Session 4: History and Examination

Artboard 4-100.jpg

Objectives

Describe the purpose of obtaining informed consent and how to obtain informed consent
Demonstrate skills to take history
Describe how to use information from the history to guide the exam
Know how to conduct physical examination
Understand why there may not be injuries, and understand when a speculum exam is needed

Videos

The videos include a fictional story of rape or intimate partner violence that may be distressing, difficult or even re-traumatizing for some viewers to watch and listen to. This video is for educational purposes to show participants how to conduct an history and interview about an incident of rape or intimate partner violence.

The videos include sensitive images such as breasts and genitals to for educational purposes to show participants how to correctly perform an examination and to document common injuries.

4.1 Welcome the survivor

4.2 Informed consent

4.3 Medical history

Video by International Rescue Committee and UCLA – Center for International Medicine. https://www.rescue.org/.
Please see https://iawg.net/resources/clinical-care-for-sexual-assault-survivors for the complete clinical care for sexual assault survivors (CCSAS) multimedia tool.

4.4 History of the incident

4.5 Performing the general examination

4.6 Genital examination

4.7 Vaginal Speculum Exam

4.8 Anal examination

Participant handouts

4.1 Sample Consent form

4.2 Preparing to gather the story

4.3 Topics to cover when taking the history with a survivor

4.4 Examination checklist

Key messages

Before taking the history, providers should explain any obligations to report and the limitations of confidentiality
Welcome the survivor, provide information, ask for consent
Obtain consent separately for each aspect of the exam
The history determines the examination, treatment and forensic evidence collection (if requested and feasible)
The purpose of the examination is to guide medical care and treatment
Let the survivor know what had been documented

Required supplies & materials

Projector
Laptop
Space for group discussions
Pen and blank paper
Print outs of handouts and scenarios for activities – depending on which activities you choose

Further resources for facilitators (Optional)

WHO (2014) Health care for women subjected to intimate partner violence or sexual violence: A clinical handbook, pg 40-48
WHO (2020) Clinical management of rape and intimate partner violence survivors Developing protocols for use in humanitarian settings, pg 15-20