Improving Accessibility and Quality of Child Abuse Medical Evaluations

Continuous Quality Improvement and Education for Child Abuse Medical Providers

Medical evaluations of child sexual abuse are acknowledged in the child maltreatment field as a valuable part of an investigation as they improve the likelihood of timely medical care to a child victim and can provide information to support legal decisions. The well being of child sexual abuse victims depends on high quality, consistent medical evaluation techniques and competencies. Provider participation in continuous education, peer review an quality improvement activities have recently been emphasized in the field. The NCA Accreditation Standards recognize that, “A medical evaluation holds an important place in the multidisciplinary assessment of child abuse. An accurate history is essential in making the medical diagnosis and determining appropriate treatment of child abuse.”

Because such activities can be costly, and accessibility limited in rural geographic areas, the Midwest Regional Medical Academy was created to bridge this gap. Our programming is designed to guide professionals through their foundational training, and then provide support through hands-on clinical experience, peer review, expert review, quality improvement programming, and supplementary resources. To view our medical offerings at a glance, download our Learning Pathway overview.



Our Medical Academy offers two online fundamental training courses.

Medical Training Academy is available for all medical professionals who seek to gain a baseline understanding of child abuse/neglect and/or a review of content. This course is available to physicians, nurse practitioners, Sexual Assault Nurse Examiners (SANEs), physician assistants and registered nurses. Continuing Medical Education (CME), ANCC, and Part II MOC credits are available. Note: Any participant requesting MOC II credits must request this at the start of the course. No partial credit can be given. As long as participant meets requirements for MOC, their information will be shared with the American Board of Pediatrics via ACCME’s PARS database for reporting.

Learn more and register at

Our Medical Training Academy: Pediatric/Adolescent Sexual Assault Nurse Examiner Course is for medical professionals who are seeking Pediatric/Adolescent SANE training/certification. This course is specifically targeted for nurses/advanced practice nurses who seek SANE training that meets International Association of Forensic Nurses (IAFN) criteria and will meet the didactic portion necessary to sit for the IAFN SANE certification exam.

NOTE: If you are a nurse who is planning on taking Medical Training Academy: Pediatric/Adolescent Sexual Assault Nurse Examiner Course (PSANE), please be aware that you MUST take the PSANE course prior to the general MTA course in order to meet IAFN rules. According to IAFN, a pediatric/adolescent SANE course must be at least 40 consecutive hours of required content. Because both courses share some content, if you take the general MTA course prior to the PSANE course, you would not be able to count the duplicative content and therefore, any duplicative content would be considered null for ANCC credit and for counting towards your 40 hours of required SANE content. For further questions, please contact Jennifer Stimson at

You can also access free live and archived webinars related to medical issues by clicking HERE.

The Child Abuse Medical Preceptorship program builds upon our foundational medical education programs by connecting providers with highly-qualified centers of practice in their region to receive hands-on technical skills and education.


Medical Peer Review occurs on a monthly basis  to provide the opportunity for participants to review documentation, discuss interpretation of findings, and provide feedback regarding the quality of documentation. This initiative is primarily for the medical providers, however, other team members may choose to participate as well.


Midwest Regional Medical Academy’s myCasereview utilizes high quality, cutting edge technology to ensure valuable case review; anonymously connecting with a nationally recognized Child Abuse Board Certified Pediatrician. You will receive a timely response within 48 hours of case submission and will have the opportunity to give feedback about your review and reviewer. The reviewers are blinded to your identity, and you are blinded to their identities.


The Midwest Regional Medical Academy has worked in collaboration with the American Board of Pediatrics (ABP), the American Academy of Pediatrics (AAP), and Children’s Minnesota to bring three different quality improvement projects to medical professionals. The goal of each quality improvement project is to assess and improve diagnostic accuracy and photodocumentation skills in child abuse cases.


RESOURCES | Resource Library
Midwest Regional CAC has created a compiled a number of publications to support medical providers working with and at children’s advocacy centers.



Midwest Regional Medical Academy programming and services are guided by nationally known experts in the field of child abuse.

Find the full list of our Child Abuse Medical Advisory Council Members, along with their biographies HERE.

Interpretation of Medical Findings in Suspected Child Sexual Abuse: An Update for 2018

From the abstract: Most sexually abused children will not have signs of genital or anal injury, especially when examined nonacutely. It is important for health care professionals who examine children who might have been sexually abused to be able to recognize and interpret any physical signs or laboratory results that might be found. In this review, we summarize new data and recommendations concerning documentation of medical examinations, testing for sexually transmitted infections, interpretation of lesions caused by human papillomavirus and herpes simplex virus in children, and interpretation of physical examination findings. Updates to a table listing an approach to the interpretation of medical findings is presented, and reasons for changes are discussed.

Updated Guidelines for the Medical Assessment and Care of Children Who May Have Been Sexually Abused
The Midwest Regional CAC is honored to have been involved in the preparation and publication of this important manuscript in the Journal of Pediatric and Adolescent Gynecology.
From the abstract: The medical evaluation is an important part of the clinical and legal process when child sexual abuse is suspected. Practitioners who examine children need to be up to date on current recommendations regarding when, how, and by whom these evaluations should be conducted, as well as how the medical findings should be interpreted. A previously published article on guidelines for medical care for sexually abused children has been widely used by physicians, nurses, and nurse practitioners to inform practice in this field. Since 2007, when the paper was published, new research has suggested changes in some of the guidelines and in the table that lists medical and laboratory findings in children evaluated for suspected sexual abuse and suggests how these findings should be interpreted with respect to sexual abuse.

The Evaluation of Suspected Child Physical Abuse
This article in American Academy of Pediatrics outlines the important role of pediatricians in preventing, identifying, and treating child physical abuse.
From the abstract: Child physical abuse is an important cause of pediatric morbidity and mortality and is associated with major physical and mental health problems that can extend into adulthood. Pediatricians are in a unique position to identify and prevent child abuse, and this clinical report provides guidance to the practitioner regarding indicators and evaluation of suspected physical abuse of children. The role of the physician may include identifying abused children with suspicious injuries who present for care, reporting suspected abuse to the child protection agency for investigation, supporting families who are affected by child abuse, coordinating with other professionals and community agencies to provide immediate and long-term treatment to victimized children, providing court testimony when necessary, providing preventive care and anticipatory guidance in the office, and advocating for policies and programs that support families and protect vulnerable children.

If you have questions or could use additional information, please contact Jennifer Stimson at You can also stay up to date by signing up for our quarterly medical eNewsletter at