Racial bias in jury selection hurts mock jurors, not just defendants: Testing one potential intervention.

OBJECTIVES: Prosecutors often use race as a basis for excluding Black jurors in cases with Black defendants. The current research tested whether this practice influences juror attitudes (Study 1). It also tested an intervention to prevent racially biased jury selection (Study 2). HYPOTHESES: We predicted that participants exposed to the exclusion of Black prospective jurors would have more negative feelings compared with those who were not exposed to such exclusions (Study 1). We also predicted that participants taking on the role of a prosecutor would be more likely to exclude a Black (vs. White) prospective juror in a case with a Black defendant and that warnings against race-based decisions would result in elaborate race-neutral rationales for the exclusions (Study 2). METHOD: In Study 1 (N = 228), participants witnessed a simulated jury selection process. For half of the participants, Black jurors were differentially excluded. In Study 2 (N = 298), participants selected between a Black and a White prospective juror for a case with a Black defendant. RESULTS: Exposure to race-based exclusions negatively impacted perceptions of fairness and emotional responses, especially for Black participants (Study 1). Participants were more likely to exclude a Black juror (vs. White juror) but gave race-neutral rationales for their decisions. The effect of race on juror selection was eliminated when participants were warned against using race as a basis for excluding jurors (Study 2). CONCLUSIONS: Race-motivated exclusions affect not only Black defendants, by depriving them of their right to a jury of their peers, but also the jurors who remain to deliberate. A warning could be a viable intervention for curbing the influence of race on prosecutorial decisions during jury selection. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The truth about snitches: an archival analysis of informant testimony.

Informants are witnesses who often testify in exchange for an incentive (i.e. jailhouse informant, cooperating witness). Despite the widespread use of informants, little is known about the circumstances surrounding their use at trial. This study content-analyzed trials from 22 DNA exoneration cases involving 53 informants. Because these defendants were exonerated, the prosecution informant testimony is demonstrably false. Informant characteristics including motivation for testifying, criminal history, relationship with the defendant and testimony were coded. Most informants were prosecution jailhouse informants; however, there were also defence jailhouse informants and prosecution cooperating witnesses. Regardless of informant type, most denied receiving an incentive, had criminal histories, were friends/acquaintances of the defendant and had testimonial inconsistencies. In closing statements, attorneys relied on informant testimony by either emphasizing or questioning its reliability. The impact of informant testimony on jurors' decisions is discussed in terms of truth-default theory (TDT), the fundamental attribution error and prosecutorial vouching.

Cowitness identification speed affects choices from target-absent photospreads.

OBJECTIVE: Three studies examined the influence of a witness's identification speed on the identification decision of another witness. HYPOTHESES: Based on research documenting cowitness effects we expected cowitness speed to affect identification decisions from target-absent photospreads. Without prior research testing the effects of cowitness speed, we did not have a specific prediction regarding how fast (vs. slow) cowitness identification decisions would affect participant-witnesses' identification rates in Study 1. Based on the results from Study 1, in Study 2 we predicted that fast (vs. slow) cowitness decisions would increase choices from target-absent photospreads when the cowitness was known to have made a positive identification. In Study 3, cowitnesses rejected the photospread. Based on the previous studies, we hypothesized that fast (vs. slow) cowitness decisions would decrease choices from target-absent photospreads. However, because a photospread rejection is qualitatively different from an identification, this prediction was tentative. METHOD: In all three studies, participants watched one of 2 stimulus videos with a confederate cowitness. After the video, the confederate made a fast (10 s) or slow (4 min) identification. Participants then attempted an identification from a target-absent photospread. In Study 1 (N = 101), the confederate's decision from the photospread was ambiguous. In Study 2 (N = 200) the confederate announced making a positive identification. In Study 3 (N = 151) the confederate cowitness rejected the photospread. RESULTS: In all 3 studies, participants paired with a fast cowitness made more choices from the target-absent photospread than did participants paired with a slow cowitness. CONCLUSIONS: Fast cowitness identifications increased choices from the target-absent photospread regardless of whether a cowitness's decision was ambiguous (Study 1), whether they made an identification (Study 2), or rejected the photospread (Study 3). Given the effects of cowitness speed on identification decisions, it might be advisable to standardize the duration of identification procedures and inform witnesses of this standardization. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Policy and procedure recommendations for the collection and preservation of eyewitness identification evidence.

OBJECTIVE: The Executive Committee of the American Psychology-Law Society (Division 41 of the American Psychological Association) appointed a subcommittee to update the influential 1998 scientific review paper on guidelines for eyewitness identification procedures. METHOD: This was a collaborative effort by six senior eyewitness researchers, who all participated in the writing process. Feedback from members of AP-LS and the legal communities was solicited over an 18-month period. RESULTS: The results yielded nine recommendations for planning, designing, and conducting eyewitness identification procedures. Four of the recommendations were from the 1998 article and concerned the selection of lineup fillers, prelineup instructions to witnesses, the use of double-blind procedures, and collection of a confidence statement. The additional five recommendations concern the need for law enforcement to conduct a prelineup interview of the witness, the need for evidence-based suspicion before conducting an identification procedure, video-recording of the entire procedure, avoiding repeated identification attempts with the same witness and same suspect, and avoiding the use of showups when possible and improving how showups are conducted when they are necessary. CONCLUSIONS: The reliability and integrity of eyewitness identification evidence is highly dependent on the procedures used by law enforcement for collecting and preserving the eyewitness evidence. These nine recommendations can advance the reliability and integrity of the evidence. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

A Randomized Controlled Trial on the Effect of a Double Check on the Detection of Medication Errors.

STUDY OBJECTIVE: The use of a double check by 2 nurses has been advocated as a key error-prevention strategy. This study aims to determine how often a double check is used for high-alert medications and whether it increases error detection. METHODS: Emergency department and ICU nurses worked in pairs to care for a simulated patient. Nurses were randomized into single- and double-check groups. Errors intentionally introduced into the simulation included weight-based dosage errors and wrong medication vial errors. The evaluator recorded whether a double check was used, whether errors were detected, and observational data about nurse behavior during the simulation. RESULTS: Forty-three pairs of nurses consented to enroll in the study. All nurses randomized to the double-check group used a double check. In the single-check group, 9% of nurses detected the weight-based dosage error compared with 33% of nurses in the double-check group (odds ratio 5.0; 95% confidence interval 0.90 to 27.74). Fifty-four percent of nurses in the single-check group detected the wrong vial error compared with 100% of nurses in the double-check group (odds ratio 19.9; 95% confidence interval 1.0 to 408.5). CONCLUSION: Our study demonstrates that nurses use double checks before administering high-alert medications. Use of a double check increases certain error detection rates in some circumstances, but not others. Both techniques missed many errors. In some cases, the second nurse actually dissuaded the first nurse from acting on the error.

The dynamic interaction between eyewitnesses and interviewers: the impact of differences in perspective on memory reports and interviewer behavior.

Despite myriad possible differences in perspectives brought to an investigative interview by eyewitnesses and interviewers, little is known about how such differences might affect eyewitness memory reports or interviewer behavior. Two experiments tested the impact of such differences in a dynamic interaction paradigm in which participants served as eyewitnesses and interviewers. In Experiment 1 (N = 38 pairs), reporting goals for eyewitnesses and interviewers were manipulated in a factorial design, with participants instructed to provide or obtain either as much information as possible or only accurate information. Matching interviewer-interviewee instructions promoted accurate reporting, regardless of the actual content of the instructions. In Experiment 2 (N = 45 pairs), access to information about corroborating eyewitness identifications was manipulated in a factorial design. Corroborating information affected interviewers, but not eyewitnesses. When interviewers did not have access to corroborating information, they provided more negative feedback, and there was a trend toward interrupting more and asking more yes/no questions. These experiments indicate that differences in perspective can have effects on both the content of a witness's report and the behavior of an interviewer. The potential for differences in perspective should be considered in research on protocols intended to maximize eyewitness report accuracy.

The effect of post-identification feedback, delay, and suspicion on accurate eyewitnesses.

We examined whether post-identification feedback and suspicion affect accurate eyewitnesses. Participants viewed a video event and then made a lineup decision from a target-present photo lineup. Regardless of accuracy, the experimenter either, informed participants that they made a correct lineup decision or gave no information regarding their lineup decision. Immediately following the lineup decision or after a 1-week delay, a second experimenter gave some of the participants who received confirming feedback reason to be suspicious of the confirming feedback. Following immediately after the confirming feedback, accurate witnesses did not demonstrate certainty inflation. However, after a delay accurate witnesses did demonstrate certainty inflation typically associated with confirming feedback. The suspicion manipulation only affected participants' certainty when the confirming feedback created certainty inflation. The results lend support to the accessibility interpretation of the post-identification feedback effect and the erasure interpretation of the suspicion effect.

Addressing Transportation Insecurity Improves Attendance at Posthospitalization Appointments.

BACKGROUND: Transportation influences attendance at posthospitalization appointments (PHAs). In 2017, our pediatric hospital medicine group found that our patients missed 38% of their scheduled PHAs, with several being due to transportation insecurity. To address this, we implemented a quality improvement project to perform inpatient assessment of transportation insecurity and provide mitigation with the goal of improving attendance at PHAs. METHODS: The process measure was the percentage of patients with completed transportation insecurity screening, and the outcome measure was PHA attendance. An interprofessional team performed plan-do-study-act cycles. These included educating staff about the significance of transportation insecurity, its assessment, and documentation; embedding a list of local transportation resources in discharge instructions and coaching families on using these resources; notifying primary care providers of families with transportation insecurity; and auditing PHA attendance. RESULTS: Between July 2018 and December 2019, electronic health record documentation of transportation insecurity assessment among patients on the pediatric hospital medicine service and discharged from the hospital (n = 1731) increased from 1% to 94%, families identified with transportation insecurity increased from 1.2% to 5%, and attendance at PHAs improved for all patients (62%-81%) and for those with transportation insecurity (0%-57%). Our balance measure, proportion of discharges by 2 pm, remained steady at 53%. Plan-do-study-act cycles revealed that emphasizing PHA importance, educating staff about transportation insecurity, and helping families identify and learn to use transportation resources all contributed to improvement. CONCLUSIONS: Interventions implemented during the inpatient stay to assess for and mitigate transportation insecurity led to improvement in pediatric PHA attendance.

Comparison of Active Learning Techniques: Audience Response Questions Versus Small Group Discussion on Immediate- and Long-term Knowledge Gain.

OBJECTIVES: Active learning techniques help with motivation, involvement, and retention during didactics. There are few studies comparing different active learning methods, and these have yielded mixed results. The objective of this study was to compare the effect of two active learning methods-small-group discussion and audience response system (ARS)-on immediate- and long-term knowledge gain. METHODS: This was a prospective experimental study of emergency medicine (EM) subinterns and residents. Participants were randomized into two groups, and baseline knowledge was assessed with a multiple-choice pretest. Didactic sessions on salicylate toxicity and ocular trauma were given to both groups utilizing either small-group discussion or ARS. A crossover design was utilized to ensure that both groups received instruction by each method. A multiple-choice posttest was administered following the didactics and again 2 months later. Pre- and posttests were identical. All test items were written by an academic faculty member with advanced training in medical education and item writing and were based on the goals and objectives of the session. Test items were piloted with a reference group of learners. Didactic instructors were blinded to test items. Data were analyzed using a linear mixed-effects model. RESULTS: Thirty-eight subinterns and residents participated in the study. Both instructional methods showed immediate- and long-term knowledge gain. The linear mixed-effects model did not demonstrate any significant difference between instructional methods on immediate knowledge gain (mean difference = 0.18, p = 0.62, 95% confidence interval [CI] = -0.52 to 0.88) or long-term knowledge gain (mean difference = -0.42, p = 0.36, 95% CI = -1.32 to 0.47). CONCLUSION: In this small study, there was no significant difference between instructional methods on immediate- and long-term knowledge gain in EM subinterns and residents.

Does post-identification feedback affect evaluations of eyewitness testimony and identification procedures?

Two experiments were conducted to test whether post-identification feedback affects evaluations of eyewitnesses. In Experiment 1 (N = 156), evaluators viewed eyewitness testimony. They evaluated witnesses who received confirming post-identification feedback as more accurate and more confident, among other judgments, compared with witnesses who received disconfirming post-identification feedback or no feedback. This pattern persisted regardless of whether the witness's confidence statement was included in the testimony. In Experiment 2 (N = 161), witness evaluators viewed the actual identification procedure in which feedback was delivered. Instructions to disregard the feedback were manipulated. Again, witnesses who received confirming feedback were assessed more positively. This pattern occurred even when witness evaluators received instructions to disregard the feedback. These experiments are the first to confirm researchers' assumptions that feedback effects on witnesses translate to changes in judgments of those witnesses.

Do prophylactics prevent inflation? Post-identification feedback and the effectiveness of procedures to protect against confidence-inflation in earwitnesses.

After viewing or hearing a recorded simulated crime, participants were asked to identify the offender's voice from a target-absent audio lineup. After making their voice identification, some participants were either given confirming feedback or no feedback. The feedback manipulation in experiment 1 led to higher ratings of participants' identification certainty, as well as higher ratings on retrospective confidence reports, in both the immediate and delay groups. Earwitnesses who were asked about their identification certainty prior to the feedback manipulation (experiment 2) did not demonstrate the typical confidence-inflation associated with confirming feedback if they were questioned about the witnessing experience immediately; however, the effects returned after a week-long retention interval. The implications for the differential forgetting and internal-cues hypotheses are discussed.

Resident Clinical Experience in the Emergency Department: Patient Encounters by Postgraduate Year.

BACKGROUND: During emergency medicine (EM) training, residents are exposed to a wide spectrum of patient complaints. We sought to determine how resident clinical experience changes based on training level in relation to the patient acuity levels, chief complaints, and dispositions. METHODS: We performed a retrospective chart review of patients seen at a safety-net, academic hospital in Los Angeles from July 1, 2015, to June 30, 2016. Resident postgraduate year (PGY) level and specialty, patient acuity (based on the Emergency Severity Index), chief complaint (based on one of 30 categories), and disposition were abstracted. Our primary objective was to examine the progression of EM resident experience throughout the course of training. As a secondary objective, we compared the cases seen by EM and off-service PGY-1s. RESULTS: A total of 49,535 visits were examined, and of these, 32,870 (66.4%) were in the adult ED (AED) and 16,665 (33.6%) were in the pediatric ED (PED). The median acuity level was 3, and 27.4% of AED patients and 7.3% of PED patients were admitted. Data from 126 residents were analyzed. This included 94 PGY-1 residents (16 EM and 78 off-service), 16 PGY-2 EM, and 16 PGY-3 EM residents. Residents of different training levels evaluated different types of patients. Senior EM residents were more likely to care for higher-acuity patients than junior EM residents. EM PGY-3s saw higher percentages of acuity level 1 and 2 patients (2.3 and 37.8%, respectively, of their total patients) than EM PGY-1s (0.3 and 18.7%, respectively). Conversely, EM PGY-1s saw higher percentages of acuity level 4 and 5 patients (27.9 and 1.6%, respectively) compared to EM PGY-3s (10.7 and 0.7%, respectively). There was a significant linear trend for increasing acuity with training year among EM residents (p < 0.001). EM PGY-1s saw more patients than off-service PGY-1s with slightly higher acuities and admission rates. CONCLUSION: The clinical experience of EM residents varies based on their level of training. EM residents show a progression throughout residency and are more likely to encounter higher volumes of patients with higher acuity as they progress in their training. When designing EM residency curriculums, this is a model of an EM residency program.

Emergency medicine and psychiatry agreement on diagnosis and disposition of emergency department patients with behavioral emergencies.

OBJECTIVES: The objective was to determine the level of agreement between emergency physicians (EPs) and consulting psychiatrists in their diagnosis and disposition of emergency department (ED) patients with behavioral emergencies. METHODS: The authors conducted a prospective study at a university teaching hospital ED with an annual census of approximately 45,000 patients. During study hours, each time a psychiatric consultation was requested, the emergency medicine (EM) and consulting psychiatry residents were asked to fill out similar short questionnaires concerning their diagnoses and disposition decisions after they consulted with their attending physicians. EM and psychiatry residents were blinded to the other's assessment of the patient. Residents were asked about their evaluation of patients regarding: 1) psychiatric assessments, 2) if the patients presented a danger to themselves or others or were gravely disabled, and 3) the need for emergency psychiatric hospitalization. RESULTS: A total of 408 resident physician pairs were enrolled in the study. Patients ranged in age from 5 to 92 years, with a median age of 31 years; 50% were female. The most common psychiatric assessments, as evaluated by either EPs, consulting psychiatrists, or both, were mood disorder (66%), suicidality (57%), drug/alcohol abuse (26%), and psychosis (25%). Seventy-three percent were admitted for acute psychiatric hospitalization. Agreement between EPs and psychiatrists was 67% for presence of mood disorder, 82% for suicidality, 82% for drug/alcohol abuse, 85% for psychosis, and 85% for grave disability. There was 67% agreement regarding patient eligibility for involuntary psychiatric hold. EPs felt confident enough to make disposition decisions 87% of the time; for these patients there was 76% agreement with consulting psychiatrists about the final disposition decision. CONCLUSIONS: The 67% agreement between EPs and consulting psychiatrists regarding need for involuntary hold, and 76% agreement regarding final disposition, demonstrate a substantial disagreement between EPs and psychiatrists regarding management and disposition of ED patients with psychiatric complaints. Further studies with patient follow-up are needed to determine the accuracy of the ED assessments by both EPs and consulting psychiatrists.

A problem with double-blind photospread procedures: photospread administrators use one eyewitness's confidence to influence the identification of another eyewitness.

In Experiment 1, photospread administrators (PAs, N = 50) showed a target-absent photospread to a confederate eyewitness (CW), who was randomly assigned to identify one photo with either high or low confidence. PAs subsequently administered the same target-absent photospread to participant eyewitnesses (PWs, N = 50), all of whom had viewed a live staged crime 1 week earlier. CWs were rated by the PAs as significantly more confident in the high-confidence condition versus low-confidence condition. More importantly, the confidence of the CW affected the identification decision of the PW. In the low-confidence condition, the photo identified by the CW was identified by the PW significantly more than the other photos; there was no significant difference in photo choice in the high-confidence condition. In spite of the obvious influence exerted in the low-confidence condition, observers were not able to detect bias in the photospread procedures. A second experiment was conducted to test a post-hoc explanation for the results of Experiment 1: PAs exerted influence in the low-confidence condition because they perceived the task as more difficult for the eyewitness than in the high-confidence condition. Independent observers (N = 84) rated the difficulty of the confederate's task as higher in the low-confidence condition compared with the high-confidence condition, suggesting that expectations of task difficulty might be driving the effect observed in Experiment 1. Results support recommendations for double-blind photospreads and emphasize that the same investigator should not administer photo lineups to multiple eyewitnesses in an investigation.