Accolades and Concerns Portal

WSU-BSOM has a student handbook providing guidance for students. In addition, there are university, city, state and national laws. So, what is the purpose of an online reporting system? The answer to this question lies in what it means to be a professional. A medical school, as a professional school, is so much more than an institution of higher learning. Our learners, along with 4000 applicants each year, applied, went through a holistic review of their application, and were chosen to become a member of this professional community. According to Catherine Lucey, M.D. “We must embrace the concept that professionalism is a complex competency” or in other words we cannot assume that professional behavior is an innate characteristic present in all who wish to practice medicine, but as a skill or competency that must be molded over time. The Accolade/Concern reporting system will allow everyone to point to those who have exemplary communication, interpersonal, academic and clinical skills as well as identify those who might need additional guidance.

According to Jo Shapiro M.D. Director of the Center for Professionalism and Peer Support, Brigham and Women’s Hospital, “Medicine is a hierarchy of responsibility, not of respect”. This hierarchical structure leads to an imbalance of power making it impossible for everyone, no matter their level of medical training, to feel empowered to provide feedback on the behaviors of everyone charged with patient care. Compound that with the fact that we generally are the worst judges of the effects of our own behavior on others and it starts to become clear why a reporting system may be beneficial to all, if used appropriately.

Before using the reporting system, we should examine our motivation. Is the behavior being reported a behavior that could harm a patient either physically or psychologically? The hierarchal medical training system results in interactions between people who have an imbalance of power. Does this power differential lead to mistreatment of one of our colleagues? In either of these cases use of the reporting system is justified. As an example, a student cheating on an exam will affect a patient. The student’s cheating is for their own benefit, at the cost of their future patients. Reporting an attending verbally berating a medical student in rounds should be reported both because it is a circumstance in which there is a clear imbalance of power and an example of unprofessional communication.

Just as complimenting a colleague after observing exemplary behavior is most meaningful, discussing an inappropriate behavior immediately will allow any extenuating circumstances to be examined as well as minimize misperceptions. According to Stephen M.R. Covey, “We judge ourselves by our intentions and others by their behavior.” Frequently, due to extenuating circumstances, these are not in alignment. A reporting system allows those who are unable or unwilling to have a direct conversation a means to fulfill their responsibility to self-police or monitor their colleagues or future colleagues in the medical profession for the benefit of society.

It is anticipated that the majority of the reported behaviors will require feedback and not discipline. An open feedback committee will be formed to meet on an ad hoc basis. Committee formation will be coordinated with representatives from each class. With a minimum of five students the cases reported will be discussed after being redacted of any identifying information. The purpose of the committee is to provide multiple perspectives on the reported behavior and determine the most appropriate feedback. This procedure should have a beneficial effect on all participants: to learn to evaluate behaviors from many different perspectives and to practice the interpersonal and communication skills needed to fulfill our responsibility as members of the medical profession.