Category: Testimony

(Have you entered our giveaway yet for IAFN conference registration?)

Yesterday a reader reminded me that for all of my discussion about reading research on FHO, I never really talk about the best way to make it *easier* to identify relevant research. “There’s so much” and “it’s so overwhelming” are frequent complaints I hear when I discuss the issue at testimony workshops. So what are the top 3 tools I suggest for staying on top of the mountain of research that’s published every month?

**Here (FHO) is a pretty good place to begin. Between the Articles of Note, the reviews in the store, and the other publications I highlight in posts throughout the year, one of the reasons I keep FHO going is to bring the science to the profession on the regular. Subscribing makes it even easier.

**Automate your searches through email alerts. To keep my inbox from becoming completely overloaded, I subscribe to alerts from two places: Google Scholar and PubMed. I have a significant number of research terms for which I have alerts set up, so I still get a ridiculous amount of email traffic, but you can decide for yourself what’s most important/relevant/urgent and make alterations as you see fit. Depending on your access, there are a variety of other databases (e.g. ProQuest, EBSCO) for which you can set up alerts. Ask your university or hospital librarians if you’re not sure what’s available.

**Subscribe to journal email alerts. Your favorite journals allow you to subscribe to things like alerts for newly published articles online, or full tables of contents. Go to individual journals or check out JournalTOCs to make the process more efficient.

As I’ve said on many occasions, reading is part of the job. But locating the research doesn’t need to be difficult or overwhelming. Hope this helps steer folks in a manageable direction.

___________________________________________________________________

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.

At the IAFN conference last week you probably heard me say this several times: be a demanding and conscientious consumers of education. This might just be my mantra for 2019. If I’ve learned anything from listening to as much testimony as I have this year, it’s that people are going to courses and conferences and swallowing wholesale what they are learning there without doing the deep dive. They are accepting as gospel what people teach simply because they are given a national (or even regional) platform, and then turning around and regurgitating that information on the stand. The problem is, that strategy won’t get you much past the direct exam, and even then, it’s pretty tough. If you don’t have a firm understanding of the material to which you are testifying, you cannot answer questions that probe the second or third layer down. And those questions will come. I promise they will. Memorizing training material won’t get you there. It will introduce you to what you need to know. And then it’s up to you to do the work.

Good education (and good educators) will give you source material. If there are statistics or metrics or numbers of any sort cited in their presentations, they will tell you where they came from. Then it is up to you to go to those sources and read them for yourself. Determine whether they apply to all circumstances or only some. Follow the footnotes to other articles that may contradict or expand upon the ideas in the original article. If they’re older, do a quick PubMed search and see if there’s newer information that has been published that may be useful. And then consider whether you might bring that information into court. Because testimony requires some work up front, and not just pretrial prep with counsel. The onus falls on you to do that work.

If you receive materials or see slides from presenters and they don’t include citations? Ask for them. Be a demanding and conscientious consumer of education. It is completely acceptable to ask for sources*. We are people of science. Science is what informs our opinions (along with clinical experience). It matters not at all how famous the educator, the course, the conference, or the academic program is–no one is above providing sources for their assertions. And if the presenters won’t or can’t give you that information? This is not information that should be the basis for any testimony you plan to give.

Every opportunity for testimony is an opportunity to be better. No one starts out a flawless expert, and errors in testimony can happen to even the most seasoned expert. But it’s possible to make sure you are approaching testimony from a position of strength (whether testifying for prosecution or defense) by ensuring your science is current, relevant, and on point. Be a demanding and conscientious consumer of education.

*I am also of the opinion that if all the source material simply consists of the presenters’ own work, that should also be consumed with a grain of salt.

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

Something to consider when it comes to evaluating experts:

One can be an expert in treating the injuries caused by a mechanism of injury…

…and not necessarily be an expert in the mechanism of injury itself.

We probably don’t talk about that nearly enough.

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.

If you are planning on attending the IAFN conference this year in Reno AND you are not committed to teaching or meetings on that Wednesday the 24th, please consider the following request–I am looking for volunteer facilitators for a new day-long testimony workshop we are doing that day. It will begin immediately after the keynote speaker that morning and go until 5pm. I need about 4 additional people (I have already compiled a great crew of facilitators, thus far, but it’s a large session, so I need a few more) with the following qualifications:

• Minimum 5 years working in forensic nursing
• Must have testified or provided expert consultation at trial 10 or more times
• Must be able to easily discuss the evidence base that supports forensic nursing practice and ethical testimony

I have nothing but my eternal gratitude to offer for your participation (plus a cocktail or two in Reno)–you will not receive any discounts or compensation of any sort for assisting. I would love to be able to do that, but this site does not generate that kind of scratch. Sorry. But you will get to participate in a terrific day or learning, mentoring new(er) forensic nurses and teaching alongside other experienced colleagues. If this sounds remotely interesting, please contact me and include a copy of your CV with your email. I will get back with folks shortly after the Labor Day holiday. Facilitators will receive details for the workshop by the end of September.

Thanks for considering it!

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.

Oh hey–I made you a thing! Actually, I built you a thing out of some solid, already crafted parts and few original ideas, so let’s not get carried away here. An FHO reader asked if I had a concrete way for people to sit down with a research article and analyze it for its relevance for practice and testimony, so here you go. It’s a mash-up of some of the best of what I have found online from a variety of sources (that I have used) for journal clubs (part I, Research Outline), plus some of my personal perspective regarding analysis (part II, Reader Synthesis). Good for a step-by-step through a research article solo, or as part of a collective discussion. Hope it’s helpful.

Loading...

Taking too long?

Reload document

| Open in new tab

Download [128.98 KB]

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.

I had a question from an FHO reader this week: if there was only one piece of advice I could give a newly minted forensic nurse about cross-examination, what would it be? That’s easy.

Concede what is possible.

It’s funny because we were working on a testimony project last week and this issue actually played itself out in front of us in a very real way, so the timing of the question is perfect, really.

I’ve watched more clinicians get themselves into trouble on cross by failing to simply concede things that could be possible are, in fact, possible. Often times it comes from a place of wanting to be helpful to “their” side (pro tip: it’s not helpful). Other times it is because people confuse possible with probable (possible is any chance at all that a thing could be; probable is more than 50% likely. Even when I don’t believe something is probable, there’s a good chance I would have to admit it’s still possible.)

If a clinician digs their heels in on the question of whether something is possible, the resulting questions can leave them looking biased or argumentative. Ultimately, it can undermine the most well-intended testimony.

Concede what is possible. We don’t take the stand to make an attorney’s case. We take the stand to educate judges and juries about what we know, what we saw, what we did, and sometimes, what we believe, based on science and our clinical experience. Simple as that.

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.

I’m so pleased to announce the newest review article is now available for sale in the FHO store: Aging Bruises Based on Color. Like its predecessor, Injury Following Consensual Sex, it is a digital download, available for $4.99. When you purchase it you will be taken immediately to the download screen (it will be the same screen as your invoice), so please watch for that. You won’t be able to go back once you leave that screen.

A brief description:

This review paper will examine a specific issue related to bruising: aging or dating bruises based on color, as seen in routine clinical assessment. It is meant to assist clinicians and allied professionals with understanding the breadth of the science, but it is not a substitute for reading the articles themselves. The paper will include an overview of the physiology of bruising, review the specific challenges in assigning timeframes to bruising colors, and provide considerations for clinicians when testifying about bruising in court.

And if you’ll indulge me, a personal request: With the exception of these research briefs, which require an incredible amount of my time, everything provided at FHO over the last decade has been free. Please continue to support the work here by purchasing the brief rather than making a digital copy of someone else’s. Doing so helps defray the cost of keeping this site online and making sure FHO can continue to bring readers all over the world current science, education and news that allows for patient-centered, evidence-based forensic healthcare. Thanks for being a supporter.

…Don’t mix. Resist the urge to post anything* about trials in which you are involved. Before, during or after. Particularly commenting on the results of trials. I love social media, and I use it all the time; there’s a lot about my life I discuss online, both personally and professionally. But not cases in which I am involved.

I mention this all the time, so many of you have heard me say this before, but periodically it needs to be repeated. One of these days I am going to write formally on this topic, but for now, please, take my word for it and just don’t comment on any aspect of a trial on your social media feeds. There is literally no upside and plenty of potential down-. And yes, I know other professions do it–I’m not talking to them. I’m talking to us, clinicians.

*I say anything because I cannot define what the bright line is between what is okay and what isn’t. I cannot tell you when something will be used in a way that will make you look unprofessional or biased. I cannot refer you to official guidance on this because there is none. All I can tell you is that there is no reason to mention this aspect of your professional life in a tweet, Facebook update or beautifully composed Instagram pic. Seriously. Let this part of your life be a bit of a mystery.

The issue of whether forensic clinicians have to testify, and if so, who determines whether they testify as a fact witness or an expert witness is one that we discuss regularly in these circles. I’ve written about it before; nothing in that post has changed. What I want to emphasize is that there are many areas in which clinicians and program managers lack control when it comes to testimony. But there is plenty over which you do have control. I would submit that in anticipating future testimony, a program has the ability responsibility to:

1. Ensure that baseline education of all staff meets the minimum standards of practice as agreed upon in the field (to the extent that there is consensus, and understanding that some areas of practice lack consensus);
2. Ensure that policies and procedures are in place, regularly reviewed, and again, consistent with the standards of practice as agreed upon in the field (see caveat in #1);
3. Ensure that practices within the program have both a clinical rationale and an evidence base to support their use, particularly where consensus or guidance is lacking;
4. Ensure that there is a quality assurance process in place so that if any mistakes were made, or a clinician deviated from policy, that issue is identified up front and the program has the opportunity to learn and grown from that issue;
5. Ensure that the program’s medical director and institution’s administration understand that testimony is a part of practice and staff need to be compensated for their time*;
6. Ensure that testimony prep happens–the exact questions may be unknown, but one can certainly anticipate the foundational questions and practice answering them ahead of time;
7. Ensure that testimony is peer-reviewed–program managers and senior staff members should go to court with less experienced staff and provide feedback on that testimony afterward (please–not while still at the courthouse).  But seriously–no one is so experienced that they can’t afford some peer-review on their testimony.
8. Ensure that if there are opportunities to observe the testimony of someone more experienced, staff take advantage of it and go. Testimony is not something one learns during the mock trial portion of the SANE/SAFE/SAMFE course. That is the place one is oriented to testimony. Honing testimony skills happens over the course of years, and there’s no better way to improve than to watch and to do.

I’m certain I haven’t covered everything, so by all means, add your own feedback in the comments. I love these conversations.

*It is not the responsibility of the prosecutor’s office to pay you for your time on the stand (or prepping to take the stand) unless they are hiring you as an expert on a case where you are not the treating clinician. If you’ve worked out this agreement with them in your community, fine, but it’s still not their responsibility. It should absolutely be the responsibility of the clinical program, and if you are spending your money on shiny new camera systems or other equipment, and not paying staff for expected activities, like continuing education and testimony, that is a fail in my book. Yep, I said it.

Our first offering in the FHO store, Injury Following Consensual Sex is now available. If you haven’t ordered a copy yet, you can find it here.