Sexual Assault Training in Emergency Medicine Residencies: A Survey of Program Directors

Abstract

Introduction:There is currently no standard forensic medicine training program for emergency medicine residents. In the advent of sexual assault nurse examiner (SANE) programs aimed at improving the quality of care for sexual assault victims, it is also unclear how these programs impact emergency medicine (EM) resident forensic medicine training. The purpose of this study was to gather information on EM residency programs’ training in the care of sexual assault patients and determine what impact SANE programs may have on the experience of EM resident training from the perspective of residency program directors (PDs).Methods:This was a cross-sectional survey. The study cohort was all residency PDs from approved EM residency training programs who completed a closed-response self-administered survey electronically.Results:We sent surveys to 152 PDs, and 71 responded for an overall response rate of 47%. Twenty-two PDs (31%) reported that their residency does not require procedural competency for the sexual assault exam, and 29 (41%) reported their residents are required only to observe sexual assault exam completion to demonstrate competency. Residency PDs were asked how their programs established resident requirements for sexual assault exams. Thirty-seven PDs (52%) did not know how their sexual assault exam requirement was established.Conclusion:More than half of residency PDs did not know how their sexual assault guidelines were established, and few were based upon recommendations from the literature. There is no clear consensus as to how PDs view the effect of SANE programs on resident competency with the sexual assault exam. This study highlights both a need for increased awareness of EM resident sexual assault education nationally and also a possible need for a training curriculum defining guidelines for EM residents performing sexual assault exams.

Validation of an emergency triage scale for obstetrics and gynaecology: a prospective study

“…Vignette #17 was a case of severe haemorrhage brought by ambulance at the end of the first trimester. Finally, vignette #24 illustrated a case of sexual assault, which represents a delicate situation from medical, psychological and juridical points of view …”

“…Finally, vignette #24 illustrated a case of sexual assault, which represents a delicate situation from medical, psychological and juridical points of view. 22 The potential impact of an underestimation would be that severe cases might be unsafely diverted to lower acuity with potentially significant negative impact on the clinical outcome. In our study, four vignettes were frequently rated with a lower level than expected (#6, 18,21,25).…”

“…We observed a wide variability in the median (IQR) number of questions asked per vignette, ranging from 8.0 (7-9) (#22, a case of a Bartholin's abscess) to 15.5 (13-21) (#12, a case of hypotension at 20 weeks of gestation) in the test phase ( Figure 1A), and from 7.5 (7-11) (#22) to 17.5 (11-21) (#12) in the retest phase. The median (IQR) number of questions asked varied also across individuals from 7.0 (4-9) to 19.0 (15)(16)(17)(18)(19)(20)(21)(22) in the test phase ( Figure 1B). The observed variability had no significant impact on the correctness of triage results.…”

Perfil De Mulheres Vítimas De Abuso Sexual Atendidas Em Hospital De Ensino

“…A agressão sexual mais comum entre as vítimas analisadas neste estudo foi o estupro. Esse ato evidencia a gravidade da agressão, justifica o atendimento em serviço de emergência, aumenta as chances de infecções sexualmente transmissíveis e é compatível com a literatura (34) . Dados mundiais indicam que 35% das mulheres sofrem violência sexual, inclusive do próprio parceiro, durante a vida (25) .…”

“…Isso sinaliza o fato das mulheres estarem preocupadas com a sua saúde e terem conhecimento da necessidade desse tipo de atendimento. Ainda assim é preocupante o fato de vítimas se consultarem após setenta e duas horas do ocorrido, uma vez que a profilaxia para HIV e outras doenças sexualmente transmissíveis tem pouca efetividade se iniciada além das 48 horas após a contaminação (34) . Das vítimas atendidas, mais da metade realizou profilaxia para HIV.…”