Category: Testimony

Articles of Note: October 2019 Edition

Post author By Jen
Post date October 16, 2019

It’s time once again for Articles of Note, our monthly romp through the newly published peer-reviewed literature. There is *a lot* of choice material to sort through this month, so I hope you will spend some quality time with the list. As always, links lead to PubMed abstracts.

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Have you checked out the FHO store lately? You can find the newest research brief, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims. Or purchase the complete set of three (Strangulation, Aging Bruises, and Consensual Sex Injury) for a special price.

Testimony

IAFN Handouts: Words Matter

Post author By Jen
Post date September 12, 2019
4 Comments on IAFN Handouts: Words Matter

Leslie and I tweaked our session, Words Matter: The Art and Science of Trial Testimony at the 11th hour, so the handout on the conference app is not as robust as the session ended up being. An improved handout can be found here for those who would like the additional FRE702 and research content. It still doesn’t have all the case law and testimony examples we use, but the remaining content is there. Thanks to everyone who came and participated. I love a standing-room-only crowd 🙂

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Testimony

Working for the Defense

I’ll be talking quite a bit this week about expert consulting and testimony, so the topic of what it means to be an ethical defense expert is on my mind. But the truth is that lately, I have been thinking a lot about what it means to work for the defense, particularly when you may be interviewing and/or testifying opposite a treating medical-forensic examiner. The reality is that no one really teaches a clinician how to be good defense expert and the ways in which that role differs from being a good prosecution expert. However, there are differences, even as the goal (regardless of who has hired you) continues to be objectivity.

There seems to be a common misperception that in order to be helpful to the defense you must destroy the treating clinician, and this is an unfortunate approach. With very few exceptions, I take the good camper approach to all treating clinicians, even as the defense expert: leave people a little better than when you found them. People are naturally wary of talking with the defense team; it costs you nothing to be collegial even while identifying issues on the part of the exam, the clinician or the documentation. There are a million ways to determine what success looks like in this work, but one sure-fire way to know that you have failed is when the clinicians you come in contact with want to quit the profession after talking with you. And yet, that’s exactly what I have heard on more than one occasion after clinicians have finished interviewing with defense experts. Can you imagine being so caustic that you literally drive someone from the profession?

By the way, the flip side also holds true: in order to be helpful to the prosecution, it is not your job to save the treating clinician. Sometimes exams are done badly; sometimes the documentation is so poor as to be utterly unhelpful. Sometimes people embellish their credentials (true story) and they have to face the music on cross-exam. Experts don’t make these cases. Experts are simply one part of a larger strategy. We educate, we advise. We don’t win or lose trials.

Every interaction with other clinicians is an opportunity for mentoring, even in the courtroom. Anyone who has been doing this work for the years it takes to be a good expert at trial should commit to growing the profession, not tearing it down. It is the very least our patients deserve.

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Articles of Note Child Abuse DV/IPV Elder Abuse/Neglect Sexual Assault Testimony

Articles of Note: September 2019 Edition

Post author By Jen
Post date September 5, 2019

It’s time once again for Articles of Note, our monthly romp through the peer-reviewed literature. Nothing free this month, but plenty worth tracking down, so I encourage you to spend some time with the list. It’s particularly fitting that I get a new edition up since I am sandwiching it between two weeks of teaching testimony, this week at Ft. Hood and next week at the annual IAFN conference, where we discuss at length the importance of fidelity to the science.

All links lead to PubMed abstracts. Happy reading!

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Sexual Assault Testimony

Going Beyond Rape Kits

Post author By Jen
Post date August 26, 2019

I am in Hawaii this week and while I will try and get posts up with some regularity, it will be a long week and the hours here are not my own. So, we’ll see how it goes. In the meantime, I’d like to draw your attention to this excellent article by IAFN CEO, Jennifer Pierce-Weeks, Going Beyond the Breakthrough Means Going Beyond Rape Kits. It beautifully encapsulates why the sexual assault medical-forensic exam is so much more than just collecting samples for a kit. Trying to figure out how to articulate in court why it’s important that patients come in and see us, even if they don’t want evidence collected? Well, Jen just helped you out by putting it down on paper. And she did it in less than a thousand words. Do yourself a favor–read it and then share it with your team.

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Articles of Note Child Abuse DV/IPV Elder Abuse/Neglect Sexual Assault Testimony

Articles of Note: August 2019 Edition

Post author By Jen
Post date August 7, 2019

It’s time once again for Articles of Note, our regular romp through the peer-reviewed science. Check it: we have not one, but two scientific papers this month on physicians committing misconduct, so that’s fascinating. We also get a look at how a clinician’s personal history of domestic violence impacts clinical care. Needless to say, there’s some good reading to be done in this edition (as always). Most links go to PubMed abstracts except where otherwise indicated.

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Testimony

Updated Clinical Guide: Court Testimony

Post author By Jen
Post date July 24, 2019

Court testimony is the most popular subject on FHO, and not surprisingly, also the most popular clinical guide. It has now been updated with the latest research and guidance from the peer-reviewed journals, so there’s a good deal of new stuff to review.

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Testimony

Updated Clinical Guide: Social Media Use for Forensic Clinicians

Post author By Jen
Post date July 17, 2019

In our course last week we naturally discussed social media use (as we do), and it made me realize that it is high time I went through the clinical guides and gave them all a facelift. So one by one, as I have the time, I will be tackling them in the quiet(er) moments of what’s left of the summer. First up is social media use for forensic clinicians. Plenty of new research articles and other resources for you to peruse in this one. Hope you find it helpful.

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Child Abuse DV/IPV Elder Abuse/Neglect Sexual Assault Testimony

Using Expert Eyes and Ears to Document What We See and Hear

Post author By Jen
Post date July 9, 2019

SAFEta has a webinar coming up, On Looking and Writing: A Guide to Using Expert Eyes and Ears to Document What We See and Hear. The session will be held August 15th at 2pm ET. From the registration:

This webinar will help participants unlock their ability to see and write; to document their patient’s physical state and behaviors in an accurate manner. You will learn how to “paint a picture” with your words and accurately describe outward appearance, visible behavior, speech and eye contact using instantly understandable language.

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Articles of Note Child Abuse DV/IPV Elder Abuse/Neglect Sexual Assault Testimony

Articles of Note: May/June 2019 Edition

Post author By Jen
Post date June 4, 2019

Time once again for Articles of Note, our (almost) monthly romp through the peer-reviewed literature in search of all things new and/or useful to clinical practice, public policy, and testimony. As you may have noticed, I didn’t make one happen in May, so this month’s combined is pretty lengthy. There’s *a lot* here to work through, but I think it’s worth it. Some familiar faces in the bunch, too. Hope you enjoy.

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Testimony

Applying the Strangulation Research to Expert Testimony: Table of Contents

Post author By Jen
Post date May 30, 2019
2 Comments on Applying the Strangulation Research to Expert Testimony: Table of Contents

I have to tell you, I am overwhelmed at the response to the new research compilation, Applying the Strangulation Research to Expert Testimony. The response has been–unexpected. But a very smart attorney to whom I am married casually mentioned it would be nice for people to see a preview of what they would be getting for their money, and it occurred to me the Table of Contents is the easiest way to provide that. So it is now part of the product description on the store page (I also added preview pages for the other two compilations), but I am providing it here for those of you who might be interested:

Thanks for all of the kind comments and messages. You are really the very best readers.

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Testimony

Applying the Strangulation Research To Expert Testimony

Post author By Jen
Post date May 28, 2019
6 Comments on Applying the Strangulation Research To Expert Testimony

It’s here, folks: Applying the Strangulation Research to Expert Testimony is now available for purchase in the store. A couple of things I’d like to mention–first of all it’s more expensive than the previous ones ($9.99) because it’s almost three times the length. So for all of you who will want to know why the big jump in price from the other two, there you go. The other thing I’d like to mention is this–these compilations don’t make me rich. Yes, you technically can share these compilations amongst yourselves once one person purchases it, but I ask you to buy individual copies where possible. An unbelievable amount of time went into this, as is this case with everything I publish here.

In putting this together, my hope is to improve the quality of expert testimony in cases of adult non-fatal strangulation. Patients shouldn’t luck into competent trial testimony by their forensic clinician. I truly believe this, which is what drives every single one of these compilations. I hear a lot of weakly informed opinions on the stand and a lot of strangulation testimony not grounded in much more than information people have picked up from a lecture they’ve heard or course they’ve taken. Often clinicians have never read the primary sources from which they are pulling supporting statistics or conclusions, making their statements vulnerable on cross. I am trying to make it simpler for people to identify and access the evidence base, so that testimony can be presented from a scientifically sound foundation where possible. And so that we can acknowledge the left and right limits of the research when asked, and develop a program of research to close the gaps.

Because we are at the point where we have the ability to do so, I am also now offering all three of the FHO research compilations (Consensual Sex Injury, Aging Bruises and Strangulation Injury) as a single downloadable zip file. That one is $16.99, so it basically saves you three bucks when you buy them as a set.

The Store page looks wonky for reasons beyond my technical abilities, so I am trying to get that worked out–but everything seems to be working. Contact me if you have any issues. As always I look forward to your feedback (and I am taking ideas for the next research compilation, although it’ll be a few months before I start it).

Testimony

Coming soon: Strangulation Research Compilation

Post author By Jen
Post date May 21, 2019

One week from today I will release the 3rd FHO research compilation: Applying the Strangulation Research to Expert Testimony in Cases with Adult Victims. It’s the biggest one to date, but it’s also the most needed. So I am spending the week traveling (hello, MSU), editing, and enjoying the girl-child’s high school graduation (hello, CLE). I’m also taking the week off the site. I will see everyone back here next Tuesday for the launch of the new compilation. Until then, friends…

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Have you checked out the FHO store lately? You can find our newest research brief, Aging Bruises Based On Color, plus our original guide, Injury Following Consensual Sex. Both available now for electronic download. Plus, coming soon: the newest research compilation, Applying The Strangulation Research To Expert Testimony In Cases With Adult Victims.

DV/IPV Sexual Assault Testimony

Peer Reviewers Needed

Post author By Jen
Post date May 1, 2019

Looking for a few folks who are interested in being peer reviewers for the next research compilation on strangulation. This compilation is much lengthier (it’s clocking in at about 25 pages, so it’s monograph-length), so you have been warned.

If you would like to be considered, and you have the time to do a thorough review in the next two weeks, please email me (jenifer.markowitz@gmail.com since you cannot attach a CV to the Contact email on the site) along with a copy of your CV. This is meant to assist clinicians with being better prepared to go to court, so I need folks who have some experience in—well, preparing to go to court. I’m less concerned about formal educational credentials, but you do need to be comfortable reading research. You do not have to be a nurse. I am equally interested in the opinions of physicians, attorneys, and other professionals who read this site who have served as expert witnesses in the past. In fact, I always have one non-nurse reviewer.

All reviewers will receive a copy of the final research compilation once it’s published, along with the other two research compilations in the store (if you don’t have them, or you want to give them to someone else, your choice).

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Child Abuse DV/IPV Elder Abuse/Neglect Sexual Assault Testimony

Updated Clinical Guide: Use of ALS to Identify Bruising

Post author By Jen
Post date April 30, 2019

In anticipation of the next research compilation, I have updated one of the most popular clinical guides on the site, Use of ALS to Identify Bruising. There have been a number of research articles published since the guide was last updated, so those have been added.

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Articles of Note Child Abuse DV/IPV Elder Abuse/Neglect Sexual Assault Testimony

Articles of Note, April 2019 Edition

Post author By Jen
Post date April 11, 2019

Time once again for Articles of Note, our monthly frolic through the peer-reviewed literature. I assure you, this month’s is *full* of science you’re going to want to read, some of which is freely available through the links posted below. Everything else takes you to PubMed abstracts, which should take you down some excellent rabbit holes of their own. Happy reading!

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Sexual Assault Testimony

SANE Expert Witness Training Update

Post author By Jen
Post date April 10, 2019

I recently posted about the live SANE Expert Witness Training we hold annually at the NAC. The application for that training is now available for those interested in applying. Here is the updated information:

The U.S. Department of Justice’s National Indian Country Training Initiative, in partnership with the International Association of Forensic Nurses, is pleased to announce the Sexual Assault Nurse Examiners’ Expert Witness Training. The seminar will be held July 9-11, 2019, at the National Advocacy Center in Columbia, South Carolina. Travel related expenses will be covered by the U.S. Department of Justice. There is no tuition charge for this training.

Sexual Assault Nurse Examiners (SANEs) are specialists in one of the most well-known fields within the field of forensic nursing. Many prosecutors are comfortable using forensic nurses to testify to the facts of a case. However, forensic nurses are often overlooked as accessible expert witnesses. Prosecutors can use forensic nursing expert testimony to educate the jury on the characteristics of battered individuals (to include minimizing and recanting, mechanisms of injury and wounds) and to inform the jury why there may be an absence of injury. Forensic nurses can also assist prosecutors by reviewing medical records prior to trial and identifying relevant portions of the documentation.

This training is designed for SANEs interested in providing expert testimony and for prosecutors assigned to sexual assault and domestic violence cases who want to learn more about the effective use of a SANE as an expert witness in their cases. Priority consideration will go to SANEs and prosecutors working on cases arising in Indian Country.

This class has a mock trial component, and prosecutors and a SANE(s) who work cases together are encouraged to register as a team.

Please complete and submit the nomination form at the following link for each of your nominees:

https://survey.ole.justice.gov/snapwebhost/s.asp?k=155421728776

Nomination forms are due by May 3, 2019.

The NICTI will review all nominations and the NICTI will send an e-mail advising nominees of their selection on or about May 13, 2019. Selected nominees will also receive information on how to book travel and lodging.

In order to ensure that our records are correct, please type in the required information when completing the nomination forms. Illegible and/or incomplete forms will not be considered.

Due to the increasing number of last minute cancellations, we must ask that only nominations for those who are certain to attend be submitted.

The Executive Office for United States Attorneys will provide reasonable accommodations to people with disabilities. Requests should be made to Delores Johnson as early as possible, preferably at least two weeks in advance of the seminar. No nominee will be excluded from a course on the basis of a disability-related accommodations request.

This training is authorized under the Government Employees Training Act.

Any questions regarding this training seminar should be directed to Delores McCarter Johnson at

(803) 705-5123 or Leslie A. Hagen at Leslie.Hagen3@usdoj.gov

Here is a bit of inside baseball: priority really is given to SANEs and prosecutors whose cases arise in Indian Country. Also, if you as a SANE apply along with a prosecutor from your area, that will also increase your chances. There is always a significant wait list for this course, so I encourage you to try and put together a nurse-prosecutor team if you are able.

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Sexual Assault Testimony

SANE Expert Witness Training Course

Post author By Jen
Post date March 27, 2019
2 Comments on SANE Expert Witness Training Course

First off, sorry for being absent this week. It’s an involved week, and you know how it is sometimes. Secondly, I know that normally I only post online events, but this is our (almost always) annual testimony course at the National Advocacy Center, and it’s one of the most fun courses I get to teach, so if you’ve got the space on your calendar, and you’re eligible, you should think about joining us this year–it is free. We have a great time, it’s a fantastic networking opportunity, and very hands on. Details:

The U.S. Department of Justice’s National Indian Country Training Initiative, in partnership with the International Association of Forensic Nurses and the SAFEta Project, are pleased to announce the Sexual Assault Nurse Examiners’ Expert Witness Training. The seminar will be held July 9-11, 2019, at the National Advocacy Center in Columbia, South Carolina. Travel and lodging accommodations will be provided by the Office of Legal Education. There is no tuition charged for this class.

This training is designed for SANEs who are going to be providing court testimony and for prosecutors assigned to sexual assault and domestic violence cases who want to learn more about the effective use of the SANE as an expert witness in their cases. Priority admission will go to those medical providers working on cases arising in Indian Country.

This class has a mock trial component, and prosecutors and SANE(s) who work cases together are encouraged to register as a team. Training Officers/SACs/SSRAs are invited to nominate individuals from their division or department who would benefit from this training opportunity.

If interested in attending the class you will be required to fill out a Preregistration survey. The preregistration survey will be forthcoming, please check back for further instructions. The point of contact for the training is Leslie Hagen, who can be reached via email at leslie.hagen3@usdoj.gov or Kim Day here.

More information here.

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DV/IPV Testimony

Radiologic Findings in Intimate Partner Violence (and also, a few words about research)

Post author By Jen
Post date March 5, 2019

Folks, I am happy to share a new study recently published in the journal, Radiology. But before I go there, let me remind readers of a couple things–the research I share is to help inform clinical practice and the opinions that we may or may not give on the stand. To give us a better understanding of what is knowable in our field, and what is still yet to be figured out. It is going to be a very rare occurrence indeed when any one article I post can be taken wholesale and generalized to a broad audience. In our discipline, we just don’t see a lot of studies like that. You’ll know this (apart from reading the Limitations section of the article, which will probably say so in black and white) because of the small sample size of the study, for instance, or the fact that all of the subjects in the sample represent a relatively homogenous population.

What I mean is that if you have an article that states that in a study of 100 people in my community, 50% of them hate dogs (what?!), you can’t take that study and say that means that half of all people hate dogs. No, half of the ~~weird~~ people in that particular study from that particular community hate dogs. But that’s all you can say. Especially if there are no other studies that have reproduced those results with other populations. Or larger populations. Or if there are studies that have found contrary results. Etc. Forgive me, because this is an oversimplification of a more complex issue, but it gets to the point, which is–read studies for what they are, but also for *what they are not*.

Why am I telling you this? Because this inappropriate generalizing of data happens a lot in our profession. Because I get emails and texts and frantic phone calls about it. Because FHO aims to help make people the best clinicians and the best expert witnesses they can be (regardless of which side they’re working for) and I would be remiss if I didn’t mention what seems to be an obvious problem with the way testimony may be going down in certain circumstances. This is not a nurse-specific phenomenon, BTW–many healthcare and healthcare-adjacent disciplines are taking the data in this area and using it in ways it shouldn’t be used at trial. Drawing conclusions you cannot draw. Anyway, you get the picture. [Rant complete.]

So with that, I bring you this very intriguing study by our colleagues out of Boston, Radiologic Findings in Intimate Partner Violence. Read it for what it tells us, and for what it doesn’t. It’s available free full text, at least right now, so before the nice people at Radiology change their mind, go ahead and download it and add it to your read pile. It’s worth your time.

(Add: based on a phone call I received, not 4 hours after posting this, let me also say, the whole generalizability conversation includes thinking long and hard about whether you can apply results in specific circumstances and apply them equally in similar, but not the same, circumstances. The answer is probably, no. Just because something is found to be likely in an intimate partner violence case, for instance, doesn’t mean it will also be likely in a human trafficking case or a child abuse case. One article, one study isn’t going to give you that.)

Articles of Note Child Abuse DV/IPV Elder Abuse/Neglect Sexual Assault Testimony

Articles of Note: February 2019 Edition

Post author By Jen
Post date February 6, 2019
4 Comments on Articles of Note: February 2019 Edition

It’s time once again for Articles of Note, our monthly waltz through the newly published peer-reviewed literature. I have to tell you, it’s a pretty glorious selection this month. Links lead to PubMed abstracts except where indicated.

Thinking about having a journal club for your team (or just looking for the next article to assign)? Here are some suggestions based on this month’s review:

For adult/adolescent SANE programs: Ectopic pregnancy following oral levonorgestrel emergency contraception use. or Vulnerabilities Relevant for Commercial Sexual Exploitation of Children/Domestic Minor Sex Trafficking: A Systematic Review of Risk Factors.

For CAC/peds programs: Barriers and facilitators affecting self-disclosure among male survivors of child sexual abuse: The service providers’ perspective. or Estimating the probability of abusive head trauma after abuse evaluation.

For expanded programs: Acquired Brain Injury in the Context of Family Violence: A Systematic Scoping Review of Incidence, Prevalence, and Contributing Factors. or Childhood maltreatment and intimate partner violence victimization: A meta-analysis.

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Have you checked out the FHO store lately? You can find our newest research brief, Aging Bruises Based On Color, plus our original guide, Injury Following Consensual Sex. Both available now for electronic download.

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