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Promoting Positive Learning Environments

All Vanderbilt School of Medicine learning environments are expected to align with established standards and facilitate students’ acquisition of the professional and collegial attitudes necessary for effective, caring, and compassionate health care.

The VUSM Compact Between Teachers and Learners in Medicine highlights the following principles that characterize this environment and guide us in making daily decisions: Respect, Service, Integrity, Accountability, Scholarship, and Compassion.

When learning as part of the Vanderbilt University Medical Center community, the VUMC Credo guides our work and our interactions with colleagues, patients and visitors:

  • We provide excellence in healthcare, research and education.
  • We treat others as we wish to be treated.
  • We continuously evaluate and improve our performance.

What is my role?

Everyone can contribute to creating and sustaining positive learning environments by following the principles detailed above. However, to fulfill our Compact and live by the Credo, we must also have a system to act when we observe undermining behaviors. We have a duty to support our community and provide opportunities for our colleagues to improve by addressing these behaviors. Without feedback, we cannot improve our behavior. Respectful feedback allows each of us to thrive in a respectful culture.

What should be addressed?

  • Any behavior that feels disrespectful or is intended to embarrass, belittle, or humiliate
  • Serious breaches of conduct and professionalism such as sexual assault or harassment; withholding benefits based on race, gender or other personal characteristics; physical harm or threats of harm
  • Abusive behavior from anyone (including patients and/or families)

How should I handle it?

Students experiencing or observing behavior that undermines the standards set forth in the Compact and Credo should address this behavior in a respectful manner.

The student is encouraged to discuss the behavior directly with the individual if possible. However, if the student does not feel safe discussing their observations, they should report the incident to university and/or medical school officials through their choice of reporting mechanisms.

  • Clinical Supervisor: Students are encouraged to speak immediately with their clinical supervisor if they feel threatened or harassed in the clinical setting.
  • Trusted Advisors: All the faculty and residents in leadership roles (for the MD program, this includes portfolio coaches, college mentors, course directors, chief residents, master clinical teachers) have been trained to advise medical students on addressing issues of disrespect, mistreatment and abuse. Additionally, all VUSM Deans, Degree Program Directors, and administrative staff have an open door for student concerns.
  • The Dean of Medical Students Amy Fleming, MD, (615) 322-5007, and each VUSM degree Program Director is an advocate for students and can discuss negative incidents and provide advising.
  • RISE is a system that allows MD, MSTP, and MIDP students to report accolades and incidents of unprofessional behavior in the learning environment. Vanderbilt University School of Medicine embraces our responsibility to create and support a learning environment for our learners. We are confident that safe and effective care of patients is shaped by an environment of quality medical education that is rooted in human dignity. We aspire to have a learning environment within which all people witness and experience a sense of respect, collegiality, and cooperation. These qualities are expected of all who impact the environment of patient care: administrators, advanced learners, other health professionals, teachers, patients, and staff. When students place a report in RISE the data comes directly to the School of Medicine and there are only two faculty (Dean Amy Fleming and Dean Kim Vinson) with access to the reports. The purpose of the professional incident RISE form is to provide a private reporting mechanism for medical students to identify any mistreatment or unprofessional conduct they have experienced within any of the learning environments of the School of Medicine. Individuals who submit this professionalism incident form will receive information about how this incident was addressed to the extent possible, should they choose to provide their email address. Any concerns related to patients should still be reported through the VERITAS system.
  • VERITAS (must be on VU or VUMC network to access): VERITAS is a database that allows anyone to submit an anonymous or signed incident report about Patient Safety or Professionalism concerns. Each report is provided as feedback through a professionally monitored process of behavioral intervention. This tool allows the Center for Patient and Professional Advocacy to target formative interventions at the individual level. By reporting through VERITAS, it allows trusted professionals to observe patterns in behavior and provide supportive, respectful feedback to individuals. This system is supported by the VUMC leadership.
  • Vanderbilt University Title IX and Discrimination office: The Title IX office has a special focus and expertise related to discrimination as well as sex- and gender-based offenses.
  • Course, Curriculum and Educator Evaluations: Feedback on regular evaluations provides important steering information for the School of Medicine leadership as well as for individual course directors, lecturers and clinical educators. However, these mechanisms are not designed to intervene individually on highly sensitive issues. Issues of disrespect, mistreatment and abuse are better reported through one of the methods above.

Why should I speak up?

The reporting options and processes are designed for the protection and support of students if/when they observe behavior that does not align with the Compact or Credo. Speaking up about negative experiences (either anonymously or with a trusted advisor) contributes to building a more positive and inclusive learning culture and a kinder, safer health care environment.

Research across many fields shows that incivility between people contributes to poor learning and health care outcomes. Most often, people will improve if they learn they have transgressed boundaries or expectations. Specific, respectful feedback is a critical component for individual and organizational improvement.

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