FAMSACA Medicolegal Matters

Enacting an “Empowerment Approach” After Sexual Assault

Mon, 08 Dec 2025 20:00:00 +1100

This month we talk with sexual assault nurse examiner Prudence Boylan. The paper discussed is:

Driver M. Enacting an “Empowerment Approach” After Sexual Assault: The Views and Beliefs of Forensic Nurse Examiners and Crisis Support Workers. Journal of Forensic Nursing. 9 February 2024

Host: Assoc Prof Kathy Kramer
Guest: Prudence Boylan

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Characteristics of alleged sexual assaults involving non-fatal strangulation

Mon, 13 Oct 2025 21:00:00 +1100

This month we talk with FAMSACA’s Education Officer, Tracey Markham. The paper discussed is:

Thomas R, Willmot K, Seimon R, Derrick N, Dinh MM, Templeton DJ. Characteristics of alleged sexual assaults involving non-fatal strangulation at a Sydney metropolitan emergency department: a prospective descriptive study. J Forensic Leg Med. 2025 Oct;115:102967

Host: Assoc Prof Kathy Kramer
Guest: Tracey Markham

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Identifying the prevalence of genital injuries

Mon, 15 Sep 2025 20:00:00 +1000

This month we talk with sexual assault nurse examiner Emily McGrath about injuries following digital-vaginal penetration. The papers discussed are:

Majeed-Ariss, R., Martin, G. P., & White, C. (2024). Identifying the prevalence of genital injuries amongst patients attending Saint Mary’s sexual assault referral centre following an allegation of digital penetration. Journal of Forensic and Legal Medicine, 102. https://doi-org.www.ezpdhcs.nt.gov.au/10.1016/j.jflm.2024.102656

Rossman L, Jones JS, Dunnuck C, Wynn BN, Bermingham M. Genital trauma associated with forced digital penetration. (2004). American Journal of Emergency Medicine, 22(2), 101–104. https://doi-org.www.ezpdhcs.nt.gov.au/10.1016/j.ajem.2003.12.012

Volpellier, M., Hirve, R., & Duckett, C. (2021). Genital injuries and allegation of digital vaginal penetration – A retrospective examination of forensic case notes. Journal of Forensic and Legal Medicine, 80. https://doi-org.www.ezpdhcs.nt.gov.au/10.1016/j.jflm.2021.102154

Host: Assoc Prof Kathy Kramer
Guest: Emily McGrath

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More than meets the eye

Mon, 18 Aug 2025 11:00:00 +1000

FAMSACA committee member and all-round good guy Cassie Noble talks us through the following study:

Parekh V, McMinn J, Brkic A, Williams D, Boxx C, Bailey L, Reid K. More than meets the eye: Lid and conjunctival injuries in cases of non-sexual assault are frequently accompanied by non-fatal strangulation, Emerg Med Australas. 2024 Dec;36(6):849-855.

Host: Assoc Prof Kathy Kramer
Guest: Cassandra Noble

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Ethical Conundrum

Thu, 31 Jul 2025 10:00:00 +1000

In this episode, Tracey Markham discusses the ability to consent to a sexual assault medical forensic examination in adult patients with serious mental illness.

Host: Assoc Prof Kathy Kramer
Guest: Tracey Markham

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Prosecutors' Perspectives on Evidence in Sexual Assault Cases

Thu, 03 Jul 2025 09:00:00 +1000

Kath Evans discusses an American paper looking at how prosecutors utilise evidence that corroborates the victim's account.

Reference:

M.Alderden, T.Cross, M.Vlajnic and L.Siller. Prosecutors’ Perspectives on Biological Evidence and Injury Evidence in Sexual Assault Cases, Journal of Interpersonal Violence 2021, Vol. 36(7-8) 3880–3902

Host: Assoc Prof Kathy Kramer
Guest: Kathryn Evans

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Non-Fatal Strangulation

Thu, 15 May 2025 09:00:00 +1000

In this episode, Assoc Prof Kathy Kramer talks about two recent studies that cover the same topic of non-fatal strangulation.

References:

Panagides et al. Enhancing foundational validity of forensic findings in nonlethal medico-legal strangulation examinations, Journal of Forensic and Legal Medicine, Volume 109, 2025, 102800

Parekh et al. Informing therapeutic care and legal process in assault cases involving non-fatal strangulation, Journal of Forensic and Legal Medicine, Volume 110, 2025, 10282

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"They made a hard day feel a little easier" - Patients’ experience of an integrated crisis response following recent sexual assault

Mon, 21 Apr 2025 19:00:00 +1000

This study explores the experiences of recent sexual assault survivors who accessed integrated crisis response services in New South Wales (NSW), Australia. There is limited research on the experiences of victim-survivors, and most available studies rely on third-party accounts from counselors or advocates rather than direct perspectives from survivors themselves. In this research, we directly hear from victim-survivors themselves through feedback questionnaires, providing firsthand insights into their experiences.

Link to article here: https://www1.racgp.org.au/ajgp/2025/march/they-made-a-hard-day-feel-a-little-easier

Host: Assoc Prof Kathy Kramer
Guest: Dr Shalu Singh

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Doxycycline - a potential game changer in STI prevention?

Mon, 21 Apr 2025 17:00:00 +1000

In this episode, we dive into the latest research on doxycycline as a potential game-changer in STI prevention. A new systematic review and meta-analysis has shown promising results for using doxycycline as a prophylactic treatment to reduce the risk of sexually transmitted infections. Join Dr Gemma Halliday and Dr Kathy Kramer as we break down the findings and discuss the implications for this with regard to the sexual assault medical consultation.

Link to article here: Doxycycline prophylaxis for the prevention of sexually transmitted infections: A systematic review and meta-analysis of randomized controlled trials - PubMed

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Survivor Perspective

Fri, 25 Oct 2024 17:00:00 +1100

In our final and most important episode, two victim-survivors who both had a medical and forensic examination, hold up a mirror to our profession.

It's not easy to listen to but we owe it to them to sit with our discomfort and hear their messages.

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Self-Care

Mon, 21 Oct 2024 12:00:00 +1100

In this conversation with experts Elisabeth Awad and Carolyn Cousins, we discuss self-care - how can we protect ourselves from our work?

Guests: Elisabeth Awad and Carolyn Cousins
Host: Kathy Kramer

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Cross-examination – what could possibly go wrong?

Fri, 11 Oct 2024 15:00:00 +1100

Tracey Markham and Kathy Kramer put their acting skills to the test as experienced advocate Hayley Dean demonstrates good, bad, and downright ugly expert witness testimony.

Hosts: Kathy Kramer and Tracey Markham
Guest: Hayley Dean

References:

Horan, Jacqueline & Goodman-Delahunty, Jane. (2020). ‘Expert Evidence to Counteract Jury Misconceptions about Consent in Sexual Assault Cases: Failures and Lessons Learned’. The University of New South Wales law journal. 43. 10.53637/FDBI9255.

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LGBTQI Issues

Mon, 07 Oct 2024 12:00:00 +1100

In this episode the delightful Hamish Whelan, Sexual Violence Consult Service Lead at ACON, talks us through ways to engage with LGBTQI+ patients – how to earn trust and tailor our care to individual needs.

Host: Kathy Kramer
Guest: Hamish Whelan

Here are some resources Hamish generously provided:

ACON's Pride Inclusion - Pride Inclusion Programs | ACON’s Pride Inclusion Programs offer a range of services to assist employers, sporting organisations and service providers with all aspects of LGBTQ inclusion.
ACON's Pride Training - ACON Pride Training - LGBTQ+ Awareness and Inclusion Training
It Left No Marks - Strangulation: A Serious Form of Violence (itleftnomarks.com.au)
LGBTIQ Health Australia - LGBTIQ+ Health Australia
Rainbow Health Australia - Rainbow Health Australia
Sexual Violence Consult Service - Sexual Violence Consult Service – Say It Out Loud
Thorne Harbour Health - Health Services for LGBTIQ+ Communities and PLHIV | Thorne Harbour Health
TransHub - TransHub

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Strangulation

Mon, 30 Sep 2024 11:00:00 +1000

In this episode, FAMSACA has had the good fortune to interview one of Australia’s absolute experts on presenting evidence about non-fatal strangulation in court, Dr Anousha Victoire.

Host: Kathy Kramer
Guest: Dr Anousha Victoire

Her excellent paper will also be helpful: Victoire A, De Boos J, Lynch J. ‘I thought I was about to die’: Management of non-fatal strangulation in general practice. AJGP. 51(11) Nov 2022.

Other useful references:

De Boos J. Review article: Non-fatal strangulation: Hidden injuries, hidden risks. Emerg Med Australas. 2019;31(3):302-308.
Glass N, Laughon K, Campbell J, Block CR, Hanson G, Sharps PW, Taliaferro E. Non-fatal strangulation is an important risk factor for homicide of women. J Emerg Med. 2008 Oct;35(3):329-35.
Malek, Adel M et al. A strangled wife. The Lancet, Volume 353, Issue 9161, 1324
Rossen R, Kabat H, Anderson JP. Acute arrest of cerebral circulation in man. Arch Neurol Psychiatry. 1943;50(5):510-528.
White C, Martin G, Schofield AM, Majeed-Ariss R. 'I thought he was going to kill me': Analysis of 204 case files of adults reporting non-fatal strangulation as part of a sexual assault over a 3 year period. J Forensic Leg Med. Apr 2021;79:102-128.
Zilkens, Renate & Phillips, Maureen & Kelly, Maire & Mukhtar, S. & Semmens, James & Smith, Debbie. (2016). Non-fatal strangulation in sexual assault: A study of clinical and assault characteristics highlighting the role of intimate partner violence. Journal of Forensic and Legal Medicine. 43. 10.1016/j.jflm.2016.06.005.

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Medical Care

Wed, 18 Sep 2024 21:00:00 +1000

Season 2 is a deep dive into various topics, starting with medical care with our special guests Ellie Freedman and Kath Evans. How has medical care following sexual assault evolved and where is it heading?

Host: Kathy Kramer
Guests: Dr Ellie Freedman and Kathryn Evans

Please note that this is a general discussion and is not medical advice for specific cases.

References:

Kink A et al. Management of acute sexual assault presenting to a large Australian sexual health clinic in 2012-2021: a retrospective clinical audit. Sexual Health 21, 2024 Apr
Parekh VR et al. Sexually transmitted infections diagnosed in individuals presenting for forensic and medical care following sexual assault. Sexually Transmitted Infections 2024;100(1):45-7
Skjælaaen K et al. Sexually transmitted infections among patients attending a sexual assault centre: a cohort study from Oslo, Norway. BMJ Open 2022;12:e064934

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A Reflection on Clinical Forensic Medicine

Tue, 10 Sep 2024 18:00:00 +1000

Professor David Ranson reflects on changes in forensic medicine over his long career and gives his thoughts on the strengths and weaknesses of different models of forensic service delivery in Australia. He talks about interesting new developments in the use of imaging in forensic medicine.

Host: Carol Stevenson
Guest: Professor David Ranson

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Communicating Expert Evidence

Mon, 19 Aug 2024 17:00:00 +1000

Professor Kristy Martire discusses her fascinating work looking at communicating expert evidence, communicating uncertainty, bias and the impact of witness likability.

Host: Carol Stevenson
Guest: Professor Kristy Martire

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Preparing for Court

Sun, 11 Aug 2024 12:00:00 +1000

In this episode Dr Shalu Singh and Dr Kathy Kramer talk about prepping for court and ideas for debriefing afterwards.

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Writing an Opinion - Part 2

Fri, 02 Aug 2024 19:00:00 +1000

In this episode we continue our discussion on how to set out an opinion and the use of standard opinion paragraphs.

Hosts: Carol Stevenson and Kathy Kramer

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Writing an Opinion - Part 1

Fri, 26 Jul 2024 15:00:00 +1000

In this episode we will discuss how to set out an opinion and the use of standard opinion paragraphs.

Hosts: Carol Stevenson and Kathy Kramer

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The Content of the Opinion

Mon, 22 Jul 2024 19:00:00 +1000

In this episode we discuss what should be covered in the opinion section of a report.

Hosts: Carol Stevenson and Kathy Kramer
Guests: David Ranson and David Wells

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Observations and exam findings: Part 2

Fri, 05 Jul 2024 15:00:00 +1000

In episode 11 we discuss controversial areas influencing decisions to document examination findings and general observations. We discuss observations of demeanour, mental state, and the examination of a patient with a history of recent alcohol and drug consumption.

Hosts: Kathy Kramer and Carol Stevenson
Guests: David Ranson and Peter Skidmore

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Observations and exam findings: Part 1

Fri, 28 Jun 2024 17:00:00 +1000

In episodes 10 and 11 we discuss controversial areas influencing decisions to document examination findings and general observations. We will cover the physical examination, observations of demeanour, mental state observations, and the examination in a patient with a history of recent alcohol and drug consumption.

Hosts: Kathy Kramer and Carol Stevenson

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Describing forensic examination procedures

Fri, 24 May 2024 19:00:00 +1000

In this episode we talk about the modern trend of including more procedural detail in reports. We'll also discuss the use (and abuse) of appendices.

Hosts: Carol Stevenson and Kathy Kramer

Guests: David Ranson and Kristy Martire

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Other sources of information

Fri, 03 May 2024 17:00:00 +1000

In this episode we will talk about how to obtain and record information that is relevant to a criminal case. How are decisions made about report inclusions? What should be in and what should be out?

Hosts: Carol Stevenson & Kathy Kramer
Guests: David Ranson and Peter Skidmore

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What to include in the patient history section of the report

Sat, 27 Apr 2024 16:00:00 +1000

In this episode we will consider the forensic and medical patient history, and what to include in the report.

Hosts: Carol Stevenson & Kathy Kramer
Guest: David Ranson

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Explaining your Qualifications

Fri, 19 Apr 2024 06:00:00 +1000

The author of a report must explain their qualifications and experience effectively.

In this episode we explore this topic and hear what happens when your qualifications are challenged.

Host: Carol Stevenson
Guests: Peter Skidmore, Marion Brown, Kath Evans

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How to Write Good

Fri, 12 Apr 2024 06:00:00 +1000

Excellent writing standards are needed to communicate effectively in court reports.

Poorly written reports will attract unwanted scrutiny in court and may be misleading.

Hosts: Kathy Kramer and Carol Stevenson

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Expert Evidence to Counteract Jury Misconceptions.

Fri, 05 Apr 2024 06:00:00 +1100

In this episode we hear from Professor Jaqui Horan who conducted a research project
exploring jury reactions to expert evidence in criminal trials.

Host: Carol Stevenson
Guest: Jaqui Horan

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Report Writing Templates

Fri, 29 Mar 2024 06:00:00 +1100

How do we decide what goes in a report writing template?
Must we follow the instruction in the template?

Hosts: Kathy Kramer and Carol Stevenson
Guest: Lang Goodsell

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Report writing: How the process is managed.

Fri, 22 Mar 2024 06:00:00 +1100

How is the process of report writing managed? What happens in services where staff work offsite? How do we maintain quality?

This is a podcast about expert testimony.

It is for general information purposes only
It’s not a substitute for professional legal advice
It’s based on opinion and experiences only
The contents may not be applicable in all circumstances

Hosts: Kathy Kramer and Carol Stevenson
Guests: David Wells, Anousha Victoire

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Introduction, the court system, expert evidence.

Tue, 12 Mar 2024 09:00:00 +1100

This is a podcast about expert testimony.

It is for general information purposes only
It’s not a substitute for professional legal advice
It’s based on opinion and experiences only
The contents may not be applicable in all circumstances

In this episode we provide an overview of the Australian court system and the role of Expert Evidence in criminal jurisdictions.

Hosts: Kathy Kramer and Carol Stevenson
Guests: Peter Skidmore and Marion Brown