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    05.29.12 The Maimonides Project: A Trial in Clinical Education, Simulation, and Law
    Lisa Smith

    Brooklyn Law School’s Prosecutor’s Clinic partnered with the Maimonides Infants and Children’s Hospital of Brooklyn this spring to pilot a novel program involving physicians in court proceedings. It was designed to educate physicians and law students about the role of testifying and the impact they have on the outcome of a child abuse case.

    The curriculum was spearheaded by Professor Lisa Smith (left) and Doctor Ingrid Walker-Descartes, the Director of the Maimonides Pediatric Residency Program. “Professor Smith, my colleague Lisa Altshuler, and I had been discussing this program for about three years now,” said Walker-Descartes. “The approach of combining learners from two different disciplines that tend to be adversarial in many ways has proven invaluable to the medical trainees who have never stepped foot in a courtroom.”

    The program centered on a simulated case with a mother presenting an infant she suspected had been sexually abused. Over the course of three days, 24 pediatricians from Maimonides Hospital participated in a court hearing, along with Brooklyn Law School students serving as mock prosecutors. Smith provided didactic instruction and explained the courtroom process. Walker-Descartes shared her experience testifying and also provided instruction.

    Child abuse and neglect are leading public health problems with significant morbidity and mortality rates. Walker-Descartes noted that a key factor in determining the outcome of many child abuse cases is the quality of the written communication, such as the medical evaluation and documentation of the findings. Pediatricians remain on the front lines for prevention and screening of child abuse where the reported prevalence rates are conservative estimates at best. Previous studies indicate that physicians often lack knowledge and confidence in addressing child abuse and neglect. Smith and Walker-Descartes sought to develop a standardized curriculum incorporating clinical recognition of child abuse, resident documentation, management and communication skills in cases of abuse, and the interface between the pediatrician and the legal system.

    Although most pediatric residents receive a didactic curriculum in child abuse pediatrics, their exposure to patients with signs of abuse, especially in the outpatient setting, may be highly variable. Smith and Walker-Descartes were pleased with the results of the program and hope to make it a part of the curriculum. “Simulation is a new trend in medical education and often the learners are all health professionals. Upon their debriefing, many of the physicians affirmed they will be better prepared for the next time they step into a courtroom,” said Walker-Descartes.

    Learn more about the Prosecutor’s Clinic.