Feedback matters: the impact of an intervention by the dean on unprofessional faculty at one medical school.

Purpose: Unprofessional behavior by faculty can result in poor patient care, poor role modeling, and mistreatment of trainees. To improve faculty or institutional behavior, unprofessional faculty must be given direct feedback. The authors sought to determine whether annually surveying medical students for their nominations of most and least professional faculty, coupled with direct feedback to unprofessional faculty from the dean, improved faculty's professional behavior.

Method: From 2007 to 2012, senior medical students at Southern Illinois University School of Medicine completed an anonymous survey naming the "most professional" and "least professional" faculty in each department. Students described unprofessional behaviors, and their descriptions were qualitatively analyzed. The most unprofessional faculty met with the dean to discuss their behavior. The authors examined differences between faculty named most professional in their department versus those named least professional and whether behavior as measured by student nominations changed following feedback.

Results: The response rate overall for six graduating classes was 92.5% (385/416). Faculty named most professional were highly associated with receiving teaching and humanism awards. Faculty named most unprofessional were shown to either leave the institution or improve their behavior after receiving feedback.

Conclusions: Attitudes and behaviors of teachers create the culture of their institution, and unprofessional behavior by these educators can have a profound, negative effect. Direct involvement by the dean may be an effective tool to improve the learning environment of a single institution, but universal application of such a program is needed if the profession as a whole is to improve its culture.