UM-Flint nursing preparing students for trauma-informed care of assault patients

In the aftermath of sexual violence, the care a survivor receives can have an impact that extends far beyond the examination room. Providing that care requires not only clinical expertise, but also an understanding of trauma, patient autonomy and the complexities that can accompany a forensic examination.

Sexual Assault Nurse Examiners, or SANEs, are specially trained nurses prepared to provide that combination of medical care and support. They may conduct medical forensic examinations, address a patient's immediate health needs and, with the patient's consent, collect evidence that could later be used in legal proceedings.

Their work addresses a widespread but significantly underreported problem. National data show that 81% of women and 43% of men report experiencing some form of sexual violence during their lifetime, while more than two-thirds of sexual assaults go unreported.

Medical forensic examinations can take place in settings ranging from community-based clinics to local hospitals. Regardless of location, evidence collection is never the sole purpose of the exam. While patients retain the right to decline it, providing quality, comprehensive medical care remains the priority.

SANE at UM-Flint School of Nursing

Introduced in 2021, the University of Michigan-Flint's SANE certificate program offers students a curriculum designed to improve patient care by preparing trauma-informed providers who can empathetically and accurately perform a medical forensic examination that encompasses assessment, collection and preservation of physical evidence and potentially testify to their findings.

Important aspects of this training are simulations and experiences that allow students to practice their skills in a supportive setting before treating real-world survivors. UM-Flint students 

Recently, one cohort of SANE students participated in a forensic photography workshop. The students received instruction from forensic photographer Eric Johnson on techniques for photographing wounds such as bruises, lacerations, abrasions and other physical trauma. By ensuring the proper use of lighting, angles, framing and optical settings, SANE nurses can provide quality photographic evidence that can be used as objective documentation in cases where the assault is going to trial.

Students also participated in a mock trial. Hosted by Manley & Manley Law Firm and guided by attorneys Timothy Turkelson and Sara Kennedy Coaster, the students reviewed real-life cases, gaining practical experience in a legal setting. That opportunity will enable them to better prepare to advocate for their patients' medical needs and navigate their role within the legal system.

"Several studies have demonstrated that medical forensic examinations conducted by SANEs improve health outcomes for SA survivors and support higher prosecution rates," said Carman Turkelson, professor of nursing.

Another hands-on learning opportunity conducted earlier this year was a three-day immersive bootcamp for Pediatric/Adolescent SANE students. Here, learners gained experience completing specialized assessments and forensic medical exams for children and adolescents who may have been victims of sexual violence. Working with standardized patients, mannequins, expert SANEs, a victim's advocate and sensitive examination teaching associates, these students processed several patient scenarios with ages ranging from infants through teens, addressing a variety of different needs to provide trauma-informed care to their patients.

Addressing the need

Less than a quarter of hospitals nationwide have dedicated SANEs, partly due to the emotional toll of taking on these cases and the lack of training resources. This leads to a gap in patients' ability to receive timely, comprehensive, one-stop care, including evidence collection and preventive treatment. 

"Survivors of sexual violence require highly specialized patient-centered care that encompasses acute injury and related illnesses while providing psychological support to address the trauma from the event, " said Turkelson. "That comprehensive psychological, medical and forensic care is what SANEs specialize in."

 The SANE shortage is particularly prevalent in Michigan's rural communities. Traveling to a location with a qualified provider delays trauma-informed care for the patient and risks the loss and integrity of physical evidence. To address this discrepancy, the SANE program aims to admit students from communities lacking current resources, with the goal of filling these gaps upon program completion.

Interested in learning more?

These activities are just a small part of the education that UM-Flint SANE students receive throughout the certificate program. The curriculum combines online coursework with on-site clinical and simulation experiences, preparing students to apply their education directly to their nursing careers.

Naomi Pee is a registered nurse at Michigan Medicine who completed the program in summer 2025. 

"I'm a visual person, so the videos were excellent to train me to address what I would encounter," she said."I also liked the boot camp, where we were there for three days straight, from 8 a.m. to 5 p.m. I loved it because I could be there and get my hands on things. I thought it was excellent to have access to standardized patients." Pee plans to use her education as a foundation for working with survivors in the community.

UM-Flint's School of Nursing offers two SANE certificate programs: Pediatric/Adolescent, and Adult/Adolescent. The exact curriculum for each student is based on the applicant's previous education and experience. The program is available to any registered nurse with two years of experience and a current, unrestricted license in the United States. Learn more about the program at https://www.umflint.edu/nursing/sane/.

Get Help

If you, or somebody you know, has been affected by sexual violence and needs to speak to a trained support specialist, call the Rape, Abuse & Incest National Network's National Sexual Assault Hotline at 800-656-HOPE (4673).