CAE Lucina Trains Nurse Examiners in Wisconsin

Simulation technology helps sexual assault specialists hone clinical and forensic skills so they can concentrate on emotional support

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By Hannah Wallace

Caution: This article contains sensitive subject matter and information regarding sexual assault which may be triggering to survivors.

At the year-old simulation learning center at Froedtert and the Medical College of Wisconsin, a manikin named CAE Lucina represents a next-generation approach to caring for victims of sexual assault.

Since 2000, the medical specialists of Milwaukee’s SANE (Sexual Assault Nurse Examiners) program have performed colossal acts of compassion combined with clinical forensics. When a victim comes forward, SANE nurses must treat both their physical and emotional trauma, all while following strict procedures for gathering evidence that can make or break a criminal trial.

Deb Donovan, a Froedtert emergency room-based SANE coordinator, first approached Jean Morzy, manager of the simulation center, to develop a simulation training program to supplement SANE’s weeklong education course. SANE nurses work on-call to respond immediately to new cases, and real-world experience can be difficult to coordinate. The sensitive nature of a sexual assault exam makes hands-on training that much more vital.

Morzy, along with Shannon Schonenberg and Jessica Rotier, decided to utilize a dual-modality approach: SANE trainees work first with the Lucina manikin, manufactured by CAE Healthcare, and then with a standardized patient, played by Deb Martinez, an experienced SANE nurse who can further replicate the delicate social cues involved in a sexual assault exam.

Following Donovan’s input, Morzy’s team preps Lucina to show bruises and bite marks on particular parts of her skin; there’s simulated bodily fluid around the manikin’s vaginal area, as well as substances under her nails and in her hair.

During the three-hour simulation session, trainees rehearse evidence collection while practicing communication as they learn how best to interact with a sexual assault victim. Sometimes experienced SANE nurses attend the sessions, too, and can offer advice on efficient, precise evidence collection and compassionate patient care.

“For some of them, it’s really hard to use those words that need to be said and ask the questions that need to be asked,” says Morzy, “This gives them the opportunity to figure out how to say things with others around and hear the different approaches, like, ‘Wow I’ve never heard it asked like that before. I’m going to use that.’”

Then, when the trainees move on to interact with the standardized patient, they have some semblance of structure to their routine and can adhere to procedures even as the patient improvises new and challenging responses.

Going forward, Morzy and Donovan will be working with the Department of Justice, which provides the initial SANE course, to further coordinate their approach to the training. While she knows of other facilitators around the country who have begun using manikins for sexual assault exam training, Morzy hopes her work with Lucina will help spread the word about the adaptability and potential of medical simulation training—both for sexual assault nurses and other scenarios previously unconsidered.

“If people know about this and can think about using Lucina for something similar, you can grow your educational experience,” she says. “I want to challenge those in simulation to really listen to the request and look at what modality is going to be best for this learning. And be creative with it. Look past the norm.”

For now, Lucina replicates a female victim. In near future, Morzy plans to give SANE nurses the opportunity to train on a male manikin, too—an especially vital component to the program, as male sexual assault victims are even less likely to come forward.

Morzy also hopes that getting the word out about simulation programs will reassure victims and encourage them to come forward and receive the treatment and guidance they need. “The numbers of sexual assaults that go unreported are shocking,” she says. “It’s important that people know that it’s a special person that they’re going to be talking to. There are people here who have received very special training to help you through this.”