Understanding and experience of the medical forensic examination after sexual assault: protocol for a mixed methods study
Authors: Stewart Mary Louise , Shackel Rita , Freedman Eleanor , Awad Elisabeth , Hunter Tara , Mooney-Somers Julie , McGeechan Kevin , Templeton David J 
Published: February 2025

Introduction

Victim survivors of sexual assault can potentially benefit from attending a medical forensic examination when it is provided by an integrated, multidisciplinary team in a trauma-informed way. Instead of being retraumatising, the examination is intended to be reassuring.

Methods and analysis

This study will explore the understanding and experience of the medical forensic examination from a population of patients who attend after a recent sexual assault. The study will also explore the barriers to attending from a population of victim survivors who did not present for a medical forensic examination. The awareness of sexual assault services will be explored through a general population survey. This project is comprised of four substudies: (1) a patient feedback questionnaire, (2) patient interviews, (3) a general population survey and (4) a survey of victim survivors (including non-users of the service). The first substudy will use 4 years of data from a patient feedback questionnaire delivered to patients attending a sexual assault service after a recent sexual assault to gain an understanding of the experience of the medical forensic examination from the point of view of patients who have attended. The patient experience will be further explored in the second substudy using semistructured interviews with a subset of these patients. The third substudy is an online survey of the general population conducted to explore the visibility and understanding of sexual assault services. This will be distributed online and through community networks. The fourth substudy will explore the barriers to attending for a medical forensic response by distributing an online survey for victim survivors, including those who did not attend for a medical forensic response. This will be distributed online through survivor networks. This is a mixed methods project. A descriptive analysis of the patient feedback questionnaire data will be performed. A descriptive analysis will also be performed for the surveys of survivors and the general public. Additionally, a multivariable analysis for associations using logistic regression will examine factors associated with not presenting to a sexual assault service. A reflexive thematic analysis of the interviews following the phases outlined by Braun and Clarke will be conducted. Qualitative data analysis software (NVivo) will be used for data management.

Ethics and dissemination

This study has received ethical approval from The Northern Sydney Local Health District Human Research Ethics Committee (2022/ETH01766). Data from the research will be used for reporting purposes within the Northern Sydney Local Health District. It will also be used to provide feedback to stakeholders (including police, the emergency department and service staff, and other support services) and to inform policy. At the time of publication of findings in peer-reviewed journals, media releases, opinion pieces and summary reports will be prepared and disseminated through survivor peer networks. Research findings from the interviews will be shared with those who participate in the semistructured interviews, if consent is provided.