Accolade Wizard

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Professionalism Accolades Report Form

We value professionalism at the University of Alberta.

The professionalism accolades report form is a means to formally acknowledge and report exemplary professionalism.

If you have witnessed a member of our FoMD or healthcare community upholding the highest standards of professionalism within any of the learning environments of the Faculty of Medicine & Dentistry, please use the accolades form to report this.

All submitted accolades forms will be reviewed at the regular, bi-monthly meetings of the Professionalism Triage Committee of the Faculty of Medicine and Dentistry.

These forms will help to identify individuals for recognition and/or awards related to professionalism.

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

Accolade Type

The Faculty of Medicine and Dentistry upholds a core set of values, including, but not limited to:

  • respect
  • honesty and trust
  • compassion
  • altruism
  • integrity
  • justice
  • accountability
  • protection of confidentiality
  • leadership
  • self-health/ work-life harmony
  • collegiality

Excellence is professionalism may look like:

  • demonstrating respect for a patient's decision, despite conflict with one's own beliefs
  • "going the extra mile" to make something good happen for a patient or a colleague
  • demonstrating excellent work-life boundaries to promote self-health
  • tactfully redirecting others in cases of unprofessional conduct from colleagues
  • consistently demonstrating a positive attitude towards work and others

Those who exemplify these values should be acknowledged. The accolades form is one key mechanism for doing this.

Do you feel that the events that have taken place reflect an upholding of the highest standards of professionalism
within the Faculty of Medicine & Dentistry?

Accolades Report

This form should be used for reporting accolades only and should not be used for reporting of concerns of student mistreatment or lapses in professionalism. Concerns of student mistreatment or lapses in professionalism should be reported via the Professionalism Concern Reporting Form.

All accolades will be acknowledged within 4-8 weeks of submission.

Date of Occurrence
(if applicable)
Location of Occurrence
Setting of Concern
Course/Rotation
Person's name:*
Person of Interest's role*

Please summarize the events including details such as:

  • Nature of their behavior
  • Names of all those individuals involved EXCEPT PATIENTS
  • Time and location (if applicable)
  • Whether you experienced the occurrence yourself or witnessed someone else experiencing it

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

Description:*

Confidentiality and Anonymity

The FoMD will protect confidentiality and respect anonymity, should it be requested by you.

All professionalism accolades reporting form will be handled and reported in a confidential manner by the professionalism panel such that reporter identity will be protected unless required by law or University policy.

Should you choose to submit this report anonymously, no identifiable information will be collected. Please note that anonymous reporting may hinder follow-up reporting mechanisms. As a result, the FoMD would like to recommend submitting your report in confidence to the FoMD program.

Should you choose to submit this report confidentially, you will be asked to provide an email address. You may then receive further contact should we require more information.

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.

Please provide us with your name:*
Please provide your email:*
Please provide us with your role:

Next Steps

Thank you for your submission. A notification has been sent to the designated professionalism committee member notifying them of your submission. Your report will be reviewed within 72 hours of submission.

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

Please come back when you encounter an event that reflects an upholding of the highest standards of professionalism in medicine.