The Reporting Process
Documentation of mistreatment, unprofessional behavior, or other concerns may be submitted through several mechanisms:
- Through One45, an evaluation system for students, which goes to the Senior Associate Dean for Medical Education in Phase 1 and the Assistant Dean for Clinical Science years 3 and 4 in Phase 2;
- Through The BEACON, which goes to the Vice Dean; or
- Submit directly to a member of the Learning Environment Advocacy Committee or any member of the Dean's leadership team in person, by email, or by phone.
Students in years 1 and 2 may also submit feedback through the Lecturer Evaluation, Facilitator Evaluation, or End-of-Block Evaluation. This report alerts the Senior Associate Dean for Medical Education.
Students in years 3 and 4 may also submit feedback through the Student Evaluation of the Attending, Resident, or Other Health Professional Form. This report alerts the Assistant Dean for Clinical Science years 3 and 4.
The appropriate deans will review the complaint and present it to the committee, which will decide on a plan to address the reported issue. The Vice Dean will present a summary report to the Dean of the medical school as well as post the number of cases discussed on the school website.
Potential Committee Actions
Committee actions may take several forms, such as:
- Serving as a sounding board for students uncertain of the seriousness of a complaint
- Counseling a student should a similar situation occur again
- Offering discussion with the faculty, program director, Graduate Medical Education trainees, designated institutional official, or staff members who have engaged in mistreatment or inappropriate behavior with a request for follow-up
- Maintaining a record to determine whether there are repeat offenders
Confidentiality and Required Reporting
A student reporting mistreatment may request not to be identified, and the committee will agree to that request, except in cases of sexual misconduct for which the committee is required to report.
In cases in which a student has made a complaint and has chosen to self-identify, the committee will take no action without that student's expressed consent unless a law has been violated. In some cases, the action related to an incident may be delayed until the student has completed and received a grade for a block, clerkship, or elective.
All anonymous complaints submitted to the committee are investigated, acted upon, and those found to be egregious or repeated are reported to the Dean.
Process for reviewing reports
All reports are reviewed by committee advisors when they are received.
- If a report is urgent, it is addressed prior to the next LEAC meeting.
- Non-urgent reports are addressed at the next LEAC meeting.
Reports are presented in de-identified format. The names of individuals involved are not shared with the full committee.
The committee initially considers two issues when reviewing a report:
- Does the report contain enough specific information to follow up?
- Does the report describe behaviors that, if founded, would be learning environment violations?
A preliminary categorization of a report is made at the first meeting, including a recommendation for follow up when appropriate.
Follow-up is recommended for reports containing adequate information that describes events that may be learning environment violations. One or more of the committee members meets with the person about whom the report was made, and/or the course director or other staff to review and discuss the report. The faculty, students, or staff involved respond to the report and provide additional information to the committee representative. A description of the follow-up process and any new information gathered is presented to the full committee at the next LEAC meeting. The committee uses both the initial report and the follow up information to finalize categorizations.
Reports are categorized as described below. The reports are cataloged. Record keeping helps assure that committee responses are consistent over time and that patterns of behaviors are identifiable.
Categories A and B are considered learning environment violations
A. Mistreatment or Unprofessional behaviors were reviewed, founded, and egregious:
Perceptions of the incident from the reporting individual were substantiated. Additionally, the behaviors met the description of Egregious Unprofessional Behaviors.
Egregious Unprofessional behaviors - any behavior deemed conspicuously unacceptable or unprofessional in a medical setting, including but not limited to acts of workplace violence, harassment, discrimination, or other behaviors that are considered unlawful. Harassment or discrimination toward any individual based on their race, color, religion, national origin, sex, sexual orientation, gender identity or expression, veteran’s status, genetic information, age or disability status, or any other characteristic protected by law is considered egregious. Additionally, behaviors such as intimidation, threats, physical attacks, property damage, stalking, bullying, or coercion fall into this category. Examples would include asking for sexual favors in exchange for grades or learning opportunities, hate speech, or verbal abuse. These kinds of unprofessional behaviors require immediate individual action plans/interventions and would result in mandated reviews outside the committee as appropriate to the reported action. An individual with this kind of report should be removed from the learning environment until the report is resolved.
B. Mistreatment or Unprofessional behaviors were reviewed and founded and not egregious:
Perceptions of the incident from the reporting individual were validated and the incident was founded as mistreatment or unprofessional behavior. The behaviors did not meet the description of egregious.
Categories C and D and E are not considered learning environment violations
C. Mistreatment or unprofessional behaviors were not found
The event was followed up and perceptions of the incident from the reporting individual were not shared by others present during the event or were not supported by new information. A determination of mistreatment or unprofessional behavior was not made, either due to insufficient information to corroborate the report, or because the gathered information did not support a conclusion of mistreatment or unprofessional behaviors. All concerns in this category have been shared with the individual and/or the department. They are not categorized learning environment violations.
D. Insufficient information to follow up on the incident
The report provided insufficient information for any follow-up. No communication about the concern was made back to the individual or department because the committee did not have enough information to act further.
E. Unprofessional Behaviors that are not a learning environment violation were reported
With guidance from advisory members, these reports are referred to appropriate individuals or committees within the medical school. They are not categorized as learning environment violations.
Process for addressing founded reports to the LEAC
Feedback/conversation: For single, non-egregious concerns (Category B), Committee members provide feedback to the course director or supervisor of the individual involved as well as to the individual.
Learning environment committee review: Three or more episodes of non-egregious, but founded events (Category B) over any three year period triggers a Committee Review which may result in recommendations to the dean. These recommendations may include: mentoring, education, or remediation of teaching skills, which could include time away from teaching. The Committee Review may result in a determination that the pattern represents an egregious concern if the pattern of behavior is “conspicuously unacceptable or unprofessional in a medical setting.”
A finding of egregious unprofessional behavior or mistreatment (Category A) will result in notification of the dean for further review. Appropriate referrals to other offices within Carilion and the medical school will be made. Other actions related to the behavior may occur but would be outside the scope of the Learning Environment Advocacy Committee.
