Stages of Clinical Competence

At Jacqueline Webb & Co we feel we have a handle on the expertise required to perform as an Expert Witness, but I commonly see confusion when I speak with people about the role. I want to explore the varying experiences that qualify OT’s as potential Expert Witnesses. Many people believe that their experience will not match up to the requirements of being an expert in their field. They are put off simply by attaching the word ‘expert’ to their name. It is this misconception we want to reverse.

The common misconception regarding Expert Witness work is that you have to fit a condition-specific box in order to fulfil the position effectively, and this is not necessarily the case. This thought leads many to think that Experts only work in Paediatrics, Spinal Cord Injury or Traumatic Brain Injury. There is a much broader range of expertise that clinicians can draw on when considering Expert work.  The work OT’s take on in the NHS and Social Care provides excellent experience from which to draw upon as an Expert. These therapists have a cross section of experience and this is beneficial to them in the litigation field. They are what we call Generalists.

Generalist Experts cover four main areas:

  • Lower limb injury or amputation.
  • Upper limb injury or amputation.
  • Mental health associated with physical disability.
  • Palliative care or end of life care.

If your experience falls into any of these areas then perhaps you should consider yourself an Expert. These disabilities will most likely be referred to community multidisciplinary teams for support. Your recommendations as an Expert should not differ substantially from your current role; you will recommend care, equipment, housing adaptation, therapy, transport etc.  When we assess potential new Experts at Jacqueline Webb these are the areas we observe. However, what stands Experts apart is their ability to think outside the box when considering how they can maximise their client’s potential; individuals who are comfortable with recommending beyond the norm despite the knowledge that implementation is unlikely in their current statutory post.

To further help you to determine your level of expertise I want to bring your attention to the ‘Benners Stages of Clinical Competence’, which I felt models the field of Expert Witness work very well. The model outlines five stages of progression from ‘Novice’ to ‘The Expert’. It is evident to me that the OT in a community team dealing with a multitude of clients in the areas mentioned is in fact an Expert in their field. It is just a very varied field.

I would encourage you to determine your own level of expertise before discounting your ability to perform as an Expert. If you feel you are the senior member of your team, the most respected member on your unit, the ‘go to’ individual in your peer group then I would highly recommend exploring this work.