Directly Observed Procedural Skills – What do the Assessors Think?

Directly observed procedural skills (DOPS) assessments are widely used in clinical education for the assessment of competency in real-life situations. There is a growing body of evidence supporting their use in medical education and some evidence to suggest that DOPS can have a positive educational impact and provide valuable opportunities for feedback within veterinary education settings (Cobb et al 2013). DOPS assessments have been used in the Veterinary Programme for the past 5 years. The aim of this evaluation study was to establish whether the DOPS assessment is achieving the outcomes we had anticipated when it was implemented (i.e. valid and reliable assessment of clinical competency, feasibility in the clinical environment, improve feedback provided to students). Each assessor (participant) was reviewed by a peer (or by self-reflection) once during the study period (3 months). Participants completed a short written survey commenting on assessors’ performance as well as a section to rate and comment on the perceived validity of the DOPS as a form of assessment. 40 DOPS assessors participated in the study. Over 90% of participants agreed that they would recommend DOPS for use in another Veterinary School, however, several concerns were raised about the educational impact of DOPS and their ability to identify poorly performing students. The process of the DOPS audit itself has started an important discussion among assessors about what constitutes a 'competent' performance. Take home message: We recommend building a peer review process into DOPS assessment and new assessor training to improve the validity of assessment

Pleading Poverty in Federal Court

What must a poor person plead to gain access to the federal courts? How do courts decide when a poor litigant is poor enough? This Article answers those questions with the first comprehensive study of how district courts determine when a litigant may proceed in forma pauperis in a civil lawsuit. It shows that district courts lack standards to determine a litigant’s poverty and often require litigants to answer an array of questions to little effect. As a result, discrepancies in federal practice abound—across and within district courts—and produce a pleading system that is arbitrary, inefficient, and invasive. The Article makes four contributions. First, it codes all the poverty pleadings currently used by the ninety-four federal district courts. Second, it shows that the flaws of these procedures are neither inevitable nor characteristic of poverty determinations. By comparing federal practice to other federal means tests and state-court practices, the Article demonstrates that a more streamlined, yet rights-respecting approach is possible. Third, the Article proposes a coherent in forma pauperis standard—one that would align federal practice with federal law, promote reasoned judicial administration, and protect the dignity of litigants. Such a solution proves that judges need not choose between extending access to justice and preserving court resources. In this instance and perhaps others, judges can serve both commitments of the federal system. Fourth, the Article illustrates how to study procedure from the bottom up. Given the persistent and widening levels of inequality in American society, no account of civil procedure is complete without an understanding of how poor people litigate today

Territorial Exceptionalism and the American Welfare State

Federal law excludes millions of American citizens from crucial public benefits simply because they live in the United States territories. If the Social Security Administration determines a low-income individual has a disability, that person can move to another state and continue to receive benefits. But if that person moves to, say, Guam or the U.S. Virgin Islands, that person loses their right to federal aid. Similarly with SNAP (food stamps), federal spending rises with increased demand—whether because of a recession, a pandemic, or a climate disaster. But unlike the rest of the United States, Puerto Rico, the Northern Mariana Islands, and American Samoa receive a limited amount of federal food assistance, regardless of need. That’s why, after Hurricane Maria, despite additional congressional action, over a million Puerto Rican residents lost food assistance. And with Medicaid, federal law caps medical assistance for each of these five territories, a limit that does not exist for the fifty states or the District of Columbia. This Article draws much-needed attention to these discrepancies in legal status and social protection. It surveys the eligibility rules and financing structure of disability benefits, food assistance, and health insurance for low income Americans in the states and the territories. A comprehensive account of these practices provokes questions about the tiers of citizenship built by a fragmented and devolved American state. Part I invokes the scholarship on social citizenship, the idea that an individual cannot meaningfully participate in society without some modicum of economic security. Part I then explores the tension between that normative commitment and one of the defining features of the American welfare state—federalism. It then elaborates the exceptional legal status of Americans who live in U.S. territories. Part II provides a comprehensive overview of federal food, medical, and disability assistance and, in doing so, demonstrates how the American territories inhabit a different and, in many ways, dilapidated corner of the American welfare state. Part III begins with an analysis of ongoing cases in federal court that challenge this facial discrimination. It then canvasses legislation introduced in Congress that would make significant progress in putting territorial Americans on par with Americans in the fifty states. To conclude, Part IV brings the states back in, using the earlier discussion of territories as an invitation to imagine an American welfare state built on a foundation other than a racial order

Litigating Welfare Rights: Medicaid, SNAP, and the Legacy of the New Property

In 2017, the Republican-controlled Congress was poised to make deep cuts to the nation’s two largest anti-poverty programs: Medicaid and the Supplemental Nutrition Assistance Program (SNAP), commonly known as “food stamps.” Yet, despite a unified, GOP-led federal government for the first time in over a decade, those efforts failed. Meanwhile, the Trump Administration and its allies in state government continue to pursue different strategies to roll back entitlements to medical and food assistance. As public interest lawyers challenge these agency actions in federal court, roughly five million Americans’ health insurance and food assistance hang in the balance. This Article asks why Medicaid and SNAP have proven so resilient. The answer lies in the fiscal federalism that governs them and the federal litigation that reinforces them. Food and healthcare programs for poor Americans are shaped by several institutions: Congress, federal and state agencies, state legislatures, and courts. The federal government pays for 100% of SNAP benefits. States pay for up to half of the costs of administering the program, but SNAP’s substantive benefits are free to the states. For Medicaid, states contribute to the substantive benefits, but the federal government pays the lion’s share. As one would expect, when the substance of the benefit is free but the procedures surrounding the benefit are not, states are reluctant to impose procedural barriers for which the state must pay to prevent its residents from accessing benefits which cost the state nothing. As a result, the fiscal rules surrounding these programs engender an unholy, but not unstable, alliance between public interest lawyers and state administrators—one that prevents the gutting of these benefit programs. When states do attempt to restrict access to these programs, public interest lawyers can rely on statutory provisions and administrative law to contest these cuts in federal court. In unearthing this legal infrastructure, this Article offers a new account of welfare litigation, one that sharpens and updates Charles Reich’s theory of government benefits in The New Property. This Article also challenges the conventional wisdom that procedural protections undermine substantive rights. Finally, it disputes the widely held belief that litigation is a poor tool for protecting poor people’s rights. Rather, public interest litigation has played a key role in Medicaid and SNAP’s durability

Litigating Welfare Rights: Medicaid, SNAP, and the Legacy of the New Property

In 2017, the Republican-controlled Congress was poised to make deep cuts to the nation’s two largest anti-poverty programs: Medicaid and the Supplemental Nutrition Assistance Program (SNAP), commonly known as “food stamps.” Yet, despite a unified, GOP-led federal government for the first time in over a decade, those efforts failed. Meanwhile, the Trump Administration and its allies in state government continue to pursue different strategies to roll back entitlements to medical and food assistance. As public interest lawyers challenge these agency actions in federal court, roughly five million Americans’ health insurance and food assistance hang in the balance. This Article asks why Medicaid and SNAP have proven so resilient. The answer lies in the fiscal federalism that governs them and the federal litigation that reinforces them. Food and healthcare programs for poor Americans are shaped by several institutions: Congress, federal and state agencies, state legislatures, and courts. The federal government pays for 100% of SNAP benefits. States pay for up to half of the costs of administering the program, but SNAP’s substantive benefits are free to the states. For Medicaid, states contribute to the substantive benefits, but the federal government pays the lion’s share. As one would expect, when the substance of the benefit is free but the procedures surrounding the benefit are not, states are reluctant to impose procedural barriers for which the state must pay to prevent its residents from accessing benefits which cost the state nothing. As a result, the fiscal rules surrounding these programs engender an unholy, but not unstable, alliance between public interest lawyers and state administrators—one that prevents the gutting of these benefit programs. When states do attempt to restrict access to these programs, public interest lawyers can rely on statutory provisions and administrative law to contest these cuts in federal court. In unearthing this legal infrastructure, this Article offers a new account of welfare litigation, one that sharpens and updates Charles Reich’s theory of government benefits in The New Property. This Article also challenges the conventional wisdom that procedural protections undermine substantive rights. Finally, it disputes the widely held belief that litigation is a poor tool for protecting poor people’s rights. Rather, public interest litigation has played a key role in Medicaid and SNAP’s durability

The reluctant Europeans:British novelists and the common market

Despite Britain’s long-standing reputation as a ‘reluctant European’, little research has been done on the treatment of the European Union in cultural production. This essay analyses responses to integration in British fiction of the second half of the twentieth century. Drawing on cultural materialist theory, the essay finds the same mixture of indifference and hostility that marked public discourse and argues that such responses were moulded by the Euroscepticism current amongst governmental and media elites. As illustrated by the work of Nancy Mitford, John Berger, Elizabeth Wilson, Tim Parks and others, engagement increased between the Treaty of Rome and the turn of the twenty-first century, although ideological commitment to ‘Project Europe’ remained largely absent

The Dilemmas of ‘Post-Communism’:Elizabeth Wilson’s The Lost Time Café

Discussion of the merits and failings of socialism is one of the major features of post-1945 European literature. Although the literary right has dominated fiction in the West, left-wing writing has persisted into the twenty-first century, offering a powerful critique of the neoliberalism that has established control over continental integration. This essay examines this critique through a study of Elizabeth Wilson’s The Lost Time Café (1993), a British dystopian thriller set at the millennium’s end. Delving into the history of the Communist Party of Great Britain, Wilson argues that the radical tradition is necessary for understanding and solving the crises of the late twentieth-century, challenging the poverty, inequality and austerity of the post-welfarist European Union with a more socialist vision of united Europe

On Fires, Floods, and Federalism

In the United States, law condemns poor people to their fates in states. Where Americans live continues to dictate whether they can access cash, food, and medical assistance. What’s more, immigrants, territorial residents, and tribal members encounter deteriorated corners of the American welfare state. Nonetheless, despite repeated retrenchment efforts, this patchwork of programs has proven remarkably resilient. Yet, the ability of the United States to meet its people’s most basic needs now faces an unprecedented challenge: climate change. As extreme weather events like wildfires and hurricanes become more frequent and more intense, these climate-fueled disasters will displace and impoverish more people. How can the United States adapt its welfare programs to assist Americans in the face of this threat?This Article maps that uncharted territory. It contextualizes the climate crisis in our scholarly understanding of the American welfare state. It then canvasses the myriad disaster provisions in each major welfare program. Equipped with an understanding of the status quo, the Article proceeds to evaluate how federal law has fared, amid the recent spate of fires and floods. The Article attends to the role of Congress, weakened as it is by increased polarization and diminished capacity, and how the resulting delays and distortions in emergency relief have hampered the governmental response. The Article then brings state and local government into focus, and in doing so, demonstrates how assistance often excludes the most vulnerable Americans. The Article also extracts lessons from the pandemic response for climate adaptation of public benefits. The Article concludes with an agenda for how to adapt welfare programs to meet the climate crisis. That agenda starts and ends with the federal government, but it includes policies states, territories, and tribes could implement if Congress and federal agencies do nothing or not enough. The Article repurposes what we know about how the American welfare state functions now to inform what federal, state, and local government should do next

'The danger zone of Europe': balkansim betwenn the cold war and 9/11

This article argues that the Balkans formed one of the major sources of alterity for the West in the decade following the end of the Cold War. Taking the place of the erstwhile communist Other, the region was constructed in journalism, political statement and travel writing as a zone of backwardness, barbarism and violence which threatened to engulf the civilized and democratic West. Using travel writing as a source material, this article argues more specifically that the ideological scepticism and aesthetic conventions of postmodernism have been an important influence on contemporary balkanism, as they have been on the representation of other non-western locations. Although the role of the Balkans has now been superseded by Al-Qaida and the 'international terror network', the post-1989 representational styles continue to have devastating political and economic effects in the region. [author's abstract