LAUSR

Sexual assault victimization rates in the USA are staggering, at 18.3% among women, and higher in marginalized communities [1]. Sexual assault causes acute and long-term sequelae for survivors, who are nearly four times more likely to suffer from psychiatric disorders [2]. Survivors of sexual assault ( any coercive sexual act, including rape and unwanted touching) may experience headaches, chronic pain, panic attacks, post-traumatic stress disorder, and difficulty sleeping [1]. Supportive and non-judgmental responses from clinicians empower sexual assault survivors to deliver an accurate medical history and pursue resources and longitudinal recovery [3]. One way to foster positive interactions between survivors and providers is by employing a trauma-informed care environment, consisting of workers who understand the complexity of psychologic trauma responses [4]. Accordingly, it is essential that clinicians not only understand protocols for care, but empathetically move beyond them to gather history and refer to resources for recovery. Psychiatrists are trained tomanage the mental and emotional needs of many vulnerable populations, including sexual assault survivors. However, a survivor’s road to mental health care is not always direct. Disclosure can occur within any trusting clinician-patient relationship, and negative health sequelae transcend psychologic needs. Survivors may first encounter other professions or specialties, such as emergency medicine, obstetrics/gynecology, family medicine, or pediatrics, prior to being referred to psychiatry [3, 5, 6]. Other specialties including dermatology and neurology have stressed the importance of identifying sexual assault sequelae [7, 8]. Furthermore, sexual assault impacts the colleagues, friends, and family of providers, who may call on them for support. Empowering survivors to receive necessary medical care involves awareness, empathy, and confidence [4, 9]. As such, future physicians across specialties need sexual assault and trauma-informed care training, as well as time to reflect on its potential psychological impact on the patient and provider [10]. In recent years, medical schools have implemented training in sexual assault and trauma-informed care utilizing methods such as physical exam training, asynchronous modules, and simulated-patients [3, 9, 11–13]. Siegel and colleagues published a sexual assault module for medical students; however, its virtual nature did not allow for meaningful discussion or interaction, thereby limiting its impact [12]. Other curricula focusing on physical exam skills and simulated-patients had limited scope and required significant educational resources [9, 11, 13]. At our institution, the existing curriculum was minimal. The focus was limited to epidemiology and treatment protocols rather than understanding the mental and emotional needs of survivors. To address this gap, we developed a student-led, TeamBased Learning (TBL) activity on sexual assault. TBLs are effective in clinical, pre-clinical, and ethics-focused educational settings [14, 15]. TBL’s “flipped classroom approach” assesses student knowledge, promotes collaboration to solve a clinical problem, engages students in active decision-making, and requires relatively few educational resources [16]. Our intervention was designed to prepare medical students to care for sexual assault survivors by building knowledge and confidence in providing empathetic, evidenced-based care.