we're thrilled to have been
• 06:09building this partnership with Yale
• 06:11for the past,
• 06:12I think, five years starting
• 06:14with our GME partnership and
• 06:16now having expanded to faculty.
• 06:18So I'm just going to
• 06:19spend a couple of minutes
• 06:20talking about our program. It's
• 06:21something that'll be accessible to
• 06:22you all starting in the
• 06:24fall. So our mission in
• 06:25Better Together
• 06:26is really to help clinicians
• 06:28stay in medicine without losing
• 06:30themselves. And I'll add researchers
• 06:31to this too. So, clinicians
• 06:33and researchers without losing themselves
• 06:35in the process.
• 06:36And we do that by
• 06:37democratizing coaching, making it accessible
• 06:39to more people, and approaching
• 06:41it scientifically
• 06:42with a goal to add
• 06:43to the evidence base and
• 06:44ensure high quality in our
• 06:45coaching.
• 06:47We are not a typical
• 06:48wellness program.
• 06:49So we recognize that there
• 06:51are
• 06:52demands in the jobs that
• 06:53we do that require emotional
• 06:55range, psychological flexibility, and conflict
• 06:57navigation skills that sometimes we
• 06:59didn't learn during our more
• 07:00traditional training. And so we
• 07:02help to build those skills.
• 07:03We are not yoga. We
• 07:05are not gratitude journaling. We
• 07:07are not bubble baths or
• 07:08good vibes only. Our work
• 07:10is really to focus on
• 07:12deconstructing internalized,
• 07:14medical culture myths, helping to
• 07:16stabilize identity, promote cognitive flexibility,
• 07:20find agency in your work,
• 07:22build emotional range, and connect
• 07:24to your mission without
• 07:25sacrificing yourself in the process.
• 07:29So we do this by
• 07:30helping you build tolerance for
• 07:31distress, sitting with uncertainty and
• 07:33disappointment without shame spiraling, navigating
• 07:36tricky and especially especially cross
• 07:38generational conversations,
• 07:40creating and honoring boundaries
• 07:42and problem solving from a
• 07:44place of empowerment,
• 07:45and less resentment.
• 07:48So there's a large evidence
• 07:50base that supports,
• 07:51coaching in
• 07:53academic medicine.
• 07:54The majority of that work
• 07:56looked at one on one
• 07:57coaching, but that is an
• 07:58expensive and time consuming thing
• 08:00to coordinate. And so in
• 08:01Better Together, our structure is
• 08:03to provide group coaching, which
• 08:05I'll explain in just a
• 08:06second. Oh, hi. Yeah.
• 08:08Oh. Oh, is that you
• 08:09outside?
• 08:13Doug, do you mind muting?
• 08:15Yeah.
• 08:17Thanks. Okay.
• 08:19Alright. And we've shown an
• 08:20impact in burnout in other
• 08:22domains,
• 08:23looking at this in a
• 08:24group format instead of a
• 08:25one on one format.
• 08:27How this works, we partner
• 08:28with institutions like Yale. Yale
• 08:30is our largest partner and
• 08:31has, identified this group, you
• 08:33all, faculty to be invited
• 08:35to join our program.
• 08:36You're gonna receive an invitation
• 08:37to join in the fall.
• 08:39Registration opens in August
• 08:41at for our fall program
• 08:42and then opens again in
• 08:43January for our spring program.
• 08:45You can join either or
• 08:46both or neither if this
• 08:48doesn't sound like something you
• 08:49want. You choose how, when,
• 08:51and how often to engage,
• 08:52and you can do so
• 08:53confidentially. So everything that happens
• 08:55in our program stays within
• 08:56our program. The only thing
• 08:58that makes it back to
• 08:58Yale is an aggregate and
• 09:00de identified,
• 09:02report of,
• 09:03how many people enrolled and
• 09:04their baseline
• 09:06metrics and, well, well-being and
• 09:08burnout scores.
• 09:10These are all of our
• 09:11partners right now. So if
• 09:12you join, you'll be joining
• 09:13a cohort from over sixty
• 09:15institutions across the country.
• 09:18You'll be joining our faculty
• 09:20cohort, but we run four
• 09:21at a time. One for
• 09:22medical students, one for residents
• 09:24and fellows,
• 09:25one for faculty, clinicians, and
• 09:26researchers, and one for advanced
• 09:28practice providers.
• 09:29These all happen in their
• 09:30own individual container, so you're
• 09:33sorted with people who are
• 09:34at the same career stage
• 09:35as you.
• 09:36And there's some crossover in
• 09:37what we call our community
• 09:38calls, which address things like
• 09:40that happen across the continuum
• 09:42of training, parenting,
• 09:44coming from underrepresented backgrounds,
• 09:47other affinity groups that make
• 09:48sense for our populations.
• 09:50Some key features of our
• 09:51program, it is confidential like
• 09:52I said. There are no
• 09:54grades, no gold stars, nothing
• 09:56is required.
• 09:57It is flexible, and you
• 09:58can come and go as
• 09:59it works with your busy
• 10:00schedule.
• 10:01It's theory informed and evidence
• 10:03based.
• 10:04If you enroll, you get
• 10:05access to really four different
• 10:07types of coaching, which I'll
• 10:08go through very briefly.
• 10:10The first is self guided
• 10:11coaching. This is a weekly
• 10:13ten minute video and self
• 10:15study worksheet that you can
• 10:16take at your own pace.
• 10:18These don't come back to
• 10:19us. These are just PDFs
• 10:20that you download and work
• 10:21through on your own. Here's
• 10:22me and Tyra. She's my
• 10:23partner in the program. These
• 10:26are the things we cover.
• 10:27So in month one, we
• 10:28teach you a metacognitive
• 10:29tool for thinking about your
• 10:31thinking.
• 10:32In month two, we apply
• 10:33that outwardly,
• 10:34thinking about what does it
• 10:36look like to get more
• 10:37into a growth mindset, what
• 10:38to do with challenging feedback,
• 10:40dealing with bias at work,
• 10:41and showing up
• 10:42in a way that is
• 10:43aligned for you even when
• 10:44things aren't perfect.
• 10:46Month three, we turn that
• 10:47inwards and we look at
• 10:48imposter syndrome, approval, addiction, perfectionism,
• 10:50and where those things might
• 10:51be showing up in in
• 10:53and outside of your work.
• 10:54And then in the final
• 10:55month, we, turn it back
• 10:57outwards and look at building
• 10:58confidence, navigating career transitions, self
• 11:00appreciation, and self compassion.
• 11:03The second way to get
• 11:04coached is in our weekly
• 11:05group coaching calls. These are
• 11:07on Zoom. They're at all
• 11:09different times of the day,
• 11:10and every week is a
• 11:11little bit different. There's separate
• 11:13calls for each of our
• 11:14cohorts,
• 11:15and,
• 11:16you can choose to participate
• 11:17or not. The majority of
• 11:18folks join and kind of
• 11:20observe. Some brave souls raise
• 11:22their hand and get coached
• 11:22in front of the group.
• 11:24It's always hosted by a
• 11:25certified coach. And then we
• 11:27know that y'all are busy
• 11:28and not everybody can come
• 11:29live, so the call recordings
• 11:31are always put on a
• 11:32private membership podcast where you
• 11:33can listen to them later.
• 11:35That's how the majority of
• 11:36folks access that content.
• 11:39The third way is through
• 11:40written coaching. This is through
• 11:41a forum on our website.
• 11:43Folks can submit a written
• 11:44request, and we respond back
• 11:46a day or two later
• 11:47with some coaching prompts.
• 11:49And then finally, everyone is,
• 11:52invited to schedule up to
• 11:53four one on one coaching
• 11:54sessions over the the four
• 11:56month program.
• 11:57We have a team of
• 11:58forty incredible,
• 12:00coaches. All of them are
• 12:01clinicians of some sort or
• 12:03researchers,
• 12:04and they're from institutions across
• 12:06the country and are really
• 12:07wonderful.
• 12:08You can choose the time
• 12:09you want, the coach you
• 12:10want, etcetera.
• 12:13We've studied this, and I'll
• 12:14just go over this briefly.
• 12:15This started as a small
• 12:17pilot program at the University
• 12:18of Colorado for women in
• 12:19GME. We started in that
• 12:21population because we knew the
• 12:22experience of burnout was higher
• 12:23in that group.
• 12:25We enrolled just over a
• 12:27hundred women and randomized them
• 12:29to receive coaching or get
• 12:30it later.
• 12:32And though we were not
• 12:33powered to see any results,
• 12:34showed a statistically and clinically
• 12:36significant improvement in emotional exhaustion,
• 12:38self compassion, and imposter syndrome.
• 12:40And this, persisted at six
• 12:42and twelve months,
• 12:45for,
• 12:46self compassion.
• 12:49We repeated the study, and
• 12:50this is where we first,
• 12:51partnered with Yale among, again,
• 12:53women trainees in GME.
• 12:55This was back in twenty
• 12:56two.
• 12:57This time, a thousand trainees,
• 12:59and we showed showed statistically
• 13:00and clinically significant improvement in
• 13:02every group.
• 13:04The number needed to coach,
• 13:05which is a term we're
• 13:06trying to coin, was about
• 13:07ten. So only ten people
• 13:09needed to participate in the
• 13:10program to take burnout from
• 13:11present to absent or imposter
• 13:13syndrome present to absent in
• 13:14one person.
• 13:15Think of a lot of
• 13:16things we do for a
• 13:17much higher number needed to
• 13:18treat than that.
• 13:20So right around this time,
• 13:20we were getting a lot
• 13:21of questions about what about
• 13:22faculty,
• 13:23what about being gender inclusive,
• 13:25and so we expanded our
• 13:26program the following year and
• 13:28studied it among faculty at
• 13:29the University of Colorado.
• 13:30This study was gender inclusive
• 13:32and looked primarily at primary
• 13:34care like faculty.
• 13:36But in this study, we
• 13:37showed improvement in depersonalization,
• 13:39imposter syndrome, and flourishing.
• 13:42We've done some qualitative
• 13:44studies of our program, and
• 13:45what we've learned is folks
• 13:47like the metacognitive tool we
• 13:48teach.
• 13:49They appreciate being part of
• 13:51a community that isn't necessarily
• 13:53exclusively within their institution. It's
• 13:55a community that is national.
• 13:58And they really appreciated that
• 13:59they can kind of come
• 14:00through the program in the
• 14:02way that works best for
• 14:03them. So some really will
• 14:04only do the self study
• 14:05work, others only come to
• 14:06the group calls. Really folks
• 14:08make it however they want.
• 14:11All of these things really
• 14:12are in service to what
• 14:13we're trying to do, which
• 14:14is increase folks' self determination,
• 14:17autonomy, relatedness, and competence,
• 14:19to support your well-being.
• 14:22Alright. So why you might
• 14:23wanna join us? There's
• 14:25very low stigma for joining.
• 14:27We invite everybody.
• 14:29It is multimodal, and you
• 14:30can choose how to participate.
• 14:32I don't know of another
• 14:33model that is robustly evidence
• 14:35based as ours.
• 14:36And you can have lifetime
• 14:38access to the materials after
• 14:39you've joined.
• 14:42I'll just add one little
• 14:43bit. We launched this year
• 14:45BT two, which is a,
• 14:46like, follow-up curriculum for folks
• 14:48who have done Better Together,
• 14:49our foundational program before. If
• 14:51you join in the fall,
• 14:52you'll be invited to join
• 14:54this the BT two curriculum
• 14:55in the spring. It's, all
• 14:57included. So for folks who
• 14:58are coming back to us,
• 14:59there will be a second
• 15:00level program in the spring.
• 15:03And I think that's the
• 15:04end of my slides. I'm
• 15:05happy to take any questions.
• 15:10And just to, to follow-up.
• 15:11So so everyone who's a,
• 15:13an assistant professor or an
• 15:15associate research,
• 15:17scientist
• 15:18in the second year of
• 15:19their first term
• 15:21is going to be invited
• 15:22to, to join the program.
• 15:23So,
• 15:25so, you know, as as
• 15:27you transition
• 15:28out of your first year
• 15:29and into your second year
• 15:30as an assistant professor or
• 15:32associate research scientist, you'll be
• 15:34in the cohort that,
• 15:36that the school has has
• 15:37paid for you to, to
• 15:39be able to join.
• 15:43Any questions for me about
• 15:45the program?
• 15:47Oh, I see something in
• 15:48the chat.
• 15:49Not for me. Okay.
• 15:51To share.
• 16:04Just reiterate that,
• 16:06folks can participate anonymously.
• 16:08So we have so many
• 16:09participants that really we don't
• 16:11track individuals progress through the
• 16:13program or really know,
• 16:16we don't want to look
• 16:16at how everybody is engaging
• 16:18because we know everybody's gonna
• 16:19engage differently. So we think
• 16:21the bar to join should
• 16:22be really low. Join us
• 16:23in the fall and,
• 16:25play around with it. See
• 16:26if it's something that feels
• 16:27right for you.
• 16:29We'd love to have you.
• 16:30Yeah. Okay.
• 16:34Alright.
• 16:36Adrianne, thanks so much for,
• 16:38for coming.
• 16:39There's a question in the
• 16:40chat. Can other than tenured
• 16:42faculty join?
• 16:45Doctor Robah, you may have
• 16:46an answer to that,
• 16:47and I may give a
• 16:48winky answer to that. What
• 16:50is the, what Can tenured
• 16:51faculty join?
• 16:55If they are in these
• 16:58either in their second year
• 16:59of their first term as
• 17:01an assistant professor
• 17:03or as in their or
• 17:05associate research scientist.
• 17:06And next year, we're going
• 17:07to expand this to,
• 17:10individuals who are in their
• 17:11who are in their
• 17:13second year of their first
• 17:14term as associate professor or
• 17:17research scientist.
• 17:19So those are the two
• 17:20cohorts that, that we're going
• 17:22to, be offering it to.
• 17:27Sounds good.
• 17:30Thanks again for having me.
• 17:31If anybody has any questions,
• 17:33I'm happy to share my
• 17:34email address. I'll just put
• 17:35it in the chat, and,
• 17:37feel free to holler.
• 17:39Terrific. Thanks so much. Really
• 17:41appreciate it. Thanks. I'll hop
• 17:42off after this. Okay.
• 17:44And for the tenured,
• 17:46faculty member, we do have
• 17:48some other coaching options that
• 17:50might
• 17:51that might work for you,
• 17:52so please contact our office.
• 17:55And they're not always, you
• 17:56know, external coaches. There can
• 17:58be external coaches, or we
• 18:00have a couple of programs
• 18:01that we are able to
• 18:03facilitate for you,
• 18:05like, through,
• 18:06other providers that are very
• 18:08kind of reasonably
• 18:09reasonable cost and those types
• 18:11of things that we can
• 18:12leverage for you if if
• 18:14you're not eligible, if you
• 18:15or you don't fall into
• 18:16the group that can,
• 18:18participate
• 18:19in,
• 18:21this coaching program. I just
• 18:22wanted to Yeah. No. There's
• 18:24options. There's options out there.
• 18:26Just call us, and we'll
• 18:27figure it out.
• 18:29K.
• 18:30I just wanna make sure
• 18:32that you're seeing the slide
• 18:33leadership grand rounds talks, academic
• 18:36year twenty six.
• 18:39Is that true? Are you
• 18:41seeing it? Are you seeing
• 18:42that on your
• 18:44Yes. Yep. Okay. Just wanna
• 18:45make sure.
• 18:48Go ahead.
• 18:51So, you know,
• 18:53we're interested in developing the
• 18:54next generation of leaders at
• 18:55the school of medicine, and
• 18:56one way that we do
• 18:58that are,
• 19:00quarterly leadership grand round talks,
• 19:03Just to,
• 19:04to plug that in
• 19:07in May,
• 19:09coming up,
• 19:10we're going to,
• 19:11be working with the Carter
• 19:12Group, which is a nationally
• 19:14renowned
• 19:15group on change management. You
• 19:17know, we're in a in
• 19:19a setting in which things
• 19:20are changing on a daily
• 19:21basis. And so the the
• 19:23Carter Group offers these,
• 19:25opportunities to to learn about
• 19:28dialing up thrive,
• 19:30strengthening agency, adaptability, and personal
• 19:33resilience
• 19:34in evolving systems.
• 19:35So, just a plug to,
• 19:37to look for our leadership
• 19:38grand rounds talks.
• 19:43Alright. So getting to, then
• 19:46our third mission of promoting
• 19:48professionalism.
• 19:50You know, everything that we
• 19:51do is connected to the,
• 19:53school of medicine core values.
• 19:55I think that you can
• 19:57sort of see how,
• 19:59professionalism
• 19:59is important
• 20:01in things like building engaged
• 20:03and productive community.
• 20:04It's obviously important in integrity,
• 20:07reflection, and communication.
• 20:09Generativity is about how we
• 20:11treat
• 20:12and think about developing the
• 20:14next generation
• 20:15of, trainees and and junior
• 20:17faculty.
• 20:19It's obviously important in in
• 20:20the work that we do
• 20:21around inclusion.
• 20:23And, you know, there are
• 20:24also ethical and and,
• 20:26other kinds of policies around
• 20:29discovery, innovation, and scholarship that
• 20:31we need to be,
• 20:32attentive to. So this this
• 20:34whole body of work is
• 20:36really informed
• 20:37by our core values.
• 20:40There are, of course, other
• 20:41standards that we're held to
• 20:44in terms of professionalism.
• 20:46I'd encourage everyone to look
• 20:47at the Yale University
• 20:49standards of faculty conduct.
• 20:51It's a very brief document
• 20:53that talks about our roles
• 20:54as educators, as researchers
• 20:57and as community members.
• 20:59These are these are standards
• 21:01that apply to all faculty
• 21:02both here at the medical
• 21:04school and at at the
• 21:05other schools
• 21:06throughout the university. Of Of
• 21:08course, the other schools don't
• 21:09have to faculty at the
• 21:10other schools don't have to
• 21:12deal with the clinical mission.
• 21:14And so we also think
• 21:15about policies related to our
• 21:18faculty roles as clinicians. And
• 21:20so the Yale Medicine professionalism
• 21:22charter
• 21:23and the Yale Medicine and
• 21:24and Yale New Haven practice
• 21:25standards
• 21:26are also documents that we
• 21:28rely on as we're thinking
• 21:30about
• 21:30this issue of professionalism.
• 21:33And, you know, it's there
• 21:34really are kind of scattered
• 21:36in multiple places. So if
• 21:38you go to our website
• 21:40under the tab that says
• 21:41developing a shared vision of
• 21:43professionalism,
• 21:44one of the things we
• 21:45first did is just put
• 21:46all of these things that
• 21:47kind of guide us,
• 21:49and anchor our behavior in
• 21:50one spot so,
• 21:52they're easily accessible to you.
• 21:57So what are some examples
• 21:58of unprofessional behavior?
• 22:01You know, it can range
• 22:02from being chronically late to
• 22:04meetings,
• 22:05hostile comments to a colleague
• 22:08can get it get
• 22:10more involved in terms of
• 22:12angry yelling
• 22:13or bullying.
• 22:15There can be scientific misconduct
• 22:17on a project.
• 22:18There could be harassment
• 22:20based on appearance
• 22:22and even sexual harassment or
• 22:24misconduct.
• 22:25So, you know, a range
• 22:26of different things that we
• 22:27might think of as being
• 22:28unprofessional.
• 22:32These these behaviors have significant
• 22:34impact on people.
• 22:36You know, psychological distress and
• 22:38anxiety,
• 22:40being subjected to these behaviors
• 22:42can erode your confidence,
• 22:44can lead to higher rates
• 22:45of staff, faculty, and resident
• 22:47turnover
• 22:48at a time when we're
• 22:49trying to, make sure that
• 22:50we have adequate staffing.
• 22:53It's really important to,
• 22:55address these issues,
• 22:56and it it it perpetuates
• 22:58a cycle of bullying
• 23:00and contributes to a negative
• 23:06culture. But what what might
• 23:07be less well known is
• 23:09that these behaviors can also
• 23:11have an impact on the
• 23:12quality of patient care that's
• 23:14provided.
• 23:16So the rates of complications
• 23:19are higher
• 23:20in surgeons who have,
• 23:23had unsolicited patient observations
• 23:26that,
• 23:27that suggested unprofessional behavior
• 23:30as well as,
• 23:32coworker complaints.
• 23:34And I think if you
• 23:35look at the general research
• 23:37regarding psychological
• 23:38safety in general,
• 23:40that literature
• 23:41and the impact
• 23:43on patient care.
• 23:45Again, that further supports these
• 23:47connections.
• 23:51I think I'll talk to
• 23:52you about our reporting mechanisms.
• 23:56Our office,
• 23:58there
• 23:59are multiple ways to reach
• 24:01us.
• 24:03We have a dedicated
• 24:04phone number,
• 24:06that is we do our
• 24:07best to answer live as
• 24:09as best we can. It
• 24:10does have a confidential
• 24:12voice mailbox just in case,
• 24:13but we do we do
• 24:15answer we try to do
• 24:16our best to answer it
• 24:17with a live person in
• 24:18case someone calls.
• 24:20We have a dedicated, again,
• 24:21confidential
• 24:22email address that is only
• 24:24accessible by
• 24:25through our office through a
• 24:26couple people in our office.
• 24:28We also have the infamous
• 24:30red button, which is on,
• 24:32scattered throughout the school of
• 24:34medicine website.
• 24:36This,
• 24:38this button, which which
• 24:41is reads report a professionalism
• 24:44concern,
• 24:45links you directly to a
• 24:47a what we call the
• 24:48professionalism
• 24:49concern form and allows individuals
• 24:52to report
• 24:54acts of of,
• 24:57of unprofessionalism
• 24:58or other acts of bullying,
• 25:01anything that they feel is
• 25:02a professionalism
• 25:03concern.
• 25:04Our office is a central
• 25:06kind of reporting
• 25:08hub, if you will,
• 25:11for all professionalism
• 25:13concerns. We're certainly not the
• 25:14exclusive
• 25:15mechanism for doing that, but
• 25:17we we do one of
• 25:18our charges is to triage
• 25:21complaints that might come in,
• 25:23from students,
• 25:25residents,
• 25:27trainees,
• 25:28junior faculty, senior faculty,
• 25:30anyone,
• 25:31related to to concerns of
• 25:33professionalism in the school of
• 25:34medicine. We obviously only have
• 25:38jurisdiction, if you will, over
• 25:40faculty
• 25:41issues,
• 25:42but we're charged with,
• 25:45triaging
• 25:45these concerns
• 25:47to the appropriate place within
• 25:48the university because in a
• 25:49big place like this, school
• 25:50of medicine or the university,
• 25:52as you can imagine,
• 25:53sometimes it's hard to know
• 25:54which office to go to.
• 25:57And
• 25:57one of our charges is
• 25:59to do that and to
• 25:59help people do that.
• 26:01In addition, people can reach
• 26:03us through the university hotline.
• 26:05Now this is a university
• 26:06resource,
• 26:08that is actually
• 26:11through a vendor, a third
• 26:12party vendor.
• 26:14It allows individuals
• 26:16to report anonymously,
• 26:19and
• 26:20I think most importantly allows
• 26:22us
• 26:23to continue
• 26:25to correspond with a person
• 26:27kind of shrouded in anonymity.
• 26:30You're able to,
• 26:32include a kind of
• 26:34protected email, so we can
• 26:36email and go back and
• 26:37forth.
• 26:38We can post questions for
• 26:40the person who reports
• 26:41and then call back.
• 26:44And so that's a real
• 26:45advantage, particularly in a complex
• 26:47type of case,
• 26:49to to be using the
• 26:50the hotline.
• 26:52The Yale professionalism concern form
• 26:54does allow for anonymous reporting,
• 26:56so someone does not need
• 26:57to put their name.
• 26:59We, again, we encourage people
• 27:01if it's a complex issue
• 27:02to
• 27:03share use the hotline,
• 27:05but because we can't correspond
• 27:07with folks through the anonymous,
• 27:09through our anonymous reporting form,
• 27:11but,
• 27:12it does allow for anonymous
• 27:14reporting,
• 27:15so people can,
• 27:17at least raise their concerns.
• 27:19The other thing that I
• 27:20always encourage people to do
• 27:22is,
• 27:23you know,
• 27:24at least call us, contact
• 27:26us, and and,
• 27:28kind of come come to
• 27:30us so that we can
• 27:31at least start a conversation
• 27:33around things like confidentiality
• 27:34and all those other the
• 27:35other pieces.
• 27:37We have many times if
• 27:39we have a trainee or
• 27:40a student, they'll say, I'm
• 27:41raising this concern, but can
• 27:43you wait until I'm done
• 27:44with this rotation, or can
• 27:45you wait for six months,
• 27:47you know, in order to
• 27:48address it just to protect,
• 27:50kind of my identity? So,
• 27:52again, we do things like
• 27:53that, but but it the
• 27:54the two
• 27:55anonymous reporting and neck mechanisms
• 27:57would be the university hotline
• 27:59and the concern form.
• 28:02So what happens when someone
• 28:03reports a reports a concern
• 28:05to our office? I always
• 28:06you know, I think one
• 28:08of the concerns always is,
• 28:10you know, I'm gonna raise
• 28:11a concern, and then next
• 28:12thing you know, I'm no
• 28:13longer driving the car. Right?
• 28:15Someone else has taken over,
• 28:16and I no longer have
• 28:17control. And
• 28:19that is a very, I
• 28:20think, understandable
• 28:21fear and anxiety about raising
• 28:23concerns. So we like to
• 28:25kind of lay out what
• 28:27we do and how it
• 28:28you know, just a general
• 28:29process.
• 28:31The first step is always
• 28:32intake. So when someone raises
• 28:34a concern with our office,
• 28:36we reach out to them,
• 28:37and we ask them kind
• 28:39of about their confidentiality
• 28:41parameters. Like, are you comfortable
• 28:43with me raising this? How
• 28:44would you like me to
• 28:45raise this?
• 28:46And, you know, we talk,
• 28:47and we learn to we
• 28:49we kind of figure things
• 28:50out.
• 28:51If something happened in a
• 28:52hallway or in an eight
• 28:53or, an OR and there
• 28:55were other people around, we
• 28:57talk about how we can
• 28:58do that. In some instances,
• 28:59if it was a one
• 29:00on one conversation
• 29:02that they you know, and
• 29:03there's concern about retaliation,
• 29:06We talk about it it
• 29:07may take on a a
• 29:08kind of a coaching almost,
• 29:10a consultation
• 29:11with the person, or,
• 29:14you know, resources, those types
• 29:16of things. So,
• 29:17the a lot of things
• 29:18happen in the intake, and
• 29:20we're really exploring what happened,
• 29:22but also the person's comfort
• 29:24level and well-being during that
• 29:25phase.
• 29:27Second step is to triage.
• 29:30And, you know, we have
• 29:31a number of professionalism
• 29:33partners throughout the university,
• 29:35the office of
• 29:36collaborative,
• 29:37excellence
• 29:38in the, school of medicine,
• 29:41the office of institutional equity
• 29:42and accessibility,
• 29:43which is a university office
• 29:45that deals with discrimination
• 29:46and, hostile environment harassment.
• 29:50So one of the things
• 29:51we first we we do
• 29:52as our second step is,
• 29:54do we need to engage
• 29:56one of our professionalism
• 29:57partners because it's really more
• 29:58appropriately handled by them,
• 30:01or do we be given
• 30:02the nature of what is
• 30:04kind of the concern is?
• 30:05Do we need to escalate
• 30:06it? And, again, we discuss
• 30:08a lot of that in
• 30:08the intake stage with the
• 30:10individual who comes forward.
• 30:13Step three is to take
• 30:14steps to address it, and
• 30:16that can again, that's a
• 30:17true function of what the
• 30:19the nature and seriousness of
• 30:21the concern that's brought forward,
• 30:23and the confidentiality
• 30:25parameters
• 30:26that we've discussed with the
• 30:27individual who's brought the concern
• 30:29forward. So
• 30:30there are a number of
• 30:31options. Inform, discuss
• 30:33with the individual who's allegedly
• 30:35engaged in this behavior.
• 30:37Sometimes
• 30:37engaging the faculty leader
• 30:39and having the faculty leader
• 30:41be that a
• 30:42a program director,
• 30:44a a section chief, a
• 30:45division chief, or a chair
• 30:46in some instances,
• 30:48kind of engaging them and
• 30:50walking alongside them as we
• 30:51kind of figure out what
• 30:52to do, or perhaps they
• 30:54address it directly with the
• 30:55faculty member.
• 30:57In some instances, given the
• 30:59nature of kind of the
• 31:00concern that's raised, we our
• 31:02office does do, like, more
• 31:04formal fact finding.
• 31:07And we always, as part
• 31:09of addressing the concern,
• 31:11always talk about with the
• 31:13individual
• 31:14that we're we're dealing with
• 31:16it. We're we're trying to
• 31:17kind of address the concern
• 31:18with. We always talk about
• 31:20the no retaliation prohibition.
• 31:22Anyone who who uses our
• 31:25who brings a concern forward
• 31:26to our office as well
• 31:28as other offices in the
• 31:29university
• 31:30are protected from retaliation.
• 31:32And, you know, we and
• 31:35retaliation is always a common
• 31:37fear raised by people. You
• 31:38know, I think, again, concern
• 31:40raised by folks.
• 31:41I don't want you to
• 31:42do anything because I'm I'm
• 31:43concerned. I'm in this lab.
• 31:46I'm in this rotation,
• 31:47or I'm a junior faculty
• 31:48member. They're a senior faculty
• 31:50member.
• 31:51I'll be up for promotion
• 31:52in a couple of years.
• 31:53So
• 31:53we navigate with the retaliation
• 31:55concerns and with how we
• 31:58we actually handle
• 31:59or address the concern,
• 32:01but also
• 32:03with respect to
• 32:04really educating the individual,
• 32:07about the, the individual that
• 32:10we're, you know, kind of
• 32:11engaging with who's alleged to
• 32:13have gated the behavior,
• 32:14really talking to them about
• 32:16what retaliation is and how
• 32:18it's prohibited and and really
• 32:20doing some education there. Then
• 32:22the fourth step is our
• 32:24is our, intervention step.
• 32:27It is remediation oriented.
• 32:30We aim to be timely,
• 32:31responsive, and proportional.
• 32:34Again, kind of and it
• 32:35it's really a focus on
• 32:37education and changing behaviors.
• 32:39And, again, no retaliation
• 32:41is emphasized in that step
• 32:43as well. As I always
• 32:44tell faculty,
• 32:45you know, listen. Right now,
• 32:46this program, I I don't
• 32:48know which camera to go
• 32:48to, but, like, right now,
• 32:50this this problem is this
• 32:52big. If there are acts
• 32:53of retaliation, it becomes much
• 32:55bigger,
• 32:57because this isn't about, like,
• 32:58a harsh word
• 33:00or, you know, kind of
• 33:01a meltdown in the OR.
• 33:03It then becomes about
• 33:04a, a a violation
• 33:07or an act that violates
• 33:08policy but also really harms
• 33:10the culture of the school,
• 33:12and we take that very
• 33:13seriously.
• 33:14It's a very serious offense.
• 33:16Step five
• 33:18is our follow-up.
• 33:20We we've closed the we
• 33:21close kind of the matter.
• 33:23We've we move back to
• 33:24the person who had raised
• 33:26the concern and say, listen.
• 33:27This has been addressed.
• 33:30We look if there were
• 33:31any kind of trainings or
• 33:33things that need to be
• 33:34done as part of the
• 33:35remediation.
• 33:36We're charged with
• 33:37ensuring compliance.
• 33:38And it and the last
• 33:40piece is, of course, assuring
• 33:42that people are fine,
• 33:44looping back with them, and
• 33:45ensuring that there's no retaliation.
• 33:52This just tells you a
• 33:53little bit more about our
• 33:54confidentiality.
• 33:55We handle all concerns with
• 33:57discretion. We discuss the parameters
• 33:59and preferences.
• 34:01If people are
• 34:03are do not do not
• 34:05want absolute
• 34:06confidentiality
• 34:07again, if something happened in
• 34:08a group, it doesn't impede
• 34:10our ability to address things.
• 34:11But
• 34:12if it was a one
• 34:13on one conversation,
• 34:16we may be limited in
• 34:17what we can do to
• 34:18to resolve it, but we
• 34:20can always we always try
• 34:21to do something to make
• 34:23things better. I mean, that's
• 34:24really the purpose of our
• 34:25office. So that's why we
• 34:26encourage people to come forward
• 34:28and at least share with
• 34:29us so we can problem
• 34:30solve around that.
• 34:32And this is the formal
• 34:33policy against no retaliation, which
• 34:35is on our website.
• 34:37Retaliation prohibited against individuals who,
• 34:40in good faith, report alleged
• 34:42violations of Yale policy or
• 34:44the law or who provide
• 34:45information in connection with the
• 34:46investigation of these matters.
• 34:49Again, we're firmly committed to
• 34:51that. We're clear about it,
• 34:53and we reinforce it throughout
• 34:54processes and programs like this.
• 35:01So as we think about,
• 35:03what to do, our focus
• 35:04is really on,
• 35:06both assisting the individual who's
• 35:08reporting the concern to us
• 35:10as well as remediating
• 35:12the faculty member who was
• 35:13said to have,
• 35:16done done the,
• 35:18the unprofessional behavior.
• 35:21You know, this this triangle
• 35:22sort of gives you a
• 35:23sense of,
• 35:24what some of the interventions
• 35:26could be. For first reports
• 35:28or or first occurrences,
• 35:31we work with the faculty
• 35:32member to make them aware
• 35:33of what happened. Oftentimes, they're
• 35:35they're unaware of of the
• 35:37way that they've,
• 35:39behaved. That's that's,
• 35:41been a concern,
• 35:42and that's sufficient. Just making
• 35:44them aware.
• 35:45The the Vanderbilt data
• 35:47suggests that ninety percent of
• 35:49people who do a first,
• 35:52you know, who have a
• 35:53first report
• 35:54of professionalism
• 35:55concern actually
• 35:57don't repeat that if you
• 35:58just talk to them about
• 35:59it and bring it into
• 36:00their awareness.
• 36:02But if it becomes a
• 36:03repeated concern or even an
• 36:05established pattern,
• 36:06then we need to do
• 36:08to do more to help
• 36:09that person remediate.
• 36:11So we might send them
• 36:12to a course. We might
• 36:14involve coaching for that for
• 36:15that individual.
• 36:17And and sometimes if it's
• 36:19really an established pattern, we
• 36:20may have to,
• 36:22to think about are there
• 36:23are there sanctions that we
• 36:25could invoke,
• 36:26like
• 36:27removing them from a leadership
• 36:28position,
• 36:30you know,
• 36:32working with
• 36:33the the the the clinical
• 36:35leadership of their section
• 36:37or department,
• 36:39to think about
• 36:40even things like, will they
• 36:42be renewed at their next,
• 36:43their next time of coming
• 36:45up for renewal?
• 36:46But but always, you know,
• 36:48hoping that we can remediate
• 36:50the, the individual.
• 36:55So just some data on,
• 36:57on our work.
• 36:59You know, in last fiscal
• 37:01year, fiscal year twenty five,
• 37:03we had almost two hundred
• 37:04and fifty issues that were
• 37:05were brought to us.
• 37:07This this may look like
• 37:08there's an epidemic of unprofessional
• 37:10behavior
• 37:11happening across the,
• 37:13the school.
• 37:14I hope it really means
• 37:16that people are becoming more
• 37:17and more familiar
• 37:18with OAPD
• 37:20and that they're feeling more
• 37:21comfortable coming and talking with
• 37:22us, that they've maybe talked
• 37:24to a colleague who's come
• 37:26to us to talk through
• 37:28an issue and who's been
• 37:29satisfied with the resolution and
• 37:31gives them the confidence to,
• 37:33to maybe come and and
• 37:34talk with us.
• 37:37So so,
• 37:38there's a a good bit
• 37:39of work involved in, in
• 37:42addressing two hundred and fifty,
• 37:44issues.
• 37:47In terms of those two
• 37:48hundred and fifty, the the
• 37:49majority,
• 37:51about sixty percent are around
• 37:52professionalism issues.
• 37:54Another twenty
• 37:55nearly thirty percent are referred
• 37:58to some of our partners.
• 38:01But we have to actually
• 38:03talk with the individual to
• 38:04find out what the issue
• 38:05is and then talk with
• 38:07our partners to make sure
• 38:09that they feel that this
• 38:10is something that they could
• 38:11handle.
• 38:12So there is is also,
• 38:13work on our part in
• 38:15making a good referral
• 38:17and and then other, kinds
• 38:19of issues.
• 38:24Just go back. Sure. I'm
• 38:25sorry. I just, point out
• 38:27that things like scientific misconduct
• 38:30are also part of our
• 38:31work.
• 38:33Doctor Linda Mays is the
• 38:34person in the,
• 38:36in our office who is
• 38:38both the chair of the
• 38:39child study center, but also
• 38:40an expert on addressing
• 38:42academic misconduct. And so, she
• 38:45helps us with those those
• 38:46issues. So academic integrity
• 38:48and authorship disputes are are
• 38:50part of what you could
• 38:51come to us
• 38:53to address.
• 38:56In terms of the kinds
• 38:58of things,
• 38:59it's similar to that list
• 39:00of of problematic behaviors
• 39:03that I, mentioned before.
• 39:05Disrespectful
• 39:06verbal and nonverbal conduct is
• 39:08about forty five percent
• 39:09of what we deal with.
• 39:11Accountability
• 39:12or compliance, you know, making
• 39:14sure that we are holding
• 39:16ourselves accountable to the rules
• 39:18and policies
• 39:19that
• 39:20that,
• 39:21that govern our behavior.
• 39:23Some things that are disruptive
• 39:25or inappropriate.
• 39:27We deal with leadership deficiencies
• 39:29and then other other smaller
• 39:31groups,
• 39:33including
• 39:34interpersonal conflict
• 39:35and,
• 39:36harassment and retaliation.
• 39:43So it's important to know
• 39:44that that we do do
• 39:47some fact checking when when
• 39:48these issues are brought to
• 39:50us.
• 39:50And in about seventy percent
• 39:52of cases, we're able to
• 39:53substantiate
• 39:54that the that the event
• 39:56happened.
• 39:57And it's also important to
• 39:59know that in thirty percent
• 40:00of times, we were not
• 40:02able to substantiate,
• 40:04that it happened or it
• 40:05was our investigation was inconclusive.