The National Center for Women and Policing
http://www.womenandpolicing.org/
Publication Date: May 2001
Instructor: Forensic examiner (physician, SANE, or other nurse examiner)
If not available, law enforcement or rape crisis advocate
Time Needed: 7 hours (with six 10-minute breaks)
Resources Needed: Self-test handout (when to obtain a forensic exam)
Flip chart
Case materials
Discuss the importance of physical evidence and the unique nature of the forensic examination.
Presentation: Brief introduction
Time: 5 minutes
Identify the four primary purposes of forensic evidence.
Presentation: Brief lecture
Time: 5 minutes
Generate examples for the type of evidence that might serve each purpose.
Presentation: Brainstorming activity
Time: 15 minutes
First, have participants write down the following title, "The purpose of forensic evidence." Then ask them to list the 4 purposes with several lines of space between them. These 4 purposes are: identifying a suspect, confirming recent sexual contact, establishing force or threat, and corroborating the victim's story. Now, ask participants to take a moment and think of 3 types of evidence collected during the forensic examination of a sexual assault victim that will serve the first purpose (i.e., identification). An example might be DNA evidence such as the suspect's blood or saliva recovered from the victim's body. Give participants a few moments to generate the examples. Afterward, go around the room and ask participants and ask them to provide 1 of their 3 examples. Request that participants only report a type of evidence that has not been previously mentioned for this purpose. Continue in the same fashion with the remaining 3 purposes.
Explain how forensic evidence can only be interpreted in the context of a comprehensive victim interview.
Presentation: Brief lecture
Time: 5 minutes
Determine when to obtain a forensic sexual assault examination.
Presentation: Self-test with review
Time: 30 minutes
Materials: Self-test handout
Provide a handout to participants with brief scenarios of sexual assault cases reported to police. For each scenario, ask participants to decide whether to obtain a forensic examination of the victim and suspect. Ask participants to complete the test, but indicate that no one will review the answers but themselves. Give participants several minutes to complete the self-test, then review the correct answers and discuss the underlying guidelines. Allow time to discuss variations in local protocol, then conclude by summarizing the guidelines from the overhead.
Prepare the victim for a forensic examination.
Presentation: Brief lecture
Time: 5 minutes
Explain the examination process to victims.
Presentation: Listing exercise
Time: 10 minutes
Ask participants to write down the things they would explain to a sexual assault victim about the process of undergoing a forensic examination. First, have them write down the title of the exercise in their notes "Things to explain to a victim about the forensic exam." Then have them briefly write down the various things that they would explain to a victim. Inform participants that do not need to write down everything they would say to the victim, just to indicate which things they would address. For example, participants might indicate that they would explain that the costs of the exam will be covered and explain the process for billing and reimbursement. After several minutes, put up the overhead and briefly review the items listed on it. Tell participants to add any items that they missed to their list. Finally, ask if participants have any items to add to the overhead, and allow time for discussion.
Address the victim's reluctance to cooperate with police investigation.
Presentation: Brief lecture
Time: 5 minutes
Identify the components of a forensic examination.
Presentation: Brief lecture
Time: 10 minutes
Discuss the various types of evidence collected in a forensic exam.
Presentation: Brief introduction
Time: 5 minutes
For each of the following types of forensic evidence, ask participants to think of a purpose (of the 4 previously described) that it might serve. Inform participants that they should be prepared to briefly describe to the class how this type of evidence would be used to meet this purpose. Use the overhead to remind participants of the 4 purposes for forensic evidence collected from the victim. Call on a few participants to provide examples, and make sure that all of the purposes listed in the training manual are mentioned. Only a few examples are needed for each.
Discuss the nature and purpose of DNA evidence.
Presentation: Brief lecture
Class examples (from above)
Time: 10 minutes
Discuss the nature and purpose of hair evidence.
Presentation: Brief lecture
Class examples (from above)
Time: 10 minutes
Discuss the nature and purpose of seminal fluid evidence.
Presentation: Brief lecture
Class examples (from above)
Time: 10 minutes
Discuss the nature and purpose of clothing evidence.
Presentation: Brief lecture
Class examples (from above)
Time: 10 minutes
Discuss the nature and purpose of saliva evidence.
Presentation: Brief lecture
Class examples (from above)
Time: 10 minutes
Discuss the nature and purpose of blood evidence.
Presentation: Brief lecture
Class examples (from above)
Time: 10 minutes
Discuss the nature and purpose of urine evidence.
Presentation: Brief lecture
Class examples (from above)
Time: 10 minutes
Discuss the nature and purpose of non-biological evidence.
Presentation: Brief lecture
Class examples (from above)
Time: 10 minutes
Discuss the nature and purpose of non-genital injury evidence.
Presentation: Brief introduction
Time: 5 minutes
Describe the purpose of non-genital injury evidence.
Presentation: Finger vote and review
Time: 5 minutes
Use the overhead to remind participants of the 4 purposes for forensic evidence collected from the victim. When discussing the purpose of non-genital injury evidence, acknowledge that "establishing force or threat" is the most obvious. However, note that there is also a second purpose that can be met with evidence of non-genital injuries. Have participants vote with their fingers whether this secondary purpose is (1) identifying a suspect, (2) confirming sexual contact, or (3) corroborating the victim's story. State that the correct answer is (3) corroboration, since the injuries will either be consistent or inconsistent with what the victim described happening.
Recognize that non-genital injury is rare among sexual assault victims, and that an absence of injury should not be interpreted as consent.
Presentation: Brief lecture
Time: 5 minutes
Discuss recommended procedure for photographing non-genital injuries.
Presentation: Brief lecture
Time: 5 minutes
Identify injuries that are common among sexual assault victims.
Presentation: Shout-out exercise
Time: 10 minutes
Ask participants to think of the injuries that they most commonly see among sexual assault victims. Have them shout out examples without any discussion, and then when they have exhausted their ideas put up the overhead with the most common injuries. Discuss the list and comment on similarities or differences with the list generated verbally by the class.
Define "patterned injury."
Presentation: Brief lecture
Time: 5 minutes
Discuss issues in the interpretation of bruising.
Presentation: Brief lecture
Time: 5 minutes
Discuss the nature and purpose of genital trauma evidence.
Presentation: Brief introduction
Time: 5 minutes
Describe the purpose of genital trauma evidence.
Presentation: Finger vote and review
Time: 5 minutes
Use the overhead to remind participants of the 4 purposes for forensic evidence collected from the victim. When discussing the purpose of genital trauma evidence, acknowledge that "confirming sexual contact" is the most obvious. However, note that there is also a second purpose that can be met with evidence of non-genital injuries. Have participants vote with their fingers whether this secondary purpose is (1) identifying a suspect, (2) proving force or threat, or (3) corroborating the victim's story. State that the correct answer is (2) proving force or threat, because there is some evidence to suggest that genital trauma is more common among victims of sexual assault than women who have engaged in consensual intercourse.
Identify the most common sites of injury among sexual assault victims.
Presentation: Self-test
Time: 10 minutes
Put up the overhead with the possible sites of genital injury. Ask participants to write down the two most common sites of genital injury among sexual assault victims. Then put up the overhead with the percent of injury that is found at each site. Discuss that the sites are actually listed in order of decreasing frequency, from the most frequent site of genital injury (posterior fourchette) to least frequent site (rectum). Allow time for discussion.
Recognize that genital and non-genital injuries often co-occur among sexual assault victims.
Presentation: Brief lecture
Time: 5 minutes
Discuss the role of the colposcope in identifying and documenting genital trauma evidence.
Presentation: Brief lecture
Time: 5 minutes
Discuss the role of toluidine blue dye in identifying and documenting genital trauma evidence.
Presentation: Brief lecture
Time: 5 minutes
Discuss the role of human sexual response in determining genital trauma.
Presentation: Listing exercise
Time: 15 minutes
Explain to participants that a lack of human sexual response by victim and/or suspect can increase the likelihood of genital trauma in a sexual assault. Ask participants to list at least 3 reasons for this. For example, a lack of pelvic tilt among victims can increase the likelihood of "acute mounting injury," which is caused by the forceful contact of the penis against the posterior fourchette. This results not only from a lack of human sexual response among the victim, but also a lack of communication and cooperation with the suspect. First, have participants title in their notes, "Reasons why genital trauma is common after sexual assault." Then ask them to list at least 3 other reasons why genital trauma is more likely among victims of sexual assault than individuals who have consented to sexual intercourse. Reassure participants that no one will see their responses. After giving them a few minutes to generate their list, put up the overhead and go over the reasons. Ask participants if they came up with any additional reasons they would like to share (do not call on anyone, but wait to see if there are volunteers).
Explain why follow-up examination is important for sexual assault victims.
Presentation: Brief lecture
Time: 5 minutes
Discuss non-evidentiary components of the sexual assault examination.
Presentation:Brief lecture
Time:10 minutes
Discuss the importance of forensic examination with the suspect.
Presentation:Brief introduction
Time:5 minutes
Identify the types of evidence to be collected from the suspect.
Presentation:Brief lecture
Time:5 minutes
Explain the policies and procedures for conducting a suspect exam.
Presentation:Brief lecture
Time:5 minutes
Discuss the importance of clarifying any discrepancies in documentation between police and medical professionals.
Presentation:Brief lecture
Time:5 minutes
Discuss what can and cannot be concluded on the basis of the forensic examination.
Presentation:Brief lecture
Time:10 minutes
Make appropriate conclusions on the basis of an initial forensic examination.
Presentation: Case studies
Time:45 minutes
Assign participants to groups of 4-6. Provide each group with the type of medical reports typically produced by a forensic examiner. Explain to each group that they are to familiarize themselves with the materials and write down any conclusions about the case that they feel are justified. In doing so, they are to follow the general guidelines that have already been discussed about what is and is not appropriate to conclude on the basis of an initial forensic examination. Groups will have approximately 15 minutes to generate their conclusions and 30 minutes to discuss their conclusions as a group. Only 3 different case studies will be provided to each of the groups, so all the groups discussing one case study should present their conclusions first -- before moving on to the groups who have analyzed the second and third case studies. For each case study, a flip chart can be used to summarize the appropriate conclusions.
The victim reports to police that a stranger vaginally raped her last night. When interviewed by the reporting officer, she indicates that she has showered and taken special care to wash her genital area. While doing so, she noticed soreness "down there."
The victim reports to police that a friend of her boyfriend?s raped her around midnight on Friday night. It is now Monday morning. The victim indicates that she just wanted to forget about the incident at first, but after several sleepless nights she realizes that this won't happen. She indicates that her assailant forced her to have intercourse and give him a blowjob. He did not, however, use any physical force and the victim sustained no serious injuries.
A 16-year old victim reports that she was "finger fucked" by a classmate at a party last night. He was an older student that she liked, but he surprised her outside the bathroom by suddenly holding her against the wall and slipping his hand down her pants. When he stuck several fingers in her vagina, she yelled in surprise and he removed his hand. He laughed and asked her if she let all the boys do that?
A male victim reports that a co-worker sexually assaulted him one week ago. He indicates that he was rectally penetrated and forced to perform fellatio on his assailant. The victim was reluctant to report because he feared that he wouldn't be believed, but he is still experiencing pain in his rectum. In addition, he is afraid of contracting the HIV virus, and this concern brought him into the hospital where the nurse contacted police.
The victim reports that her husband vaginally raped her a week ago. They have since had consensual intercourse. Although her husband is occasionally violent, he did not use any physical force to perpetrate the sexual assault. The victim therefore sustained no injuries as a result; she complied out of fear for what he might do.
The victim reports that she was almost raped the day before yesterday. She was studying with a young man from her college class, when he turned aggressive and pinned her down. First, he pushed her shirt up and sucked on her breasts before attempting to vaginally penetrate her. Although his penis did not make contact with her vagina, it did rub against her thighs before a noise distracted him and allowed the victim to escape.
A 19-year old victim reports that she thinks she was raped sometime between midnight and 5:00am. She was at a rave party where a man she didn't know offered her a pill that he said would make her feel great. After taking the pill at around midnight, the victim says that she started to feel weird and then cannot remember anything until she woke up in the bathroom around 5:00am. Although she can't say with certainty that she was raped, her clothes were disheveled and her vagina was sore. She doesn't know who the man was who offered her the pill, but she thinks her friends might.
The victim reports that she was vaginally raped Tuesday night by a man that she was dating casually. It is now Friday afternoon. The two had been on several dates, but on this occasion he turned aggressive in his car and forced her to have intercourse. The assailant used his body weight to pin her down, and the victim was afraid to try to escape because they were parked in an isolated campground. She sustained no injuries. Prior to the rape, the two had been drinking beer and smoking crack together.
This document was not developed by Violence Against Women Online Resources. The document's author or sponsoring organization granted VAWOR permission for placement on this site. Points of view in this document are those of the author(s) and do not necessarily represent the official position or policies of the U.S. Department of Justice.
This web site is a cooperative project of Office on Violence Against Women and Minnesota Center Against Violence & Abuse at the University of Minnesota and is supported by grant number 2004-WT-AX-K075 awarded by the Office on Violence Against Women, Office of Justice Programs, U.S. Department of Justice.
Additional information about this site can be obtained by reading Email us for more information and assistance.
©Copyright 1998-2005 Minnesota Center Against Violence and Abuse (MINCAVA)
File Last Modified on: 14