ASDE Winter Newsletter

Newsletter Winter 2021 A Section of the American College of Dentists Mission Statement The mission of ASDE is to lead education and scholarship in dental ethics.

Core Values of ASDE Leadership Community Education Collegiality Scholarship Service Professional integrity Officers President: Odette Aguirre (2022) President Elect: Kathryn Ragalis (2022) Treasurer: Phyllis Beemsterboer (2022) Past President: Frederick More (2022) Members at Large: Carlos Smith (2023), Regina Messer (2023), Terrence Hoffeld (2022), Robert Stevenson (2022) ACD Liaison: Toni Roucka Executive Director: Frederick More

Reminder on ACD Journal Ethics Section The Journal of the American College of Dentists is now published electronically online at www.acd.org The Journal has an ethics section and one does not have to be an ACD member to access it as it is outside the firewall.

ASDE Business Meeting Held Virtually The Board continues to meet virtually and is hoping and planning on a face-to- face meeting in 2022.

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ACD/ASDE and the Academy of General Dentistry In 2018 we began a collaboration between Academy of General Dentistry (AGD) and the American College of Dentists (ACD) to write ethics columns for their publication AGD Impact. We will reprint some of those columns in future ASDE Newsletters.

Bullying in the Workplace and Classroom – Increased Awareness is Necessary Toni M. Roucka, RN, DDS, MA, FACD September/October 2019

Bullying incidences in the workplace and in the classroom are on the rise. There is no place for bullying within any environment, let alone a learned profession like Dentistry. It is important to understand what constitutes bullying, who bullies are and how to intervene when bullying issues arise in the office and classroom environments. While it may be difficult to think of challenging coworkers, employees or professional students as bullies, sometimes in fact that is exactly what they are. All members of the dental profession have a shared responsibility to protect the integrity of the work and academic environments and prevent and or stop bullying.

“Bullying” is defined by the American Psychological Association as “a form of aggressive behavior in which someone intentionally and repeatedly causes another person injury or discomfort. Bullying can take the form of physical contact, words, or more subtle actions.”1 When bullying occurs, by nature, there is a power differential at play. The bully either has or is perceived to have, power over the victim in some way.

The bully, for instance, may be the owner dentist, or a dental school faculty member.

On the other hand, a bully might be a very

intelligent but selfish student who is perceived by another student (the victim) to be superior to them in some way.

What all bullies have in common is the need to feel superior over others in order to satisfy their own feelings of inadequacy.

When a bully acts against another person, for a fleeting moment, they feel superior.

Because the feeling does not last, they repeat the behavior.2 Common types of bullying include; • Verbal Bullying - name calling, unwelcome teasing, shaming, insults, etc.

• Social Exclusion – leaving someone out on purpose or spreading rumors • Physical Bullying – physically harming someone or their property or using intimidating body language against them • Cyberbullying – using electronic devices and or social media platforms to post damaging comments, photos etc. against another person. The effects of cyberbullying on an individual can be devastating as the broadcast net of disparaging remarks can be very broad and involve many people.

• Covert bullying – passive aggressive behavior that is insidious, such as mimicking to ridicule, condescending looks, and sabotage.

Different types of bullies vary in their modioperandi, but as mentioned above, their objective is always to make themselves dominant over another.1, 2 Bullies may be narcissistic and premeditate their actions, impulsive an react under stress, or secondary and jump on another bully’s bandwagon in order to avoid being bullied themselves. Regardless of the type of bully, their actions are hurtful and harmful. Often, adult bullies have been bullied themselves.

In the dental school and dental practice environments, there are natural power differentials. Faculty have power over students regarding grades. Senior faculty and administrators have the ability to make or break a junior faculty member’s career.

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More experienced practitioners often have authority over new graduates in a practice, and dentists in general have power over office staff. All of these relationships have the potential to create or propagate a bullying situation. Consider the “old-school” approach to dental education, where a faculty member might destroy a student’s subpar wax-up to create a “learning moment”. That type of approach to teaching is not conducive to learning and may influence a future dental educator or employer to act similarly, perpetuating the cycle.

The prevalence and costs of adult bullying is somewhat shocking. In one survey, almost one in three Americans (31%) admit to having been bullied as an adult. 43% say the behavior is becoming more accepted. 3 Many of these incidences occur in the workplace or school environments. The health impact of bullying in America is significant. Adults who have been bullied can suffer from stress, anxiety / depression, loss of confidence, loss of sleep, headache, mental breakdown and an altered ability to function at work or school. Other issues include GI changes, nausea, hypertension and other diseases3.

It is estimated that in the US, the economic impact of bullying amounts to a minimum of $250 million dollars related to costs involving healthcare, litigation, staff retraining and lower productivity in the workplace.4 Dental practice and dental education are not exempt from the toll paid for this behavior, however, the exact impact is unknown. Employees and students who are bullied are less motivated at work / school, go to great lengths to avoid unpleasant situations, call in sick or miss class more often and consider leaving their jobs or quitting school. Employers and universities may also be liable for legal costs resulting from the mistreatment of employees or students.5 In 2013, the Commission on Dental Accreditation (CODA) recognized the need for ensuring that the educational environment for students, faculty and staff is "humanistic" in nature by instituting an

accreditation standard. CODA 1-3 states, "The dental education program must have a stated commitment to a humanistic culture and learning environment that is regularly evaluated:'6 Because of this mandate, most dental schools have instituted policies and procedures that give students, faculty and staff recourse when bullying occurs.

Similarly, dentists practicing in institutional settings like community health centers or hospital environments may have similar policies and procedures that protect them against bullying and harassment. When policies are in place, it is easier for victims of bullying to take action and utilize available resources, and they should do so.

This is often easier said than done, but bullying that goes unchecked may continue indefinitely.

In private practice, it is up to individual practice owners to set standards and policies against bullying and harassment.

Developing a practice mission statement that includes verbiage supporting a humanistic environment is a good start.

Monitoring office morale and keeping communication open between supervisors and staff, including young colleagues, are important. Catching problems early and intervening with mediation or disciplinary action against bullies will set a tone of zero tolerance and enable office staff to feel supported. Employees who feel discriminated against may take advantage of federal laws that protect against workforce discrimination, such as laws enforced by the U.S. Equal Employment Opportunity Commission.7 If possible, it is best to manage these situations before they escalate to this level.

Becoming aware of what adult bullying is and how it affects students, workers and society as a whole is the first step toward stopping and preventing it. Each individual must take responsibility for ensuring that their own behavior and that of their peers are collegial and professional. By structuring institutions to prevent bullying and educating victims how to properly handle it, our society can move toward being more inclusive of everyone.

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References: 1.

Ni, Preston. "S Ways that Adults Bully Each Other." Psychology Today, 22 Jan. 2017, www. psychologytoday.com/us/blog/communic ation-success/201701/5-ways-adultsbully each-other. Accessed 3 July 2019.

2.

U.S. Government. Stop Bullying, www.stopbullying.gov/. Accessed 3 July 2019.

3.

"Adult Bullying: Survey Finds 31% Of Americans Have Been Bullied As An Adult." Doctors of Osteopathic Medicine, doctorsthatdo.org/adult-bullying-surveyfinds-31-americans bullied-adult.

Accessed 3 July 2019.

4.

More, Frederick et al. "Working Together to Prevent Bullying Recognize, Address, STOP!" 2019 ADEA Annual Session & Exhibition - Celebrating Our Collaborative Spirit, Chicago, 18 March 2019, Hyatt Regency Chicago.

Conference presentation.

5.

Wajngurt, Clara. "Prevention of Bullying on Campus." American Association of University Professors. May-June 2014, www.aaup.org/article/preventionbullying-campus. Accessed 10 July 2019.

6.

Commission on Dental Accreditation.

"Accreditation Standards for Dental Education Pro grams." American Dental Association, www.ada.org//media/CODA/Files/pde.pdf. Accessed 10 July 2019.

7.

"Laws Enforced by EEOC." U.S. Equal Employment Opportunities Commission, www.eeoc. gov/laws/statutes/.

Accessed 10 July 2019.

With acknowledgment of the contributions of Drs. Frederick More, Herminio Perez, Juliette Daniels and Professor Pamela Zarkowski.

Check Your Ethics Vocabulary What does pusillanimous \pyoo-suh-LANuh-muhs) mean?

A. Lacking in courage and resolution; cowardly B. lacking in character, directness, or moral or emotional strength: C. unmoved by persuasion, pity, or tender feelings; stubborn.

D. characterized wickedness; sinful.

Answer provided at the end of the Newsletter.

Reflection Quote "Learn from yesterday, live for today, hope for tomorrow. The important thing is to not stop questioning."

Albert Einstein

Book Suggestion Justice: What’s the Right Thing To Do? By Michael J. Sandel Published by Farrar, Straus and Giroux. 2009.

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Membership We encourage dental, dental hygiene and advanced program educators, as well as dental and dental hygiene practitioners to join ASDE. If you are a member, encourage your colleagues to join.

For membership applications please use the following addresses at the ACD office:  Mail submissions: ASDE Membership

American College of Dentists 103 North Adams Street Rockville, Maryland 20850 301-977-3223 ~ office@acd.org

 Email Submissions: office@acd.org

Check Your Ethics Vocabulary Answer is A

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