Sexual Assault: Virtual Training Takes Responders From Exam Room to Courtroom
by Kristina Rose
About the Author
Ms. Rose is senior advisor to the director at the National
Institute of Justice. Prior to joining NIJ, Ms. Rose was
the chief of staff at the Office on Violence Against Women,
where she participated in the development of the U.S.
Attorney Generals National Protocol for Sexual Assault
Medical Forensic Examinations and SAFE Training Standards.
When Karen Carroll was taken to the hospital examination room
13 years ago after being brutally sexually assaulted, the
doctor assigned to her case took out the directions to the
rape kit and began to read them. Carroll, an emergency room
nurse at the time and now associate director of the Bronx
Sexual Assault Response Team, had to guide the doctor
through her own examination because he had never received
training on how to properly conduct a sexual assault forensic
exam.
Although many jurisdictions around the country offer sexual
assault forensic examiner training, Carrolls scenario is
not uncommon. Cost and travel concerns often present barriers
to training, particularly in rural and remote areas of
the country.
To help ensure that sexual assault victims do not find
themselves in Carrolls situation during a forensic exam,
the National Institute of Justice (NIJ) and the Office on
Violence Against Women funded Dartmouth Medical School to
create a state-of-the-art training tool on forensic examinations.
Available soon through the Internet and in CD format,
Sexual Assault: Forensic and Clinical Managementfor
health professionals, law enforcement, prosecutors, victim
advocates, and lab personneloffers training in a
virtual sexual assault forensic facility. In the virtual
facility, students can participate in interactive training
sessions on all aspects of the sexual assault forensic
examinationfrom interviewing the survivor through
courtroom testimonywith master practitioners and
trainers, including Karen Carroll.
How Critical Is the Forensic Exam?
The forensic examination is arguably the most critical
component in the aftermath of a sexual assault. The exam
has two main goals: to treat the assault survivor for
medical injuries and to collect evidence that may lead to
the arrest, prosecution, and conviction of the offender.
Exams are usually conducted by a sexual assault forensic
examiner, or SAFEa medical professional who has
received specialized education and has fulfilled clinical
requirements to perform medical forensic examinations.
SAFEs can be nurses (often called sexual assault nurse
examiners, or SANEs), doctors, or even physician assistants.
All sexual assault survivors have the right to a properly
conducted exam in which they are treated with dignity,
compassion, and respect. In September 2004, former U.S.
Attorney General John Ashcroft released the Attorney
Generals National Protocol for Sexual Assault Medical
Forensic Examinations (SAFE Protocol), which offers
guidance for communities that want to develop a response
that is sensitive to sexual assault victims and promotes
offender accountability. Produced by the Office on Violence
Against Women and based upon best practices from around
the country, the SAFE Protocol also examines the roles of
other members of the sexual assault response team (SART),
namely law enforcement officers, prosecutors, victim
advocates, and forensic scientists.
A recent study funded by NIJ examined the efficacy of
SANE/SART interventions as tools in the criminal justice
system. The study findings indicate that in communities
with these programs, sexual assault cases are reported more
quickly. In cases involving SANE/SART interventions, the
average time between the assault and the report is 5.6
days, compared to 33 days in cases without these interventions.
According to the researchers, cases with SANE/SART
interventions have more evidence available and are more
likely to have victim participation. Further, they found
that this intervention is a significant factor in the
identification and arrest of a suspect, is a strong predictor
that charges will be filed, and increases the likelihood
of conviction.[1]
A SANE Success Story
Consider the case of Gina. In 2001, Gina was sexually
assaulted in the laundry room of her apartment building
by a man she recognized as a new neighbor. The man turned
off the lights, closed the door, and trapped her behind
a row of dryers. As Gina prayed out loud, her attacker
inexplicably stopped and left the laundry room, only to
return moments later to continue his violent assault.
After making Gina promise that she would not tell anyone,
he finally left the laundry room. Once she felt confident
that her attacker was not going to return again, Gina ran
to a neighbors apartment and called 911.
She was taken to the hospital, where a SANE was called. That
nurse was Karen Carroll. As Gina described it, When Karen
walked into the room, I immediately felt comfortable. She
oozed confidence and competence. She was so compassionate.
She explained everything she was doing and gave me the
choice to stop at any point. However, I didnt want her
to stop, as I was determined to do everything I could to
catch this guy.
Gina was severely bruised and bleeding. Careful collection
by the SANE recovered a microscopic drop of blood on Ginas
bathrobe that was analyzed to reveal the DNA profile that
linked a man named Oscar Mercado to the crime. Though DNA
was just one piece of the evidence used at trial, Gina
feels that it was critical.
We had other evidence that was able to tie him to the crime
scene, she said, but it was the DNA evidence that ultimately
proved to the jury that he was the man who sexually assaulted
me. Mercado was eventually tried and convicted of four
counts of sexual assault and sodomy. He was sentenced to
28 years in prison.
Gina praises the team that worked with her: the SANE, the
detective, and the prosecutors. Although it took her a long
time to recover emotionally from the attack, she feels that
her healing process began with the positive experience she
had during the forensic examination with Carroll.
Not all exam experiences are as positive and successful as
Ginas. In many parts of the Nation, especially rural and
remote locations, forensic examination training for medical
personnel is rare or nonexistent because of high cost and
travel constraints. Consequently, victims may find themselves
in a situation like Carrollsin an exam room with a
doctor or nurse who has never been trained on how to properly
conduct a sexual assault forensic examination.
Virtual Forensic Facility
Virtual Forensic Facility
When trainees enter the virtual forensic facility (see
graphic, Virtual Forensic Facility), created by
Dartmouth's Interactive Media Laboratory, they will find:
Exam Room A: Here, the student observes interactions
between the SAFE and a young woman named Mary Lange.
The student serves as an apprentice, working closely with
a master practitioner in two scenarios. In the first, Mary
has been raped by an acquaintance. Through video, audio,
still, and animated graphics, this scenario teaches students
about the basic forensic examination, including history-taking,
consent, treatment, and using a virtual sexual assault
evidence collection kit to gather evidence.
In the second scenario, Mary is the victim of a
drug-facilitated assault. Using knowledge gained from
the first scenario, the student again works under the
supervision of a master practitioner. In essence, Exam
Room A is where students can conduct a complete sexual
assault forensic examinationto the extent allowed
by electronic technologyfrom initial encounter
through preparation of collected evidence, including
proper chain of custody.
- Exam Room B: In this room, students observe the
SAFE working with three patients who represent a mix
of demographic variables, including age, gender, and
relationship of the victim to the offender. Exam Room
B exposes students to various types of sexual assault
and the wide range of challenges they may confront in
their work.
- Pretrial Preparation Room: Here, students learn
how to prepare for court testimony.
- Courtroom Area: Here, the student becomes an
expert witness in the Exam Room A case. In this simulation,
the student interacts with prosecutors and defense
attorneys, selecting from possible responses and receiving
feedback from a coach. The student can also observe the
SAFE as an expert witness and learn the best ways of
presenting information in court. The coach for this
section is Roger Canaff, an assistant district attorney
from the Bronx District Attorneys Office, who has
extensive experience prosecuting sexual assault cases
and preparing SAFEs to testify in court.
- Forensic Lab Area: In the lab, the student views
talks by forensic scientists covering the basic science
of DNA and how tests are interpreted. This section also
emphasizes the value of close collaboration between
SAFEs and laboratory personnel.
- Conference Room: In this room, noted experts
discuss a range of topics, including cultural competency
and forensic photography. Students listen to roundtable
discussions among real-life members of a SART as they
discuss specific cases and the day-to-day challenges
they face.
- Learning Resources Room: Here, the student
listens to the personal accounts of sexual assault
survivors, including their experiences with sexual
assault forensic exams. The student learns how survivors
interactions with the SAFE and members of the SART
shaped their view of the justice system and affected
their healing process.
Who Benefits From the Training?
This training tool provides an innovative way to learn the
fundamental elements of conducting a timely, competent
forensic exam. For forensic examiners and trainers with
limited resources, the training offers a unique and
cost-efficient program that can easily be incorporated
into a preexisting curriculum or training module. It can
be used as a refresher for SAFEs practicing in rural areas
who may handle only a few cases a year. Law enforcement
officers, prosecutors, victim advocates, and lab personnel
will find the program beneficial, particularly with the
programs strong emphasis on a team approach.
The ultimate goal is to ensure that all victims of sexual
assault have access to health care professionals who perform
forensic examinations that minimize trauma; promote healing;
and increase the likelihood that the perpetrator will be
caught, prosecuted, and convicted of the crime. Victims
deserve to have justice served. Ensuring that innovative,
state-of-the-art training is available to all forensic
examiners is a crucial step in that direction.
NCJ 219610
Sidebar
MORE TECHNICAL ASSISTANCE IN SEXUAL ASSAULT FORENSIC EXAMS
The Sexual Assault Forensic Examiner Technical Assistance
(SAFE TA) project offers guidance for those using the U.S.
Attorney Generals National Protocol for Sexual Assault
Medical Forensic Examinations (SAFE Protocol). Under
this project, the International Association of Forensic
Nurses provides technical assistance to service providers
and agencies serving victims of sexual assault, including
medical professionals, law enforcement officers, attorneys,
victim advocates, and first responders.
Funded through a grant from the Office on Violence Against
Women, this project disseminates the SAFE Protocol,
establishes a national toll-free help-line, hosts an
interactive technical-assistance Web site for the SAFE
Protocol, offers some onsite assistance on establishing and
maintaining sexual assault response team initiatives, and
provides a national training and education plan. The SAFE
TA project also will disseminate the virtual sexual assault
forensic examination training tool discussed in the main
article.
For More Information
Note
[1] |
Nugent-Borakove,
M.E., P. Fanflik, D. Troutman, N. Johnson, A. Burgess,
A.L. OConnor, Testing the Efficacy of SANE/SART
Programs: Do They Make a Difference in Sexual Assault
Arrest & Prosecution Outcomes? final report
submitted to the National Institute of Justice,
2006 (NCJ 214252), available at
www.ncjrs.gov/pdffiles1/nij/grants/214252.pdf. |