Location: Hyatt Hotel & Spa Mission Bay, San Diego, CA
This course is one of the first of its kind, specifically targeted to meet physicians’ educational needs in caring for the adult patient who has experienced sexual assault. The course was previously offered in an eight-hour format but has been expanded to 12.5 hours.
Participants will gain practical expertise in conducting medical-forensic examinations, knowledge about expert witness courtroom testimony, conducting programmatic CQI, cultural and legal controversies in care, and the science behind DNA/STRs for sexually assaulted patients. This course will provide state-of-the-art practical information for emergency physicians practicing in academic, community, or rural settings with or without the support of specially trained sexual assault nurse examiners (SANEs). A specific evening program will be dedicated to “The Forensic Evaluation of the Child.” Program managers are encouraged to attend with their medical director colleagues at a discounted rate.
This course has been divided into two components to optimize physician education and time.
Part One, an excellent, highly suggested prerequisite, is a self-paced at-home review of The Sexual Assault: Forensic and Clinical Management, a Virtual Practicum. This 12-hour interactive DVD was created by Dartmouth School of Medicine and reviewed by the American College of Emergency Physicians’ education committee, which said “It is very well done and would provide relevant CME to ACEP members.” The DVD can be purchased through the International Association of Forensic Nurses (IAFN) at iafn.site-ym.com/store/ViewProduct.aspx?id=2630637 for $46.
After reviewing this DVD, participants may purchase optional CME directly from Dartmouth for an additional $65. Further information about the DVD can be obtained at ccehs.dartmouth-hitchcock.org/activity/1922767/detail.aspx.
Part Two is our on-site, 12.5-hour CME course on Thursday afternoon, September 8, and Friday, September 9. Upon successful completion of this live activity, the California Clinical Forensic Medical Training Center in conjunction with the Institute for International Medicine will issue a CME certificate stating that you have participated in the live activity titled “Advanced Sexual Assault Medical-Forensic Course for Physicians,” and you will be awarded a maximum of 12.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of the participation in the activity. CMEs will also be awarded for the main conference.
Registration: 11 a.m. – Noon
Welcome and Introductions: Noon
Module I: Noon – 1:30 p.m.
Sexual Assault Care—Past, Present, and Future
Michael L. Weaver, M.D., FACEP
The care of patients who have been sexually assaulted has changed in many ways, including how they present, where they present, and how we approach their evaluation and management. The evolution to a multidisciplinary team approach has proven to lead to more successful outcomes for patient care and in the criminal justice system.
At the conclusion of this educational offering, attendees will be able to:
- Explain the development of sexual assault programs and the SANE model.
- Discuss persistent myths and major shifts in patient presentation.
- Verbalize the evolution from SART to SARRTs.
Module II: 1:30 – 3 p.m.
Forensic Exam and Evidence Collection Essentials
William Green, M.D., FACEP
Overview of the Sexual Assault Forensic Exam Process
- History
- Physical exam
- Forensic evidence
- Forensic Evidence and Findings
- Anticipation and Identification
- Guided by the history
- Enhancements (ALS, TB, magnification)
Overview of DNA Evidence
Avoiding Evidence Problems
- Contamination and degradation
- Chain of custody
- Inadmissibility
At the conclusion of this educational offering, attendees will be able to:
- Verbalize the basic forensic exam process, including history, physical exam, evidence collection,and management.
- Describe the procedures and techniques for forensic evidence collection, handling, labeling, andpackaging.
- Summarize the significance and use of DNA evidence in the context of sexual assaultexamination and investigation.
- List and describe potential problems with sexual assault evidence and strategies to preventthese problems.
Break: 3 – 3:15 p.m.
Module III: 3:15 – 4:45 p.m.
The Difficult Assessment of Drug and Alcohol Facilitated Sexual Assault
Michael L. Weaver, M.D., FACEP
This module will review the components of drug and alcohol facilitated sexual assault (DFSA) and will discuss the clinical presentations, treatment, and medical/legal aspects of forensic evidence collection in these cases.
At the conclusion of this educational offering, attendees will be able to:
- Discuss the initial assessment of a patient that is a victim of DFSA.
- Discuss the common drugs used in DFSA.
- Discuss the forensic testing and procedures in DFSA.
Module IV Dinner Evening Program: 5 – 7 p.m. The Forensic Evaluation of the Child: What Do I Need to Evaluate Children in My Hospital? MD TBD
As forensic providers, we provide evaluations of possible victims of child sexual abuse, physical abuse, and all types of neglect. This presentation will discuss appropriate care and resources for caring for these patients.
At the conclusion of this educational offering, attendees will be able to:
- Verbalize the necessity of collaboration among medical disciplines in the evaluation of thealleged child abuse case.
- Identify medical conditions and accidental injuries commonly mistaken for child physical abuse.
Conference Offering for Physicians, continued Day 2: Friday, September 9, 2016
Module V: 8 – 9:30 a.m.
Forensic Aspects of Injury Identification, Interpretation of Findings, and Enhanced Techniques
William Green, M.D., FACEP
Documentation of Findings
- Three types
- Overview of forensic photography
Injuries
- Definitions
- Pattern injuries
- Non-specific injuries
- Body injuries (examples and significance)
- Anogenital injuries (examples and significance)
Realistic Assessment and Conclusions
- Consistency versus diagnostic certainty
- Can the examiner determine consent?
At the conclusion of this educational offering, attendees will be able to:
- Describe the principles of forensic documentation.
- Summarize the basic forensic photographic procedures and techniques.
- List and describe the common types of injuries encountered in sexual assault and discuss theirforensic significance.
- Summarize the basic components of the assessment and conclusions that can be fairly drawnafter completing the sexual assault forensic exam.
Module VI: 9:30 – 10:15 a.m.
STI, HIV, and EC Post-Exposure Prophylaxis 2015
Michael L. Weaver, M.D., FACEP
This module will review the current emergency contraceptives (EC) as well as the alternatives in STI, HIV, and hepatitis in sexual assault patients.
At the conclusion of this educational offering, attendees will be able to:
- Discuss the appropriate care for sexual assault STI and HIV prophylaxis.
- Verbalize the indications for the most recently available EC products.
Break: 10:15 –10:30 a.m.
Module VII: 10:30 – Noon
Cultural and Linguistical Competence in SAFE Care: Are You Prepared?
Michael L. Weaver, M.D., FACEP
As our population is increasingly diverse, this module will discuss the culturally appropriate care for the sexual assault patient.
At the conclusion of this educational offering, attendees will be able to:
- Discuss different approaches to patients from different races/ethnicities, religious, gender, andsexual orientation.
- Discuss cultural issues when caring for the elderly and domestic violence victims.
Lunch on your own: Noon – 1:30 p.m.
Module VIII: 1:30 – 3:15 p.m.
Case Preparation and Expert Witness Forensic Testimony
William Green, M.D., FACEP
Overview of the Criminal Justice Process
- Forensic process and goals
- Law enforcement investigation
- Prosecution
Prosecution and Defense Strategies
Case Preparation and the Pretrial Conference
Testimony Basics
Difficult Testimony Issues
At the conclusion of this educational offering, attendees will be able to:
- Explain the basic forensic process and goals.
- Summarize the investigative and prosecutorial processes in sexual assault.
- List and discuss the essential elements of the pretrial conference.
- Summarize the elements of effective testimony.
- Discuss common problematic areas in sexual assault expert testimony.
Break: 3:30 – 3:45 p.m.
Module IX: 3:45 – 4:45 p.m.
Principals of Medical Directorship and SAFE Case Review
William Green, M.D., FACEP
Michael L. Weaver, M.D., FACEP
This presentation will review the core elements of providing medical oversight of sexual assault care for established SANE programs or for physicians in institutions with only policies for emergency department nurses.
At the conclusion of this educational offering, attendees will be able to:
- Discuss how to identify and support medical directors.
- Discuss staff training, protocols, quality assurance, community alliances, follow up, and fundingissues related to running a successful program.
- Discuss interesting cases submitted by attendees.
Adjournment/Evaluations: 5 p.m.
Faculty
James D. Anderst, M.D., MSCI, is division director for the Section on Child Abuse and Neglect at Children’s Mercy Hospital in Kansas City. He is also associate professor of pediatrics at the University of Missouri–Kansas City School of Medicine.
William Green, M.D., FACEP, was founding co-chair of the American College of Emergency Physicians, Forensic Section, in 2007. He was asked to serve as an advisor to the Department of Justice in its development of the National Protocol for Sexual Assault Medical-Forensic Examinations and to the first White House Roundtable on Sexual Violence in 2011.
Michael L. Weaver, M.D., FACEP, was founding co-chair of the American College of Emergency Physicians, Forensic Section, in 2007. He was asked to serve as an advisor to the Department of Justice in its development of the National Protocol for Sexual Assault Medical-Forensic Examinations and to the first White House Roundtable on Sexual Violence in 2011. Saint Luke’s Hospital was the first private sexual assault center in the United States. Dr. Weaver has been the medical director since 1980 through the establishment of their SANE program to the evolved Forensic Care Program for sexual assault, interpersonal violence, and elderly and child abuse.