MARY T. KILLACKEY, MD, is a professor of surgery and pediatrics at Tulane and chair of the Department of Surgery. Killackey is one of the initiators of The Tulane Professionalism/Environment of Learning Program, which was created in 2017 to promote professional behavior among medical students, residents, fellows and faculty in the School of Medicine.
Q. What triggered the professionalism project?
When Dr. Marc Kahn (now at University of Nevada–Las Vegas) and I started this, we conducted a status survey in the School of Medicine. For the most part, our results showed that we work in a collegial environment, we trust our colleagues, and we think that people are choosing to do the right thing.
But more than 50% of us had either witnessed or participated in a lapse of professional behavior [such as a verbal outburst] in the last 12 months. And the most concerning thing was that only 20% to 30% of the people surveyed had some understanding of how to report incidents and what happens when it’s reported, and how they’re addressed.
Q. So you thought it was important to have a structured system in place to address issues of professionalism?
Exactly, and we wanted it to feel safe. What’s really important is to emphasize that this is [supposed] to help. This is to keep people here, not to get rid of them. It’s not punitive.
Most people [who lapse] are acting out because they’re stressed, they’re depressed, or there are other things going on. So, you have to make people aware of how they’re behaving because a lot of times people just don’t realize it.
The system is also a way to let us know of people who have displayed exemplary behavior.
Q. How does the program help faculty and students identify a lack of professionalism?
We have a website now where we explain the whole process. Any report that comes in gets triaged by three senior faculty who were selected by the dean. We have about 40 faculty that have agreed to participate as messengers, and they were trained this June.
If there is a report, a peer reaches out and delivers the message [to the subject of the complaint]: “Just letting you know.” There’s no judgment, they’re not doing an investigation. It’s simply, “Here’s the message.” Because it’s delivered by peer messengers and not your boss, it more effectively holds individuals accountable to their community. By tracking reports, it allows for identification of patterns and escalated intervention.
Q. How else do you create a positive mindset and positive work environment?
In collaboration with our Office of Multicultural Affairs, we offer trainings and bring in high-impact speakers. Our current phase involves working with a consultant to engage the entire school — faculty, staff, residents and students — to really nail down our core values and define the behaviors associated with those values.