Teacher-Learner Conduct Policy

Scope

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Policy Statement

Indiana University maintains a Code of Academic Ethics, which outlines the professional conduct of faculty members in their interactions with students. The policy herein is a supplement to this university-wide Code of Academic Ethics and provides an interpretation and implementation process specific to the IU School of Medicine (IUSM).

Interactions in the learning environment, whether student-student, student- teacher, or teacher-teacher, should promote the core values of IUSM and be consistent with the expectations for professionalism outlined in the IUSM Honor Code. Learner mistreatment is defined as intentional or unintentional behavior that interferes with the learning process and displays disrespect for the dignity of others.* Disruptive, abusive, harassing, or discriminatory conduct will not be tolerated. Such conduct or other behavior that interferes with an effective learning environment and is disrespectful should be reported through the procedures outlined within this policy. Retaliation against those who report mistreatment is strictly prohibited.

* - Mavis B, Sousa A, Lipscomb W, Rappley MD. Learning about medical student mistreatment from responses to the medical school graduation questionnaire. Acad. Med. May 2014;89(5):705-711.

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Reason for Policy

It is the mission of IUSM to advance health in the State of Indiana and beyond by promoting innovation and excellence in education, research and patient care. Grounded by core values of excellence, respect, integrity, diversity and cooperation, IUSM strives to create a learning environment that is conducive to teaching and learning. All members of the IUSM community are expected to uphold the expectations outlined in the IUSM Honor Code.

IUSM is thus committed to maintaining the highest standards of professionalism. This commitment also includes an obligation to promptly investigate alleged violations of the IUSM Honor Code. The policy herein provides examples of mistreatment and other behavior that will not be tolerated and the procedures for reporting instances of conduct and other behavior that interfere with effective teaching and learning such that they can be addressed.

Certain conflict or conduct can be effectively managed through prompt and direct actions between the parties involved. Doing so can lead to resolution of the conflict itself, promote trust and also lead to the development of conflict resolution skills. However, when a member of the learning environment has doubt about whether a direct effort should be attempted or would like assistance in resolving their concerns, the primary resource to contact for guidance is the IUSM Ombuds Office, which is available to faculty and all IUSM learners.

Learners are strongly encouraged to report mistreatment through their course or clerkship evaluation forms and/or via the online IUSM Mistreatment Incident Report Form; this form allows for confidential or anonymous reporting. Incident reports are triaged by dean’s office institutional authorities who determine whether a formal or informal investigation is necessary and coordinate the response per a standard protocol. If there is concern that the behavior, conduct or conflict involves harassment, discrimination or retaliation, the IUPUI Office of Equal Opportunity (OEO) will be involved per University policy. Those with information that fall within the charge and authority of OEO are urged to promptly communicate their concerns and other available information to the IUSM via the Mistreatment Incident Report or to the OEO directly. Note, responsible employees who learn of behavior that falls under the Indiana University Discrimination, Harassment, and Sexual Misconduct Policy have a duty to report such incidents as outlined in the policy.

While online reporting is the recommended method of reporting mistreatment, learners are strongly encouraged to report mistreatment and can do so by other means, such as contacting the IUSM Ombuds Office; speaking with a lead advisor, course or clerkship director, faculty member of the Office of Medical Student Education; or, by talking with a member of the Teacher-Learner Advocacy Committee.

IUSM assumes that learners who report mistreatment do so in good faith. A student who is dishonest and/or malicious in making an allegation of mistreatment will be referred to the Student Promotions Committee and may be subject to disciplinary action. Similarly, if a resident is dishonest and/or malicious in making an allegation of mistreatment, he/she may face disciplinary action per GME policy and procedures.

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Procedures

Procedures for Processing Allegations of Learner Mistreatment

1. The Complaint

A complaint is an allegation of a violation of the policy described herein, the IUSM Teacher Learner Conduct Policy (TLCP). A complaint may be made directly by a learner (medical student, graduate student, resident, fellow), or indirectly by a member of the IUSM community on behalf of a learner.

Complaints can be submitted through the online IUSM Mistreatment Incident Report Form or via course/clerkship evaluation forms, and the complainant may submit the report confidentially or anonymously. When learners directly report concerns of a potential TLCP violation to a member of the Teacher Learner Advocacy Committee, a lead advisor, course or clerkship director, Ombuds Office, or other member of the IUSM community, the learner will be encouraged to formally report the complaint through the online form or via the course/clerkship evaluation form.

When a learner is reluctant to initiate a complaint directly, the person with whom the learner reported a potential TLCP violation is expected to submit the complaint on behalf of the learner through the online IUSM Mistreatment Incident Report form (with the exception of the IUSM Ombuds Office, which operates confidentially and informally per the IUSM Ombuds Office Guidelines). When submitting on behalf of a learner, the person submitting the incident report must include his/her contact information.

2. Roles and Responsibilities for Initial Triage

The Executive Associate Dean for Faculty Affairs, Professional Development and Diversity (EAD for FAPDD; or designee) will have the responsibility for coordinating the response to alleged violations of the TLCP. Complaints are initially triaged by the EAD for FAPDD, the Senior Associate Dean for Medical Student Education, Associate and Assistant Deans for Medical Student Affairs, Senior Associate Dean and Assistant Dean for Graduate Medical Education, Associate Dean for Diversity Affairs, Associate Dean for Graduate Education and/or University Counsel; this triage group receives an autogenerated alert when a complaint is received via the online IUSM Mistreatment Incident Report. When a learner makes a report via the course/clerkship evaluation form, this same group is alerted by a staff member of the Program Assessment and Evaluation (PAE) office or the course or clerkship director.

3. Pathways

Complaints are initially categorized into one of three assessment pathways:

A. Requiring an Informal Investigation

When a complaint is made directly by a learner, and the learner identifies him/herself, a member of the initial triage group will contact the learner to obtain follow up information. Learners may be asked whether there were any witnesses to the incident, and may also provide follow up information in writing.

When a specific person is identified as having allegedly violated the IUSM TLCP (the respondent), he/she will also be contacted for follow up information. He/she will be presented with a general summary of the relevant aspects of the complaint (without providing the identity of the complainant) and asked for his/her response to the assertions.

If a violation of the TLCP is deemed to have occurred, but it is not egregious, and it is a single or first report for the respondent, the response will consist of a Level 1 intervention on the IUSM Graduated Response to Mistreatment as outlined below. When deemed appropriate, an education leader (e.g, vice chair for education, course/clerkship director, residency program director, regional campus dean) may meet with the faculty member for this purpose.

When a specific respondent is not identified in a complaint, the appropriate course/clerkship director or residency program director will be notified that a complaint has been received and of the nature of the complaint. He/she will take follow up action to improve the learning environment as deemed necessary or possible.

B. Requiring a Formal Investigation

When a complaint alleges an egregious incident and/or that a respondent may have violated additional university policies (such as the IU Discrimination, Harassment, and Sexual Misconduct Policy), a formal investigation may be warranted. The initial triage group will make this determination, and if so, the EAD for FAPDD (or designee) or University Counsel will initiate contact with the Office of Equal Opportunity or other appropriate university office. Follow up investigatory actions would subsequently be done in coordination with established protocol of those offices.

When a complaint alleges unprofessional behavior of a clinical faculty member impacting the quality of patient care or other behavior that would be pertinent to a hospital facility or outpatient medical staff office, the issue may be referred to or investigated in coordination with the relevant professional standards committee(s). In such a situation, the IUSM Clinical Quality and Safety Peer Review Committee Policy may be invoked, in which case, the allegations would be reviewed according to the terms of that policy.

C. No Merit; not Mistreatment; Category other than Mistreatment

Occasionally, complaints are received that are not regarding violations of the TLCP, for example, a complaint about an interpersonal conflict between staff members that does not involve a policy violation. Such complaints are reviewed by the initial triage group and, where indicated, referred to the appropriate office or personnel (e.g. IU Human Resources Administration). When possible, feedback will be provided to the person who submitted the report.

4. Repeated Patterns of Behavior and Egregious Incidents

When a complaint is received on a respondent who has been the source of previous complaints, the triage group, coordinated by the EAD for FAPDD, will decide which level of response is warranted. After obtaining follow up information from the complainant (when possible), the appropriate level of intervention will be triggered according to the IUSM Graduated Response to Mistreatment as outlined below. At any time, when an egregious incident occurs, action can be taken for the well-being of the learner such as reassigning him/her to another instructor; disallowing a faculty member from issuing a grade; removing the faculty member from contact with learners; or other sanctions up to and including dismissal, pursuant to applicable university policy.

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Definitions

Examples of Mistreatment and other Behavior that Interfere with Effective Teaching and Learning

Annually, the Association of American Medical Colleges surveys graduating medical students via the Graduation Questionnaire about perceived mistreatment experiences. In order to promote IUSM’s compliance with the AAMC survey, the examples listed below are taken directly from the Graduation Questionnaire and are included here for illustrative purposes only.

• Publicly embarrassed or humiliated
• Threatened with physical harm or being physically harmed
• Required to perform personal services
• Subjected to sexual advances
• Asked to exchange sexual favors for grades or other rewards
• Denied opportunities for training or rewards based on gender, race or ethnicity, or sexual orientation
• Subjected to offensive, sexist remarks/names; racially or ethnically offensive remarks/names; or subjected to offensive remarks/names related to sexual orientation
• Received lower evaluations/grades based on gender, race or ethnicity, or sexual orientation
  
  

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Sanctions

When it is determined that an individual has violated the Teacher-Learner Conduct Policy and behaved inconsistently with the Honor Code, the IUSM Graduated Response to Mistreatment begins. Disciplinary action will be taken only after there have been opportunities for improvement except in cases of egregious incidents including but not limited to physical harm; sexual advances and/or offers to exchange grades or other rewards for sexual favors; or discrimination based on sex, race/ethnicity, sexual orientation, religion, or other personal characteristics.

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Additional Contacts

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Oversight

Roles and Responsibilities of Others Involved in the System

A. Vice Chair for Education: May be designee for level 1 intervention for faculty in their department (e.g. cup of coffee conversation).

B. Department Chair or Regional Campus Dean: Responsible for faculty annual reviews. May be involved in level 1; must be involved in levels 2 and higher.

C. Course or Clerkship Director: Responsible for improvements at the course/clerkship level if pattern emerges or incidents are reported that describe general non-identifiable concerns in learning environment. May be designee for level 1 feedback.

D. GME Program Director: Responsible for improvements at the residency or fellowship program level if pattern emerges or incidents are reported that describe general non-identifiable concerns in learning environment. Responsible for resident/fellowship performance reviews. May be designee for level 1 feedback.

E. Governance and Oversight Committees

Reports on the IUSM mistreatment system are created annually and semi-annually, are distributed broadly, and are regularly reviewed by the committees listed below.

    • Medical Student Council
    • Graduate Medical Education Committee
    • Curriculum Council Steering Committee
    • IUSM Diversity Council
    • IUSM Women’s Advisory Council
    • Faculty Steering Committee (elected officers of the Faculty)

In addition, data on mistreatment as reported through the annual Association of American Medical Colleges Graduation Questionnaire are also reviewed by several of the above committees, as well as the School Executive Committee.

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History

1. Presented at CCSC on 09 February 2016; again on 16 August 2016.
2. Presented at FSC on 18 August 2016. Approved by FSC on 15 September 2016.
3. Procedures updated 08 February 2017.
4. Contacts updated 26 October 2017.
5. Policy migrated and published to new policy portal 04 June 2021.
6. Technical/editorial review updated 15 December 2020.
7. Policy updated in policy portal 15 November 2021.
8. Policy updated on 20 April 2023 to reflect change in University Office title as well as to update the link to the revised Graduated Response to Mistreatment picture.

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