Faculty of Medicine & Dentistry
Professionalism/Mistreatment Reporting Form

We value professionalism and psychological safety at the University of Alberta (https://www.ualberta.ca/medicine/resources/faculty-and-staff/professionalism/psychological-safety.html

The purpose of the online reporting process is to enable a safe, confidential and/or anonymous reporting mechanism for learners and staff who have experienced unprofessional behaviour and/or mistreatment within the learning and working environments at the Faculty of Medicine & Dentistry.

This reporting process should be used for reporting concerns only and should not be used for emergencies. If there are concerns around the Reporter’s immediate safety in terms of mistreatment, harassment, physical and/or psychological safety, we encourage contact of the following services:

IMMEDIATE HEALTH OR SAFETY CONCERNS

For sexual violence crisis, options include:

For other forms of reporting including threats or violence, options include:

Wellness Supports:

Submissions will be reviewed within 3 business days of submission, and will be triaged according to level of urgency.

All individuals who submit confidential concerns will be communicated with as to what actions/outcomes occurred as a result of their concerns being submitted. We are unable to communicate back to individuals who submit anonymous concerns, because of the lack of identifying information provided. Anonymized professionalism/mistreatment reports will be available on the professionalism website on an annual basis (delayed release greater than six months after preceding academic year.

For a full review of the concern reporting process, please click here.

Have you experienced or witnessed an event that involves immediate health or safety concerns?

No Yes
Immediate Health or Safety Concerns

For sexual violence crisis, options include:

For other forms of reporting including threats or violence, options include:

Wellness Supports:

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Concern Types & Settings

Settings

FoMD Activities

Refers to any activity that occurs at the Faculty of Medicine and dentistry including but not limited to:

  • Any delivery of curricular material in any program in the FoMD
  • Any activity owned by or controlled by the Faculty of Medicine and Dentistry or on FoMD property
  • Any learning activity including practicums, clerkships and clinical education of any kind
  • Any research related activity including primary research practice, presentations, conferences, and related activities on and off campus
  • Any and all University-related social networking events affiliated with the faculty of medicine and dentistry
  • Any and all social media associated with the FoMD

Unprofessional behaviors are not limited to, but may include:

  1. Mistreatment (treating others badly, puts down others, yelling, insulting, belittling or offensive remarks)
  2. Rudeness and Disrespect (lack of respect for others and others’ opinions, foul language in the workplace)
  3. Bullying, Threatening and Intimidation (use of superior strength/influence to force others to do what one wants)
  4. Harassment (inappropriate physical and/or sexual contact, unacceptable behavior in the context of social norms including racism)
  5. Discrimination (unjust, unequal or prejudicial treatment of different categories of people based on grounds of race, ethnic origin, religion, marital or family status, genetic characteristics, age, gender identity, disability)
  6. Spreading Rumours, Gossiping, Saying Untrue Things
  7. Microaggressions (a subtle, powerful, often unintentional form of discrimination)
  8. Sexual or Physical Violence
  9. Passive-aggressive(refusal to return pages/calls/emails, deliverance of promised work; conflicts of interest; disregard for stewardship of resources; refusal to demonstrate competence, lateness; complete billing/documentation)

Do you feel the events in this concern meet the definition of unprofessional behaviour and/or mistreatment?

No Yes
Professionalism & Mistreatment Concern Reporting Form

This form should be used for reporting concerns only and should not be used for emergencies.

All forms will be reviewed within 3 business days of submission, and triaged according to level of urgency.

You will be contacted by a triage officer within 3 business days of submission. Note: we are unable to respond to anonymously placed concerns due to not having the reporter's contact information. We can only contact those who provide their names and contact information.

Please summarize the events of the concern including details such as:

  • Nature of the concern
  • Names of all individuals involved EXCEPT PATIENTS
  • Precise time and location
  • Whether you experienced the concern yourself or witnessed someone else experiencing it

Please note: The events of the concern must be made in good faith and to your best recollection of the concern. Filing of a false, frivolous, retaliatory, vexatious, or malicious report will be considered a professionalism lapse.

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Confidentiality and Anonymity

All reports will be handled, investigated and reported on a confidential and/or anonymous basis such that reporter identity will be protected unless required by law; University policy (Faculty Relations, Human Resources, and the Office of Dean of Students); or regulations: College of Physicians & Surgeons of Alberta regulations; and the Health Professions Acts for Alberta Dental Association & College Health; College of Registered Dental Hygienists of Alberta; Alberta College of Medical Diagnostic & Therapeutic Technologists; and the College of Medical Laboratory Technologists of Alberta.

Should you choose to submit this report anonymously, no identifiable information will be collected. Please note we are unable to contact those who report concerns anonymously. Anonymous reporting may hinder investigations, outcomes and prevent any follow-up reporting mechanisms. As a result, the FoMD would like to recommend submitting confidentially if possible.

Should you choose to submit this report confidentially, you will be asked to provide an email address. Your contact information will be used to provide a transparent process of investigation to you. You will also receive further contact should we require more information or have completed our investigation.

For a description of this reporting mechanism, please click here.

Thank you for your confidence. Please provide your name and email for further confidential contact.

Reporters may select a support person of their choosing, or can ask for a support person to be provided to them, from offices/associations including but not limited to:

You may choose and contact a support person to help you through the reporting process on your own. You are welcome to choose a support person not on the list above. Alternatively, you may indicate that you would like a support person and the triage officer can aid in connecting you to a support person during the initial meeting (such as someone from the list above).

Your report will be submitted anonymously. Please click the submit button below to submit the report.

Concern Submitted Successfully

Thank you for your submission. A notification has been sent to the designated triage officer notifying them of your submission. Your report will be reviewed within 3 business days of submission. However, investigation and resolution of the concern will require more time. If you have provided your contact information, you will receive a final report of the resolution of the investigation. Note: we are unable to respond to reporters of anonymously placed concerns due to not having the reporter's contact information. We can only contact those who provide their names and contact information.

If you have not received a response within 3 business days, please email smyth@ualberta.ca.

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