Scope

Professional conduct is a cornerstone of medical practice. Professional conduct is characterized by aspects of etiquette, defined as the customary code of respectful and considerate behavior among members of a profession, and virtue, defined as behavior manifesting high moral standards. We take the view that everyone can improve these skills. To improve, people need supportive feedback and a nurturing, growth-enabling culture and mindset.

Dell Medical School will evaluate and nurture the professional conduct of its medical students. As a curricular goal, opportunities to learn and grow will be anticipated in each course and clerkship. Medical student conduct will be noted across the curriculum using the online Student Feedback Report system. Any student, faculty, or staff member may use this online system to notice things people do well (model behavior) and areas that show opportunity for individual, community, and system improvement.

Policy

Physicians and physicians-in-training are expected to develop and demonstrate an exemplary level of professional conduct. Dell Medical School shall provide a robust system for evaluating professional conduct, providing timely feedback to support medical student development, and a fair process for identifying and addressing growth opportunities while anticipating, mitigating, and learning from biases in order to protect students, faculty, and staff. The actions authorized under this policy intend to educate, support, and—when merited--remediate students with identified opportunities for improved professional conduct. Egregious behavior is addressed through a separate pathway detailed in the Sanction section at the end of this document.

Medical Student Professional Conduct Committee

To meet the professional conduct objectives above, Dell Medical School shall establish a Medical Student Professional Conduct Committee (“Professional Conduct Committee”). The Professional Conduct Committee has two subgroups: the Professional Conduct Committee Triage Team (“Triage Team”) and the Education and Remediation Team. The Professional Conduct Committee and its subgroups include the following members:

• Professional Conduct Committee:
  • Eleven (11) Members selected from Dell Medical School Faculty and/or Staff
    • Eight (8) Voting Members selected from Faculty and/or Staff, including one member appointed as Chair
    • Three (3) Non-Voting Members (Associate Dean for Student Affairs, Associate Dean for Undergraduate Medical Education, Assistant Dean)
  • Eight (8) Student Members
• Triage Team: three (3) Voting Members of the Professional Conduct Committee with a specific responsibility for initial investigation of feedback reports (detailed below).
• Education and Remediation Team: one Voting Member (Chair of the Professional Conduct Committee) and two Non-Voting Members (Associate Dean for Student Affairs, Associate Dean for Undergraduate Medical Education)

Faculty and Staff Membership of Professional Conduct Committee

• Faculty and Staff are eligible to be members
• Members are selected by a committee of the Executive Vice Dean of Academics and Chair of Medical Education, the Associate Dean for Student Affairs, and the Associate Dean for Academic Affairs.
• The term of appointment shall be 3 years and members may serve in successive terms.
• All members are expected to act as expeditiously as their other responsibilities will permit to ensure that feedback events are addressed in a timely manner.

Student Membership of Professional Conduct Committee

• Two students per year from each class
• Candidates (4 from each class) are proposed through a nomination system. The Associate Dean for Student Affairs will discuss candidate suggestions with the students prior to making final approval.
• Term of 1-year renewable on agreement of committee and student.
• Role and commitment similar to other members – participation in discussions and providing input that inform the committee’s processes (1 meeting/month; 30 minutes of work or so in between)
• Exception: Students are recused from discussion and voting on feedback events.

Feedback Event Process

1. Identification of Feedback Events

Using an online Student Feedback Report system, faculty and students are encouraged to report feedback events, defined as a commendation or growth opportunity. Anonymous submissions are not acceptable, but confidentiality will be maintained to the extent possible. These reports are forwarded by automated process to the Triage Team. Any course evaluation of professional conduct rated as “marginal pass” or lower will also be reported to the Triage Team.

1. Triage Team Review

The Triage Team will review all feedback events, and a confirmation email will be sent to the reporter within 48 hours notifying the reporter the review/triage is in process. Students mentioned in the feedback event will be notified when the Triage Team reviews the submission and begins their preliminary assessment.

The Triage Team will review all reports from the Feedback Event System and assign the incident to a pathway:

• Commendation: Exceptional and admirable professional conduct (e.g., community service, patient advocacy, or peer support)
• Organizational Growth Opportunity: System deficiencies or human error rather than personal growth opportunities (e.g., unclear or contradictory instructions)
• Personal Growth Opportunity (Former Level 1): Deviation from personal professional conduct that represents a one-time learning opportunity
• Coaching Intervention (Former Level 2): Single important Feedback Event or a pattern of Feedback Events as determined by the Professional Conduct Committee after receiving the report of the Triage Team
• Student Success Plan (Former Level 3): Feedback discussions and support during a Coaching Intervention do not result in expected insight and growth (e.g., serious or repeated concerns regarding professional conduct, failure to adapt to previous attempts to support improved behaviors)
• Sanction: Conduct that is an egregious violation of professional conduct standards and may impact the student’s opportunity to obtain licensure will result in sanction up to and including referral to Medical Student Academic Standing Committee for possible adverse action up to and including dismissal from Medical School (e.g., unwillingness to participate in coaching or remediation, ongoing substance misuse, criminal activity, falsifying any record, or violence in any form)

If an incident is initially designated as a Personal Growth Opportunity, Coaching Intervention, or Student Success Plan, the Triage Team will meet with the student mentioned in the feedback event to understand their perspective before giving the event a preliminary designation. The final designation is determined by vote of the 8 voting members of the Professional Conduct Committee. Once a final designation is determined, a notification letter will be emailed to the student. Because Sanctions may involve situations that require rapid response (e.g., danger to a student or others) and are referred to groups outside of the Professional Conduct Committee (see Sanction section below), a Sanction may proceed as initially designated.

1. Responses to Feedback Events

Feedback events will be held in a secure file (“Professional Conduct file”) by the Professional Conduct Committee. The Professional Conduct file is not related to a student’s permanent academic file and students may request access via the Associate Dean for Student Affairs at any time. The response to a feedback event varies by incident pathway assigned by the Triage Team, outlined below.

Commendation

The Triage Team shall send a notice of the commendation with specific details, as available, to the student(s) and to the Associate Dean for Student Affairs. Commendations will be retained for possible inclusion in appropriate public forums.

Organizational Growth Opportunity

These will be directed to the units involved for optimal institutional learning and improvement. The result of the quality improvement endeavors catalyzed by these feedback reports will be communicated to the person who filed the event and more widely to Dell Medical School with the permission of those involved.

Personal Growth Opportunity

There are two varieties of Personal Growth Opportunities: Professional Conduct Growth Opportunities and Interpersonal Growth Opportunities. All feedback events identified to be Personal Growth Opportunities (both varieties) will be held in a Professional Conduct file to monitor for a pattern of Personal Growth Opportunities.

Professional Conduct Growth Opportunities may include conduct that occurs within a course and is subject to evaluation and grading impact outlined in the syllabus policies of that course (e.g., unexcused absence, tardiness, failure to complete assignments, communication lapses with patients, faculty, members of health care team, or peers, engaging in conduct disruptive to an effective learning environment). Professional Conduct Growth Opportunities are placed in the feedback event system at the discretion of the instructor and are strongly encouraged whenever a student receives a professional conduct evaluation of marginal pass or lower in any course. These concerns are initially addressed by the instructor within the course through a course feedback discussion. A summary of course feedback discussions, relative to a Professional Conduct Growth Opportunity, must be submitted to the Professional Conduct Committee afterward.

Interpersonal Growth Opportunities can occur on-campus or off-campus when the event is related to Dell Medical School (e.g., disrespectful, unruly, and/or offensive behavior at DMS-sanctioned events, insensitive comments on social media, privacy and confidentiality violations). Interpersonal Growth Opportunities are placed in the feedback event system at the discretion of those involved. Interpersonal Growth Opportunities are to be addressed with a peer-to-peer feedback discussion, with trained peers available to assist. A summary document of the feedback discussion must be submitted to the Professional Conduct Committee afterward.

Coaching Intervention

If a simple majority of the Professional Conduct Committee agrees on a Coaching Intervention, they shall notify the Education and Remediation Team. The Education and Remediation Team shall develop a Coaching Intervention plan for the student. The Education and Remediation Team will update the full Professional Conduct Committee on progress.