VCOM Professionalism and Ethics Exam 2 (Lec 12-20)

colorism

the belief that one type of skin tone is superior or inferior to another within a racial group

Discrimination

prejudiced action against a group of people

the unjust or prejudicial treatment of different categories of people or things, especially on the grounds of race, age, or sex.

institutional racism

racism embedded in social institutions

Prejudice

biased thought based on flawed assumptions about a group of people

making assumptions and decisions based on inaccurate or faulty information and assumptions

Racial Steering

the act of real estate agents directing prospective homeowners toward or away from certain neighborhoods based on their race

racism

a set of attitudes, beliefs, and practices that are used to justify the belief that one racial category is somehow superior or inferior to others

Sometimes Overt, Sometimes Subtle, Continues to Plague U.S. Health Care

Redlining

the practice of routinely refusing mortgages for households and business located in predominately minority communities

sedimentation of racial inequality

the intergenerational impact of de facto and de jure racism that limits the abilities of black people to accumulate wealth

Stereotypes

oversimplified ideas about groups of people

White Privilege

the benefits people receive simply by being part of the dominant group

Who said it?

"People fail to get along because they fear each other; they fear each other because they don't know each other; they don't know each other because they have not communicated with each other."

MLK Jr.

We are all the same, but we are not all equal.

Explain balancing power with racial justice

• RacialJustice ≠ diversity
• Diversity = variety
Racial Justice ≠ Equality
• Equality = sameness
RacialJustice = equity
•Equity = fairness, justice

People get what they need

___________ are oversimplified ideas about groups of people, a statement, action, or incident regarded as an instance of indirect, subtle, or unintentional discrimination against members of a marginalized groups.

____________ refers to thoughts and feelings, while discrimination refers to actions.

___________ refers to the belief that one race is inherently superior or inferior to other races.

Stereotypes

Prejudice

Racism

7 Forms of Racism

SIR SIID

• Representational Racism
• Ideological Racism
• Discursive Racism
• Interactional Racism
• Institutional Racism
• Structural Racism
• Systemic Racism

Microaggressions in Medicine

statement, action, or incident regarded as an instance of indirect, subtle, or unintentional discrimination against members of a marginalized group such as a racial or ethnic minority.

What is privilege

"Privilege exists when one group has something of value that is denied to others simply because of the groups they belong to, rather than because of anything they've done or failed to do. Access to• privilege doesn't determine one's outcomes, but it is definitely an asset that makes it more likely that whatever talent, ability, and aspirations a person with privilege has will result in something positive for them."
Peggy McIntosh

What does it mean to have privilege ?

It is defined as "unearned access to resources (social power) only readily available to some people as a result of their advantaged social group membership".

Determining who has privilege or disadvantage is complex because cultural, social, and historical changes affect which groups are privileged and which groups are not.

Health Literacy

"the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions."

What can we do to be aware of cultural competence and acceptance and equality?

• Culturally-Sensitive Education
• Listening and Adaptation
• Representation
• Accessibility
• Means and Ends

What does racial and ethnic disparities in health care originate from?

...from a multiple complex factors, discrimination in health care, genetics, unequal educational opportunity, income gaps, health care access disparities, cultural beliefs, and community systems. Easy solutions are not available, however there is a moral imperative that must be brought to bear to address these differences. Improving access to quality care, reforming the health care delivery system, improving cultural understanding, diversifying the health care workforce, and improving social influences of health are all worthy goals but more is needed.

Cultural and linguistic competence is...?

Cultural competency in health care is...?

...a set of congruent behaviors, knowledge, attitudes, and policies that come together in a system, organization, or among professionals that enables effective work in cross-cultural situations

....the ability of healthcare providers and organizations to meet the cultural, social, and linguistic needs of their patients.

Define Culture

How is it shaped?

What must a culturally competent healthcare professional or institution take into account?

• Culture- encompasses a person's learned beliefs, thoughts, and behaviors, their values, customs, and traditions, their communication style, their views on relationships, and the different ways they interact with others.
• Culture is shaped by many things, including race, ethnicity, nationality, heritage, socioeconomic status, education, and other factors.
• all of these aspects of an individual to achieve cultural competence.

Diversity

Distinct qualities, backgrounds, characteristics and beliefs which make us different from each other either as individuals or as groups.

Race

An identified group of individuals of the same species who have identifiable biological traits passed from one generation to the next.

Careful - this may be touchy as it can be linked to stereotypes

Ethnicity

A cultural, linguistic, religious, racial, or national heritage which identifies an individual with a group of individuals.

Minority

An identified group of individuals which has little power or representation in a given society.

Gender

The state of being male or female (typically used with reference to social and cultural differences rather than biological ones.)

Religion

age

a particular system of faith and worship

the length of time that a person has lived

Sexual Orientation

A person's sexual identity in relation to the gender to which they are attracted. The fact of being heterosexual, homosexual or bisexual.

Socioeconomic Circumstances

an individual's or family's economic or social position in relation to others based on income, education and occupation.

Mental and Physical Disabilities

A condition that impairs, interferes or limits a persons ability to engage in certain tasks or actions or participate in daily activities.

Military Personnel and Family

A person's serving predominantly full time in the United States Armed Forces and their families who live in military environments that often have their own unique subculture and lifestyle apart from the general population.

Why does cultural competence in healthcare matter?

• Improve patient care and satisfaction
• Decrease malpractice risks and insurance costs
• Experience operational efficiency
• Increase compliance with state and federal regulations
• Overall, reduce health disparities among populations

What is the relevance of cultural competency in Health Care?

*Ability to interact effectively with people of different cultures

*This skill set allows one to increase their appreciation and understanding of differences without bias between groups of individuals.

*Application of this skill allows the health care provider to interact successfully and appropriately to provide needed health care to all identified groups of individuals.

*Being culturally competent is an "ongoing process". As the world progresses and becomes more diverse, we as health care providers, must do likewise.

It is projected that people of color will account for over ______ (_____%) of the population in 2050, with the largest growth occurring among ________.

half (52%); Hispanics

Define Health Care Disparities

Why do they occur?

Health and health care disparities refer to differences in health and health care between groups that are closely linked with social, economic, and/or environmental disadvantage.

Disparities occur in healthcare because of "differences that occur by gender, race or ethnicity, age, education or income, disability, geographic location, or sexual orientation."

Woman are more likely than men to have ______ conditions, but men die from them more.

chronic

Health Care Disparities Examples: Sexual Orientation/ LGBTQ+

health issues?

environmental factors?

Unique health challenges?

Gay/ Bisexual men and HIV?

HIV prevalence in trans females?

Routine care for lesbian/bisexual women?

LGBT youth and abuse?

Health Disparities linked to social stigma, discrimination and denial of civil and human rights.

Health issues: psychiatric, substance abuse, suicide

Environmental factors: victimization, violence

Unique health challenges: access to care, insurance

Gay and bisexual men=more than half of new HIV infections in US each year

HIV prevalence in transgendered females exceeds 25% nationwide

Lesbian/bisexual women receive less routine care than other women, including breast and cervical cancer screenings

Approx 30% of LGBT youth report physical abuse by family members due to sexual orientation or gender identity/expression

Health Disparities Examples: Race and Ethnicity (CHART)

what are they caused by?

minority populations usually have higher rates of?

What did the Chronic Disease Death Rates by Race and Ethnicity chart show?

Health disparities between different racial or ethnic groups are caused by differences in genetic factors, environments or health behaviors, and also other factors such as systemic racism and bias.

Minority populations often have higher rates of chronic disease. The chart shows below shows how death rates for diabetes, heart disease and cancer can vary widely by racial and ethnic groups.

The chart shows that:
1) Black/African American, American Indians and Hispanic groups are more likely to die of diabetes
2) Black/African Americans and White groups have higher death rates for heart disease and cancer
3) For all three diseases, Black/African Americans have the highest death rates while Asian/Pacific Islanders have the lowest

Health Disparities Examples: Race and Ethnicity

Covid 19

Most people who got COVID were white, but primarily black patients died from it. This shows a significant current health disparity

Health Disparities Examples: Income or Education

Groups with low incomes?

Higher income groups?

What did the US Obesity Rates and Income Chart show?

Groups with the lowest income and education levels also have the lowest health status. Groups with higher income are more able to access medical care and health information.

Higher income groups are also more able to take part in healthy behaviors such as exercise and eating well. The chart below shows how income is related to people's perceptions of their health status.

The chart below shows five income levels and the percent of obese people in those income levels. Obesity among the poorest group is twice the level of the richest group.
The less money people have, the more calories (or less nutrient dense food) they eat

Health Disparities Examples: Disability Status

Disabilities, whether present or acquired at birth or developed later in life, can manifest into?

People with disabilities represent about _____ percent of the U.S. population (Brault, 2012).

There is ample evidence to suggest that people with disabilities are at increased relative risk for?

People with disabilities also report higher rates of what?

physical, cognitive, or mental health- related impairments, which can affect health outcomes.

18.7

poor well-being, but this population has been overlooked.

obesity, lack of physical activity, smoking, and three to four times the rate of cardiovascular disease versus people without disabilities

Health Disparities Examples: Geographic Location

The Appalachian Region Commission Studies have identified what? (7)

1) Higher rates of Cancer, in particular cervical cancer

2) Higher rates of Heart Disease

3) Higher rates of premature infant
mortality

4) Higher rates of lung disease

5) People living at or below poverty level

6) Poor access to medical services

7) High school drop - out or non- completion

Complex Causes of Healthcare Disparities

Social Determinants of Health (______ Contributor)?

Racial or ethnic bias (______ Contributor)

Health ________ or _______

______ and ______ barriers

Number of providers (_____ contributor)?

Lack of _____ of health care providers

Quality of _____

Lack of ______ across providers

Major - socioeconomic status, education, physical environment, social support, access,
employment

Major - clinical uncertainty when interacting with patients of another racial or ethnic group

infrastructure or coverage

Culture; language

Major - Physicians are less likely to locate in areas where greater poverty exists

diversity

care

communication

How Does Cultural Incompetence Lead to Healthcare Disparities?

i.e. providers and trust

Providers may unintentionally provide lower expectations for patients who are in disadvantaged positions and therefore influence patient health outcomes

Providers may employ stereotypes when under time constraints resulting in poor patient communication

Patient may mistrust medical profession → leading to poor adherence → resulting in provider cynicism toward the patient → thereby provider offers patient fewer services (repeat)

What can be done to stop incompetence and health disparities? (7 steps)

1) Identify and verify a healthcare disparity which is problematic based on accepted medical and scientific standards.

2) Define those healthcare disparities which have a realistic solution and the intervention utilized to address the problem has a clear outcome measure.

3) Increase community awareness of disparities.

4) Set priorities among disparities.

5) Articulate valid reasons to expend resources to reduce and eliminate priority disparities.

6) Implement universal and targeted intervention programs.

7) Aim to achieve a faster rate of improvement among vulnerable groups.

Medical Student Cultural Competence - What skills should you develop to be Culturally Competent? (7)

1) Develop knowledge of diversity as it relates to disease processes

2) Be able to obtained a culturally competent history and physical

3) Learn sources of information regarding cultural diversity

4) Develop understanding of personal biases through
introspection

5) Be able to conduct culturally competent patient education

6) Be able to develop culturally competent treatment plans

7) Understand epidemiological data relevant to practicing culturally sensitive medicine

What are the Best practices for students to become culturally competent?

Self-Awareness (introspection)

Learn the language or colloquialisms

Use a worldview approach (assumptions about reality)

Use caution in eliciting help from family/friends in interpretation

Know customs (eye contact, touching, asking questions, space, time)

Ask questions—don't assume

Small talk, self-disclosure

Use the formal name when unsure

Don't ask "do you understand?", repeat in own words

Ask permission

Negotiate treatment

How to Support Diversity in the Health Professions? (3)

1) Medical Outreach: International/Appalachian Outreach

2) Get involved in student organizations:
Student National Medical Association
American Medical Women's Association
Hispanic Community Medical Outreach
PRIDE in Healthcare
And more!

3 )AMA and AOA recommend getting involved in programs encouraging interest in medicine among minorities and low income youth

What can we do as a health care system to promote cultural competency? (10)

1) Provide training to increase cultural awareness, knowledge, and skills

2) Provide interpreter services

3) Recruit and retain minority staff

4) Coordinate with traditional healers

5) Use community health workers

6) Incorporate culture-specific attitudes and values into health promotion tools

7) Include family and community members in health care decision making

8) Locate clinics in geographic areas that are easily accessible for certain populations

9) Expand hours of operation

10) Provide linguistic competency that extends beyond the clinical encounter to the appointment desk, advice lines, medical billing, and other written materials

Define Gender (W.H.O. def)

"Gender - refers to the socially constructed characteristics of women and men - such as norms, roles and relationships of and between groups of women and men. It varies from society to society and can be changed. While most people are born either male or female, they are taught appropriate norms and behaviors - including how they should interact with others of the same or opposite sex within households, communities and work places. When individuals or groups do not "fit" established gender norms they often face stigma, discriminatory practices or social exclusion - all of which adversely affect health. It is important to be sensitive to different identities that do not necessarily fit into binary male or female sex categories."

Social Contruct

1) Sexual Orientation

2) Gender Identity

3) Gender Expression

1) A person's EMOTIONAL &/or PHYSICAL ATTRACTION to people of the same gender &/or a different gender
• Most people identify themselves as lesbian, gay, bisexual, or heterosexual, but there are many other terms that people use to describe their sexual orientation

2) An individual's INTERNAL SENSE OF GENDER, which may or may not be the same as one's gender assigned at birth

3) Way in which an individual OUTWARDLY presents their gender, through how they choose to speak, dress, or generally conduct themselves socially.
(The way one expresses their gender is NOT always indicative of their gender identity)

Meaning of LGBTQ+

(L) Lesbian: a woman who is attracted to other women
(G) Gay: a man who is attracted to other men
(B) Bisexual: someone attracted to people of either gender
(T) Transgender: when one's biological sex and gender-identity
do not match
(Q) Queer: individuals who don't identify as straight or who have non-binary gender identity
(+) inclusive of all identities

Fluidity of Terminology

• It is important to remember that the terminology itself is fluid.
• Terms are not static and can vary in different cultures.
• With identity terminology, trust the person who is using the term and their definition of it.

Cisgender

having a gender identity that matches one's assigned sex

Intersex

A general term used for a variety of conditions in which a person is born with reproductive or sexual anatomy that doesn't seem to fit the typical definitions of female or male.

Gender non-conforming

Anyone who does not fit neatly into a gender role. Sometimes this is used to suggest that there is something wrong with people who do not fit gender roles. There is not.

Trans*

An umbrella term derived from a contraction of "transgender" or "transsexual". The asterisk is a "wildcard" that stands for the multitude of ways that trans people identify. The prefix "trans" can mean beyond, across, between, through, transcending, or changing. Many trans people have a gender identity that is different from the one they were assigned at birth. Some people identify as trans* if their gender expression is different than what is expected for their gender.

MTF

1. "Male to female"; a person who was assigned male at birth and identifies as a woman
2. Some trans* people use "MTF" to describe their medical transition goals; they want their body to lose some "male-typical" sex characteristics and gain some "female-typical" sex characteristics.

FTM

1. "Female to male"; a person who was assigned female at birth and
identifies as a woman.
identifies as a man.
2. Some trans* people use "FTM" to describe their medical transition
goals; they want their body to lose some "female-typical" sex characteristics and gain some "male-typical" sex characteristics.

Binary

Having two parts. Some societies such as ours tend recognize just 2 genders, male and female

Non-binary

A person whose gender identity does not fit the strict man/woman dichotomy.

Some non-binary people feel that their gender identity is between a man and woman, is simultaneously fully man and fully woman, changes from man to woman and back, is a separate entity without connection to man or woman, is similar to either man or woman but is not quite either, is entirely neutral, or does not exist at all.

Two-spirit

A term for LGBTQ members of the Native American community, first coined in 1990 by a Native American group in Winnipeg. The term references a tradition common to several tribes, where some individuals possessed and manifested a balance of both feminine and masculine energies, making them inherently sacred people.

How does Stigma and Discrimination affect the LGBTQ+ community's health?

Stigma can act on multiple levels to create both personal and structural barriers to accessing care.

Barriers may be reinforced for LGBTQ+ people who belong to more than one marginalized and stigmatized group (race, ethnicity, or SES), or who simply express themselves in ways that differ from accepted norms.

This "accumulated stigma" leads to both medical and behavioral health disparities.

Understanding Disparities

LGBTQ+ people experience a higher prevalence of...?

LGBTQ+ health disparities largely track to long history of...?

Stigma and discrimination - direct and indirect effects?

Despite the existence of discrimination and disparities, a sizable _________ of LGBTQ+ people live healthy, productive lives that are integrated into the activities and professions of general society.

...of a range of medical and behavioral health issues.

....societal stigma and discrimination directed at sexual and gender minorities.

• Directly: Bias by health care professionals, violence fueled by hatred of LGBTQ+ people, and policies that deny health insurance coverage to same-sex partners
• Indirectly: Discriminatory actions toward LGBTQ+ people around the world creating a negative environment for LGBTQ+ individuals wherever they may reside.

majority

For LGBTQ+ individuals, there is an increased risk for what?

Delayed or refusal of healthcare impact?

• Increase risk for depression, anxiety, suicide attempts, and substance use disorders
• LGBTQ+ youth are 4x as likely to attempt suicide

• 19% of transgender individuals reported being refused care because of their
gender identity
• Fears or concerns over disclosing sexual identity and lack of culturally competent providers

Barriers of Insurance for LGBTQ+ members

Wording excludes coverage outside of standard care (hormones, surgery, definition of family)
Lack of providers' knowledge of social issues surrounding the LGBT community, or lack of desire in treating this particular population.

LGBTQ+ in the elderly in understanding barriers

Limited social support systems

Discrimination in assisted living facilities in dealing with homophobia/ transphobia

SSand pension plans often exclude a partner from being on a significant others plan if marriage is not legally recognized.

SOCIAL DETERMINANTS OF LGBTQ+ HEALTH

Social determinates of health refer to economic & social conditions that influence individual and group differences in health status (e.g. social & economic resources such as housing education, employment, and health care; government & institutional policies)

Social determinates of health are often linked to stigma & discrimination. Examples in clude:
Schools that do not include sexual orientation & gender identity/expression protections in their anti-bullying programs can leave LGBT youth vulnerable to verbal & physical harassment, which is associated with depression, suicidality, & risk for HIV & other STIs.
Employment discrimination against transgender people can cause many to go without health care & can lead some to engage in the sex trade as a means of survival, putting them at risk for multiple health issues.

Unequal access to health care is of critical importance to all LGBTQ+ people, particularly those who are poor &/or living with HIV/AIDS

Beyond insuranceissues, many LGBTQ+ people continue to lack access to providers who are knowledgeable about their unique health needs or who understand how to address them with cultural sensitivity.

Creating affirmative and inclusive clinical environments

The environment of care can affect one's overall health care experience begins well before a patient greets a clinician in the exam room.

What makes for a gender affirming environment ? (7)

1) Have reading materials in your lobby areas that are encouraging of all patient types

2) Single occupancy restrooms

3) Call patients by their preferred names

4) Allow patients to determine who can visit and who cannot (family member, friend, or other individual)

5) Have patient intakes that ask:
• Assigned Sex at Birth
•Current Gender Identity

6) EMR flags/tags indicating transgender patient

7) Have clinical policies that help train staff on ways to best work with those whom are different than themselves

What are the 4 conceptual Frameworks for understanding LGBTQ+ HEALTH-
RELATED CHALLENGES

SLIM

Life course
social ecology
minority stress
intersectionality

life course

People have different health care needs at different life stages.

Ex. LBGTQ+ youth may have concerns related to coming out to their families, while older LGBTQ+ adults may have concerns about loneliness & living without extended families.

social ecology

Characteristics of the social environment, including family, other relationships, the community, culture, and general society, can affect an individual's behavior and well-being. How does the social context of people's lives influence their health?

Minority Stress

Sexual and gender minorities (like other minority groups) experience chronic stress arising from social stigmatization and manifested in both external and internal processes. Lack of social tolerance of homosexual behavior may result in stress-related disorders, such as depression, for LGBTQ+ people, especially in those who feel the need to be covert about their sexual orientation or gender identity.

Intersectionality

Social, racial/ethnic, religious, economic, cultural and other factors-in addition to sexual orientation and gender minority status-influence the identities, health, and lived experiences of LGBTQ+ people. Clinicians may need to explore and understand the role and intersection of different identities and other factors in their patient's lives.

Intersectionality was coined in the late 1980s by _______ _______, a legal scholar and civil rights activist. She introduced the term as a way to ...?

Kimberle Crenshaw

help highlight the fact that some individuals experience multiple or compound types of oppression and discrimination, because of the diversity in their identities.

What does intersectionality inform us ?

that we cannot just discuss separate categories of diversity and not address that they are also interdependent.

What is diversity ?

It is a broad concept that refers to the variety of group experiences that result from the social structure of society. It is influenced by social constructs such as but not limited to race, gender, age, class, nationality, sexual orientation, religion, region of origin, and so on...

based on the definition of diversity, how can we interpret intersectionality?

And so intersectionality is the intersecting of our diverse social constructs. And these social constructs are what help us formulate our identities.

And our identities are what drive our sense of SELF...Our Value Systems...AND how we see ourselves and the world around us.

Intersectional lines

It is important to always keep an open mind; and to remember that people are more than just what we see on the outside.

When viewed by an intersectional lens we can start to get more of an understanding about a person.

We can start to see the intersecting lanes and gain a better understanding of what might be some obstacles or disadvantages that a person is facing. And when we can do that we can start to help someone on a deeper level.

Intersectionality and Health Care?

The extent to which identity formation is creating emotional, physical, or social distress is a consideration for health care providers. Using a client-centered approach is one method to examine this.

The provider's self-awareness is equally as important as understanding the many facets of the LGBTQ+ individual.

The provider should strive to have an awareness of the potential range of identities and that these identities come together to create a unique experience for the patient.

The provider should seek to understand, explore, and listen to the patient's meaning, perspective, and impact of these identities.

Having self-awareness allows the provider to incorporate how their own views impact and set expectations of who their patients are and should be. Further understanding of the social, psychological, and identity issues of the patient provides a rich opportunity to support patient engagement and positive mental and health outcomes.

What policy does VCOM have for equal opportunity policies according to the national standards?

Equal Opportunity Policy (Statement)

If you have a discrimination issue, what VCOM policy helps you?

Acts of Discrimination, Harassment and Violence Policy by VCOM

What constitutes discrimination?

Discrimination is an act of making distinctions between people based on the person belonging to or being from a certain group such as religion, race, ethnicity, sexual orientation, disability or other categories to which they are perceived to belong.

VCOM had adopted a zero-tolerance to inappropriate behavior exhibited as an act of discrimination

What Constitutes Harassment?

Commonly understood as offensive behavior that demeans, humiliates, embarrasses, annoys, intimidates, alarms or threatens someone and is characteristically identified as being unacceptable in terms of social and moral reasonableness.

VCOM has zero tolerance for harassment, whether based on a protected classification or not.

What is always considered unacceptable behavior?
This includes physical contact through any act of violence, physical control, and/or intimidation through threat of violence.

_________ ______ includes unwanted sexual contact through intimidation, physical control, and extends to an act of sexual contact with a person who is incapacitated to the point of being unable to voice consent or their lack of consent.

Violence

Sexual Violence

What does sexual violence encompass?

Sexual violence encompasses several categories including rape, sodomy, and sexual assault by a person or with an object and includes the crimes of dating violence, domestic violence, sexual assault, and stalking.

What is sexual assault?

Sexual assault for purposes of this policy is any type of sexual contact or sexual behavior that occurs without the explicit consent of the recipient.

Title IX Brief History? (5 points)

1) TITLE IX OF THE EDUCATION AMENDMENT OF 1972 (amended the Higher Education Act of 1965) and states "NO PERSON IN THE UNITED STATES SHALL, ON THE BASIS OF SEX, BE EXCLUDED FROM PARTICIPATION IN, BE DENIED THE BENEFITS OF, OR BE SUBJECTED TO DISCRIMINATION UNDER ANY EDUCATION PROGRAM OR ACTIVITY RECEIVING FEDERAL ASSISTANCE."

2) When TITLE IX was signed in 1972, the purpose was focused on equity and access for female student, particularly as it pertained to athletics, financial aid, and admissions.

3) Over the years this was expanded to include protections against sexual harassment and sexual violence, as well as gender discrimination against transgender students and pregnant students.

4) Title IX is a living and breathing document, with currently, over 20 suggested amendments to the law.

5) New requirements have been added in recent years to ensure that colleges prevent, respond to, and remedy sexual misconduct.

The Clery Act

The CLERY ACT requires institutions of higher education to report crime statistics, notify the campus community of threats, and compile and distribute (or post) an annual campus security report to the campus community, prospective students, and employees.

The CLERY ACT was created after ..?

1992- amended to require ...?

1998- amended and renamed the ...? Increased the categories of reportable crimes.

2000- amended to require institutions to provide information on the state's public ...?

...a student named Jeanne Clery was raped and murdered in her dorm room by a fellow student at Lehigh Univ. in 1986.

....the development and implementation of policies and procedures to protect the rights of sexual assault survivors.

....Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act

...sex offender registry and allowed the disclosure of registered sex offender information without violating privacy laws.

2008- after the 2007 Virginia Tech shootings...?

2013- amended again as part of the reauthorization of what Act? What does it incorporate? Increased reportable crimes including ....? What else did it increase?

...the Clery Act was included within the new Higher Education Opportunity Act of 1965 and amended to include new regulations re: emergency notifications and response, timely warnings, missing student notification, fire safety reporting, and hate crime reporting.

Violence Against Women Act (VAWA) which incorporated provisions of the Campus Sexual Violence Elimination
Act (SAVE).
domestic violence, dating violence, sexual assault, and stalking. Also increased the rights of victims.

2016 - following the Penn State sex abuse scandal of young boys sexually abused over several years. What happened as a result?

2019, following the investigation of the case of Larry Nassar at Michigan state, ...?

Many ____ were filed at the state level by Institutions of Higher Education as they believed the states were moving the responsibilities of the courts (in deciding guilt) to the colleges and universities.

The Department of Education conducted the most extensive investigation ever conducted. Penn State was also fined 2.4 million dollars
2019, following the investigation of the case of Larry Nassar at Michigan state, the University was fined 4.5 million dollars, the largest ever Clery Act penalty. During the 2018 - 2019 period several states' higher education accrediting bodies along with the Dept. of Education, increased their reporting requirements on sexual crimes.

...the University was fined 4.5 million dollars, the largest ever Clery Act penalty. During the 2018 - 2019 period several states' higher education accrediting bodies along with the

appeals

Department of Education (DoE) Title IX Final Rule vs clercy act

burden on who?

Contains many of the policies, definitions and provisions of the Clery Act, however the process and procedures for
reporting have been changed and are now specifically limited.

The new rule specifically places undue burden on the victims as well as institutions.

Many appeals to the new rule have already been filed.

VCOM Policy on Sexual Harassment - How is this one policy with two procedures?

VCOM'S Policy on Discrimination, Harassment and Violence is much broader than the federal laws, incorporating them and prohibiting unprofessional and unethical conduct not covered by constitutional protections but expected of a physician.

Cases of alleged sexual harassment will proceed under the procedures set out in the Title IX Final Rule. All other cases of alleged Discrimination, Violence, and Harassment violations of the VCOM Policy will proceed under the College's procedures for the Discrimination, Harassment and Violence Review Committee.

As future Physicians you are held to a higher standard; by VCOM and by Medical Boards in the future.

SEXUAL HARASSMENT (Dept. of Ed TITLE IX Final Rule)Conduct on the basis of sex that satisfies one or more of the following: (3)

1) An employee of the recipient conditioning the provision of an aid, benefit, or service of the recipient on an individual's participation in unwelcome sexual contact; or

2) Unwelcome conduct determined by a reasonable person to be so severe, pervasive and objectively offensive that it effectively denies a person equal access to the recipient's education program or activity; or

3) Sexual assault, dating violence, domestic violence, or stalking

VCOM Policy on Sexual Harassment - SEXUAL HARASSMENT (TITLE IX) is conduct on the basis of sex satisfying one or more below: (3)

1) An employee of an institution conditioning the provision of an aid, benefit, or service of the institution on an individual's participation in unwelcome sexual contact.

2) Unwelcome conduct determined by a reasonable person to be so severe, pervasive, and/or objectively offensive that it effectively denies a person equal access to the institution's educational programs or activities.

3) Sexual assault which includes dating violence, domestic violence, and stalking.

What are 3 things we need to consider for the Final Rule issue?

1) The conduct complained of must have taken place against a person in an educational program or activity of VCOM in the Unite States.

2) For purposes of Title IX the "education program or activity" includes when the sexual harassment has occurred in an educational program, event, or in a facility owned by VCOM or where VCOM had substantial control over the location and the respondent.

3) These limitations do not apply to VCOM policies.

How does VCOM define consent?

• Consent is informed-
• Consent is an affirmative
(Yes means Yes and No means No)
• Consent if knowing and unambiguous, and
• Consent is a conscious decision
where each participant engages in mutually agreed-upon sexual activity.