Promising Practice Programs

Medical Responses to Adults Who Have Experienced Sexual Assault is an interactive educational module for doctors including trainees in Emergency Medicine, General Practice, Surgery, Psychiatry and some components of Adult Medicine, as well as Obstetricians and Gynaecologists. Paediatricians may find the Module helpful in understanding the long term sequelae of childhood sexual assault however, the care of children who have been sexually assaulted is not addressed in this Module.
The development of the module involved the collaboration of eight medical colleges and over twenty specialist advisors from two countries in fields such as sexual assault service provision, forensic medicine, psychiatry, pharmacology, sexual health and gynaecology.
The module is designed for self-learning and provides case studies, readings and activities to augment the learning process. Learning sessions and workshops based on the module and delivered by experienced sexual assault service providers and trainers are also available. Video conferencing facilities are available to deliver training into remote areas or to negate the cost of travel for trainees. It is envisaged that the module will ultimately be available as an on-line resource to medical practitioners.
Learning objectives are for doctors to:

• better understand the nature and incidence of sexual assault;
• recognise common behavioural cues that may assist in the identification of sexual assault;
• recognise a range of behaviours which may indicate that a patient has been sexually assaulted as a child;
• demonstrate enhanced understanding of effects an individual's social context and background may have on their experience of sexual assault;
• offer appropriate support and locate information about specialised support services;
• locate information about relevant law;
• discuss with patients issues related to consent to medical and forensic examinations;
• adopt attitudes and language appropriate to the needs of individual patients;
• conduct an examination of a sexual assault victim which allows them to retain their dignity and minimises negative sequelae;
• recognise a range of injury patterns in sexual assault;
• be aware of the procedure for conducting and reporting on a forensic examination;
• make appropriate judgements when discussing sexually transmitted infection and offering pregnancy prophylaxis;
• communicate sensitively with the family and friends of patients;
• communicate effectively and appropriately with colleagues and police; and
• understand vicarious trauma and principles of debriefing and professional peer support.

• Takes account of contemporary research and practice developments in the field of sexual assault.
• Positions diversity as key to the development, understanding and delivery of good practice models.
• Contributes to improving systems' responses to sexual assault, and is directed at preventing sexual assault.
• Demonstrates a sensitivity towards the barriers faced by victim/survivors in disclosing and reporting sexual assault.
• Has a clearly defined conceptual framework.
• Includes processes of accountability and evaluation.
• Demonstrates a capacity for replication (i.e. other services/organisations could adapt/re-model the program for their use).

AHMAC recognised the medical and social problems caused by the inappropriate care of sexual assault victims - predominantly women - and sought to provide doctors with a training module to improve the standard of care.

The psychological, emotional and physical health impacts of sexual assault are widespread, extensive, and can be chronic and sometimes fatal. Most of all, many of these health impacts are very often preventable or can be significantly ameliorated. The philosophical position of the module is that improved health outcomes for victim/survivors of sexual asault are possible, desirable, and a priority.

• Internal
• Written following attendance
• Pre - test
• Post - test

Internal evaluation: Each tailored training session or workshop is individually evaluated and the results used to inform further development of training materials. The overwhelming and outstanding response to date is that doctors want more information and more training in this area. (Professionals from other sectors including para-medical and police have enrolled for workshops).
Participants' feedback will also be intergrated into future editions of the module.
External evaluation: Negotiations are underway at present to mount a three year evaluation of the module in practice. Details of the mode of evaluation are not yet finalised, however it is intended that doctors who have used the module in practice be surveyed for their views and feedback. The module will be reviewed taking into account the feedback of doctors/users, AHMAC secretatiat feedback and will include contemporary research, pharmacological, economic, legislative and practice changes.