Code of Ethics

Purpose

The following Code of Ethics and Conduct is informed by INACSL’s core values, as well as the mission and vision outlined in INACSL’s Bylaws. Through this code of ethics, INACSL affirms the ethical responsibilities of our profession, our members, and our association. INACSL members are expected to be aware of the ethical implications of their professional actions and work to uphold and adhere to the guidelines and principles set forth in this code. 

Healthcare Simulationists and Their Profession

In 2018, the Society for Simulation in Healthcare (SSH) released the Healthcare Simulationist Code of Ethics, a set of values to promote, strengthen, and support an ethical culture among all individuals and organizations engaged in healthcare simulation. The six values of integrity, transparency, mutual respect, professionalism, accountability, and results orientation underscore the commitment of healthcare simulationists to the highest standards of integrity. The Code of Ethics can be found here. 

The INACSL Board of Directors voted to adopt the Healthcare Simulationist Code of Ethics in 2018, joining more than 23 healthcare simulation associations internationally. The Code of Ethics cannot be edited or changed as published by SSH. However, the Board of Directors can submit a request to SSH to annotate the Code of Ethics for specific concerns relevant to INACSL. The Board of Directors shall review and reflect on the Code of Ethics every two years in order to evaluate its continual alignment with INACSL’s mission, vision, and values. 

INACSL Members

Membership into INACSL is based on connection, engagement, support, and inspiration. Membership to INACSL is contingent upon the following standards of conduct:

• Respecting and valuing the knowledge, perspectives, contributions, and areas of competence of fellow members, colleagues, trainees, and professionals
• Sharing knowledge and providing mentorship and guidance for the professional development of other members, colleagues, trainees, and professionals
• Taking responsibility and credit only for work they have actually performed and to which they have contributed
• Appropriately acknowledging the work and contributions of others
• Maintaining appropriate boundaries and a professional environment that is free from bias or discrimination

 Association Leadership and Staff 

The INACSL Board of Directors, volunteers, and staff shall adhere to federal, state, and local laws and regulations, including business ethics policies and the standards of conduct outlined in the previous two sections.

INACSL Board of Directors, volunteers, and staff shall maintain confidentiality regarding all Association business. Board Members, volunteers, and staff who have questions concerning the confidentiality or appropriateness of disclosure of particular information should contact the Executive Director. 

Complaint Review Procedure

Purpose

The purpose of this procedure is to encourage members, volunteers, and staff to come forward with information on illegal practices or serious violations of adopted policies of the Association. This procedure specifies that the Association will protect the person from retaliation, identifies where such information can be reported, and outlines how reports will be handled. 

Encouragement of Reporting

The Association encourages complaints, reports, or inquiries about illegal practices or serious violations of the Association’s policies, including illegal or improper conduct by the Association itself, by its leadership, or by others on its behalf. Appropriate subjects to raise under this policy include financial improprieties, accounting or audit matters, ethical violations, or other similar illegal or improper practices or policies. 

Protection from Retaliation 

To the extent possible, INACSL will maintain in confidence the identity of the Complainant, although the identity may have to be disclosed for INACSL to make a thorough investigation of the report, to comply with applicable law, and to provide any accused individual with their legal rights of defense. The Association prohibits retaliation by or on behalf of the Association against Complainants for making good faith complaints, reports, or inquiries under this policy or for participating in a review or investigation under this policy. This protection extends to those whose allegations are made in good faith, but prove to be mistaken. The Association reserves the right to discipline those who make bad faith, knowingly false, or vexatious complaints, reports, or inquiries or who otherwise abuse this policy. 

Filing a Complaint

A complaint may be filed against the Association, a member, volunteer, or staff. The Complainant shall be promptly notified of the receipt of the Complaint and advised when the complainant will be notified as to when the complaint will be reviewed.  

FILE A COMPLAINT

Initial Review and Conflict of Interest

Complaints submitted through the INACSL Complaint Form will be reviewed by the Executive Director, President of the Board of Directors, and a designated member of the Governance Committee. If it is evident upon review that one of the three reviewers is implicated in the complaint, said reviewer is immediately excused from the review process and the remaining reviewer(s) will determine whether the complaint is more appropriately handled by the Board of Directors, the Governance Committee, or if legal counsel is needed, using the following guidelines:

• In the event that one or more members of the Board of Directors has a potential or actual conflict of interest arising from the filed complaint, the Governance Committee and a Board Liaison shall handle the complaint.
• Legal counsel shall be sought for complaints of illegal practices or conduct. 

Any individuals who have an actual or potential conflict of interest arising from the filed complaint or response to the complaint will recuse themselves from any discussion or consideration of the matter. Recusal may be either because of direct knowledge of the matter under discussion or a personal/professional relationship with either party that may affect an impartial perspective. 

Review Procedure

The following procedures shall apply in the event that either the Board of Directors or Governance Committee (hereby known as the Reviewing Body) is deemed appropriate for handling the complaint. In instances where legal counsel is sought, the procedure will be dependent upon the legal counsel. Every effort will be made to execute each of the following steps in a timely manner (within 30 days of the preceding step), but consideration should be given to the frequency at which the Reviewing Body can reasonably meet. Both the Complainant and Respondent shall be informed of the outcome each of the following steps following each occurrence or decision. 

1. Acknowledgment

The Reviewing Body will inform the party named in the complaint (“Respondent”) that a complaint has been filed and request a response, including any supporting documentation, from the Respondent within thirty (30) days. As stated above under “Protection from Retaliation,” to the extent possible, INACSL will maintain in confidence the identity of the complainant. The complainant and the respondent shall be notified of the obligation to keep all matters confidential and that neither party shall be retaliated against with regard to the making of the complaint and the responding to the complaint. Both parties shall sign a confidentiality agreement. The following will be sent to the Respondent:

• A description or copy of the complaint.
• The reviewing body and its members that will review the matter, in case the respondent wishes to raise any concerns regarding potential conflicts of interest. 
•  A deadline by which to respond to the complaint.

 2. Discussion & Hearings

The Reviewing Body will review the complaint, the response, and any associated materials. From this review, the following actions may be taken:

• Dismiss the complaint based on a finding of no merit.
• Request more information from the Complainant or Respondent. A letter will be sent to the appropriate party requesting additional information which must be provided within thirty (30) days of the request.
• Determine that probable cause exists and request a hearing prior to a resolution.
• Determine that an infraction has occurred and recommend disciplinary action. A letter will be sent to the Respondent notifying them that disciplinary action is recommended and provide the Respondent an opportunity for a hearing.  

The Respondent may request a hearing by the Reviewing Body, rather than have a preliminary review by the Reviewing Body. Hearings will be held by teleconference. The Respondent and Complainant may each request to be present at the hearing, or may waive that right. Failure of a party to request to be present at the hearing means that the individual has waived their right to be present. The Respondent and Complainant may each have legal counsel present, but must notify the Reviewing Body of their intent to do so two weeks prior to the hearing.

 3. Resolution

The members of the Reviewing Body by majority vote may decide to impose sanctions it deems appropriate. The sanction applied must reasonably relate to the nature and severity of the violation, focusing on reformation of the conduct of the affected and deterrence of the same or similar conduct by others. Potential sanctions include: 

• Letter of caution for conduct that is not cause for formal discipline and is intended to remind the Respondent of an issue of concern or an ethical obligation, or to recommend changes in behavior or procedures, or to suggest an appearance of impropriety that should be avoided.
• Letter of admonition that is intended to address conduct that falls short of conduct that is cause for formal discipline. A written reprimand is an expression of disapproval of conduct, and may contain a proscription to follow a corrective course of conduct, and may direct professional treatment, counseling, or assistance.
• Written reprimand for engaging in conduct which either violates the Code of Ethics. It is a rebuke for one or more violations that does not require censure. A reprimand usually involves an isolated incident or behavior that can be easily corrected. It could involve misconduct that is more serious, but the respondent presented substantial mitigating factors.
• Written censure is a formal sanction for conduct which violates the Code of Ethics. A censure is a declaration that the Respondent is guilty of misconduct that does not require suspension or removal. Censure is a stern rebuke that finds the conduct of the Respondent detrimentally affects the integrity of the organization and its members and undermines public confidence in the mission and values of the organization. It could involve misconduct that is more serious, but the Respondent presented substantial mitigating factors. A censure may include a requirement that the Respondent follow a specified corrective course of action. A censure is public in nature and therefore serves as a public warning to other individuals of the consequences of similar violations.
• Suspension or revocation of membership for a designated period of time based on serious misconduct that merits more than a censure, but less than removal. It can be imposed for egregious or repetitive conduct. It could involve misconduct that is more serious, but the respondent presented substantial mitigating factors. A suspension may require that the respondent follow a specified corrective course of action before being reinstated. If the respondent holds a volunteer or elected position with INACSL, the Respondent is suspended from their position for a designated period of time.
• Permanent expulsion from INACSL membership with the inability to renew membership in the future, as a result of extreme or gross misconduct involving the Respondent’s integrity, substantial harm to public confidence and trust in the organization and its members, damage to the reputation of the organization and its members, damage to the ability of the organization to uphold its mission and values, or the inability of the respondent to function as a member of the organization. Mitigating factors, if any, presented by the Respondent were unable to affect the decision to remove the Respondent from membership. The Respondent is no longer eligible to be elected, appointed, or otherwise serve as a member of the organization. 

 4. Appeals 

The Respondent may file an appeal of the decision by the Reviewing Body if they think the Reviewing Body has violated its policies and procedures and/or the decision of the Reviewing Body was not fair and reasonable taking into consideration all of the relevant facts and circumstances. The Reviewing Body will appoint an impartial three-person Appeals Panel consisting of at least one past Board Director, a Past President, and a previous Governance Committee Chair. 

No member of the appeals panel may have a conflict of interest involving the Complainant or the Respondent. The appeals panel will review the documentation from the hearing, the processes and procedures, and all other relevant documentation. Their deliberation can result in three possible outcomes:

• Complete reversal of the initial decision resulting in elimination of all sanctions
• Partial reconsideration of the initial decision resulting in complete or partial modification of the original sanctions, resulting in either less or more severe sanctions
• Denial of the appeal, resulting in maintenance of the original sanctions 

Substantial New Evidence

For a complaint that has been heard and closed, the Respondent may submit substantial new evidence that was not available at the time of the hearing, and petition that the case be reopened. The original Reviewing Body will review the new evidence and decide whether or not to reopen the complaint. 

Member Records

Disciplinary actions will be noted in the member’s record. Members with three disciplinary actions in less than ten (10) years will be reviewed by the Board of Directors to determine if further disciplinary action is needed.