Academy expands medical forensic care and response

L. Diane Casto and Angelia Trujillo

The Alaska Comprehensive Forensic Training Academy, the first of its kind in the nation, trains nurses and health care providers to support victims of interpersonal violence in a trauma-informed manner and to preserve potential evidence and information for future prosecutions.

Participants at the first in-person ACFTA training. Image credit: L. Diane Casto.Interpersonal violence in any form is emotional and trauma-inducing for victims, families of victims, perpetrators and communities. Alaskans who are working to stop violent behaviors need more tools and resources, as well as better training, in order to provide healing to victims and accountability for perpetrators.

The University of Alaska Anchorage’s College of Health, the Council on Domestic Violence and Sexual Assault (CDVSA, part of the Alaska Department of Public Safety) and the Alaska Nurses Association collaborated in March 2019 to launch the Alaska Comprehensive Forensic Training Academy (ACFTA), a training for comprehensive forensic documentation that is the first of its kind in the nation. The ACFTA is a pilot program designed to promote and develop forensic training for nurses, physicians, nurse practitioners and physician assistants in order to build communities’ capacity to respond to violence. The academy does not replace specialized sexual assault trainings. Rather, it gives participants important tools to assist victims of all forms of interpersonal violence, whether sexual assault, intimate partner abuse, child abuse, elder abuse, strangulation or other forms of assault. Participants develop the skills needed to collect and preserve evidence from victims, and learn to work in partnership with local law enforcement, advocates, service providers and others to consistently assess and document victimization.

Because Alaska has the highest rates of interpersonal violence in the country, it is important to focus on broad, comprehensive assessments and care for all victims of violent crime. The ACFTA is designed to provide an evidence-based and trauma-informed care approach: Instead of simply treating and releasing a victim, a healthcare provider who is trained at the academy can more comprehensively evaluate a patient, document evidence with an awareness of forensic principles, and connect the patient to community resources. Additionally, the academy will increase community awareness of occurrences of violence that are not reported, investigated and, when warranted, prosecuted.

Building community capacity to respond to violence is especially important for small communities with limited human and fiscal resources. In rural Alaska, many communities cannot sustain a specialized sexual assault nurse examiner or a sexual assault forensic examiner, but have established health care, law enforcement, and advocacy roles. If the one health provider in a community is trained broadly to respond to many forms of violence and understands how to work with law enforcement and advocates, theoretically there is a better chance that victims of violence will be appropriately treated, and that forensic evidence will be collected to assist in the pursuit of justice.

The academy is a two-part program that includes approximately 25 hours of online training and 24 hours of in-person, hands-on training. The online training, offered on an ongoing basis, includes modules developed by national and Alaska educators and researchers in the fields of sexual assault, domestic violence, strangulation, elder abuse, and pediatric sexual and physical abuse. The in-person training takes place at the University of Alaska Anchorage campus and is offered approximately every three months. This hands-on portion of the curriculum focuses on experiential training to develop the ability to complete forensic exams that will help the victim and improve outcomes in the justice system. CDVSA offers travel scholarships for those who would otherwise be unable to travel to Anchorage for a three-day training.

As the pilot ACFTA trainings continue to be offered, program developers will refine both the online modules and in-person classes using feedback from participants and formal evaluation. Future plans include discussion of how to expand the academy to better meet the needs of corrections personnel, behavioral health providers, and community health aides in providing medical forensic care for victims. The academy’s sponsors are also promoting awareness of the program on a national level, and there is potential for piloting it in locations outside Alaska in the coming years.

For information on registration and travel scholarships, visit https://dps.alaska.gov/CDVSA/.

L. Diane Casto is executive director of the Alaska Council on Domestic Violence and Sexual Assault. Angelia Trujillo is associate professor with the University of Alaska Anchorage School of Nursing.

Photo of participants at the first in-person ACFTA training by L. Diane Casto.