CARLISLE, Pa. — Law students and pediatric medicine residents from Penn State Health had a firsthand opportunity to hone their trial advocacy skills as part of “Treating Medical Errors: A Medical-Legal Colloquium” in the Apfelbaum Family Courtroom & Auditorium on the Dickinson Law campus.
For Dickinson Law students, the colloquium reinforces the study of the liability of professionals and institutions in health care, and introduces an experiential element into an otherwise lecture-and-discussion-based course.
“For students who are interested in any aspect of health law, understanding the professional culture of medicine is extremely important,” said Medha Makhlouf, clinical professor of law and director of the Medical-Legal Partnership (MLP) Clinic. “The colloquium provides an opportunity for students to interact and work cooperatively with physicians, as well as to engage in challenging discussions about reform of the health care system — discussions that are typically siloed in the legal and medical professions, respectively.”
Makhlouf and Dr. Steven J. Wassner, professor of pediatrics at the Penn State College of Medicine and chief of the Division of Pediatric Nephrology and Hypertension at Penn State Children’s Hospital, organized the event. It has been offered to both law and medical students for the past 10 years.
“For the pediatric residents, this is a wonderful interactive opportunity to be in a courtroom and interact with their legal colleagues,” Wassner said. “At the end of the exercise, they are more aware of their responsibilities both to their patients and to society. In addition, the interaction allows both groups to gain a greater respect for their fellow professionals.”
Together, Makhlouf and Wassner presented an abbreviated civil trial centered on the issues of proving and defending against claims of medical negligence. Pediatric residents played the roles of the defendant, expert witnesses for both the plaintiff and the defendant, and consultants to their respective legal teams. Members of the community served as jurors.
The case — like many medical malpractice cases — is so complex that no two students or pediatric residents approach their role in the same way. Observing the same case being tried in different ways allows the students and faculty to gain deeper insights about how the medical malpractice system does and does not work.
Third-year law student John Rafferty chose to take a more active role in the mock trial because of his interest in litigation. He was responsible for the direct examination of the expert witness, including preparing questions, explaining the examination process, and preparing the witness for cross-examination.
“Malpractice cases contain medical jargon that needs to be fully explained, and it’s easy for the jury to get lost or zone out,” said Rafferty. “This experience allowed me to realize the importance of breaking down complex issues for the jury while maintaining their attention. Effective litigators need to find a proper balance.”
In addition to practicing their trial advocacy skills and receiving immediate feedback from jurors, law students gain experience working closely with physicians, exposure to the professional culture of medicine, and a unique opportunity to sit down with physicians in a non-adversarial setting to discuss whether the medical malpractice system needs to be reformed.
Prior to a trial-preparation meeting, the law students and pediatric medicine residents review a binder of discovery documents and secondary materials. About two weeks before the colloquium, law students travel to Penn State Children's Hospital to have dinner with the pediatric residents and educate them about the law of medical negligence. The residents, in turn, educate the law students about the medical issues in the case. Law students and residents spend the next two weeks communicating via phone and email to finalize their trial strategy and witness preparation, and schedule an additional in-person meeting if needed. The law students and residents take the lead in all aspects of trial preparation, with faculty serving as resources if questions arise.
“I've been really impressed with the willingness of the students in my law and medicine course — even those who haven’t yet taken trial advocacy — to volunteer for roles that stretch their abilities and make them a little uncomfortable, and to run with it,” noted Makhlouf.
Participating in the mock trial as defense counsel, third-year law student Janene Druck saw this as an opportunity to practice her oral advocacy skills in a controlled environment. Druck conducted the cross-examination of the plaintiff’s expert.
“Although oral advocacy was a large part of this experience, the most important takeaway came after the trial when we spoke with the jurors,” said Druck. “This unique opportunity provided a glimpse into how the jury perceived the trial and reached its verdict. Although a jury is instructed to consider only the evidence before the court, it is important to remember that all jurors bring with them their own life experiences and levels of expertise, which undoubtedly factor into the their individual impressions and thought processes, deliberations and, ultimately, the verdict.”
Beginning this fall, students with an interest in health law will have the opportunity to enroll in the new MLP Clinic. The MLP Clinic is a partnership with Penn State Hershey Medical Group in which law students will work alongside physicians at an outpatient medical clinic in Harrisburg to screen patients for civil legal issues, such as the denial or termination of public benefits that are impacting their health. The law students and physicians will then engage in joint medical-legal advocacy to "treat" the health and legal issues. Two of the students who participated in the colloquium will be members of the inaugural MLP Clinic class. Learn more about the MLP Clinic here.