Learner Mistreatment

Mistreatment is generally defined within the education context as intentional or unintentional behaviour that shows disrespect for the dignity of others.  Mistreatment can involve a single incident or a pattern of behaviour and can range from subtle gestures and/or comments to egregious actions. Any behaviour involving the mistreatment of another person compromises the learning environment.

Mistreatment includes ‘micro-aggressions’, which are often unintentional, but experienced as a pattern of, snubs, slights, put-downs, and gestures that demean or humiliate individuals based on their belonging to a group, particularly those identified by gender, race/ethnicity, sexual orientation, immigration status, and/or socioeconomic class.

North York General Hospital is committed to providing a safe environment in which all employees, physicians, learners, volunteers and contractors are treated with dignity and respect. Any form of harassment and discrimination in the workplace will not be tolerated and we recognize that everyone:

• Has the right to a workplace free from harassment, including sexual harassment, discrimination, bullying and violence in compliance with the Ontario Human Rights Code and the Ontario Occupational Health and Safety Act.
• Has the right to claim and enforce their rights, in good faith, without reprisal or threat of reprisal for having done so.
• Has the right to freedom from intentionally false (bad faith) claims of discrimination and harassment.
• Our team is here to listen, support, and guide those who have experienced or witnessed such incidents.

Mistreatment can be categorized in numerous ways. Behaviours that fall under the discrimination and discriminatory harassment and sexual violence and sexual harassment categories are considered unprofessional. However, they are considered discrete mistreatment categories since they are defined and addressed through specific NYGH policies as well as the Ontario Human Rights Code.

The examples provided below are not exhaustive and are not intended to represent the spectrum of behaviours that may be considered mistreatment. If you are unsure, we encourage you to get in touch through the disclosure form.

Unprofessional behaviour (selected examples):

• required to perform personal services
• publicly humiliated, implicitly (e.g., eye-rolling) or explicitly
• subjected to recurring outbursts of anger (e.g., shouting, throwing objects)
• subjected to disparaging remarks about the character or patient care of another physician/health professional/learner
• inhibited by a person in authority from providing appropriate feedback/evaluation, including disclosures or reports of mistreatment
• subjected to retaliation in response to a disclosure, report and/or investigation of mistreatment
• threatened with physical harm
• physically harmed
• faced issues related to academic integrity or research integrity

Discrimination and discriminatory harassment (selected examples):

• subjected to offensive remarks/names related to or based on race, ethnicity, gender, sexual orientation, religion or any of the other protected grounds identified in the Ontario Human Rights Code
• denied opportunities for training or rewards based on any of the protected grounds identified in the Ontario Human Rights Code
• received lower evaluations/grades based on any of the protected grounds identified in the Ontario Human Rights Code
• denied and/or subjected to critical, dismissive or demeaning remarks about approved academic accommodations (e.g., time to perform a smudging ceremony, pray, commemorate religious observance)
• not provided with reasonable academic accommodations based on disability

Sexual Violence and Sexual Harassment (selected examples):

• subjected to offensive sexist remarks/names
• subjected to sex-related comments about my/someone’s physical appearance or actions
• subjected to unwanted sexual advances
• asked to exchange sexual favours for grades or other rewards
• inhibited by a person in authority from reporting unwelcome sexual comments or unwanted sexual advances

Discussing

Discussing is when you meet with a designated program leader to talk about, debrief, or unpack an incident or experience. If you are comfortable, this could include: your preceptor or supervisor; your area or professional lead (such as education lead, chief, manager, practice leader or clinical coordinator); or a designated hospital leader

Disclosing

Disclosing is when you convey information about the conduct of an individual to the hospital (a designated hospital leader) to seek information about your options, including for safety, support, or accommodations.

Reporting

Reporting is when information about an individual’s conduct is conveyed with the intent that the hospital formally reviews and potentially acts upon the information.

The decision to disclose and the decision to report are separate decisions made by the student, except in cases where NYGH is required to take steps, including out of health or safety concerns, as required by law or Hospital policy.

Anonymous Disclosures: If the decision is to proceed with an anonymous disclosure or report, you will not be able to participate in the review process or receive information about its outcome.

Confidentiality During Reporting
The designated Centre for Education leaders, as well as all other parties involved in responding to a mistreatment disclosure or report, must maintain confidentiality to the extent possible. Only those who need to be involved to review the matter, to respond, or are requested to provide personal support will be informed. If you identify yourself but does not wish to be named to the individual who is the subject of the disclosure or report, you should be aware:

• that there are circumstances where NYGH may need to disclose your identity in extenuating circumstances (i.e., regulatory or legal obligations). This includes if there is an imminent risk to yourself or others, violence against someone aged less than 16 years, or sexual violence by a regulated healthcare professional.
• that it may be possible for the individual to identify you based on their description of the underlying incident(s).
• that the individual may have a limited ability to respond to an unidentified or anonymous disclosure or report.
• that NYGH may be limited in the scope of its review, if the individual has not had a meaningful chance to respond to the disclosure or report.
• that NYGH may be limited in the sanctions that it can impose against the individual.

Anonymous Disclosures
Using the Disclosure Form, you have the option to disclose/report mistreatment anonymously (i.e. without the requirement that you provide your identity), with the understanding that the ability to respond to such disclosures/reports is limited. When deciding whether to proceed with a review of an anonymous disclosure or report, NYGH may consider whether the issues underlying the disclosure or report are egregious and if there is sufficient information to enable the review. If the decision is to proceed with an anonymous disclosure or report, you will not be able to participate in the review process or receive information about its outcome.

You can always come forward in person to discuss or debrief what has happened, but request to remain anonymous when moving forward. 

We may include anonymous discussions, disclosures, and reports, in our Annual Report, to be able to promote transparency and accountability, however we continue to safeguard your anonymity by continuing to keep you de-identified and sharing data in the aggregate.