Drukteinis Dainius A, O'Keefe Kelly, Sanson Tracy, Orban David
University of South Florida/Tampa General Hospital, Tampa, Florida.
J Emerg Med. 2014 Jan;46(1):95-103. doi: 10.1016/j.jemermed.2013.08.017. Epub 2013 Sep 24.
Fear of malpractice affects the daily life of many emergency physicians. Educational programs to prepare for litigation are lacking.
An educational collaboration between an emergency medicine residency and a law school, whereby a medical malpractice mock trial competition is used to teach residents basic skills for testifying in legal proceedings.
Ten residents in an academic emergency medicine program volunteered as witnesses in a malpractice mock trial competition at a law school. Residents testified two or three times and, after each appearance, were provided feedback to prepare them for subsequent rounds of testimony. They were also given access to videotaped testimony. Judges rated each resident using a nine-question survey scored on a 10-point Likert scale. Scores were compared as a group between rounds of testimony.
Participants demonstrated significant improvement in seven of nine measured categories. p-Values reached significance in: Worked Well on Direct Examination (p < 0.001), Demeanor/Body Language (p < 0.001), Was Not Arrogant/Did Not Lose Poise on Cross-Examination (p = 0.001), Convincing Witness (p = 0.001), Appeared Knowledgeable (p = 0.012), Courtroom Attire (p = 0.012), and Expressed Themselves Clearly (p = 0.017). In addition, residents anonymously reported broad educational benefit.
This novel educational collaboration taught residents about the process of litigation. It improved their communication skills and expanded their knowledge of documentation pitfalls, problems with staff interaction, and consequences of medical errors. This mutually beneficial partnership between a medical residency and a law school solidified it as a permanent feature of the residency program.
对医疗事故诉讼的恐惧影响着许多急诊医生的日常生活。目前缺乏针对诉讼准备的教育项目。
开展急诊医学住院医师培训项目与法学院之间的教育合作,通过医疗事故模拟审判竞赛,教授住院医师在法律程序中作证的基本技能。
一所学术性急诊医学项目中的10名住院医师自愿在一所法学院的医疗事故模拟审判竞赛中担任证人。住院医师作证两到三次,每次出庭后都会收到反馈,为后续轮次的作证做准备。他们还可以观看证词录像。法官使用一份有九个问题的调查问卷对每位住院医师进行评分,评分采用10分制李克特量表。对各轮次作证的得分进行组间比较。
在九个测量类别中的七个类别中,参与者有显著改善。p值在以下方面达到显著水平:直接询问表现良好(p < 0.001)、举止/肢体语言(p < 0.001)、交叉询问时不傲慢/不失态(p = 0.001)、证人可信度(p = 0.001)、表现出知识渊博(p = 0.012)、法庭着装(p = 0.012)以及表达清晰(p = 0.017)。此外,住院医师匿名报告了广泛的教育益处。
这种新颖的教育合作让住院医师了解了诉讼过程。它提高了他们的沟通技巧,扩展了他们对文件记录陷阱、员工互动问题以及医疗差错后果的认识。医疗住院医师培训项目与法学院之间的这种互利伙伴关系巩固了其作为住院医师培训项目的一项永久性特色。