The Learning Environment

Principles of the Learning Environment at the Warren Alpert Medical School of Brown University

 


The Warren Alpert Medical School of Brown University (AMS) is an educational community composed of students, residents, fellows, faculty, other healthcare professionals and staff who aim to support all medical students in achieving their fullest potential while providing quality patient care.  The principle of our educational community is the promotion of a positive learning environment through respectful education of all community members, recognizing that an appreciation for diversity is an essential component of medical education.

 

To promote this goal, AMS upholds the expectation that medical students will be treated appropriately and with dignity.  Respect is to be demonstrated toward all students, regardless of race, ethnicity, national origin, age, disability, gender, sexual orientation, or religion.  Under no circumstances will AMS consider it acceptable practice for faculty or staff to demonstrate bias, prejudice, exclusion, or other unprofessional behavior* such as humiliation towards our students. A respectful learning environment also includes the use of appropriate language, through attention to cultural sensitivity (i.e. referring to students by their preferred pronouns; using respectful terminology when referring to race or other identifying characteristics of a particular group of people).  Students are held to the same professional standards of respect towards all colleagues, faculty, and staff in the learning environment, as outlined in the student handbook.

 

We recognize that some violations of this principle may be unintentional, and we strive to create an environment in which those and other violations will be addressed and corrected in a thoughtful manner.

 

Given our shared values for optimal learning and quality patient care, the AMS Principles support all members of our community in achieving their goals as excellent learners, teachers, and medical professionals.  AMS will continue to promote a positive learning environment through ongoing discussions with members of the educational community and oversight of its system for reporting violations of this learning environment.

 

*Such unacceptable behavior includes the creation of a concern of “retaliation” for the filing of a complaint about mistreatment.

 

How is feedback defined in the learning environment?

 

In order for our students to receive guidance and to improve their skills throughout their education, a learning environment must include honest and constructive feedback. Such feedback should be provided in a helpful, specific and accurate manner, focused on behaviors and opportunities to improve, and, when negative, given privately and respectfully. Those providing feedback should do so mindful of the goal of helping the student to improve. Those receiving feedback should do so graciously, with the assumption that it is given generously and in good faith.  Similarly, when students are asked to evaluate their teachers, they should be thoughtful with word choice and provide feedback that is specific and with the goal of helping their teachers to improve their skills.

 

How is mistreatment defined in the learning environment?

 

We define mistreatment as any behavior that is harmful or offensive to an individual student and interferes with the student’s learning. This may include public embarrassment or humiliation; threat of or actual physical harm; sexual harassment or assault; discrimination or harassment based on race, religion, ethnicity, gender, sexual orientation, physical ability, age, or personal beliefs; psychological punishment; and the use of grading and other forms of assessment in a punitive, harassing, or discriminatory manner.  

 

How are other issues with the learning environment (“curricular events”) defined?

 

Other issues with the learning environment (“curricular events”) may not meet this definition of mistreatment but may raise concerns for a student.  Examples would include a lecturer who uses inappropriate terminology to describe a group of people, or a handout that includes a biased use of photographs (e.g., a handout on sexually transmitted infections includes photographs of dark-skinned patients only).  Events such as these are important to recognize, and we encourage an environment in which they can be rapidly and thoughtfully corrected. We also encourage an environment in which questions and concerns about our curriculum can be discussed in a respectful fashion.

What are some examples of behaviors that promote a positive learning environment?

An individual (faculty member, staff member, etc):

  • Demonstrates an openness to adapt practice and language to create an environment that is welcoming to all students

  • Conducts interactions in a manner free of bias and prejudice

  • Provides a clear description of expectations for all participants at the beginning of all educational endeavors, rotations and assignments

  • Encourages an atmosphere of openness in which students will feel welcome to ask questions, ask for help, make suggestions, and respectfully disagree

  • Provides timely and specific feedback in a constructive manner, appropriate to the level of experience/training, and in an appropriate setting, with the intent of guiding students towards a higher level of knowledge and skill

    • Focuses such feedback on observed behaviors and desired outcomes, with suggestions for improvement

    • Focuses such feedback on performance rather than personal characteristics of the student

  • Encourages an awareness of faculty responsibilities towards all individual learners in a group setting

  • Bases rewards and grades on merit, not favoritism

  • Gives a lecture using appropriate terminology and statistics with respect to race, gender, and other identifying characteristics

A student:

  • Conducts all interactions in a manner free of bias or prejudice of any kind

  • Acknowledges course or rotation expectations and the responsibility for fulfilling those requirements to the best of one's ability

  • Asks for feedback from professors, residents, nurses, and attending physicians

    • Accepts such feedback in a professional manner and incorporates such feedback into future efforts so as to achieve the desired educational outcome

    • Understands that feedback is given with the intention of helping to further professional growth

  • Provides feedback - usually written, but potentially verbal - to peers and supervisors, when such feedback is likely to enhance those individuals’ skills as physicians or teachers

  • Engages in professional, respectful behavior towards learning opportunities (i.e., arrives on time for rotations or small groups; appears interested in material)

  • Addresses professional responsibilities in a timely fashion

What are some examples of behaviors that do not promote a positive learning environment?

An individual (faculty member, staff member, etc):

  • Questions or otherwise publicly addresses students in a way that would be considered by others to be humiliating, dismissive, ridiculing, berating, embarrassing or disrespectful

  • Asks students to perform personal chores (e.g., running errands)

  • Tells inappropriate stories or jokes (e.g., ethnic, sexist, racist)

  • Behaves in an aggressive manner (e.g., yelling, throwing objects, cursing, threatening physical harm)

  • Denies educational opportunities to students

  • Makes disparaging comments about students, faculty, patients or staff

  • Touches students in a sexual manner

  • Takes credit for a student's work

  • Retaliates against a student for raising a concern about mistreatment or the learning environment

  • Gives a lecture using inappropriate terminology or statistics with respect to race, gender, or other identifying characteristics

  • Demonstrates difficulty adapting practice and language to best care for all patients

A student:

  • Questions or otherwise publicly addresses colleagues in a way that would be considered by others to be humiliating, dismissive, ridiculing, berating, embarrassing or disrespectful

  • Tells inappropriate stories or jokes (e.g., ethnic, sexist, racist)

  • Makes disparaging comments about students, faculty, patients or staff

  • Does not take learning seriously (i.e., consistently arrives late for rotations or small groups, appears disinterested in material)

  • Communicates disrespectfully or in an untimely fashion with staff, colleagues, and teachers

  • Does not address professional responsibilities in a timely fashion

 

Students, faculty, and staff at AMS also adhere to the Principles of the Brown University Community

 

Summary

Through these principles on the learning environment at AMS, we affirm our commitment to shaping a culture of teaching and learning that is rooted in respect for all. The Learning Environment procedures will outline the steps by which mistreatment or other violations of the learning environment are handled in our institution.