Denver Health & Hospital Authority, Denver, Colorado ; University of Colorado, Aurora, Colorado.
West J Emerg Med. 2013 Sep;14(5):461-6. doi: 10.5811/westjem.2013.2.12201.
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).
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.
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.
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.
目前，急诊医学住院医师没有标准的法医学培训课程。随着旨在提高性侵犯受害者护理质量的性侵犯护士检查师（SANE）计划的出现，这些计划如何影响急诊医学（EM）住院医师的法医学培训也尚不清楚。本研究的目的是收集有关 EM 住院医师培训计划在性侵犯患者护理方面的培训信息，并从住院医师培训计划主任（PD）的角度确定 SANE 计划对 EM 住院医师培训经验的可能影响。
这是一项横断面调查。研究队列为所有完成电子封闭应答式自我管理调查的已批准 EM 住院医师培训计划的 PD。
我们向 152 名 PD 发送了调查，其中 71 名 PD 回复，总体回复率为 47%。22 名 PD（31%）报告说，他们的住院医师不需要进行性侵犯检查的程序能力，29 名 PD（41%）报告说，他们的住院医师只需观察性侵犯检查完成情况即可证明能力。住院医师 PD 被问及他们的计划如何为性侵犯检查建立住院医师要求。37 名 PD（52%）不知道他们的性侵犯检查要求是如何建立的。
超过一半的住院医师 PD 不知道他们的性侵犯指南是如何制定的，而且很少有指南是基于文献建议制定的。PD 如何看待 SANE 计划对住院医师进行性侵犯检查能力的影响，尚无明确共识。这项研究不仅强调了全国范围内提高对 EM 住院医师性侵犯教育的认识的必要性，而且还可能需要制定一个培训课程，为进行性侵犯检查的 EM 住院医师制定指导方针。
