Downloaded 13 times
![source of the idea…
Medical education:
Around 50 years of practice and research:
497 biomed literature citations & abstracts
527 journal articles
30 books
[Medline PubMed, keywords <“simulated patient”> 26.10.11]
Widespread use in medical schools, MEUs, hospitals, primary care,
CPD, assessment centres.
Professor Paul Maharg 4](https://image.slidesharecdn.com/tle2slides-111030101907-phpapp01/75/The-Standardized-Client-Initative-a-portrait-of-the-outsider-as-teacher-4-2048.jpg)
![training of SCs
‘The best way to learn how to do standardized patients is
to do it along side of someone who has already done it
before. It’s [the] apprenticeship system.’
Wallace, P. (1997) Following the threads of an innovation: the history of standardized patients in medical
education, Caduceus, A Humanities Journal for Medicine and the Health Sciences, Department of Medical
Humanities, Southern Illinois University School of Medicine, 13, 2, 5-28.
Professor Paul Maharg 11](https://image.slidesharecdn.com/tle2slides-111030101907-phpapp01/75/The-Standardized-Client-Initative-a-portrait-of-the-outsider-as-teacher-11-2048.jpg)
![Study
2000 Research Study
1 Law Society of England & Wales
‘I went to [my current solicitor] because of her reputation
and expertise… She is a part-time Registrar and has a big
reputation as a specialist in this area but she just doesn’t
listen’.
Professor Paul Maharg 22](https://image.slidesharecdn.com/tle2slides-111030101907-phpapp01/75/The-Standardized-Client-Initative-a-portrait-of-the-outsider-as-teacher-22-2048.jpg)
![Study
2000 Research Study
1 Law Society of England & Wales
‘I like my current solicitor because I can have a chat with her, I trust
her ... ... The other solicitor — I was just a file for him, but for [her
current solicitor] I’m a real person and that comes across in court’.
‘I wanted the law to be explained. ... The way the solicitor views the
client is important. He has to be interested in our views’.
‘They must be able to give you time. If solicitors haven’t got enough
time, they can’t get enough out of you. You have to have time to be
able to tell your story’.
‘I never liked him. ... we couldn’t have had a solicitor like him for
this [matter]; I think he was perfectly competent, but there was no
sympathy’.
Professor Paul Maharg 24](https://image.slidesharecdn.com/tle2slides-111030101907-phpapp01/75/The-Standardized-Client-Initative-a-portrait-of-the-outsider-as-teacher-24-2048.jpg)
The Standardized Client Initative: a portrait of the outsider as teacher
The Standardized Client Initiative (SCI) aims to improve legal education by using standardized clients (SCs) to assess lawyer-client communication, highlighting that current assessment systems are unreliable and invalid. The initiative is supported by extensive research on client experiences, indicating that empathy and effective communication are critical for client satisfaction. Future research and applications are proposed to enhance the use of SCs in legal education and practice.
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The Standardized Client Initative: a portrait of the outsider as teacher
- 1. The Standardized ClientInitiative: a portrait of the outsider as teacher Professor Paul Maharg
- 2. 1. What isthe SCI, and what are SCs? 2. Current uses? 3. Training? 4. Ethical issues…? 5. The wider picture Professor Paul Maharg 2
- 3. Standardised Client Initiative Original personnel: Professor Clark Cunningham, Georgia State University Professor Gregory Jones, GSU Dr Jean Ker, Clinical Skills Unit, Medical Faculty, University of Dundee Professor Paul Maharg, Northumbria Karen Barton, Strathclyde Professor Paul Maharg 3
- 4. source of theidea… Medical education: Around 50 years of practice and research: 497 biomed literature citations & abstracts 527 journal articles 30 books [Medline PubMed, keywords <“simulated patient”> 26.10.11] Widespread use in medical schools, MEUs, hospitals, primary care, CPD, assessment centres. Professor Paul Maharg 4
- 5. SCI: our hypothesis With proper training and carefully designed assessment procedures, Standardised Clients (SCs) can assess important aspects of client interviewing with validity and reliability comparable to assessment by law teachers. Professor Paul Maharg 5
- 6. aims develop a practical and cost-effective method to assess the effectiveness of lawyer-client communication which correlates assessment with the degree of client satisfaction & confidence. ie answer the following questions… 1. Is our current system of teaching and assessing interviewing skills sufficiently reliable and valid? 2. Can the Standardised Patient method be translated successfully to the legal domain? 3. Is the method of Standardised Client training and assessment more reliable, valid and cost-effective than the current system? Professor Paul Maharg 6
- 7. results Questions Results 1 Is our current system of teaching and assessing interviewing skills sufficiently 1. reliable? 1. No 2. valid? 2. No 2 Can the Standardised Patient method be translated successfully to the legal domain? Yes. 3 Is the method of Standardised Client training and assessment more 1. reliable, 1. Yes 2. valid 2. Yes 3. cost-effective 3. Yes than the current system? Professor Paul Maharg 7
- 8. discussion… We make what the client thinks important in the most salient way for the student: an assessment where most of the grade is given by the client We do not conclude that all aspects of client interviewing can be assessed by SCs We focus the assessment on aspects we believe can be accurately evaluated by non-lawyers We focus the assessment on initial interview (which is currently being extended at Northumbria to an advice- giving interview) This has changed the way we enable students, trainees and lawyers to learn interviewing & client-facing ethical behaviour Professor Paul Maharg 8
- 9. current status ofSCI Current SC initiatives: Strathclyde U WS Society (Edinburgh) University of New Australian National Hampshire University Northumbria U KwanseiGakuin U (Osaka) SRA (QLTS) Law Society of Ireland Hong Kong U ? New York Law School ? Project was funded by: Clark Foundation for Legal Education, Scotland College of Law, England and Wales Burge Foundation, Georgia State U., USA Professor Paul Maharg 9
- 10.
- 11. training of SCs ‘The best way to learn how to do standardized patients is to do it along side of someone who has already done it before. It’s [the] apprenticeship system.’ Wallace, P. (1997) Following the threads of an innovation: the history of standardized patients in medical education, Caduceus, A Humanities Journal for Medicine and the Health Sciences, Department of Medical Humanities, Southern Illinois University School of Medicine, 13, 2, 5-28. Professor Paul Maharg 11
- 12. SC training 1:script conference read script as group discuss the role discuss feelings, reactions clear up ambiguities re role of lawyer use feedback to modify the scenario Professor Paul Maharg 12
- 13. SC training 2:practising the role There’s a need for the SCs to calibrate: Body language Tone of voice Attitudinal swings Dealing with the lawyer’s open questions… Improvising on closed questions… Performance analysis: ‘What prompted you to say…?’ ‘How did you feel…?’ And to: Be aware of orientation towards lawyer at first sight Respond congruently to the lawyer Consult the internal ‘invigilator’… Professor Paul Maharg 13
- 14. SC training 3:assessing lawyers We discuss the marking system, and form a common understanding of it SCs view and mark videos, comparing to ‘standard’ SCs view each other’s ‘live’ performances and mark them Process repeated until everyone has role-played at least once Comment on performance Marks are collated in the room (suspense factor…) Professor Paul Maharg 14
- 15. Client interviewing assessment form Professor Paul Maharg 15
- 16. key activities Be aware of your self: Body language Eye contact Acting vs enacting Responding to questions and improvisation Relaying information Staying in neutral Congruence with own feelings Three-level thinking: Get the important facts right Improvise Assess according to criteria Professor Paul Maharg 16
- 17.
- 18. after initial training? SCs role-play clients with students, real lawyers and other professionals SCs are given refresher training on the scenario If they are trained on a new scenario they will have the same pattern of training They should form a community of practicewith two core members of staff – ideally, admin + academic to: improve practice meta-regulate (in Parker’s sense) the community within the law school suggest ways they may be used inside or outside the law school Professor Paul Maharg 18
- 19.
- 20. Study 2000 Research Study 1 Law Society of England & Wales Interviewed 44 clients of 21 different solicitors in the north of England. 50% said that they had previously used a solicitor whom they did not like. The most common complaint was lack of respect, followed by a lack of interest in the client, and then poor communication. Hillary Sommerlad & David Wall: Legally Aided Clients and Their Solicitors: Qualitative Perspectives on Quality and Legal Aid Professor Paul Maharg 20
- 21. Study 2000 Research Study 1 Law Society of England & Wales ‘I sent my former solicitor packing because she wouldn’t listen. That is absolutely fundamental; this was my case, only I knew the full circumstances’. Professor Paul Maharg 21
- 22. Study 2000 Research Study 1 Law Society of England & Wales ‘I went to [my current solicitor] because of her reputation and expertise… She is a part-time Registrar and has a big reputation as a specialist in this area but she just doesn’t listen’. Professor Paul Maharg 22
- 23. Study 2000 Research Study 1 Law Society of England & Wales ‘She listens for part of what I have to say, and then interrupts, saying something like “OK, I’ve got the picture, what we’ll do is ...” and she hasn’t really got the picture, she’s only got half the facts. I think it’s partly because she so busy and also because she’s simply not used to giving clients a voice. What’s more she has actually made me frightened of expressing my views. I am about to change to another solicitor’. Professor Paul Maharg 23
- 24. Study 2000 Research Study 1 Law Society of England & Wales ‘I like my current solicitor because I can have a chat with her, I trust her ... ... The other solicitor — I was just a file for him, but for [her current solicitor] I’m a real person and that comes across in court’. ‘I wanted the law to be explained. ... The way the solicitor views the client is important. He has to be interested in our views’. ‘They must be able to give you time. If solicitors haven’t got enough time, they can’t get enough out of you. You have to have time to be able to tell your story’. ‘I never liked him. ... we couldn’t have had a solicitor like him for this [matter]; I think he was perfectly competent, but there was no sympathy’. Professor Paul Maharg 24
- 25. summary: clients andtheir solicitors For many clients, their engagement with the law was not simply about achieving a result. Their responses indicated that the process itself was important. Empathy and respect were not luxury items: they were fundamental to the service. Professor Paul Maharg 25
- 26. summary: what doclients dislike? Inaccessibility Lack of communication Lack of empathy and understanding Lack of respect Professor Paul Maharg 26
- 27. summary: what doclients most care about? Three things, in descending order: 1. the process, ie having their problems or disputes settled in a way that they view as fair 2. achieving a fair settlement 3. the number of assets they end up winning. Tyler, T. (1988) Client perceptions of litigation. What counts: process or result? Trial Magazine, 7, 40-47 Professor Paul Maharg 27
- 28. Study 2 competence in client communication Study by Sherr: 143 actual 1st interviews 24 % trainee solicitors 76% experienced solicitors 70% at least 6 years 23% more than 11 years High percentages of ineffective interviews Experienced solicitors generally no better than trainee solicitors Paterson, Alan and Moorhead, R. and Sherr, A. (2003) What clients know: client perspectives and legal competence. International Journal of the Legal Profession, 10 (1). pp. 5-35 Professor Paul Maharg 28
- 29. Study 2 competence in client communication 51% failed to get client agreement to advice or plan of action 76% failed to confirm with client the solicitor’s understanding of the facts 85% failed to ask before ending whether there was anything else the client wanted to discuss Professor Paul Maharg 29
- 30. Study 2 competence in client communication Experienced solicitors: Used less legalese Better at “filling in the gaps” Rated their own interview performance higher than did trainee solicitors But the clients saw no difference in performance between trainees and experienced solicitors Professor Paul Maharg 30
- 31. Study summary: competence in client 2 communication ‘Being ‘‘client centred,’’ … is about paying attention to the practical and emotional needs of the client, not necessarily agreeing with the client’s motives, policy or philosophy and not necessarily doing what the client says they want. The client centred lawyer will listen to the client in order to advise on all options, as well as showing what they think is best for the client’. Paterson, Alan and Moorhead, R. and Sherr, A. (2003) What clients know: client perspectives and legal competence. International Journal of the Legal Profession, 10 (1). pp. 5-35, 12. See also Felstiner, W.L.F., Pettit, B. (2002) Paternalism, power and respect in lawyer-client relations, in Sanders, J., Hamilton, V.L., eds, Handbook of Justice Research in Law, Kluwer Academic Publishers, New York, 135-154. Professor Paul Maharg 31
- 32. The wider picture… ProfessorPaul Maharg 32
- 33. SCs : theoutsider as insider The SC approach challenges: 1. Curriculum methods 2. Ethics of the client encounter 3. The cognitive poverty of conventional law school assessment 4. Law school as a self-regarding, monolithic construct 5. Law school categories of employment 6. The curricular isolation of clinic within law schools 7. Hollowed-out skills rhetoric 8. Conventional forms of regulation by regulatory bodies 9. The role of regulator, as encourager of innovation & radical reform…? 10. Disciplinary boundaries – what about a SC Unit that’s interdisciplinary? 11. Local jurisdictional practices: how might such a project work globally? Professor Paul Maharg 33
- 34. future uses &research? Future use: More use by regulators Interdisciplinary uses, eg in sim courts Use in online simulations + mobile technologies Use in clinics Research: Further correlative studies More collaborative research between institutions Longitudinal research, on experience of SCs and clients Use in clinical situations and in real office situations Professor Paul Maharg 34
- 35. more information… 1. Websites: these slides @ http://paulmaharg.com; for more information on SCs, see http://zeugma.typepad.com/sci 2. Barton, K., Cunningham, C.D., Jones, G.T., Maharg, P. (2006). Valuing what clients think: standardized clients and the assessment of communicative competence. Clinical Law Review, 13,1, 1-65. 3. Maharg, P. (2007). Transforming Legal Education: Learning and Teaching the Law in the Early Twenty-first Century. Aldershot, Ashgate Publishing, chapter 2, 64- 67. 4. Garvey, J.B. (2010). New Hampshire’s performance-based variant of the Bar Examination, http://www.ncbex.org/uploads/user_docrepos/790210_Garvey.pdf 5. Barton, K., Garvey, J.B., Maharg (2012, in press). ‘You are here’: learning law, practice and professionalism in the academy. In Bankowski, Z., Maharg, P. del Mar, M., editors, The Arts and the Legal Academy. Beyond Text in Legal Education, vol 1. Aldershot, Ashgate Publishing. Professor Paul Maharg 35
- 36. planned book Standardized Clients in Legal Education Edited by Paul Maharg and Jean Ker (c.2014/15), introduced by Clark A chapter from each of the SCI centres, focusing on a specific aspect of research into SCs Chapters from medical educators Seminars & roadshows Professor Paul Maharg 36
- 37. SC in action… ProfessorPaul Maharg 37