Confidentiality, Fair Treatment & Social Media
Records & Confidentiality
Under the Family Education Rights and Privacy Act of 1974, students may have access to all items of their file except for those items to which they waive their rights. Others who have access to a student's file are the following:
- The Student Promotions Committee
- The Honor Code Council
- Faculty advisors
- Faculty with legitimate interests (they may access portions of a student's file at the discretion of the Office of Student Affairs and Admissions)
- Anyone else with written consent of the student, and
- State or federal officials with a subpoena
Students will be notified of a subpoena on their file. Generally each file contains the following:
- A copy of AMCAS application;
- An undergraduate transcript(s);
- A School of Medicine transcript;
- Written evaluations from instructors, including Year 3 clerkships and Year 4 electives;
- Letters of recommendation;
- Lists of activities while in the School of Medicine;
- Letters specifying actions from the Student Promotions Committee and Honor Code Council; and
- The Medical Student Performance Evaluation (Dean's letter).
Students are encouraged to review and update their files, especially during the clinical years. No materials may be removed from the files, and the files are to be examined in the presence of a member of the Office of Student Affairs and Admissions.
Students should review and update the list of activities in their files each year. Student activities, in addition to academic performance, frequently influence opportunities for awards and the content of recommendation letters.
Students who believe a grade, comment, or item in their record is inaccurate, should refer to the previous section "Appeal of a Course Grade and/or Written Evaluation." Students who are not satisfied with the outcome of such discussions, may place a rebuttal letter in their file.
The School is strongly committed to a policy of fair and equal treatment for all members of its community. In addition, the School has a responsibility to foster in medical students, postgraduate trainees, faculty, and other staff the development of the kind of professional and collegial attitudes needed to provide caring and compassionate health care. In pursuit of these goals, the School recognizes that each member of the medical school community should be accepted as an autonomous individual and treated civilly, without regard to his or her race, color, religion, gender, sexual orientation, national or ethnic origin, age, or disability.
An atmosphere of mutual respect and collegiality among teachers and students is essential to the educational mission of the School. However, the diversity of the members of the academic community, the intensity of the interactions that occur in the health care setting, differences in personality, and other factors may lead to incidents of inappropriate behavior or mistreatment. The victims and perpetrators of such behavior might include students, faculty, residents, nurses, or other staff. For purposes of this policy, to mistreat is to treat in a harmful, injurious, or offensive way. The following are examples of mistreatment:
- to speak insultingly or unjustifiably harshly to or about a person
- to belittle or humiliate
- to threaten with physical harm
- to physically attack (e.g., hit, slap, kick)
- to require the performance of personal services (e.g., shopping, babysitting)
- to threaten with a lower grade for reasons other than course/clinical performance
Such actions are contrary to the spirit of learning and professionalism, violate the trust between teacher and learner, and will not be tolerated by the School. Accusations of racial or gender discrimination or harassment are not handled under this policy, but rather under other medical school and university policies. Likewise, disputes over grades are handled not by this policy, but by School academic policies as described in this Student Policy Guide.
In order to promote an environment respectful of all individuals, the School will provide ongoing education to students, residents, faculty, and other staff emphasizing the importance of professional and collegial attitudes and behavior. Also, the School will make available a readily-accessible neutral party (called the ombudsperson) whom parties may approach if they believe that have been mistreated. A process has been established to seek reconciliation between the parties in cases of alleged mistreatment. This process seeks to protect the accuser from retaliation and to protect the rights and reputations of all parties involved in a complaint and is set forth below.
Resolution of Claims of Mistreatment
When an allegation of student mistreatment occurs, the parties directly involved should try to resolve the matter themselves, since many such incidents are amenable to resolution in this matter. In some situations, however, this informal approach might be hindered by various factors, including reluctance of the accuser to approach the accused, intransigence of the accused, or differing perceptions of the incident by the parties involved. In such cases, a more formal alternative process is available for resolving the matter. This process is designed to be fair to both the accuser and the accused and to be perceived by the accuser as effective, impartial, and unlikely to result in retaliation.
The position of "ombudsperson" has been established to help resolve such conflicts. The ombudsperson shall be appointed by the Dean for a term of four years. The ombudsperson's role is to maintain a neutral point of availability to initiate the dispute resolution process in the event of a claim of mistreatment. The first communication between the ombudsperson and the person whose action is the subject of the claim will be informal. It is intended to clarify the source of the conflict as well as to identify possible avenues of resolution. The ombudsperson will describe the matters raised by the complainant and request a response from the respondent. The respondent will explain his or her position to the ombudsperson and provide any existing documentation. The ombudsperson will attempt to help each party communicate with the other and understand the other's view of the situation, in order to help the parties resolve the matter in a constructive manner. If it appears to the ombudsperson that there may be areas of flexibility which could lead to a resolution of the matter that is agreeable to both parties, the ombudsperson will help the parties pursue those areas. If, at the conclusion of these efforts, both parties are satisfied with the proposed resolution, the matter is resolved. Otherwise, the ombudsperson shall act to begin formal proceedings by interacting with the Dean's office to schedule a meeting of the Dispute Resolution Council (DRC).
The DRC shall be composed of members who are chosen to provide a fair and impartial representation of the various constituencies involved in the medical education process. Each member shall be appointed by the Dean after being recommended by the relevant body. Two first biennium and two second biennium students shall be nominated by the Medical School Student Council; two first biennium faculty and two second biennium faculty members shall be nominated by the faculty; and two residents shall be nominated by the DAGMEC executive committee. In addition, the Dean may appoint additional members if necessary or desirable to provide appropriate racial or gender representation, or to provide appropriate representation for groups involved in the claim (e.g., nurses, staff) that are not otherwise included in the DRC. The Dean shall appoint the chair from the committee membership. Finally, the ombudsperson shall be a member ex officio who votes only to break ties.
When the DRC hears a case, the ombudsperson, accuser, and accused are present. The ombudsperson is responsible for notifying the parties in advance of the date, time, and place of the DRC meeting. The proceedings begin with the ombudsperson presenting the claim. The accuser and accused both have an opportunity to speak and to bring witnesses to speak. The order of speakers is as follows: (1) the accuser; (2) witnesses for the accuser; (3) the accused; and (4) witnesses for the accused. The accused has the right to be present whenever statements are being made by the ombudsperson, the accuser, or any witnesses. Similarly, the accuser has the right to be present during statements by the ombudsperson, the accused, or witnesses. Witnesses will be present only when they are called to give information. After speaking, they will be asked to leave, in order to protect the confidentiality of the parties involved. Both the accused and accuser can be harmed by breaches of confidentiality, and all who are involved in the process of responding to allegations must maintain confidentiality. In some situations the DRC might be justified in communicating ordinarily confidential information to other university officials, provided there is a legitimate "need to know." The accuser and accused are not allowed to bring lawyers to DRC meetings as advocates, advisors, or observers, nor may they bring any other persons, except witnesses. This process is intramural, and its purpose is to resolve the problems without going outside the university.
The process of dispute resolution embodied in the DRC is intended to be as flexible as possible. The "rules of evidence" found in a judicial setting will not apply, and the parties may present any evidence or testimony they wish to the DRC. Any evidence presented will be reviewed by the DRC, who will decide credibility issues. After all parties have presented any evidence they wish to present, all individuals who are not members of the DRC shall leave the room, and the DRC shall discuss the claim and arrive at a conclusion about the facts of the matter. The DRC shall designate one person to prepare a memorandum setting forth the conclusions and recommendations of the DRC. All members of the DRC shall review the memorandum for accuracy and sign it. The completed memorandum shall be forwarded directly to the Dean. Upon receipt, the Dean shall notify both the accuser and the accused of the recommendations of the DRC. The Dean shall advise the parties that either party shall have seven business days to request an appeal, and that if neither party requests an appeal within the time allowed, the DRC's proposed actions shall be implemented.
As set forth above, either party may appeal the recommendations of the DRC. An appeal is initiated by either party notifying the ombudsperson of his or her desire to appeal. Upon the initiation of an appeal, the ombudsperson shall notify the Dean, who shall appoint an appeal panel ["Panel"] for purposes of hearing the appeal. The Panel shall be composed of one member from each constituency represented in the original DRC. Each member shall be selected and appointed by the Dean after consultation with the relevant constituency groups. The Panel shall not hear new evidence, but will only review the testimony presented and the conclusions and recommendations forwarded to the Dean by the original DRC. After reviewing the testimony, conclusions and recommendations, the Panel shall, by majority vote, support or reject each recommendation of the DRC. The Panel's decision and all relevant documentation will be forwarded in writing to the Dean. The Dean will review the relevant documents and notify the student in writing of the Dean's decision.
Every effort will be made to protect alleged victims of mistreatment from retaliation if they seek redress. Although it is impossible to guarantee freedom from retaliation, it is possible to take steps to try to prevent it and to set up a process for responding to it. To help prevent retaliation, those who are accused of mistreatment will be informed that retaliation is regarded as a form of mistreatment. Accusations that retaliation has occurred will be handled in the same manner as accusations concerning other forms of mistreatment; however, accusations of retaliation shall be subject to a higher level of scrutiny.
Online social networks such as Facebook, LinkedIn and Twitter have taken on increasing importance in both personal and professional life. These social media offer unique opportunities for people to interact and build relationships and have great potential to enhance interpersonal and professional communication. As health care professionals with unique social and ethical obligations, medical students, resident physicians and medical school faculty must be keenly aware of the public nature of social media and the permanent nature of its content.
This policy has been developed to ensure that actions taken on the social Internet by members of the Boonshoft School of Medicine community reflect the school's core values of professionalism, compassion, accountability, integrity, honor, acceptance of diversity and commitment to ethical behavior.
Scope & Definitions
This policy applies to all employees and students of the Boonshoft School of Medicine, including contractors acting on its behalf, and covers all interaction with social media. It incorporates all Wright State University and Boonshoft School of Medicine policies relating to professional conduct, ethical behavior and online communications, including but not limited to the Boonshoft School of Medicine Code of Faculty Behavior, the Medical Student Professional Honor Code, HIPAA and Responsible Use of Information Technology. Students and employees should follow these guidelines whether participating in social networks personally or professionally, or using personal or university-owned computing equipment when doing so.
The terms social media, social web and social networks comprise Internet- and mobile-based tools for sharing and discussing information based on user participation and user-generated content. Examples include social networking sites like LinkedIn and Facebook, social bookmarking sites like Del.icio.us, social news sites like Digg, Twitter, Youtube and other sites that are centered on user interaction. Social media content may take the form of blogs, social networks, social news, wikis, videos and podcasts.
Official School Business
Only university employees or students authorized by the medical school administration may use social media to portray themselves as representing the medical school or to conduct official business in the name of the school or one of its units. Use of any social media in an official context should have the approval of the school's Office of Marketing and Communications or the Office of the Dean. University or school logos may not be used on any social media site without the express written approval of Marketing and Communications.
Postings within social network sites are subject to the same professionalism standards as any other personal interactions. Students and employees of the Boonshoft School of Medicine should routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others, is accurate and appropriate. Professionalism standards are outlined for students in the Student Policy Guide and for faculty in the Code of Faculty Behavior.
Students and employees of the Boonshoft School of Medicine who participate in a social media site, whether in a personal or official capacity, should:
Take steps to ensure that they have implemented appropriate privacy settings to avoid inadvertent dissemination of personal information to audiences outside their control. This includes making an effort to ensure that you are not 'tagged' in images posted by others that might be seen as portraying you in an unprofessional manner.
Include a disclaimer with any posting that relates to their role as a member of the Boonshoft School of Medicine community clearly stating that all opinions belong to the poster alone and do not necessarily reflect the views of the Boonshoft School of Medicine or Wright State University.
Refrain from violating standards of patient confidentiality or communicating about patients in a manner that could in any way convey a patient's identity, even accidentally. Patients with rare diagnoses, unusual physical appearances and/or in specific locations within the community may be easily identifiable even in the absence of names and medical record numbers.1
Not express defamatory comments about employees, students, health professionals or patients associated with the medical school or its affiliates, post images that would denigrate anyone they come into contact with in the course of carrying out their roles as students or employees of the school or depict other students or employees engaging in unprofessional behavior.
Not interact with or 'friend' individuals through social networks when they are or have been in a physician-patient or similar relationship.
University administrators may look up profiles on social networking sites and may use the information in informal or formal proceedings without providing notice to the individuals involved. The same standards of professional conduct apply to social networking as to any other ethical or professional breach up to and including dismissal from the school or termination of employment.
Regardless of whether students, faculty, staff, or residents are conducting official school or personal business, they are ambassadors for the school and the medical profession. In online social networks, the lines between public and private, personal and professional are blurred. Just by identifying oneself as WSU medical student or employee, those affiliated with the school portray an impression of the institution for those who have access to their social network profiles or blogs. Each member of the Boonshoft community should ensure sure that all content he or she is associated with is consistent with his or her position at the school and with the school's values and professional standards.
'If the information that is shared is generic enough that nobody can identify a patient in the course of reading (Berkman, Massachusetts Medical Law Report, Social Networking 101 for Physicians, 2009), the post is permitted and is a valuable tool for physicians to share information and skills with other physicians faster than ever before.' From 'Social Networking and the Medical Practice: Guidelines for Physicians, Office Staff and Patients,' published by the Ohio State Medical Association See: http://www.osma.org/files/documents/tools-and-resources/running-a-practice/social-media-policy.pdf.
The American Medical Association adopted the following policy on Nov. 8, 2010
AMA Policy: Professionalism in the Use of Social Media
The Internet has created the ability for medical students and physicians to communicate and share information quickly and to reach millions of people easily. Participating in social networking and other similar Internet opportunities can support physicians' personal expression, enable individual physicians to have a professional presence online, foster collegiality and camaraderie within the profession, provide opportunity to widely disseminate public health messages and other health communication. Social networks, blogs, and other forms of communication online also create new challenges to the patient-physician relationship. Physicians should weigh a number of considerations when maintaining a presence online:
- Physicians should be cognizant of standards of patient privacy and confidentiality that must be maintained in all environments, including online, and must refrain from posting identifiable patient information online.
- When using the Internet for social networking, physicians should use privacy settings to safeguard personal information and content to the extent possible, but should realize that privacy settings are not absolute and that once on the Internet, content is likely there permanently. Thus, physicians should routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others, is accurate and appropriate.
- If they interact with patients on the Internet, physicians must maintain appropriate boundaries of the patient-physician relationship in accordance with professional ethical guidelines just, as they would in any other context.
- To maintain appropriate professional boundaries physicians should consider separating personal and professional content online.
- When physicians see content posted by colleagues that appears unprofessional they have a responsibility to bring that content to the attention of the individual, so that he or she can remove it and/or take other appropriate actions. If the behavior significantly violates professional norms and the individual does not take appropriate action to resolve the situation, the physician should report the matter to appropriate authorities.
- Physicians must recognize that actions online and content posted may negatively affect their reputations among patients and colleagues, may have consequences for their medical careers (particularly for physicians-in-training and medical students), and can undermine public trust in the medical profession.