Why the MILES Committee was Created
Previous Barriers to Mistreatment Reporting
Student mistreatment at the Johns Hopkins School of Medicine has been a concern for students, faculty, and residents. Though it is known that mistreatment occurs, it is difficult to define what qualifies as mistreatment. It is also difficult to determine what the best avenues are to address and resolve student mistreatment.We know that mistreatment, discrimination, and other factors that lead to a negative learning environment must be addressed. We know that memories of mistreatment are lasting for students and affect morale, confidence, and empowerment to speak up in other situations – particularly when patient safety is at risk. Mistreatment can also affect perceptions of and choice of career paths in medicine. It has been linked to loss of "humanity" during medical training, burnout, and mental health concerns.
The most commonly reported reasons by Hopkins students for not reporting mistreatment events include:
- Fear of their report not remaining confidential
- Doubt that administration would also consider it mistreatment
- Doubt about whether their negative experience constitutes mistreatment
- Concern it would negatively affect evaluations, grades, opinions, or the future career of the student
- Perceived lack of any possible adequate resolution will make reporting not worth the time or energy
- Not feeling empowered to report it – culture of not reporting, of being taught to accept the status quo, of being told that "this is just part of training"
With these in mind, we have attempted to create an optimal reporting structure and process that emphasizes principles of CONFIDENTIALITY and TRANSPARENCY. We have attempted to create a committee comprised of faculty diverse in backgrounds and clinical endeavors, viewed as "trusted third parties", and who are accessible and committed to bettering the learning environment for trainees. This committee will emphasize a student-directed process and provide follow-up to those who file reports.
