Adams School of Dentistry: Policy on Student Professionalism

Title

Adams School of Dentistry: Policy on Student Professionalism

I. Introduction

Purpose

The purpose of this document is to operationalize the principles stated in the Adams School of Dentistry's (ASOD) Technical Standards and Code of Conduct (see Section V, "Related Requirements") and to provide a mechanism for adjudicating whether student or resident conduct has failed to meet the School's expectations for professionalism.

Scope of Applicability

This Policy applies to all students at the Adams School of Dentistry. For the purpose of this Policy, the term "student" encompasses a broad number of groups (see the "Definitions" section below).

II. Definitions

1. Executive Dean for Operations: chief operations officer for the Adams School of Dentistry.
2. Investigator: Adams School of Dentistry official that has been tasked with reviewing an allegation of unprofessional conduct by a student. Typically, this would be the Executive Vice Dean for Education, the Associate Dean for Advanced Dental Education (ADE), the Assistant Dean for Student Life, or their designee(s).
3. Student: refers to any individual enrolled at the Adams School of Dentistry, including Doctor of Dental Surgery (DDS) and Dental Hygiene (DH) candidates, ADE students, residents, visiting scholars, exchange students, or other trainees.

III. Policy

A. Policy Statement

Students must not engage in any conduct that jeopardizes their fitness to practice dentistry or dental hygiene. The general responsibilities and fundamental expectations for all dental professionals at the School are codified in the Technical Standards and the Code of Conduct.

In addition, students are required to comply with all policies of the University of North Carolina at Chapel Hill ("University") and the ASOD including, but not limited to, those pertaining to:

• infection control,
• emergency management,
• HIPAA privacy and security,
• vendor relations,
• harassment, and
• discrimination.

The ASOD Professionalism Committee (the "Committee") is charged with reviewing and responding to administrative findings of student misconduct relating to professionalism. The Committee should review administrative findings of conduct that:

• is within the scope of Section III-B and is not identified as "out-of-scope" in Section III-C;
• is regarded by the Investigator as a Level I or Level II professionalism offense as described in Section III-D-1; and
• meets one of the following criteria:
  • is expressly regulated by policy, but not subject to a clearly-prescribed sanction; or
  • is not expressly regulated by an existing policy, but nonetheless raises concern about the student’s professionalism.

B. Conduct Adversely Affecting a Student's Professionalism

Conduct adversely reflecting on a student's professionalism includes, but is not limited to, the following:

• Imperiling the safety and welfare of a patient.
• Imperiling the safety and welfare of faculty, staff, visitors, or other students.
• Imperiling the student’s own safety and welfare.
• Failing to observe the ASOD's standards for patient care.
• Abusing drugs, alcohol, or other substances that may adversely affect the delivery of care.
• Compromising patient privacy, whether deliberately or inadvertently.
• Engaging in abusive, harassing, or retaliatory conduct toward others.
• Committing any acts or omissions identified as unprofessional conduct per se by the North Carolina Board of Dental Examiners in 21 NCAC 16V .0101 or 21 NCAC 16V .0102.
• Undermining academic oversight or impairing clinic operations, such as:
  • providing false or misleading information to ASOD officials; or
  • failing to notify ASOD officials about any personal circumstances that may foreseeably jeopardize patient care activities.
• Forging documentation or otherwise disregarding proper record-keeping practices, such as:
  • failing to document informed consent; or
  • failing to complete/sign progress notes or treatment plans.
• Violating any ASOD or University policies, standards, or procedures.
• Deliberately providing false or misleading information to - or failing to cooperate with - a School or University official conducting an investigation into any of the foregoing conduct or otherwise acting in the exercise of their official duties.
• Other conduct that is not consistent with the principles and expectations articulated in the ASOD's Technical Standards or Code of Conduct.

C. Conduct Outside the Scope of Committee Review

1. Academic Performance Committee

Concerns about a student's academic performance must be referred to the ASOD's relevant Academic Performance Committee.

2. University Honor Court

Some offenses reflecting on a student's professionalism may also constitute offenses under the University’s Honor Code, such as:

1. Academic Dishonesty. Academic integrity is a fundamental responsibility of every student at the University. Although academic dishonesty is clearly inconsistent with the ASOD's expectations for professionalism, potential violations of this type must be referred to the University's Office of Student Conduct.
2. Other Conduct. For any other matter within the Committee’s scope also constituting an offense under the Instrument of Student Judicial Governance (the “Instrument”), the Investigator must exercise reasonable judgment as to which forum is appropriate. In making this determination, the Investigator should consider:
   1. Whether the offense is expressly listed in Section II.C of the Instrument,
   2. The nexus between the offense and the student’s fitness to practice dentistry or dental hygiene, and
   3. Whether the offense is a component of a documented pattern of unprofessional conduct more appropriately reviewed in context by licensed dental professionals.

3. University Emergency Evaluation and Action Committee

Some matters may warrant immediate intervention and resolution. If a student has displayed behavior that poses a threat to self or others or has been charged with a crime of violence, ASOD's Academic Affairs and/or Clinical Operations will coordinate with the University’s Emergency Evaluation and Action Committee (“EEAC”) to assess appropriate next steps.

4. Equal Opportunity and Compliance Office

The Equal Opportunity and Compliance Office (EOC) is the University’s central office for addressing prohibited discrimination, harassment, and retaliation based upon age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status. Additionally, EOC coordinates resources for those affected by sexual harassment and sexual violence.

Faculty and staff members to whom a student reports a concern regarding discrimination, harassment, retaliation, or related misconduct including sexual assault must contact the EOC Office immediately.

D. Sanctions

For minor conduct that does not amount to a Level I or Level II professionalism concern as described below, the Investigator must not refer the matter to the Committee for review. Instead, the Investigator should consult with Academic Affairs, Clinical Affairs, or the Office of Dean as needed to determine the appropriate administrative sanction. The sanction imposed pursuant to this approach must not be reflected in the student's academic record.

1. Severity Level

2. Relevant Factors

The Committee will take into consideration the following factors in assessing severity and imposing sanctions:

1. The gravity of the offense in question, including but not limited to:
   1. intent and deliberation involved in committing the offense, where relevant;
   2. implications for the patient; and
   3. implications for faculty, staff, and fellow students.
2. The value of learning through experience so as to develop a greater sense of responsibility for one’s actions and their consequences to others.
3. The importance of equitable treatment for similar offenses.
4. The likelihood the sanction will serve as a deterrent for repeated offenses by the student.
5. Any aggravating factors, including but not limited to:
   1. recidivism,
   2. actual harm suffered, and
   3. lack of cooperation with the investigation.
6. Any mitigating factors, including but not limited to:
   1. prior record of professionalism,
   2. the extent to which the student has acted to mitigate any actual harm,
   3. cooperativeness with the investigation, and
   4. demonstrated responsibility and contrition for one’s actions.

3. Available Sanctions

All sanctions imposed by the Committee must be reflected on the student’s academic record:

1. For Level I offenses:
   1. written warning,
   2. clinical suspension (either indefinite or with defined length),
   3. mandatory educational or counseling program, or
   4. any combination thereof.
2. For Level II offenses:
   1. class retention,
   2. suspension from the ASOD,
   3. dismissal from program, or
   4. expulsion from the University system (with the approval of the Chancellor).

IV. Procedural Due Process

A. Rights of Students

1. Information and Informed Choices. The right to examine this policy, active or constructive notice for all policies and procedures for the ASOD, and periodic reminders about prohibited conduct.
2. Notice and Hearing. The right to be provided with notice about an allegation of misconduct and the right to be heard before any adjudicative determination is made.
3. Proof that is Clear and Convincing. The right to have an alleged offense proven by evidence that is clear and convincing, meaning that the evidence is substantially more likely to be true than not and that the Committee has a firm belief or conviction in it.
4. Counsel. N.C.G.S. 116-40.11 grants all University students accused of violating the conduct rules of their institution the right to be represented (at the student’s own expense) by a licensed attorney or non-attorney advocate who may participate fully in the disciplinary proceedings against the student to the same extent as the student’s right to participate in the same disciplinary proceeding. This statutory right does not apply for:
   1. allegations of academic dishonesty; or
   2. matters that are referred to the University’s Honor Court for adjudication by the student’s peers.
5. Appeal. The right to appeal the Committee’s determination to the Executive Dean (see Section IV-C).

B. Committee Hearing Procedure

1. Allegations and Investigation

The Committee is an adjudicative body. Whenever a professionalism offense is suspected, it must be reported in the first instance to the Associate Dean for ADE or the Executive Vice Dean for Education for investigation. Suspected patient privacy violations must be reported to the School’s HIPAA Privacy or Security liaisons, who will coordinate with the University’s Institutional Privacy Office (IPO) to conduct an investigation. The Investigator must not be a member of the Committee.

The Executive Vice Dean for Education or Associate Dean for ADE must notify the student in writing that there is an ongoing investigation into alleged misconduct as soon as practicable, unless notifying the student would pose some risk to the investigation (e.g., destruction of evidence) that warrants delaying - but not denying - notice to the student.

The Investigator will provide a written report of the investigation results to the Committee Chair, along with a recommended sanction.

2. Hearing

Upon receiving the Investigator's report, the Committee should hold a hearing within ten (10) business days. The Committee must permit the student to appear before the Committee to respond to the allegations and the investigation report. Alternatively, the student may elect to provide the Committee with a written statement rather than appear in person. The student may dispute investigative findings, bring the Committee's attention to any new information or mitigating factors, or accept the findings and offer willingness to accept the Investigator's recommended sanction.

The Committee may invite witnesses or the Investigator to appear at the hearing to answer questions directly.

3. Determination

After the hearing process has concluded, the Committee will vote on the following issues:

1. Whether clear and convincing evidence has been presented to conclude that the student’s conduct fell below School’s standards of professionalism;
2. Whether the student’s conduct amounts to a Level I or Level II offense; and
3. Appropriate sanction commiserate with the offense level, which may or may not match the Investigator's recommendation

All Committee determinations will be decided by a majority of the voting Committee members. In the event of a tie, the outcome most favorable to the student will control. In the event of a vote where no majority or tie is reached, the proposal garnering the least amount of support will be eliminated from consideration, and the Committee will repeat the vote.

The Committee Chair will provide the student with a written determination of the issues considered above.

C. Appeals

Refer to the ASOD's Policy on Student Due Process.

V. Related Requirements

A. External Regulations and Consequences

1. N.C. Administrative Code - 21 NCAC 16V .0101 - Definition: Unprofessional Conduct by a Dentist
2. N.C. Administrative Code - 21 NCAC 16V .0102 - Definition: Unprofessional Conduct by a Dental Hygenist
3. N.C. General Statute § 116-40.11 - Disciplinary proceedings; right to counsel for students and organizations
4. UNC-Chapel Hill Instrument of Student Judicial Governance
5. UNC-Chapel Hill Standard on HIPAA Sanctions
6. UNC-Chapel Hill Emergency Evaluation and Action Committee Policy and Procedures

B. Unit Policies, Standards, and Procedures

1. Adams School of Dentistry: Code of Professional Conduct
2. Adams School of Dentistry: Technical Standards
3. Adams School of Dentistry: Policy on Student Due Process

VI. Contact Information