Medical Preceptorship | Application + Pre-Test
Thank you for your interest in the Midwest Regional CAC's
Child Abuse Medical Preceptorship Program.
All applicants must have completed a didactic course in child sexual abuse/PSANE prior to applying for the medical preceptorship course. Please complete the entire application and pre-test. You must receive a score of 75% or higher on the pre-test to be considered for the preceptorship.
If you have any questions about the application,
please contact Midwest Regional CAC’s Medical Program Manager, Jennifer Stimson, at
jennifer.stimson@childrensmn.org
.
Contact Information
First Name
Last Name
Pronouns
Please let us know what pronouns you use so we can address you correctly. Examples: he, she, they, ze
Title
Agency Name
Agency Address
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Email Address
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Are you affiliated and/or provide exams for a Children's Advocacy Center through a formal linkage agreement, contract or employment?
Yes
No
What is the name of the Children's Advocacy Center (CAC) that you provide exams for?
Unfortunately, if you are not affiliated with or providing exams for a Children's Advocacy Center, you do not meet a key program requirement and will
not be able to participate.
Please exit from this registration form.
We invite you to explore other programming at
www.mrcac.org/medical-academy
.
How many children are seen at your child advocacy center each year?
<100 children/year
101-250 children/year
251-400 children/year
501-1000 children/year
>1000 children/year
I don't know.
Does your child advocacy center currently offer medical evaluations?
Yes
No
If yes, what percentage of children are receiving a medical evaluation at your center?
<10%
11-25%
26-50%
51-75%
>75%
I don't know.
Does your child advocacy center currently have a medical provider?
Yes
No
If no, how far are children currently traveling to receive their medical evaluation?
<10 miles
11-25 miles
26-50 miles
>50 miles
I don't know.
Will you have a medical expert who will supervise you once you start examining patients?
Yes
No
If you responded no, how will you receive your peer review and case consultation?
What do you perceive to be the greatest barrier for children in your community to receive a medical evaluation?
Tell us why participation in this program will be critical to serving children in your community.
Participant Information
Please select the highest professional degree you have obtained.
Associate Degree
Bachelor's Degree
Master's Degree
Doctorate Degree
Please select your current certification(s) related to this field.
APN
APNP
APRN
ASN
CAP
CEN
CFN
CPEN
CPNP
CRNP
DNP
DO
FAAP
FN-CSA
FNE
FNP
FNP-BC
FNP-C
LPN
MD
NP
NP-C
PA
PHRN
RN
SAFE
SANE
SANE-A
SANE-P
Other
Credentials:
In what year did you begin providing medical care/evaluations for victims of suspected child abuse?
Please indicate how many patients you see in a given month for evaluation of suspected child abuse.
<5 patients/month
5-10 patients/month
11-15 patients/month
>15 patients/month
How competent are you in the following skills?
Not competent
Somewhat competent
Competent
Very competent
Conducting physical examinations
Conducting genital exams
Interpreting medical findings
Documenting medical findings in writing
Photodocumenting (colposcopy, digital camera) medical findings
Communicating evaluation findings to others
Collaborating with the multidisciplinary team
How much do you agree with the following statements?
Do not agree
Somewhat agree
Mostly agree
Agree
My needs for mentorship are being met.
I desire more collegiality/community with other medical providers who work in child abuse.
I want additional opportunities to teach/share knowledge.
I am resilient enough to continue this work (able to adapt to change and tendency to bounce back after hardship).
What is the single most difficult issue that you encounter in providing medical evaluations for child abuse?
What other challenges do you encounter in providing medical evaluations for child abuse?
I agree to allow the Midwest Regional Children’s Advocacy Center (MRCAC) to utilize my demographic information, including, but not limited to: credentials/licensure, enrollment in other MRCAC program offerings, pre- and post-test results, evaluation results and course completion results. This information will be utilized to determine efficacy in the course offerings and whether the courses are meeting their desired outcomes as well as assist in creating future programming. No personal identifying information will be utilized in the data analysis.
Yes
No
Professional Experience and Goals
Please describe the type of didactic training you attended, including the name of the training.
How many hours was your didactic training?
Name the instructor/s of the didactic training
How many prepubertal pediatric sexual abuse exams have you completed?
I have not performed any sexual abuse medical exams to date.
1-5
6-10
>10
Are you Board Certified in Child Abuse Pediatrics?
Yes
No
Please enter your ABP number.
How would you rate your level of expertise?
Novice
Some experience
Program Requirements and Follow-Up
Upon completion of the Child Abuse Medical Preceptorship, students are automatically enrolled in the myCasereview program (an anonymous online HIPAA compliant platform) so that they can share cases seen for review by a Board Certified Child Abuse Physician. This helps to ensure that as you begin seeing patients, you are correctly classifying genital findings and can receive feedback on your photodocumentation skills, written documentation skills, as well as your clinical exam interpretations. The expectation is that you will submit
ALL
cases for a year following completion of the preceptorship.
Do you agree to this requirement?
Yes
No
myCasereview Program Conditions
In order to participate in myCasereview, you will need to capture high quality photo documentation of the physical findings and later forward those images to myCasereview electronically. Prints or scanned images will not be accepted. Are you able to capture, store and electronically send the files obtained from your examinations?
Yes
No
Do you agree to familiarize yourself with the article,
Kellogg, N. D., Farst, K. J., & Adams, J. A. (2023). Interpretation of medical findings in suspected child sexual abuse: An update for 2023. Child Abuse & Neglect, 145. https://doi.org/10.1016/j.chiabu.2023.106283
? You will be expected to read and be familiar with the content of this article as you will be using these guidelines when indicating your diagnostic conclusion.
Yes
No
In order to participate in myCasereview, you will need to access files on Box.com or through the Box application. You will need to establish a Box.com account, but you will not be required to have a paid subscription. Are you able to meet that requirement?
Yes
No
Please indicate which of the following equipment you use to obtain photodocumentation for child sexual abuse exams. Click all that apply.
Digital still camera
Digital video camera
Digital still colposcope
Video colposcope
Other (Please specify)
Other equipment:
Will you need financial assistance to attend this preceptorship?
Please note:
If you click yes, you are agreeing to stay in your current position for at least six months or - if you leave prior to that time period - you agree to reimburse your Regional Children's Advocacy Center for the scholarship expenses.
Yes
No
You are required to have malpractice insurance from either your employer or through an individual plan to cover you while at the preceptor site. The insurance should cover you at an amount of not less than $1 million/occurrence and $3 million in the aggregate. You will need to provide proof of insurance.
Are you covered with a liability insurance plan that meets or exceeds these coverage levels?
Yes
No
Each of the sites may require additional paperwork specific to their hospital, such as proof of immunization, current CPR documentation, and confidentiality agreements.
Do you agree to provide requested information prior to starting your preceptorship?
Please note:
For students attending the preceptorship at Portland, Oregon, or Corpus Christi, Texas, you will need to pay up to $50 to have a background check conducted prior to starting the preceptorship, as well as provide proof of a ten-panel drug screen.
Yes
No
Pre-Test
1. According to the National Children's Alliance (NCA) Standards for Accreditation, a multidisciplinary team (MDT), at a minimum, should consist of members from which of the following professional disciplines?
Law enforcement, child protective services, school officials, prosecution, case managers
Family members, law enforcement, child protective services, medical providers, mental health
Law enforcement, child protective services, prosecution, victim advocate, CAC staff, medical providers, mental health
Defense attorneys, child protective services, case managers, law enforcement, medical providers, mental health
2. What is the most basic tenet of court testimony?
Use your case notes
To try to help the prosecutor
Memorize the case facts
To tell the truth
3. What is the best way to document a statement made by the child to the clinician during the medical exam?
It is best to not document the statement.
Paraphrase the statement in the medical report.
Document the statement verbatim in quotes in the medical report.
Tell the investigator in person, but do not document it in the written report.
4. Which of the following best represents the most complete history that should be documented in a medical report?
Presenting history, forensic interview, past medical history, family history
Forensic interview, past medical history, family history, social history
Presenting history, past medical history, social history, family history, review of systems
Past medical history, social history, family history, review of systems
5. Non-specific behavioral findings that may occur in child sexual abuse are:
Nightmares
Knowledge of sexual act that is not developmentally appropriate
Severe intrusive masturbation
Sexual play with dolls
6. What percentage of children, on exam, demonstrated physical findings when examined non-acutely (>72 hours post assault)?
0-5%
6-15%
16-25%
17-30%
7. The presence of a bruise on the hymen indicates which of the following?
It is diagnostic of sexual abuse.
It indicates that there has been a penetrating injury to the genitalia.
It indicates penile vaginal penetration.
It is diagnostic of a self-inflicted injury.
8. According to the Updated Adams Guidelines (2018), the following infection is best placed in the "not related to sexual contact" findings for sexual abuse category:
HPV
Candida albicans
Molluscum contagiosum
Neisseria gonorrhea
9. The purpose of the medical examination in child sexual abuse includes all of the following EXCEPT to:
Begin the process of healing from the abuse.
Confirm the truthfulness of the child's history.
Collect evidence if appropriate timing.
Rule out sexually transmitted infections.
10. Which of the following would be the best reason to perform a speculum examination?
Should be used as a standard technique in every exam
Should be used to determine a source of bleeding in a pubertal female
Should be used to determine a source of bleeding in a prepubertal female
Should be used to collect forensic evidence in all children
11. The need for a forensic evidence collection kit would be indicated in which of the following scenarios?
The examination of an 11 year old girl who disclosed penile vaginal penetration 2 days ago
The examination of a 16 year old girl who disclosed penile vaginal penetration 3 months ago
The examination of a 6 year old boy who disclosed penile oral penetration 5 days ago
An evidence collection kit should be obtained in every exam.
12. According to the Updated Adams Guidelines (2018), after which of these timeframes is it no longer useful to collect forensic evidence during the examination of a child for sexual abuse?
24 hours
48 hours
72 hours
7 days
There is no definitive time frame.
13. Which of the following would represent the best source of forensic material for the forensic evidence kit in a 5 year old girl reporting penile vaginal contact 2 days previously?
Swabs of the vagina
Swabs of the external genitalia
The girl's underwear
The girl's mattress
14. Which of the following is NOT the main purpose of oversight, quality and peer review in child abuse practice?
To ensure accuracy of diagnosis
To share expertise of others
To evaluate performance of clinician's documentation skills
To see new cases
15. Which condition is diagnostic of sexual contact?
Bruising of the hymen
Pregnancy
Transection to the base of the hymen
Laceration of the posterior fourchette
16. A periurethral band is best categorized as which type of medical finding?
A finding that could be the result of sexual abuse
A finding commonly caused by other conditions
A normal finding
A finding with no consensus regarding sexual abuse
17. Which of the following would be the most common cause of vaginal discharge in a 7 year old girl being evaluated for sexual abuse?
sexually transmitted infection
seminal products
non-venereal infection
vaginal foreign body
18. Photodocumentation of the genital exam is recommended when:
All children who have obvious physical injury to the genitalia.
All children who have a questionable finding on physical exam of genitalia.
All children who present with a history of sexual abuse.
All children and/or caregivers who request that exam be photodocumented.
All of the above.
19. Which of the following is not considered a normal finding?
Linea vertibularis
Septate hymen
Genital erythema
Superficial laceration of the posterior fourchette
20. What is the best description of a hymenal transection?
Complete cleft to the base of the hymen at the 3 o'clock or 9 o'clock location
Notch or cleft in the hymen rim, at or below the 3 o'clock or 9 o'clock location that extends nearly to the base of the hymen
A defect in the hymen below the 3 o'clock or 9 o'clock location that extends to or through the base of the hymen with no hymenal tissue discernable at that location
Acute laceration of the hymen, of any depth, partial or complete
21. Which of the following best characterizes absence of the hymen on a girl's genital examination?
It is a no consensus medical finding.
It is commonly described in prepubertal girls.
It is a diagnostic finding of penetrating trauma.
It can be acquired through riding a bicycle.
22. Which of the following is an indication to test for a sexually transmitted infection following sexual abuse/assault?
Alleged offender is at high risk for having a sexually transmitted infection.
A household contact has a sexually transmitted infection.
History or exam is concerning for genital contact or penetration.
All of the above
23. The use of nucleic acid amplification testing (NAAT) is the recommended test of choice for N. gonorrhea and chlamydia trachomatis.
True
False
Score
Rounded Percentage
CAMP CampaignCaseSafeID
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