Understanding Pediatric Medical Forensic Exams (with Karin Wickwire)

Today, hosts Karen and Kalen welcome Karin Wickwire, President of the International Association of Forensic Nurses (IAFN) and an experienced forensic nursing clinical coordinator. We dive into pediatric medical forensic exams and the most sensitive, misunderstood, and critically important aspects of pediatric care in suspected abuse cases. Karin Wickwire brings her wealth of experience as a forensic nurse since 2012 and as a nurse practitioner for the Erie Care Clinic, a satellite of the University of Pittsburgh Medical Center Children's Hospital Advocacy Clinic. This important conversation delves into the nuances of pediatric forensic exams, multidisciplinary approaches, and the challenges forensic nurses face when working with children who are survivors of abuse.

Key Episode Learnings:

• Learn how pediatric medical forensic exams differ from adult exams, with a greater emphasis on rapport building and developmental considerations
• Discover the importance of differentiating between medical history gathering and forensic interviews in child abuse cases
• Understand why "normal" exam findings don't rule out abuse and how to explain this to caregivers and multidisciplinary team members
• Explore the specialized training and expertise needed for nurses interested in pediatric forensic nursing
• Dive into strategies for preventing vicarious trauma when working with victims of child abuse

Episode Glossary:

• Advocate or victim advocate: In the United States, this is a trained professional who provides unbiased information and options to victims/survivors of violence at each stage in their journey. Victim advocates may be located at non-profits, where support may be confidential and conversations protected by law, depending on their state, or systems-based advocates based at government agencies, with a more narrow purview focused on supporting victims through the criminal justice process. Advocates may provide education and referrals, can assist in the criminal justice system processes, and facilitate access to other multidisciplinary resources. Advocates may also provide accompaniment to victims during the medical forensic exam, criminal justice proceedings, and more.
• Child Advocacy Center or “CAC” (nationalchildrensalliance.org/cac-model/): An organization that coordinates the investigation, treatment, and prosecution of child abuse cases by providing a child-focused, safe environment for victims and their families.
• PA (Physician Assistant): In the United States healthcare system, this is a licensed healthcare professional who works in collaboration with physicians to provide medical care to patients.

Register for the #IAFN2025 Virtual Conference here: https://myonline.forensicnurses.org/integratedEvents/home/2025-IAFN-VIRTUAL-ANNUAL-CONFERENCE

Episode Resources:

• National Protocol for Sexual Abuse Medical Forensic Examinations – Pediatric: https://www.justice.gov/archives/opa/pr/justice-department-releases-national-guide-sexual-abuse-medical-forensic-examinations
• Interpretation of Medical Findings in Suspected Child Sexual Abuse: https://cdn.icmec.org/wp-content/uploads/2023/10/Revised-Adams-Guidelines-2023.pdf
• Emergency Department Care for Prepubescent Patients Who Have Been Sexually Abused - Joint Position Statement: https://www.forensicnurses.org/wp-content/uploads/2023/08/Care-of-the-Prepubesent-SA-V13-FINAL-1-ENA.pdf

IAFN Resources

• IAFN Online Learning Center (OLC): forensicnurses.org/page/OLCAccess/
• TeleSAFE Toolkit: Access this Step-by-Step Guide to a Trauma-Informed Program at forensicnurses.org/page/TeleSAFE/
• International Association of Forensic Nurses (IAFN): Learn more at forensicnurses.org
• IAFN Foundation: Support our work to spread forensic nursing at fundforensicnursing.org
• IAFN’s SAFEta Resources: Explore safeta.org