3. Due Process Procedures for Responding to Problems in Trainee Performance 

Occasionally, trainees encounter learning difficulties or problems in performance.  The types of performance problems that trainees display fall into three non-exclusive categories.  The first category, which will be referred to as “non-compliance,” reflects a supervisee’s failure to behave in a manner that is consistent with ethical guidelines, UCS or university policies, and/or supervisors’ directives.  The second type of problem arises when a student has difficulty mastering expected skills.  The third type arises when a trainee’s performance slips from a level attained previously, because of a trainee’s inability to manage personal stress, emotional reactions, or psychological disorder.

• a. Formal Notice. Formal notice is tied to completion of the evaluation form appropriate to the training level.  This could be triggered at any time during the semester, and at the earliest possible point.
  • (1) Notice in Response to Non-Compliance or Ethical Concerns.  
    • The supervisor(s), UCS Practicum Coordinator (when the focus of attention is a practicum student), and the UCS Training Director will evaluate non-compliance or ethical issues immediately.  The trainee is given written notice about the behavior(s) of concern, which will be shared with the appropriate representative of the program department (e.g., course instructor for practicum students, departmental Director of Clinical Training (DCT) for interns, UCS Administrative Supervisor for UCS staff member).  The program representative will be invited to share their input about best course of action. 

    • In the case of a serious breach by an intern, practicum student, or post-degree staff member, the UCS may suspend clinical privileges immediately.  Depending on the outcome of the hearing described below, the trainee’s clinical privileges may not be reinstated.  At the point at which the decision is made NOT to reinstate clinical privileges, the trainee will be terminated from the training position. 

    • If a trainee engages in an action that is concerning, but is not at the level of "a serious breach," the UCS may institute a remediation plan.  For practicum students, they may be in collaboration with or separate from the sponsoring department's remediation process.  

    • If a clinical supervisor believes that an unlicensed staff member supervisee has engaged in unethical behavior, the clinical supervisor notifies the individual's administrative supervisor, who then follow UI's HR policies and procedures.

  • (2) Notice in Response to Problems in Skill Development for Practicum Students

    • Supervisors provide all trainees with verbal feedback about their skill development throughout the course of the semester.  When supervisors, in consultation with the UCS Coordinator of Practicum and the UCS Training Director, note that skill development on one or more of the competencies delineated in the evaluation form is occurring at a notably slower than typical pace, the trainee is provided with feedback in writing.  A member of the UCS training staff, most often the Training Director, consults with the appropriate representative(s) of the graduate program (e.g. course instructor(s), placement coordinator, etc.) to determine the best course of action, which could include collaborating with the graduate program to implement the graduate program's due process plan.

  • (3) Notice in Response to Problems in Skill Development for Interns. 

    • When a supervisor, in consultation with the UCS Training Director and the intern's primary clinical supervisor, note that the intern's level of performance on one or more of the profession-wide competencies (PWCs) is below expected levels, the intern is provided with written feedback describing the concern.  The Training Director drafts the written notice, in consultation the intern's primary clinical supervisor.

       

  • (4) Notice in Response to Problems in Skill Development for Unlicensed Staff Members 

    • Clinical supervisors provide all supervisees with verbal feedback about their skill development throughout the course of the semester.  When a primary clinical supervisor concludes that skill level on one or more of the competencies delineated in the evaluation form is at a notably lower than expected level, the staff member is provided with feedback about this in writing. The supervisee's administrative supervisor is provided with a copy, so that it can be integrated into the supervisee's personnel evaluation. Written feedback may be accompanied by a performance improvement plan which should be drafted in compliance with university HR policies. The administrative supervisor should notify the department's HR representative if a staff member will be placed on a performance improvement plan. The department's HR representative should also be notified if a staff member's performance will result in a performance review rating lower than "Meets Expectations."

  • (5)   Notice in Response for Difficulties Managing Personal Stress

    • When the clinical supervisor observes that a trainee's performance is falling below expected levels because of inability to control personal stress, psychological disorder, and/or strong emotional reactions that interfere with professional functioning, the clinical supervisor integrates feedback into a written evaluation.  For practicum students, a member of the UCS training staff, most often the Training Director, consults with the appropriate graduate program representative (e.g. practicum course instructor(s), practicum placement coordinator) to determine the best course of action, which might include collaborating with the graduate program to implement the graduate program's due process plan.  For a supervisee who is employed as a staff clinician, the administrative supervisor is provided with a copy of the clinical supervisor's written evaluation, so that the administrative supervisor can incorporate it into the personnel evaluation process.  When the supervisee is an intern, the trainers proceed with next steps of the due process procedures, described below.

    • Notice of difficulty managing stress will be considered when the quality of the services delivered by the trainee is sufficiently negatively affected, the problem is not restricted to one area of professional functioning, the trainee does not acknowledge, understand, or address the problem when it is identified, and/or a disproportionate amount of attention is required of training personnel.

• b. Hearing. 

  If clinical privileges have been suspended, interns and practicum students are entitled to an informal hearing in which they present their response to descriptions of non-compliance.  Interns and practicum students are entitled to the same type of hearing if presented with ratings indicating inadequate performance.  The trainee presents their response to the group of people who determine the UCS action; the group includes the clinical supervisor(s), the UCS Practicum Coordinator (when focus of attention is a practicum student), the UCS Training Director.  
  
  UCS supervisors' participation in graduate programs' due process policies may also involve a hearing.  The nature and description of the hearing would be specified in the graduate program's policies.

• c. Remediation Plan for Interns. 

  Unless clinical privileges have been terminated in response to an ethical concern, the TD, in collaboration with the supervisor(s) and the trainee, develop a remediation plan.  A remediation plan outlines responsibilities of the intern, the supervisor(s), and the Director of Training.  It includes a plan for continued monitoring, and a deadline for further review, to be no later than the next evaluation period.  Possible alterations of the curriculum include reduced caseload, increased supervision, additional reading assignments, and/or adjustment in the focus or process of supervision.  Adjustments in caseload will be noted in any written evaluation.  In cases in which client welfare is seriously in question, suspension of clinical privileges may be initiated or continued.  A leave of absence and/or additional training experiences may be required.  Personal counseling outside of the UCS may be recommended as a resource to help the trainee manage more effectively.  However, counseling will not be mandated.  The trainee will be evaluated based on their performance within the training environment.

• d. Remediation Plan for Practicum Students.

  In response to ethical concerns that have the potential to lead to a practicum student's subsequent dismissal from practicum, unless clinical privileges have already been terminated, the Training Director, the supervisor(s), and the trainee may develop a remediation plan.  UCS trainers apprise the student's program representative(s) and invite them to collaborate to develop the plan.  The plan outlines responsibilities of the student, the supervisor(s), and the Training Director.  It includes a plan for continued monitoring, and a deadline for further review, to be no later than the next evaluation period.  

• e. Outcome.

  At the next review period, the supervisor(s) complete(s) an additional evaluation.  The remediation plan is updated to include the decision that the supervisor(s) reach regarding the outcome.  If the issue is resolved, the trainee either continues with the training experience or completes it successfully, if it has reached its planned termination. 

  If the issue is not resolved, the trainee may either 1) continue remediation until the next specified review period, or 2) be terminated from the training experience. When a doctoral intern is the subject of an unresolved remediation plan, the Training Director must acquire permission from APPIC to release the UCS from the Match Agreement prior to a decision to terminate the internship. When a practicum student the subject of an unresolved remediation plan, the Training Director will consult with appropriate representatives from the graduate program prior to terminating the practicum placement.

  In most cases with practicum students, the departmental representative is directly involved in a collaborative plan.  If the UCS conducts an independent remediation process, the departmental representative is informed about the outcomes of the remediation plan(s); the TD sends the evaluation and written outcome of the remediation plan.  During the communication, the departmental representative is invited and encouraged to arrange a telephone consultation with the TD. 

• f. Appeal Process available to Interns.

  The intern may accept the terms and outcome of the remediation plan, or they may appeal it. An intern may appeal by informing the Training Director in writing.  The intern has five working days after receiving either the terms of a remediation plan or the outcome of the plan to appeal the decisions.  If the Training Director serves as a clinical supervisor, the TDTraining Director will identify a designee, a licensed psychologist and member of the UCS training staff to chair the review panel described below.  Upon receipt of an appeal, the following process will be implemented:

  (1)   The Training Director will convene a Review Panel consisting of the Training Director, a Training staff member selected by the Training Director, and a Training staff member selected by the supervisee.

  (2)   The Review Panel, chaired by the Training Director, will hear the supervisee’s appeal and their supporting evidence.

  (3)   The supervisee has the right to hear all observations presented about their performance and has the opportunity to present their view.  The Review Panel will submit a report to the Director of the UCS including any recommendations for further action.  The supervisee will receive a copy of the report.  The supervisee is informed of the recommendations.

  (4)   The Director of the UCS may accept the Review Panel’s action, reject the Review Panel’s action and provide an alternative, or refer the matter back to the Review Panel for further deliberation.  If the last option is chosen, the Review Panel will submit a report of the further deliberations back to the Director, with a copy to the supervisee.  The Director will than make a final decision regarding the action to be taken.

  (5)   The Training Director, evaluator, supervisee, sponsoring department, and other appropriate individuals are informed in writing of the action taken.  The supervisee may submit a written response.

The UCS staff may be informed of the impending departure of a trainee upon the deadline for appeal, or if an appeal is received, upon the denial of an appeal.   

D.  UCS Grievance Procedures for Receiving and Responding to Trainee Complaints 

1.   Policy

To protect the needs and rights of all trainees and staff members/supervisors, a formal complaint procedure has been developed.  Giving feedback to staff member/supervisors or the Training Director is encouraged.  Likewise, staff members/supervisors are encouraged to create an environment that facilitates open dialogue and feedback. While it is hoped that any concerns or complaints can be discussed and resolved informally, a formal mechanism is appropriate given power differences between supervisors and trainees.

2.   Procedures 

If the complaint is related to the outcome of a remediation review, the trainee should utilize the appeal process described in IV.B.3f above.  Procedures covered in this section may be initiated in the two following situations:

• a trainee has a complaint about a staff member/supervisor regarding a circumstance other than evaluation.
• When a trainee has a complaint concerning another trainee.
  • a. Complaints Regarding Training Environment
    • (1)   The trainee is encouraged to speak directly with the staff member/supervisor involved for a resolution.
    • (2)    If the situation is not resolved, or if the trainee prefers not to speak directly to the staff member/supervisor, the trainee may discuss the complaint with the TD.  If the TD receives a complaint in writing, Training Director must review the complaint and determine whether policies in the UI Operations Manual or the UCS Staff Manual have been violated.  If the Training Director receives a verbal complaint, that if verified, would violate UCS or UI policies, the complaint will be investigated.  All UI Operations Manual and UCS Staff Manual policies will be followed.
      • (a)   In the case of a complaint concerning a Merit staff member, the Training Director will consult with the administrative services coordinator (administrative supervisor) prior to developing plan(s) of action.
    • (3) Complainants will be provided with referral information about the UI Office of the Ombudsperson and the Office of Civil Rights Compliance.
    • (4)  In the event that the complaint is against the Training Director, the trainee should discuss the complaint with the Director of the University Counseling Service.  The Director will implement procedures 1-2 outlined above to resolve the complaint, with the UCS Director replacing the Training Director or appointing a designee for that role.
    • (5)  In the case of a sexual harassment complaint, the trainee will be referred to The University of Iowa Policy on Sexual Harassment http://www.uiowa.edu/~our/opmanual/ii/04.htm and the policy on Consensual Relationships Involving Students http://www.uiowa.edu/~our/opmanual/ii/05.htm which identifies University resources for advocacy and filing a complaint, including the Office of Sexual Misconduct.  When UCS administrative supervisors become aware of reports of behaviors that violate the UI sexual harassment policy, they are required to file a report with the Office of Civil Rights Compliance who will investigate instances of sexual misconduct.  Administrators also provide mental health services, and when they function as mental health clinicians rather than as supervisors, their clinical work is confidential.
  • b. Review Procedures / Hearing
    • When needed, a Review Panel will be convened by the Training Director (or Director). The role of the Review Panel is to review a grievance filed by the trainee.
    • The Training Director (or Director) will convene a Review Panel consisting of two staff members selected by the Training Director and a staff member selected by the trainee/complainant. The Training Director (or Director) will serve as the Chair of the Review Panel.
    • Within five (5) work days, the Review Panel will convene to review the grievance and to examine the relevant material presented. Relevant material includes:
      • Information from the verbal report brought to the Training Director.
      • Information from the written report brought to the Training Director.
      • Response from the involved staff member(s)/supervisor(s)/fellow trainee(s).
    • Within three (3) work days after the completion of the Review Panel meeting, the Review Panel will submit a written report to the Chair with recommendations. Recommendations made by the Review Panel will be made by majority vote if a consensus cannot be reached.
    • Within three (3) work days of receipt of the recommendation, the Training Director (or Director) will either accept or reject the Review Panel's recommendations.  If the Chair rejects the recommendation, they may refer the matter back to the Review Panel for further deliberation and revised recommendations or may make ammendments to the recommendations.
    • If referred back to the Panel, a report will be presented to the Chair within three (3) work days of the receipt of the Chair's request of further deliberation.
    • The Chair informs the trainee, staff member(s) involved, and necessary members of the training staff of the decision and any action taken or to be taken.
    • If the trainee/complainant disputes the Chair's final decision, the trainee has the right to appeal. The trainee will submit a written appeal to the Review Panel or by contacting the University of Iowa's Office of the Ombudsperson. The the appeal is submitted to the Review Panel, the Review panel has five (5) working days to convene, review the appeal, amend any recommendations, and submit a revised written report to the Chair. The Chair will inform the trainee/complainant, staff member(s) involved, and necessary members of the training staff of the decision and any action taken or to be taken.
    • If the trainee/complainant continues to have have unresolved concerns, or the involved staff member(s)/supervisor(s)/fellow trainee(s) dispute the Chair's decision, the concerned party may contact the University of Iowa's Office of the Ombudsperson.