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Safe and Healthy Learning Environment

The Northwestern University Feinberg School of Medicine is committed to the principle that educational relationships should be one of mutual respect between teacher and learner. Because the school trains individuals who are entrusted with the lives and well-being of others, we have unique responsibilities to assure that students learn as members of a community of scholars in an environment that is conducive to learning. Feinberg wants to encourage students to bring attention to any breach or perceived breach of the Safe and Healthy Learning Environment, and wishes to be open about the process the university has in place should such a claim be made. The process flow document illustrated in Appendix A offers a snapshot of our reporting, escalation, and resolution procedures related to a student claim of alleged mistreatment by a faculty member or instructor / supervisor. The school also offers an ombudsperson for student support.

 I. INTRODUCTION

Maintaining such an environment requires that the faculty, administration, residents, fellows, healthcare professionals, staff, and students treat each other with the respect due colleagues. All teachers should realize that students depend on them for evaluations and references, which can advance or impede their career development. Teachers must take care to judiciously exercise this power and to maintain fairness of treatment, avoiding exploitation or the perception of mistreatment and exploitation. The quality and worth of a Feinberg School of Medicine education rest not only in the excellence of the content and the skills that are taught, but also in the example provided to students of humane physicians and scientists who respect their professional colleagues at all career levels, their patients, and one another.

 II. RESPONSIBILITIES OF TEACHERS AND LEARNERS

The teacher-learner relationship confers rights and responsibilities upon both parties. Behaving in a way that embodies the ideal teacher-learner relationship fosters mutual respect, minimizes the likelihood of learner mistreatment, and optimizes the educational experience.

Responsibilities of Teachers

  • Treat learners fairly, respectfully, and without bias related to their race, color, religion, national origin, sex, pregnancy, sexual orientation, gender identity, gender expression, parental status, marital status, age, disability, citizenship status, veteran status, genetic information, or any other classification protected by law or University policy.
  • Distinguish between the Socratic method, where insightful questions are a stimulus to learning and discovery, and overly aggressive questioning, where detailed queries are repeatedly presented with the endpoint of belittlement or humiliation of the learner.
  • Give learners timely, constructive, and accurate feedback and opportunities for remediation.
  • Provide written evaluations on time.
  • Be prepared and on time for all activities.
  • Provide learners with current material and information and appropriate educational activities.

Responsibilities of Learners

  • Be courteous and respectful of others, regardless of their race, color, religion, national origin, sex, pregnancy, sexual orientation, gender identity, gender expression, parental status, marital status, age, disability, citizenship status, veteran status, genetic information, or any other classification protected by law or University policy.
  • A medical student should act in accordance with this Feinberg School of Medicine Student Handbook and the Northwestern University Student Handbook.
  • Be prepared and on time for all activities.
  • Be aware of the medical condition and current therapy of patients.
  • Put patients' welfare ahead of educational needs.
  • Know limitations and ask for help when needed.
  • Maintain patient confidentiality.
  • View feedback as an opportunity to improve knowledge and performance skills. 
  • Tips on Maintaining a Healthy Learning Environment

 III. DESCRIPTION OF INAPPROPRIATE BEHAVIOR

Inappropriate behaviors are those that are not respectful or professional in a teacher-learner relationship. Examples of inappropriate behaviors which compromise the integrity of the educational process include, but are not limited to:

  • Unwanted physical contact (such as touching, hitting, slapping, kicking, pushing) or the threat of the same;
  • Sexual harassment and other forms of sexual misconduct (see the Northwestern University Policy on Sexual Harassment);
  • Discrimination based on race, color, religion, national origin, sex, pregnancy, sexual orientation, gender identity, gender expression, parental status, marital status, age, disability, citizenship status, veteran status, genetic information, or any other classification protected by law or University policy (see the Northwestern University Policy on Discrimination and Harassment);
  • Requiring learners to perform personal chores (e.g., running errands or babysitting);
  • Verbal harassment, including humiliation or belittlement in public or privately (see the Northwestern University Policy on Civility);
  • Use of grading and other forms of assessment in a punitive or self-serving manner;
  • Romantic or sexual relationships between a teacher and student, resident or fellow (see the Northwestern University Policy on Consensual Romantic or Sexual Relationships Between Faculty, Staff and Students).

The list above identifies a few specific situations.  See Mistreatment Examples for further examples. Other behaviors may qualify as student mistreatment and, if the student is unsure, s/he should consult with the appropriate faculty or university officials as detailed below.

 IV. RETALIATION

Northwestern University strictly prohibits retaliation against any member of its community for reporting a violation of University policy or for participating, in any manner, in a University disciplinary process. The University considers such actions to be protected activities in which all members of the Northwestern community may freely engage. Retaliation is materially adverse action taken against an individual because they engaged in protected activities, when the adverse action is sufficiently severe or pervasive that it could deter a reasonable person from engaging in the protected activities. Members of the community are prohibited from engaging in actions directly or through others that reasonably could deter a party or a witness from reporting misconduct or participating in an investigation or hearing. Examples of retaliation could include, but are not limited to: removing someone from an organization; direct or indirect intimidation, threats, or coercion; harassment, terminating someone’s employment; reducing a grade; or other forms of discrimination. Allegations of retaliation will be resolved through the applicable Feinberg or University process (see the Northwestern University Policy on Non-Retaliation).

 

Students are strongly encouraged to report any alleged incident of retaliation to the Vice Dean for Education, the faculty ombudsperson (see below), the Office of Equity (for cases of alleged sexual misconduct, discrimination, or harassment), or to EthicsPoint, a phone- and web-based resource available 24 hours a day, 365 days a year. All reports will be handled as promptly and discreetly as possible, with facts made available only to those who need to know to investigate and resolve the matter.

 V. WHAT TO DO IF YOU BELIEVE INAPPROPRIATE BEHAVIOR OR MISTREATMENT HAS OCCURRED

While we believe that professional behavior is generally practiced and respected by the members of our diverse community of scholars throughout Feinberg, we recognize there may be occasions when real or perceived incidents of unprofessional behavior directed toward learners occur. In these circumstances, Feinberg is committed to establishing the facts through a fair process, which respects, to the extent possible, the privacy of the involved parties.

A complaint should be reported in a timely fashion, typically within 30 days of the end of an academic quarter or the clinical rotation in which the alleged incident occurred (although claims of discrimination can be reported at any time). Depending upon the nature of the complaint, different avenues of reporting are available. Our approach and process for addressing complaints are illustrated in Appendix A, and described in more detail below.

To provide medical students with an impartial initial point of contact, faculty ombudspersons are available for students to contact. (All Feinberg students, including MD students, can email Ombudsperson Lisa Rone, MD; MD students can also email Ombudsperson Ike Okwuosa, MD.) The faculty ombudsperson is a confidential point of contact and will only generally disclose information with the student’s consent or without the student’s consent if there is a risk of harm to the student or others. Alternative contacts are the student’s college mentor, one of the education deans or another faculty member with whom the student feels comfortable discussing the incident. These individuals can either help address the concern directly or help with referral to an appropriate office or individual who is best suited to address the problem.

If after discussion of the incident, the student and faculty point of contact agree that particular events could constitute student mistreatment, the incident can be addressed as described below. If the incident involves sexual misconduct, the student will be referred to the University Office of Equity for further discussion and investigation. If the incident involves other types of discrimination or discriminatory harassment, the student will be referred to the University Office of Equity for further discussion and investigation. 

If the incident does not fall into either of these categories, a first choice, where appropriate, is to seek informal resolution. This may be achieved through direct communication between the faculty point of contact and the respondent (individual being reported by the student) with or without the student depending on student preference. If an informal approach is either not appropriate or unsuccessful, then the student should make a formal complaint with the Vice Dean for Education.

If the incident does not involve sexual misconduct or other types of discrimination or discriminatory harassment, and the student and faculty point of contact disagree that the incident was mistreatment, the student may pursue the matter directly with the Vice Dean for Education. As a first step, the Vice Dean, where appropriate, will seek an informal resolution. If that approach is unsuccessful or not appropriate, the Vice Dean will ask the student to submit a formal complaint.

Students may always directly contact an office empowered to address specific policies. In cases of possible sexual misconduct, the University’s Title IX Coordinator should be contacted at TitleIXCoordinator@northwestern.edu or (847) 491-3881. For concerns related to discrimination and harassment, the Office of Equity may be contacted at the Incident Report portal, equity@northwestern.edu, or (847) 491-6697.

An alternative approach for reporting concerns of any nature is to use EthicsPoint. EthicsPoint is intended to provide students and University employees with a simple way to report activities that may involve misconduct or violations of University policy, including academic or research misconduct, conflicts of interest, criminal activity, health or safety issues, fraud, financial improprieties, or acts of discrimination, harassment, sexual harassment, or retaliation, as well as workplace violence or threats. Reports may be filed online at www.northwestern.edu/ethics or by calling (866) 294-3545. EthicsPoint provides reporters with options to protect their identity. Any suspected problems or complaints reported via EthicsPoint will be reviewed in accordance with current University procedures, including those described in the Faculty Handbook, Staff Handbook, and Student Handbook.

 VI. CONFLICTS AND DOCUMENTATION

  • If the Vice Dean for Education is part of the complaint, or in any other way has a conflict of interest or the appearance of a conflict of interest, s/he is obligated to remove him or herself from the case during the investigation, and the Dean of the School of Medicine shall appoint someone else to assume responsibility for the complaint.
  • The School of Medicine may act under these procedures, irrespective of possible civil or criminal claims arising out of the same or other events. The Vice Dean for Education, with the concurrence of the Dean of the School of Medicine, after consulting with the Office of the General Counsel, shall determine whether the University shall, in fact, proceed against a respondent who also faces related charges in a civil or criminal complaint. If the University defers proceedings, it may subsequently proceed, irrespective of the time provisions set forth in these procedures.
  • The Vice Dean for Education shall have the authority to take any actions on behalf of the School of Medicine that s/he deems necessary to protect the complainant and/or the respondent, or to address other needs or deliberations related to the situation, pending the investigation and resolution of the complaint.

 VII. PROCESS FOR COMPLAINTS

As described above, students with concerns related to mistreatment can use the faculty ombudsperson that is designated specifically for this purpose, college mentors, student deans, or a trusted faculty member as an initial point of contact. Together with this individual, the student can decide whether to seek an informal resolution to the problem and/or whether to move forward with a formal complaint.

If the complaint alleges discrimination or sexual misconduct, the complaint must be referred to the University Office of Equity. Complaints brought to the University Office of Equity will be handled using the processes and procedures of the office, per University protocol and policy. Otherwise, if the student decides to proceed with a formal complaint of mistreatment, it will be addressed according to the process described below.

 

The process for addressing formal student complaints of mistreatment by faculty members or instructors / supervisors is as follows:

  1. Inquiry into a violation of the standards of conduct committed by any individual, whether or not affiliated with the University, should be initiated by written complaint and filed with the Vice Dean for Education as soon as possible, typically within 30 days of the end of an academic quarter or the clinical rotation in which the alleged incident occurred. A delay in filing may be grounds for rejection of a complaint.
  2. The complaint must be detailed and specific, and accompanied by appropriate documentation, if available.
  3. After receipt of a properly documented complaint, which has been made in good faith, the Vice Dean will conduct an initial review of the allegations to determine the appropriate path of resolution. Available options include: (a) dismissing the case when insufficient information exists to move forward or when the alleged misconduct – even if substantiated – would not be a violation of this policy; (b) resolving the case through any other ongoing, related disciplinary matters (i.e., an ongoing faculty or student misconduct matter involving related facts); or (c)investigating and resolving as detailed below.
  4. If the complaint is not dismissed or resolved through another ongoing matter, the Vice Dean shall inform the respondent of the nature of the charges. The Vice Dean will also remind the respondent about the non-retaliation policy of the University described above.
  5. Typically, the Vice Dean, or his/her designee, will investigate the complaint of mistreatment him/herself, but in cases of allegations that may result in separation of the respondent from the University, the Vice Dean shall appoint an investigation committee of not less than three individuals, all of whom shall be faculty members of the School of Medicine but not members of the same department as, or collaborators with, the complainant or respondent. The investigation will typically be initiated within two weeks of receiving the complaint, and the complainant and respondent will be notified that the investigation has been initiated. The Vice Dean shall also make every effort to protect the identities of both complainant and respondent, with respect to the larger community.
  6. The Vice Dean / investigation committee shall undertake a thorough examination of the charges. Whenever possible, interviews should be conducted with the complainant and respondent. Interviews may also be conducted with others having information regarding the allegations, if the Vice Dean / committee deems it necessary. In cases that may result in separation of the respondent from the University, summaries of any such interviews should be prepared, provided to the interviewed party for comment or revision, and included as part of the file. When appearing before the Vice Dean / committee, the respondent and the complainant may each be accompanied by a non-attorney adviser who is not a family member. The student's adviser shall be a School of Medicine faculty member and the respondent's adviser must be a Northwestern University employee. Except in unusual cases, the respondent and the complainant will not appear before the Vice Dean / committee at the same time.
  7. Following the completion of the investigation, the Vice Dean / committee shall submit a report of findings to the Dean. This report shall describe the policies and procedures under which the investigation was conducted, how and from whom information was obtained, the findings, and the basis of the findings, and texts or summaries of the interviews conducted. This report shall ordinarily be submitted to the Dean within 60 days of the receipt of the complaint. The complainant and respondent shall be permitted to make a written reply to the Dean within 15 calendar days of receipt of the report. Such replies shall be incorporated as appendices to the report. The entire investigation process shall typically be completed within 90 calendar days of its initiation, unless circumstances warrant a delay. In such cases, the reasons for a delay shall be documented.

 VIII. RESOLUTION FOR COMPLAINTS

  1. If the Dean finds the charges to be unfounded, the matter shall be dropped and the concerned parties shall be informed.
  2. If the Dean finds the charges against a respondent to be substantiated, he/she will notify the following offices:
  • For a non-faculty employee of the Feinberg School of Medicine or one of its affiliated clinical entities (including but not limited to nursing, housestaff, and fellows), the Dean shall inform the Office of Human Resources of the appropriate institution (e.g., Northwestern University, Northwestern Memorial HealthCare, etc.) or, for a resident or fellow of the McGaw Medical Center of Northwestern University, the Senior Associate Dean for Graduate Medical Education.
  • If charges against a faculty member are substantiated, the Dean will proceed to take whatever actions are appropriate to the seriousness of the offense, in consultation with the Provost and in accordance with University procedures, and which consider the previous record of the respondent. For major offenses by any faculty members, the Dean of the School of Medicine shall determine with the Provost whether there is substantial reason to believe that just cause exists for imposition of a major sanction, e.g., termination of appointment or suspension. Such action will be executed in accordance with the policies and procedures in the Faculty Handbook. For less serious offenses, the Dean of the School of Medicine may impose minor sanctions, as described in the Faculty Handbook. These may include, but are not limited to, removal from a particular project, a letter of reprimand, special monitoring of future work, or probation.
  1. The respondent shall have access to all established University grievance and appeal procedures, as described in the Faculty Handbook.

  IX. POLICY UPDATE SCHEDULE

Policy review to occur one year after initial implementation and every three years thereafter.

 X. RELEVANT REFERENCES