Title: Vicarious Trauma and Coping among Forensic Medical Examiners of Sexual Assault - A qualitative Study

Introduction: Forensic science involves applying scientific methods to criminal justice, particularly in evidence collection and analysis. Forensic scientists specialize in various fields like biology, chemistry, and digital analysis, while forensic medical examiners (FMEs) play a crucial role in sexual assault cases, gathering evidence and treating victims. Working with such traumatic material can lead to vicarious traumatization, where professionals experience trauma symptoms similar to those of the victims. This exposure can disrupt their cognitive beliefs and worldview, particularly if they frequently work with severe cases like sexual assault. However, factors like adaptive coping strategies, emotional intelligence, and organizational support can help mitigate these negative effects.

Review of literature: 

Ms. Sarah Rostron, et.al 2018 - Older Forensic Medical Examiners (FME) were less likely to use social support as a coping strategy, and the coping mechanisms were somewhat related to the FMEs’ age and years of experience.

Donia.P.Slack 2020 - 1. Forensic scientists frequently encounter traumatic content, such as victim accounts and crime scene evidence, which can lead to conditions like PTSD, secondary traumatic stress (STS), or vicarious traumatization (VT), depending on their involvement in cases.

Andrew P. Levin MD et.al 2021 - FMEs who worked in the laboratory reported mild to moderate STS, compared to FMEs who worked in the field showed high STS. 

Anna Kathryn Taylor 2018- The study identified key themes such as the emotional impact of work, the need for better support and self-care strategies, and the risk of burnout due to inadequate training and insufficient ongoing assistance. 

Alcina J. S. Barros et.al 2020- Forensic specialists experienced significant impacts on their personal and professional lives, including negative shifts in worldview and increased concern for loved ones, with vicarious trauma (VT) leading to apathy, particularly in those lacking psychological training, and complicating emotional responses when focusing solely on technical case details.

Literature gap:  A noticeable dearth of research exists, specifically among forensic medical examiners nationwide. This gap in the literature underscores the necessity for empirical investigations tailored to this specialized demographic group to elucidate their unique perspectives, challenges, and practices in forensic medicine. The sample sizes in the findings of most studies are notably small, limiting the generalizability and statistical power of their findings. Cultural characteristics and beliefs regarding sexual assault among forensic medical examiners remain largely unexplored, particularly within the Indian context. Most professionals interviewed were females, thereby introducing potential bias into the results.

Need for the study: The impact of working with adult and child perpetrators of abuse on the overall well-being of medical professionals and their staff was scarcely ever covered in the literature. The absence of empirical inquiry into this crucial domain hinders efforts to understand the sociocultural factors shaping forensic practitioners’ attitudes, perceptions, and responses to sexual violence cases in the Indian context. The paucity of research about vicarious trauma areas hampers efforts to understand and address the psychosocial well-being of healthcare professionals. There is a pressing need to investigate coping strategies that may exacerbate the risk of secondary trauma stress and vicarious trauma, particularly within the Indian context among forensic medical practitioners. It is crucial to maintain equal gender representation in research investigating forensic medical examiners’ susceptibility to vicarious trauma in the event of sexual assault.

Aim of the study: To explore and understand vicarious trauma among forensic medical examiners of sexual assault.

Objectives: 

• To explore what forensic medical examiners experience while dealing with both adult and child sexual assault cases.
• To explore how forensic medical examiners manage their professional and personal lives.
• To explore how forensic medical examiners manage vicarious trauma. 

Material and Methodology:

• Study design: Qualitative Exploratory Approach.
• Study setting: Face-to-face / online interviews with Forensic medical examiners who have consented to participate in the study.
• Study duration: September 2024 to July 2025.
• Participants: Forensic medical examiners worked in medicolegal cases.

·       Inclusion criteria

i)      Forensic medical examiners who have worked in medicolegal cases, especially sexual assault cases.

ii)    Forensic medical examiners who have seen at least 10 sexual assault cases in the last year.

iii)   Both males and females will be recruited.

iv)   Forensic medical examiners who have been working as professionals at least for one year. 

·       Exclusion criteria:

i)      Forensic medical examiners who are no longer in service. 

·       Sampling method: Purposive Sampling and snowball sampling

·       Tester: A postgraduate student pursuing an MPhil in Clinical Psychology, will be undertaking training for the same.

·       Sample size:

Sample Population: Forensic medical examiners worked in medicolegal cases. 

Total sample size (n):  20 or until all data saturation is reached.

·       Tools

         Sociodemographic Details Sheet: Age, sex, marital status, residence, education, Years of experience, category of sexual assault caseload (adult and child), and frequency (average number of times participants encountered such cases)

         Semi-structure interview guide: Overall experience, vicarious beliefs, secondary trauma symptoms, changes in professional life and personal life, and coping. 

Procedure: 

1. Obtain necessary approvals from the Departmental Scientific Committee, Institutional Research Committee, and Ethics Committee, followed by registration in the Clinical Trial Registry-India.

2. Share study details via social media and forensic medicine forums to identify interested professionals.

3. Contact interested professionals by email, clarify queries, and obtain informed consent and socio-demographic information.

4. Schedule and conduct 45-60 minute interviews with forensic medical examiners, recording audio for transcription with consent.

Data Analysis:

·       Data from the in-depth interview will be transcribed and subjected to qualitative data analysis.

·       Thematic Analysis

                                    I.          Familiarization with the data.

                                  II.          Generating the initial codes.

                                III.          Searching for themes.

                                IV.          Reviewing of themes.

                                  V.          Defining and naming of themes.

                                VI.          Producing a report. (Braun, V., Clark, V., 2006)

     Ethical Considerations:

• ·       Informed consent shall be obtained from the participants.
• ·       Consent will be obtained for the audio recording of the interview.
• ·       The Principal Investigator will be the sole custodian of the recordings.
• ·       The recordings will be stored securely with passwords on a computer device.
• ·       The recordings will be stored for three years after completion of the thesis, after which the Principal Investigator will ensure the destruction (deletion of all copies and backups) of the recordings.
• ·       Confidentiality of information will be assured and maintained throughout.
•       Participants who experience distress following the interview will be referred to mental health professionals for assistance and support.