Learning Environment

Expectations and mechanisms for reporting positive contributions to the learning environment and mistreatment

Welcome to the Geisel Medical Student Learning Environment and Mistreatment Reporting System. We use a dual approach in this system, where all Geisel community members may report instances of student mistreatment or of positive and inclusive learning environments.

Our site is indexed as follows:

Report of positive learning environment Student mistreatment report

What is medical student mistreatment?

The Association of American Medical Colleges defines mistreatment as behavior that shows disrespect for the dignity of others and unreasonably interferes with the learning process. Many examples of mistreatment may be explicitly covered by Dartmouth’s broader policies on nondiscrimination, research misconduct, sexual or gender-based misconduct, or other institutional policies or by law. The vast majority of Geisel community members engage in conduct that is supportive of a positive and inclusive learning environment, and Geisel encourages reports of such conduct so that the positive contributions of students, staff, faculty, residents, nurses and others to the Geisel educational experience may be recognized.

What are some examples of conduct that may be mistreatment?

Examples include, but are not limited to:

  • Being subject to or an observer of offensive remarks, including those directed against race, color, citizenship, national origin, regional origin, religion/spirituality (and atheism), sex, sexual orientation, gender identity or expression, marital or parental status, disease state, age, sexual orientation, disability, genetic information, military or veteran status, political affiliation, or any other category protected by law or Dartmouth/Geisel policy.
  • Receiving lower grades or lesser evaluations predicated on criteria enumerated above.
  • Being asked to perform personal services for supervisors including, but not limited to, obtaining food or running errands not related to clinical care or academic obligations.
  • Being subject to any behavior that is prohibited by Dartmouth’s Sexual and Gender-based Misconduct Policy.
  • Holding students responsible for academic/clinical obligations not clearly delineated and/or for making detrimental assessments of students based upon academic/clinical obligations not clearly delineated.
  • Being subject to retaliation with respect to any protected activity, such as the good faith reporting of a suspected violation of applicable laws, government or Dartmouth/Geisel policies.
  • Taking inappropriate credit for the contribution of a student or other team member, including not providing appropriate acknowledgment on scholarly work (e.g., as expected by Geisel according to ICMJE guidelines)
  • Pressuring students to not abide by their work hour limits.
  • Pressuring students to perform patient care duties without sufficient training or supervision.
  • Threatened or actual violence against individuals or damage to property (e.g., throwing objects, slamming doors).

References: https://students.med.psu.edu/academics/respectful-learning-environment/definitions/ and https://med.stanford.edu/md/mdhandbook/section-3-md-requirements-procedures/section-3-13-respectful-educatorand-mistreatment-policy.html

*For acts of bias against members of a protected class, please also consider notifying Dartmouth Inclusive Excellence/Achieving Community Together

What if I am unsure if something that happened is mistreatment?

Sometimes in a learning environment, it can be difficult to discern if an uncomfortable instance constitutes mistreatment. To discuss if conduct may constitute mistreatment, individuals may contact the Director of Learning Environment, one of the UME coaches, course/clerkship directors, student advisors, any of the associate deans (Student Affairs, Preclinical, Clinical, Diversity, and Inclusion) or the Learning Environment, Student Affairs or DICE offices at Geisel.

What exactly happens after a report is filed?

Please reference the flowchart below. Unless otherwise specified by superseding policies, when Geisel receives a report of mistreatment that may have an impact on a UME student, such reports will be referred to the Director of Learning Environment (DLE). If complaints/reports received by the DLE have not already been lodged with appropriate other Dartmouth or Geisel offices (e.g., the Title IX Office), the DLE will refer incoming reports to the appropriate office or individual as required by any superseding Dartmouth/Geisel policy or by law (e.g., any faculty member receiving a complaint related to sexual or gender-based misconduct must refer that information to the Dartmouth College Title IX Office).

For reports that would not be handled via other Dartmouth/Geisel policies and procedures, and where action through Geisel's Office of Learning Environment is otherwise appropriate, the DLE will review them with the Committee on Respectful Learning Environment (CRLE). The following individuals will constitute voting members of the CRLE: a pre-clinical Geisel faculty member, three clinical Geisel faculty members, the student governmentChair(s) for diversity, two additional students who serve as DICE or other Student Government representatives in phases 2 or 3, a member of nursing leadership, a DHMC resident, and one other clinical health professional(non-physician) engaged in the UME program (e.g. staff member, advanced provider, social worker, psychologist). Voting members shall serve renewable terms of three years. The DLE and the ADSA shall serve on the CRLE as non-voting members. The CRLE determines whether the reported instance constitutes mistreatment. Depending on this determination, the CRLE will refer the reported instance to the appropriate Geisel/Dartmouth office or procedure, or, as appropriate and in accordance with applicable data privacy requirements, to the appropriate Geisel clinical affiliate, for further review. Unless otherwise provided by superseding policies, and where possible due to the nature of the complaint, students and other reporting parties may choose to be identified or remain de-identified during this process and will be given an opportunity to express reasonable preferences regarding the timing of action undertaken through the CRLE.

Potential Mistreatment Incident

View or Download Potential Mistreatment Incident Flow Chart

*Which types of reports would go to which offices:

  1. Title IX: sexual misconduct/sexual or gender-based harassment
  2. Student Professionalism procedure: A student violates something in the UME professionalism policy (social media posts, community behavior): first to coach, then to CSPC
  3. Honor Council: student cheats on exam, plagiarizes
  4. Research misconduct: falsification/fabrication/plagiarism
  5. IDE: Staff member exhibits racist behavior toward student

# CRLE members: Nicole Borges PhD; Aden Henry MHA, MSN, RN. The selection of additional members is currently pending. Ex-officio member: Manish Mishra MD, MPH

%A surrogate is the party through whom the student submitted the report. This could be any dean, the course director, DICE, a coach or a student advisor

Mistreatment reporting may cause stress and anxiety. Please reach out for support:

Students advisors and all the deans are specifically trained to help students through the reporting process.
Student Advisors:

What is the response to reported mistreatment?

Processes for reporting and addressing a complaint of mistreatment or other unprofessional behaviors by faculty, non-faculty academic (NFA ) appointees, and other non-NFA staff at Geisel are set out in the Expectations for Professionalism for the Faculty and Staff at Geisel Policy and Procedures. Please note that where individuals engaging in alleged mistreatment are not Geisel or Dartmouth College community members (for example, a patient or member of a patient’s family; Dartmouth-Hitchcock staff without Geisel appointments), Geisel will take steps as appropriate and in accordance with applicable law to ensure that the alleged mistreatment is reported to the appropriate entity (e.g., Dartmouth-Hitchcock Human Resources) and to ensure that appropriate supportive measures are put in place where possible for any Geisel community member who is adversely affected by this mistreatment. The pyramid below is a model used by Dartmouth-Hitchcock to respond to staff members that are engaged in mistreatment or other unprofessional behavior. Other entities may use alternative responding models for their employees.

How do I get feedback once I have filed a mistreatment report?

Students who provide their names in a report will be given direct individual feedback on the outcome by the DLE to the extent possible. Students might also choose to name a surrogate party to receive feedback through, while not entering their name in a report. This surrogate could be a coach, another dean, an advisor, course or clerkship director. The student would need to talk with their surrogate in order to receive feedback through them. A student could choose to remain anonymous but would then not receive any individual feedback on the outcome of the reporting. Aggregate reporting to the student body will occur through semi-annual written reports distributed to the student body and discussed at town halls. Please note that it may not be possible to provide detailed feedback on reports of alleged mistreatment due to laws such as those protecting the confidentiality of personnel, student and/or patient records.

Report of positive learning environment Student mistreatment report

What if I want to report but do not want to go through the Office of Learning Environment?

If the report involves a faculty member you can instead choose to contact the Geisel Dean of Faculty Affairs.
If the report involves a Geisel staff member you can instead choose to contact the Geisel Chief of Staff.
If the report involves a Geisel student you can instead choose to contact the Director of Student Affairs
If the report involves a resident, fellow or DHMC staff member you can instead choose to contact the DHMC compliance line 888-442-2084.
If the report involves an incident that occurred at the White River VAMC, please use the VA Employee Reporting Center (link only accessible from within the VA firewall)

What if I want to report mistreatment but do not want to use the Geisel system?

There are multiple options to report mistreatment outside of the Geisel system. Students or other community members may report through the following options:

Through Dartmouth College: Dartmouth College Achieving Community Together online form.

Through a third-party entity that will remove all identifiers and then report back through Dartmouth College: EthicsPoint

Associated policies: