‘It Starts With Us’ Has Launched

Introducing Upstander Engagement: the model chosen by the Faculty of Medicine to help us build a strong, safe, and supportive community

It Starts With Us

Learn more about It Starts With Us: an interactive series of presentations, round table discussions, and workshops.

Thank you to everyone who joined us on February 24th for the launch of the It Starts With Us series. The first session introduced the principles of Upstander Engagement: encouraging members of our community to stand up against injustice for themselves and for others. You can read more about Upstander Engagement here.

Anyone who was not able to join us can view the recording here.

The session was well attended and the engagement during the presentation was exciting. We have already learned that in future events we need to devote more time for questions and discussion. Our panel has answered the questions that remained in Slido at the close of the event; you can read our responses below.

We appreciate your thoughtful comments and questions, and look forward to offering you more events to continue this important conversation.

Launch Event: Questions & Answers

The Faculty of Medicine has established a robust system for responding to learner mistreatment complaints. We have a dedicated website with an online and in-person reporting system for anonymous and confidential reporting of experiences of mistreatment or other conduct that negatively affects the learning environment. Reports can be made by witnesses and by groups of learners. Other ways to raise concerns are described on the website.

While there are many points of entry into the reporting system, the Respectful Environments, Equity, Diversity & Inclusion (REDI) office is the designated triage point responsible for gathering data about learner concerns so that we may identify patterns of conduct, ensure alignment and consistency in responses, and monitor our progress.

REDI has a Learning Environment Advisor who contacts learners who provides contact information. The Learning Environment Advisor ensures that the learner has support and discusses options for managing the concern. Reporting a concern does not oblige a learner to proceed any further. The Learning Environment Advisor will triage the report and assist/guide/support the appropriate designated persons responsible for addressing mistreatment and learning environment issues. Except in cases of risk to safety of learners, the Learning Environment Advisor will only discuss the concern outside of REDI within the scope of consent provided by the learner. The Learning Environment Advisor will maintain contact with the learner and will provide feedback, within the constraints of privacy legislation, on the outcome of the response to the concern.

REDI is working with decision makers within the Faculty of Medicine to identify ways of dealing with reports without placing the burden of filing a formal complaint on the learners.

REDI is working with Human Resources within the Faculty of Medicine to establish a parallel system for faculty and staff to for reporting and addressing concerns about disrespectful, racist and other inappropriate conduct in the working environments. We are developing a website and will clarify processes for reporting concerns and ensuring a fair process in response to those concerns.

We hope to have the faculty and staff website established over the next few months.

Fear of reprisals or retaliation is one of the biggest barriers to speaking up. Power imbalances in the Faculty of Medicine are real and, in the past, individuals have recounted experiences of speaking up and suffering some negative consequence. Retaliation is prohibited both in the Faculty and University polices. We will investigate reports of retaliation and, if established, there will be disciplinary action. We cannot establish safe spaces for all voices to be heard until we address this issue.

On a positive note, we have participated in many successful interventions in which persons in positions of power have listened, learned, and changed behaviour as a result of being ‘called in’.

REDI and the Faculty of Medicine take all complaints seriously and, provided we have sufficient information about the experience, we will follow up. We have several options for intervention and not all require formal investigations in which findings of fact are made, based on a balance of probabilities.

REDI and the Faculty of Medicine are committed to fair process for all persons involved in the resolution of a reported concern. We ensure not only that the person reporting is listened to, heard, and supported but also that the person about whom the complaint is made has an opportunity to respond to the concerns.

Our primary goal is to change behaviour through our interventions. There are situations where this is not possible or where the behaviour is egregious, demonstrates a pattern of conduct, or is not responsive to remediation. In these cases, disciplinary action may be appropriate.

These steps are taken in accordance with the Faculty of Medicine’s obligations under existing policies and agreements with employee associations.

You are correct - it is not too late to act. In our experience, those in power will act when given sufficient support and guidance. Traditionally, people have been appointed to leadership roles based on their expertise in other areas but not always based on abilities in managing people, navigating conflict, or embracing diversity. We are working to address this in two ways. First, by supporting leaders in further developing these abilities. Second, we are engaged in systematic and structural interventions such as ensuring that these abilities are embedded in job descriptions, and taken into account in performance reviews and promotion in leadership.

It takes time and patience to deal with a situation in which inappropriate behaviour has gone unchecked and sometimes it is easier to turn a blind eye. This cannot continue if we are to transform our culture.

In my experience, anonymous complaints are limited, but they can be useful. Sometimes anonymous complaints indicate a pattern of conduct in an individual or in a unit. In the education environments the Associate Deans monitor exit surveys and internal and external review reports so that they can take appropriate action when patterns are revealed.

We also ensure that we raise concerns raised in an anonymous report with those responsible for the learning or work environment to alert them to potential issues. This can result in an institutional inquiry or environmental scan to obtain confidential information upon which an intervention strategy can be based. Once someone “turns the lights on”, even if anonymously, we have to inquire, as best we can, to determine whether there are steps we can take to address the situation. Of course, the more detailed information we have the better equipped we are to inquire. In my view a confidential report is more effective than an anonymous report and we work with learners who make confidential reports to protect their personal information, and in some cases, keep their identity anonymous.

Upstander or Active Bystander engagement has been used in various campaigns since the late 1990s, although the principles underlying the model are also present in social justice activities, in which the power of individual actions is harnessed to make change, for much longer. The model has been used to reduce bullying, sexual harassment, sexual violence, racist comments and conduct – any situation where there is power-based personal violence.

The Green Dot campaign, begun in 2006 in Kentucky high schools, was the subject of an influential 5-year study by Dr. Anne Coker published in 2017 in the American Journal of Preventive Medicine. Dr. Coker found that the campaign – which encouraged participants to find their green dot, a behaviour or act that promotes safety for everyone in the community, – reduced rates of sexual abuse, dating violence and interpersonal violence by a statistically significant percentage.

There are myriad variations of the Green Dot campaign across the US, the UK, Europe, and Canada. Multiple studies attest to the effectiveness of Active Bystander or Upstander training.

Upstander engagement is but one strategy we will employ in our efforts to change our culture. We know that systemic changes are needed. No single strategy or intervention will be effective on its own. Addressing structural and systemic barriers will enhance the effectiveness of our behavioural changes. We will monitor both.

I apologize that the focus on being calm when responding to offensive or oppressive comments or behaviour was perceived as tone-policing or indicated a failure to recognize that these situations can, and do, provoke anger.

When oppressed people speak about their experiences with racism, microaggressions, and discrimination, the substance of the message must be heard however it is delivered. To the extent that tone-policing criticizes displays of emotion and inhibits honest dialogue, it has no place in our environments.

Given the increased incidences and potential risks of speaking up marginalized people experience, we also want to acknowledge the significant impacts prolonged and recurring distress takes on our bodies, emotions, and relationships.   We want to encourage the prioritization of self-care without adding the additional burden of response to those who find themselves experiencing high levels of distress.  Please to reach out for support from friends, community, and our faculty first; courage takes many forms and upstander engagement is not always immediate.

I will revisit this section of the presentation to balance the suggestion for an upstander to cultivate calm as a mechanism to maintain their sense of safety and agency with the invitation to express themselves authentically.

We welcome any additional comments on how this messaging can be improved.

The transforming culture initiative focusses on both interpersonal and systemic interventions to reaching our working and learning environment goals. We have a steering committee which will consider all the Faculty commitments under our framework documents such as the UBC Inclusion Action Plan, the UBC Indigenous Strategic Plan, and UBC Strategic Plan, along with the Faculty of Medicine Strategic Plan and our actions spelled out in the Response to the TRC Calls to Action. We have also received a number of recommendations for change from community groups or reports such as the In Plain Sight report of the independent investigator Dr. Mary Ellen Turpel Lafond. The committee will review these recommendations and in collaboration with working groups across the Faculty in admissions, curriculum, human resources, research to implement as appropriate and as possible.

Our current situation reflects the persistent impact of historic systems of oppression, patriarchy, and unearned privilege. The current representation in leadership roles cannot be explained by a lack of talent amongst women, LGBTQ, or BIPOC folks. It reflects our hiring, recruitment, and retention efforts. Changing the leadership balance is a challenge. Progress will not be linear or even. Certainly, the presence of women in leadership positions has changed, although more change is needed. The current slate of leaders may be relatively set – although changing circumstances will create new entry points. The queue in our current pipeline can be changed. Hiring and promotion processes are being reviewed through an equity, diversity and inclusion (EDI) and anti-racism lens so that they can be changed to more effectively recruit and retain a more diverse population amongst our faculty and staff.

At minimum, we must work toward preparing the next generation of leaders, ensuring diversity, inclusivity and equity. One way in which we will work to achieve this is to increase mentoring. We will also continue to encourage examination of other ways to identify leaders.

As one of our commenters noted: “I think the successful transformation would need commitment, deliberate strong leadership support, accountability, fear of consequences, balancing power, an independent support group for each unit (composed of a diverse panel) and more!”

One of the Dean’s Task Force on Respectful Environment recommendations challenged us to incorporate EDI criteria into promotions and awards processes. Community stakeholders have also identified this deficiency. Promotions for faculty are governed by the collective agreement but we are looking at ways to include performance in relation to EDI principles and actions in the consideration of awards and promotions.

It Starts With Us appeals to, and applies to, everyone in our community. As Dean Kelleher noted each of us must live the Faculty values. That includes leadership throughout the Faculty and each of us must be held accountable.

You may be surprised by how many people in power from all groups have experienced poverty.

For learners in particular, the challenge is to ensure that we have mechanisms in our processes to account for disparities in socioeconomic status amongst our applicants. The Undergraduate Medical Program has undertaken several steps to expand the reach of our application process. More financial support through scholarships and bursaries are also needed.

In addition to Faculty-wide initiatives such as the It Starts With Us series, REDI is working collaboratively with Faculty Development, Faculty of Medicine education programs, and the UBC Equity and Inclusion Office to create education, training, and skill building resources to support respectful environments, anti-racism, and equity, diversity and inclusion at the unit, department, division, school and centre levels.

We are in the process of hiring an Anti-racism advisor and an Indigenous Advisor who along with the Learning Environment Advisor will work collaboratively across the Faculty to support the development and delivery of robust programs for faculty, staff, and students.

The Faculty is working to obtain funding to make cultural safety and humility training through UBC 23 24 available to all learners, staff, and faculty.

We received feedback to improve future Q&A sessions, including providing more time! We will incorporate the feedback into our upcoming sessions and will continue to look for ways to engage our community in these important, and sometimes uncomfortable, situations. We are looking at ways to include taking live questions from the audience to promote greater dialogue and holding sessions with alternative formats that could be more conducive to dialogue.

Consideration is being given to the question of whether some aspects of training should be mandatory. Some of the training will be incorporated into curricula and onboarding programs. Participation in equity, diversity and inclusion (EDI) training and activities may be incorporated into criteria for certain positions within with the Faculty.