Clinical Skills Scholarship
The Oregon Attorney General's Sexual Assault Task Force, in collaboration with the Oregon Department of Justice and the Office for Victims of Crime Training and Technical Assistance Center, is offering scholarship applications to send a limited number of SANE/SAEs in Oregon to an out-of-state clinical skills training facility. Eligible SANE/SAE's must have completed the 40-hour didactic adult/adolescent SANE/SAE training. Priority will be given to providers who practice in regions of Oregon where access to medical-forensic care is limited and to SANE/SAEs who are actively pursuing their certification. Scholarships will cover registration, air-fare, baggage, lodging, and per diem at the federal rate, up to $1,000 per participant.

Please note that your scholarship application cannot be approved without detailed information as requested below. Responses about your facility and community response will be held in strict confidence.

The application review committee will consist of up to 3 individuals, including SATF staff members.

Applications must be submitted by January 29th, 2018 (12pm, PST). Applicants will be notified by end of business, February 12th, 2018.

Full Name *
Your answer
Home Address (City, State, Zip Code) *
Your answer
Phone Number *
Your answer
E-Mail Address *
Your answer
What community do you practice in? *
Your answer
If given adequate notice, can you commit to traveling out-of-state for a 2-day clinical skills training? Please choose the dates you are available below, please consider travel days in addition to training days. *
Required
How long have you provided services to sexual assault patients/victims of crime (this includes your time as a SANE, a healthcare provider, or another capacity). Please specify the length of time. *
Your answer
Please provide a thorough description of the medical-forensic care you currently provide. Include the population(s) you serve, and the specific range of services you provide to sexual assault patients (per OVC, a minimum of 5 sentences is required). *
Your answer
Please describe what you wish to gain from attending the clinical skills training event and how it will help you improve the patient care you provide. Include why this training is relevant to the patient care you provide, what specific knowledge, skills and abilities you hope to acquire and how you will use them in your provision of medical-forensic care for sexual assault patients (per OVC, a minimum of 5 sentences is required). *
Your answer
What barriers have you experienced in completing your clinical preceptorship? *
Your answer
Do you intend to become certified as an Adult/Adolescent SANE? Check all that apply. *
Required
When did you last attend a 40-hour didactic adult/adolescent SANE training? *
Your answer
What other sexual assault-specific training (mock, advanced, 40-hour pediatric, etc.) have you attended and when? *
Your answer
What is the model for SANE/SAE response in your community (contract with a SANE program, SANE/SAEs work in the hospital, etc.)? *
Your answer
Approximately how many SANE/SAEs practice in your community? *
Your answer
Does your facility support the provision of medical-forensic care and SANE/SAE practice? All responses will be held in confidence. Please explain either way. *
Your answer
Are there any other extenuating factors or circumstances that we should consider in reviewing your scholarship application? *
Your answer
Can you commit to submitting your full Oregon certification application within 6 months of clinical skills training? *
Would you be able to attend an out-of-state clinical skills training without the aid of a travel scholarship? *
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