The practice of medicine is not an individual pursuit. It takes a team of people to deliver the care our patients require. That is why we must not just model collaborative team care as we train healthcare professionals in Temerty Medicine but also practice it.
We model this approach in our education programs through collaborative learning opportunities. For example, our undergraduate health professional programs include small group learning with shared problem-solving. The Interfaculty Pain Curriculum provides shared learning to more than 1,000 health professional students across disciplines and faculties. And we are now offering MD plus programs, such as the MD/MBA program, in which learners complete programs in two faculties. Now, as we prepare to launch the Scarborough Academy of Medicine and Integrated Health at the University of Toronto Scarborough, we are exploring new ways space can be shared to support collaborative learning in the MD, Physical Therapy, Physician Assistant and Nurse Practitioner programs.
A fundamental element of a strong team is a sense of trust among its members. If you don't feel supported by other team members, you cannot do your best work individually or as a team. It is even more complicated when negative interactions between team members threaten or actively undermine successful, effective care. Therefore, we need to foster teams that place trust at their core, where each member feels supported and included and where everyone can utilize their unique skillset to lift the group's overall capabilities.
Trust is something earned, not something that can be demanded. It’s built upon a suite of skills, including thoughtful communication, accountability, mutual respect, and conflict resolution. That is why we embed this approach within our education programs and strive to display it through our actions.
While I and other leaders in Temerty Medicine endeavour to model these traits and earn trust from our learners and colleagues, we sometimes fall short. This is not due to a lack of attention or concern. My most important priorities are fostering collaborative teams, supporting others, building and maintaining trust, and ensuring a safe, respectful, and inclusive learning environment. Temerty Medicine has made the learning and working environment a priority and established the Learner Experience Unit in the Office of Learner Affairs, which Dr. Reena Pattani leads. She has overseen the redevelopment of our learner mistreatment pathways so that when unprofessional, uncivil, discriminatory, harassing, or other concerning conduct occurs, we can support learners, ensure remediation or other consequences as needed to those whose behaviour is being questioned, and ensure accountability. When egregious behaviour occurs, we take swift action to ensure our learners are protected, supported, and kept safe and that their needs and goals are centred.
We are also educating our faculty on how they can support inclusive and respectful learning environments where our learners feel safe and where negative behaviours are addressed effectively. For example, in collaboration with our colleagues in the Toronto Academic Health Science Network (TAHSN), we introduced the mandatory Professional Values Module in 2020, which focuses on the Standards of Professional Behaviour for Clinical (MD) Faculty and is completed by clinical MD faculty members at the time of their initial hospital appointment and then every three years. We are also working with our TAHSN partners to address learner mistreatment by patients and families, among other new initiatives.
I know that there is frustration that we cannot report on the details of how individual cases and concerns are addressed. This requirement is rooted in the need to protect complainants' privacy and ensure that due process is respected. However, we have – and will continue – to report annually on concerns brought forward, as well as outcomes, in an aggregated and de-identified manner, which we hope will bring greater transparency to how concerns are managed. Our goal is to ensure you can hold us accountable and see that we are responding meaningfully to concerns brought forward in an integrated manner between Temerty Medicine and clinical learning environments.
We must also ensure that we do not lose focus on the attributes of a positive learning and working environment: collaboration, collegiality, trust, and the ability to learn from all members of the health care team, including patients and their families. They need to be recognized and celebrated, as we do through the Temerty Awards for Excellence in Professional Values, as one example.
We are one large team, each with our own roles and responsibilities. Only by working together can we in Temerty Medicine prepare the next generation of healthcare leaders capable of providing patient care in an extensive, complex, and ever-changing system. We must collaborate, confident that through our actions and conduct, we can build and maintain trust in each other to reach our highest ambitions. So, as we begin a new academic year, let us work to build trust and foster a team in which all members are valued and respected.
Patricia Houston
Vice Dean, Medical Education
Temerty Faculty of Medicine
