The Uniformed Services University of Health Sciences (USUHS) in Bethesda, Maryland, completed their second sexual assault evidence collection simulation exercise March 21-24, with the vital assistance of the forensic healthcare coordinator at Naval Medical Center Portsmouth (NMCP).

Michelle Ortiz, the program manager of the Sexual Assault Forensic Exam (SAFE) team at NMCP, helped develop the curriculum for the faculty at USUHS who implemented the annual exercise in 2015. Ortiz facilitated the initial exercise, and she was invited to return this year to walk students through case studies and best practices.

This curriculum helps prepare medical professionals - students of the medical and nurse graduate program - to treat and care for victims of sexual assault. During what could be one of the most trying times in a person's life, a forensic health care professional has to break the ice and make the patient comfortable, all while collecting sensitive, yet vital, evidence.

It took Ortiz roughly six months to complete the curriculum, consisting of a 40-hour didactic - or classroom - phase that includes a hands-on component. During the didactic, Ortiz gives students cases to study. These studies cover a diverse spectrum of real-life sexual assault scenarios to prepare students for actual cases.

Ortiz uses these realistic scenarios to teach the importance about critical evidence, proper interview strategies, and care prioritization.

Students are also taught about the proper collection of evidence using medical items contained in physical evidence recovery kits. Ortiz emphasizes correct collection techniques because of their importance for successful judicial outcomes.

Beyond evidence collection, these students must be prepared to interview the victim in a sensitive manner that documents important facts about the incident. Ortiz said she helps the students learn to use objective empathy effectively in the situation. According to Ortiz, this makes the students able to get the "nuts and bolts" of the situation, and that's making better outcomes for justice.

"They have actors pretend to be patients, who are extremely convincing, and the medical students do the interview and mock examination on them," Ortiz said. "We discuss how to get past that first, 'Hi, I understand you've been sexually assaulted, what can I do to help?' This is the most intimate conversation in someone's life with a stranger, so they need to learn how they start it. They learn what they need to get from the interview and they conclude it so they are more comfortable in the exam room."

Afterward, Ortiz debriefs the students to find out what was difficult for them and what was less challenging. They discuss what the students may have missed and how to overcome hurdles.

"When we have better training, that means better results," Ortiz said. "This training impacts the student's ability to get those better results because it helps with the phrasing and verbiage; helps teach them how to keep their feelings out of the exam; and teaches them about the chain of custody for evidence."

Ortiz stresses that while in the role of collecting forensic evidence, her client is the evidence she collects, because that is what she represents in court.

"We do quality exams to get whatever evidence is available and this gives better results," Ortiz said. "That gives better outcomes in court. No denying that someone walks out of court upset, but you can only present what's made available to the examiner. This is the evidence that was before me, and by getting quality evidence, the jury is in a better place to render justice."

"NATO found out about the curriculum from the USUHS faculty," Ortiz said. "It was submitted as an innovative way to meet the training needs for medical professionals."

The curriculum was so well received that NATO then offered an invitation to USUHS faculty to present at their conference last October.

"This is the most amazing field in nursing and also the newest," Ortiz proudly stated.

After spending more than 21 years as an active-duty perioperative nurse and moonlighting as a forensic examiner nurse, she was hired as the NMCP forensic nurse in 2011. Ortiz said the job is so engaging because she learns every single day.

"I stay engaged with the puzzle and the science. It's easy to love your work when you are constantly challenged, learning and perfecting. Technology is always changing, and we have to keep up."

Ortiz loves to share her passion with other nurses and providers, but especially with the USUHS students.

"I need the best and the brightest, and the people who come to me are better nurses and better providers once they learn the work," she added. "We are one of the most committed teams you will find in Navy Medicine."

Ortiz said that they may be one of the smallest groups of nurses, but there is such pride, that it is so heartwarming to see so much pride go into this field.

"When we started the SAFE program, I could count on one hand my supporters, but it has gone full tilt," Ortiz said. "We have made a program that I am so proud of and that everyone should be proud of because every day, we are making a difference in people's lives."

"I help someone every day and I love it," she added.

For more news from Naval Medical Center Portsmouth, visit www.navy.mil/.