Self-Reflection and Peer Review
*Note: A full list of ICRC outcomes is available in the Risk Assessment Framework
The Inquiries, Complaints, and Reports Committee (ICRC) may offer a dentist who is the subject of a complaint or report the opportunity to complete a Self-Reflection, or a Self-Reflection and Peer Review. In accordance with the College’s Risk Assessment Framework, the ICRC uses these remedial outcomes after they have identified “some concerns” about a dentist’s practice that pose a low risk to patient care, safety, or the public interest.
What is Self-Reflection?
A Self-Reflection is a paper or essay written by the dentist. In the paper, the dentist analyzes the concerns raised by the ICRC, applies relevant learning resources, and identifies strategies to help them improve their practice. The dentist may be asked to reflect on relevant RCDSO Standards, Guidelines, and Practice Advisories. They may also consult literature from professional associations, academics, or other sources that are relevant to the identified concerns.
Details about the Self-Reflection process
The dentist will receive a Self-Reflection template, instructions, and a checklist. The dentist will be asked to carefully review the decision and reasons of the ICRC, applicable College authorities and other applicable relevant resources. The dentist must submit the completed Self-Reflection paper to the College within 60 days of the signed ICRC decision. College staff will review the Self-Reflection paper to determine if it has been completed satisfactorily.
Some of the resources a dentist may use are:
- RCDSO’s Standards, Advisories, and Guidelines
- RCDSO Code of Ethics
- Dental journals
- Relevant research publications
- Write-up of discussions and/or information received from discussions with faculty
- Materials received during recent training and courses
What are the main steps of the Self-Reflection process?
What is Peer Review?
Peer Review adds an additional component to the Self-Reflection process.
The objective of a Peer Review is to help improve the dentist’s knowledge, skill, and judgment with respect to the concerns identified by the ICRC, with the support of another dentist who will act as a peer reviewer.
During a Peer Review, the dentist must discuss the concerns raised by the complaint or report with another active registrant of the RCDSO, and answer questions about this conversation as part of their Self-Reflection paper. The dentist does not need to disclose to the peer reviewer the fact that they are the subject of a complaint or report to the College.
Typically, the ICRC will ask the dentist to complete a Peer Review when the dentist shows a lack of accountability and/or insight during the investigative process. It may also be used for low-risk concerns that show a pattern of repeated conduct.
Details about the Peer Review process
The dentist is responsible for identifying an appropriate peer reviewer. The peer reviewer must be an active registrant of the RCDSO who does not have any of the following on the Public Register:
- Terms, Conditions, or Limitations on their license
- ICRC outcomes: Caution and/or Specified Continuing Education or Remediation Program (SCERP) that relate to the concerns raised in your case
- Suspensions: Registration, Interim Order and/or Discipline Committee
- Referrals to the Discipline Committee or the Fitness to Practise Committee.
- Discipline Committee findings of professional misconduct or incompetence
- Fitness to Practise Committee findings of incapacity
- Active criminal proceedings or convictions
- A minimum of 5 years of continuous practice in Ontario as a registrant of the RCDSO
Prior to contacting a potential peer reviewer, the dentist should review the College’s Register to ensure that the peer reviewer criteria are met.
The dentist must maintain the confidentiality of a patient’s personal health information during the discussion and guidance session with the peer reviewer.
The dentist should discuss the following with their peer reviewer:
- Summarize the concerns detailed in the ICRC decision to the peer reviewer. The dentist can describe them as if they are a neutral third party reviewing a case study - they do not need to disclose the ICRC decision or that these concerns arose because of a College investigation.
- Discuss how these concerns could have been mitigated and/or how the dentist will address them if they arise in the future. If necessary or helpful, the dentist can review the patient record (which must be anonymized) with the peer reviewer as part of this discussion.
- Discuss any other relevant concerns or questions that arise.
- Discuss resources that might be relevant to addressing the concerns.
- Discuss appropriate source documents that could be reviewed (Standards, Guidelines, Practice Advisories)
The dentist is encouraged to take notes during the discussion to help in writing their Self-Reflection.
After the guidance session with the peer reviewer, the dentist must finalize the Self-Reflection process and submit it to the College.
What are the main steps of the Peer Review process?
