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News | March 24, 2021

Expanding Compassionate Care for Sexual Assault Survivors: Fort Drum sexual assault healthcare specialist provides training in forensic examinations to Navy doctor

By Warren Wright, Fort Drum MEDDAC Public Affairs

When a sexual assault occurs within the military community, no matter where the patient is, be it a service member or a Family member, it’s essential the victim has access to the support and services of specially trained medical specialists.  These caring and experienced healthcare professionals ensure survivors receive the care they need while collecting evidence to help hold perpetrators responsible.
The job of providing this specialized care for survivors falls to the Sexual Assault Medical Forensic Examiner (SAMFE), registered nurses, nurse practitioners, certified nurse midwives, physician assistants and doctors who have undergone specialty training in conducting sexual assault forensic exams.
Traditionally, SAMFE training occurs in San Antonio at the U.S. Army Medical Center of Excellence Department of Nursing.  However, COVID-19 restrictions and the need to mitigate the risk of spreading the virus have made traveling a long distance to attend the course difficult. 
To help adhere to COVID-19 restrictions and limit the amount of time participants need to quarantine after travel, the San Antonio-based school reached out to experienced SAMFE providers to train and certify new volunteers across the DoD, including one specialist on Fort Drum, New York.
Upon receiving the request to help train new examiners, Rachel Countryman, the Fort Drum Sexual Assault Medical Management Office program manager, jumped at the opportunity.
“When I was initially asked, I was very honored to be able to help out,” she said after receiving the request from San Antonio.  “Right now, with the way things are with quarantine and all that, the two-week course ends up being five weeks.  It’s great to be able to help out a (service member) and have them not be away from their work and their duty longer than they should be.”
At first, Countryman had only administered training for Army medical specialists from the local Fort Drum area.  However, that would change when she received a request from the SAMFE school to help train a U.S. Navy doctor based in Newport, Rhode Island.
In February, U.S. Navy Lt. Ann Lehto, a general medical officer with the, became the first sister service medical provider Countryman trained under the school’s new preceptorship program, which serves as a bridge during the transition from student to practitioner.
“Our whole network needed a SAMFE, and there was no one available to fill that role,” Lehto said.  “I am very interested in women’s health and everything that comes with being a SAMFE, so I volunteered.”
The entire SAMFE course consists of one week of online didactic training and one week of hands-on clinical training.  For the didactic portion, Lehto joined Maj. Melissa Perkins, a Fort Drum nurse practitioner, online using virtual platforms to learn the basic skills necessary for certified SAMFEs.  Then, Lehto traveled to Fort Drum to complete the clinical requirements of the course.
“It was excellent,” Lehto said.  “It was three pretty intense days of reviewing how to do the exam and how to document it appropriately.  What I enjoyed most was hearing the stories that Rachel and Maj. Perkins had with their clinical knowledge and experience doing the exams on real patients.”
During the clinical training at Fort Drum, Lehto and Perkins took turns performing the role of a sexual assault victim. At the same time, the other conducted the sexual assault forensic exam interview, something Countryman feels is far more effective than simply going through the motions with a mannequin.
Overall, the clinical portion consisted of a full day of practice with Countryman overseeing and providing guidance, a day where they complete a practice forensic exam, followed by a final practical exam on the last day.  Once completed, Countryman completed all the necessary paperwork, signing off on the completed training, and sent it to the school in San Antonio, where the training certificate was officially issued.
“It’s very rewarding to feel like I’m a part of the schoolhouse now,” Countryman said.  “I’m hoping in the future when things go back to normal that I’m asked to come out there (to San Antonio) for classes and be able to test out students for the second week as well.”
For Lehto, coming to Fort Drum to receive the hands-on instruction gave her a unique perspective on how the Army’s medical services operate.
“It’s interesting, coming from the Navy, to see how the Army does things,” Lehto explained.  “I felt like there was an added benefit sharing (experiences) by coming out to Fort Drum.”
Now that Lehto has the necessary training and certificate requirements to be a SAMFE, her organization can now expand the services it can provide to survivors of sexual assault.
“I’ll be the point of contact if there are any cases that arise requiring a SAMFE; I would be the person who would travel to do the exam” within NMRTC – New England, she said.  Additionally, “we’re in the process of arranging MOUs (memorandum of understanding) with civilian hospitals since we don’t have anything set up on base currently.”
Entering into agreements through official MOUs with civilian hospitals will allow Lehto to conduct sexual assault forensic examinations for Navy-associated victims being cared for in civilian hospitals and clinics, much like current agreements Fort Drum has with local healthcare facilities.
Countryman said it’s important to continue running the program and not freeze in the wake of COVID-19 and the restrictions it’s brought about.  Now, she hopes the experience will allow her to continue training locally with advanced practice providers even after the pandemic has ended.
“Right now, I encourage my RNs who are going to the course to go to the course (in San Antonio), only because being tested out by the mannequin is much different than a live person,” she explained.  “Now, advanced practice, someone who is used to doing this and someone who’s already acquired the skill, it’s not really as important to go there.  I think if they can do it virtually and do it at a home base, that would be great.”
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