Policy on the Appropriate Treatment of Medical Students in an Educational Setting

Preamble:

It is the basic philosophy of the University of Arkansas College of Medicine that optimal learning occurs in an atmosphere of mutual respect. The medical learning environment is expected to facilitate students' acquisition of the professional and collegial attitudes necessary for effective caring and compassionate health care. The development and nurturing of these attitudes requires mutual respect between teachers (including faculty, residents, fellows, nurses, staff, and students in a teaching role) and students at all levels, and between each student and his or her fellow students. While it is the responsibility of the Faculty and the College to provide a proper atmosphere for education, it is also the responsibility of the student to develop and maintain personal honor and integrity, as well as compassionate and ethical behavior. Students must pledge their utmost effort to acquire the knowledge, skills, attitudes, and behaviors required to fulfill all educational objectives established by the faculty. This policy is set forth to assist in the maintenance of an optimal learning environment, but is not meant to be used as an excuse for students to disregard their own responsibilities in the educational process.

Definition of Mistreatment:

Mistreatment is behavior that adversely affects the learning environment and negatively impacts the student/teacher relationship. Inappropriate and unacceptable behaviors promote an atmosphere in which abuse is accepted and perpetuated in medical training. Examples of mistreatment include, but are not limited to:

• Harmful, injurious, or offensive conduct

• Verbal attacks

• Insults or unjustifiably harsh language in speaking to or about a person

• Public belittling or humiliation

• Threats of physical harm

• Physical attacks (e.g., hitting, slapping, or kicking a person)

• Requiring performance of personal services outside of the educational environment (e.g., shopping, baby sitting)

• Threatening with a lower grade or poor evaluation for reasons other than course/clerkship performance

• A pattern of intentional neglect or lack of communication

• Disregard for student. safety

Unnecessary or avoidable acts or words of a negative nature inflicted by one person on another person or persons intended to cause humiliation. (Pointing out during rounds, conferences, and the like, that a student has not adequately prepared for his/her assignments or learned required material is not mistreatment unless it is done in an inappropriate manner)

Exclusions from this Policy:

Specifically, this policy is not intended to include complaints of sexual harassment or complaints of discrimination on the basis of disability, race, color, sex, creed, veteran's status, age, marital or parental status, or national origin. The College of Medicine has specific policies to address these complaints (Please see Student Handbook).

Process for Reporting and Dealing with Allegations of Mistreatment:

Stage 1: When it is felt that an incident_ of mistreatment has occurred, the parties directly involved should try to resolve the matter themselves. Many such situations are amenable to resolution in this manner. However, it is acknowledged that this informal approach may fall short at times, because of reluctance of the student with a complaint to directly interact with the accused, intransigence of the accused, or differing perceptions of the incident by the parties involved. In such -"" "cases, the following steps shall be taken:

Stage 2: When the matter cannot be resolved in Stage 1, assistance should be sought from representatives of the Student Advocacy Council. These elected peers in the various classes may, with the help of their faculty advisors, be able to resolve the matter either by counseling .the student with a complaint on appropriate steps to take, by directly intervening with the accused, or by referring the matter to the next stage. When the situation is elevated to Stage 2, anonymity of the student and the accused can no longer be maintained. Nevertheless, confidentiality is critical, and no information may be given to those not directly involved in the process.

Stage 2B:If the matter cannot be resolved at Stage 2, the Student Advocacy Councilor the accuser should directly consult the Executive Associate Dean for Academic Affairs. It is possible that an individual in the administration, such as the Executive Associate Dean, can intervene in a manner not possible for students in the Student Advocacy Council. For example, it might be possible for this individual to directly discuss the problem with the accused or his/her Chair or supervisor. When the situation reaches this stage, in the case where the accused is a faculty member, the Chair of the involved department should be notified so that he/she can be involved in any discussions with the accused if appropriate. In a case where the accused is a Chair, the Dean should be notified.

Stage 3: It is anticipated that most situations will be resolved in Stages I or 2. For those unusual cases that are not resolved, the student should discuss the problem with the Executive Associate Dean for Academic Affairs. If the accused is within the College of Medicine, the student will be advised of their right to file a formal grievance utilizing the "Grievance Procedure" as defined under "Academic, Disciplinary and Grievance Procedures" in the Student Handbook. If the accused is outside of the College of Medicine (e.g., Nurse, Respiratory Tech, etc.), the Executive Associate Dean for Academic Affairs will communicate the problem to the accused's supervisor and they will work together to determine the appropriate formal grievance procedure.

Protection from Retaliation:

Every effort will be made to protect alleged victims of mistreatment from retaliation if they seek redress. ,Retaliation will not be tolerated. To help prevent retaliation, those who are accused of mistreatment will be informed that retaliation is regarded as a form of mistreatment. Accusations that retaliation has occurred will be handled in the same manner as accusations concerning other forms of mistreatment.

Malicious Accusations:

A complainant or witness found to have been dishonest or malicious in making the allegation of mistreatment will be subject to disciplinary action.

Education:

Education is the cornerstone in the prevention of student mistreatment. A thorough and on-going effort should be made to inform all involved individuals about the appropriate treatment of medical students, and of this policy dealing with alleged mistreatment. To that end, the following notification mechanisms will be utilized:

Medical Students - This policy will be included in the Student Handbook. A discussion of mistreatment in general, as well as of this policy in particular, will take place each year during freshman and junior orientations. Each course and clerkship director will be encouraged to include this policy in course and clerkship related policy materials.

Faculty, Residents, and Fellows - An informative written message will be sent each year from the Dean's office to all Department Chairs. The Dean will direct the Basic Science Chairs to convey the information to all Basic Science Course Directors. The Course Directors, in turn, will be asked to convey the information to all faculty teaching in their courses. The Dean will direct the Clinical Chairs to assure that all clerkship and course directors of clinical courses, as well as all residency/fellowship training program directors, faculty, fellows, and residents in their departments, are aware of the College's philosophy on the appropriate treatment of medical students, and of this policy. The Dean's Office will also ask the AHEC office to convey this information and policy to all AHEC directors, as well as to their faculty and residents.

Nurses - An informative written message will be sent each year from the Dean's Office to the individual in charge of nursing at each of the major teaching hospitals utilized by our students. They will be asked to make this information, and this policy in particular, known to the nurses in their institution by whatever means they feel the most appropriate.

Summary

It is hoped that this policy will promote a positive environment for learning in the College of Medicine and will affirm the importance of collegiality and respect for others.