Psychopathology and the Legal System at Sharpe Hospital

LOCATION: William R. Sharpe, Jr. Hospital, 936 Sharpe Hospital Road, Weston, WV
PRECEPTOR: Tracy Coffman, MD
DURATION: 2 or 4 weeks
OFFERED: Continuously
STATUS: Elective **Can be taken to satisfy part of the rural requirement**


Sharpe Hospital cares for patients who have been found incompetent to stand trial and not guilty by reason of mental illness.  This environment provides a valuable and unique learning opportunity for students to gain experience with severe psychopathology, the intersection of the law and psychiatry, and long-term psychiatric hospitalizations.  Students will become a part of a multidisciplinary treatment team and participate in the daily care of inpatients at Sharpe.  Experiences may include initial psychiatric evaluations, daily psychiatric rounds, family meetings, therapeutic groups, and court hearings. 

Patient care

  • Demonstrate ability to develop rapport with patients, their families, and other allies
  • Demonstrate ability to elicit psychiatric history from patients, their families, and other allies
  • Demonstrate ability to perform mental status examination of patients with severe psychiatric illness

Medical knowledge

  • Demonstrate adequate knowledge of psychiatric disorders listed in the DSM 5, including their diagnostic features and basic elements of treatment
  • Demonstrate basic knowledge of medical-legal concepts including involuntary commitment, competency to stand trial, and the not guilty by reason of mental illness verdict
  • Demonstrate the ability to utilize diagnostic tools, such as the Mini Mental State Exam (MMSE) and Abnormal Involuntary Movement Scale (AIMS)
  • Demonstrate adequate knowledge about potential side effects of common psychiatric medications, especially tardive dyskinesia
  • Demonstrate basic knowledge of the differences between treatment-oriented psychiatric evaluations and forensic evaluations

Interpersonal skills and communication

  • Demonstrate the ability to empathize with severely mentally ill patients
  • Demonstrate the ability to effectively participate in a multidisciplinary treatment team
  • Demonstrate the ability to accurately elicit, record, and communicate information among patients, their families, other allies, and treatment team members

Practice Based Learning and Improvement

  • Demonstrate the ability to recognize deficits in one’s current knowledge
  • Demonstrate the ability to address identified deficits


  • Demonstrate respect toward patients, their families, other allies, colleagues, hospital staff, and other professionals
  • Demonstrate responsibility and accountability in the performance of assigned duties
  • Maintain confidentiality at all times

Systems based practice

  • Demonstrate basic knowledge of the legal system’s role in determining setting of care and disposition for psychiatric patients with legal charges
  • Demonstrate the ability to identify the correct level of care for a psychiatric patient

Methods to Achieve Objectives

Primarily supervised clinical experiences and informal or “bedside” teaching.  Students will also be expected to attend any scheduled educational sessions (such as Case Conference and Grand Rounds) taking place during their rotation and may be assigned to present at Case Conference.  Depending on availability and interest, the students may also observe forensic evaluations and observe or participate in therapeutic groups.  Other instructional methods such as readings of journal articles and didactic teaching sessions may be used at the discretion of the individual preceptor. 

Examination Procedures and Evaluation Criteria

Formative Assessment:  Students will be provided with feedback on an ongoing basis throughout their clinical experience. 

Summative Assessment Criteria:  Student achievement of the above objectives will be rated by the preceptor at the end of the clinical experience using a standardized survey. 

Pre-Rotation Instructions

Please contact Dr. Coffman at 2 weeks prior to the start of the elective.