Factors Associated With Knowledge Retention 3 Months After a Sexual Assault Forensic Examiner Blended Learning Course.

Introduction: A blended learning continuing education course may appeal to busy healthcare professionals because the primary content can be learned online while an in-person component can hone clinical skills. The current study assessed knowledge retention in a sample of healthcare professionals who participated in a nationwide sexual assault forensic examiner blended learning course (12-week online course and 2-day in-person patient simulation).

Methods: Participants' characteristics, motivation, and external barriers were collected through a precourse web-based survey.

Fat-water separation by fast metabolite cycling magnetic resonance spectroscopic imaging at 3 T: A method to generate separate quantitative distribution maps of musculoskeletal lipid components.

Purpose: To provide a rapid, noninvasive fat-water separation technique that allows producing quantitative maps of particular lipid components.

Methods: The calf muscles in 5 healthy adolescents (age 12-16 years; body mass index = 20 ± 3 kg/m ) were scanned by two different fat fraction measurement methods. A density-weighted concentric-ring trajectory metabolite-cycling MRSI technique was implemented to collect data with a nominal resolution of 0.

Shifting Sexual Assault Forensic Examiners Orientation From Prosecutorial to Patient-Centered: The Role of Training.

Sexual assault forensic examiners (SAFEs) have a complex role that entails providing health care and medical forensic evidence collection. The literature indicates that there are two orientations that guide SAFEs in this role. A patient-centered orientation emphasizes attending to emotional needs, offering options, and respecting survivors' decisions, which has been linked to positive emotional outcomes.

Lessons Learned From iCare: A Postexamination Text-Messaging-Based Program With Sexual Assault Patients.

Background: Although beneficial, few sexual assault patients seek follow-up healthcare or counseling after a medical forensic examination. Mobile technology interventions may help patients engage in postcare, but there is a dearth of research on patients' utilization of these interventions. The current study examines patients' engagement with a 4-week postassault text message program (iCare), which assessed patients' safety and well-being, if they needed assistance with accessing nonoccupational postexposure prophylaxis, or scheduling appointments for follow-up pregnancy and sexually transmitted infection testing, and their experience with the criminal justice system.

A Qualitative Exploration of Sexual Assault Patients' Barriers to Accessing and Completing HIV Prophylaxis.

Sexual assault patients may encounter barriers when accessing, accepting, and completing nonoccupational postexposure prophylaxis (nPEP), such as lacking insurance or an understanding of nPEP. However, less is known about how sexual assault forensic examiner (SAFE) programs' protocols, approaches to discussing nPEP, and community resources may influence nPEP completion. Utilizing a qualitative case study framework, we conducted semistructured interviews with 10 SAFEs from an urban SAFE program in which emergency department physicians write prescriptions for nPEP before sending patients to the SAFE program.

Is Online Learning a Viable Training Option for Teaching Sexual Assault Forensic Examiners?

This study assessed knowledge attainment of healthcare professionals who participated in a nationwide sexual assault forensic examiner training program developed by the International Association of Forensic Nursing. A comprehensive curriculum was divided into 12 modules that students accessed through an online learning management system. Using a one-group pretest-posttest design, we assessed students' knowledge attainment for all 12 online modules.

Predictors of attrition for a sexual assault forensic examiner (SAFE) blended learning training program.

Introduction: Participant attrition is a major concern for online continuing education health care courses. The current study sought to understand what factors predicted health care professionals completing the online component of a sexual assault forensic examiner (SAFE) blended learning training program (12-week online course and 2-day in-person clinical skills workshop).

Methods: The study used a Web-based survey to examine participant characteristics, motivation, and external barriers that may influence training completion.

Understanding how advocates can affect sexual assault victim engagement in the criminal justice process.

Following a sexual assault, survivors may seek help from multiple community organizations including the criminal justice system (CJS). However, sexual assault survivors often feel apprehensive about participating in the CJS and thus, few report their victimizations to law enforcement. Of those who report, many withdraw their participation from the CJS.

Interdisciplinary team communication among forensic nurses and rape victim advocates.

Victim advocates and forensic nurses provide integrated care to address the complex legal, medical, and mental health needs of rape survivors. Research suggests that conflict exists between nurses and advocates, but it remains unknown how their communication patterns contribute to or resolve these conflicts. Utilizing a qualitative case study approach, the current study interviewed 24 nurses and advocates from a Midwest organization to better understand team communication patterns when addressing conflicts.

Prosecution of adult sexual assault cases: a longitudinal analysis of the impact of a sexual assault nurse examiner program.

Most sexual assaults are never reported to law enforcement, and even among reported cases, most will never be successfully prosecuted. This reality has been a long-standing source of frustration for survivors, victim advocates, as well as members of the criminal justice system. To address this problem, communities throughout the United States have implemented multidisciplinary response interventions to improve post-assault care for victims and increase reporting and prosecution rates.

The problem of untested sexual assault kits: why are some kits never submitted to a crime laboratory?

Victims of sexual assault are often advised to seek postassault medical care to have a forensic exam, which includes evidence collection (termed a sexual assault kit [SAK]). After the exam, law enforcement personnel are supposed to submit the SAK to a crime laboratory for analysis. However, recent media reports suggest that in many communities throughout the United States, thousands of SAKs are left untested.

The impact of detectives' manner of questioning on rape victims' disclosure.

Research has documented that few reported rapes are prosecuted by the legal system. The purpose of this study is to explain how the interactions between victims and detectives can strengthen or weaken the investigation itself. Twenty rape victims were interviewed to examine how law enforcement detectives' manner of questioning affects rape victims' level of disclosure.

Adult sexual assault survivors' experiences with sexual assault nurse examiners (SANEs).

Sexual assault survivors often feel traumatized by the care received in traditional hospital emergency departments. To address these problems, Sexual Assault Nurse Examiner (SANE) programs were created to provide comprehensive medical care, crisis intervention, and forensic services. However, there is limited research on the actual experiences and emotional impact of sexual assault survivors who seek treatment from SANEs.

Defining the boundaries: how sexual assault nurse examiners (SANEs) balance patient care and law enforcement collaboration.

Forensic nursing is multidisciplinary in nature, which can create tensions for practitioners between their responsibilities to patient care and collaborations with law enforcement and prosecutors. Because there are compelling reasons grounded in both nursing theory and legal precedent to maintain separation, there is a pressing need to understand how sexual assault nurse examiner (SANE) programs successfully negotiate these potentially conflicting roles. The purpose of this study was to examine how SANEs define their work with their patients, how they collaborate with law enforcement, and how they negotiate roles differentiation.

Using Mixed Methods to Evaluate a Community Intervention for Sexual Assault Survivors: A Methodological Tale.

This article reviews current epistemological and design issues in the mixed methods literature and then examines the application of one specific design, a sequential explanatory mixed methods design, in an evaluation of a community-based intervention to improve postassault care for sexual assault survivors. Guided by a pragmatist epistemological framework, this study collected quantitative and qualitative data to understand how the implementation of a Sexual Assault Nurse Examiner (SANE) program affected prosecution rates of adult sexual assault cases in a large midwestern community. Quantitative results indicated that the program was successful in affecting legal systems change and the qualitative data revealed the mediating mechanisms of the intervention's effectiveness.

Anogenital injuries in childhood sexual abuse victims treated in a pediatric Forensic Nurse Examiner (FNE) program.

Medical forensic exams for victims of childhood sexual abuse (CSA) can be a helpful resource for addressing patients' complex medical, psychological, and legal needs. These exams can be performed by physicians or forensic nurses to identify and treat injuries, evaluate the risk for sexually transmitted infections and pregnancy, and collect evidence. In this study, we examined CSA cases treated in a midwestern, community-based forensic nurse examiner (FNE) program to document rates of anogenital injury and identify what factors predict the presence of such injuries (N= 203).

Using ecological theory to evaluate the effectiveness of an indigenous community intervention: A study of Sexual Assault Nurse Examiner (SANE) programs.

In recent years, there has been renewed interest among community psychologists in indigenous interventions, which are programs created by local practitioners (rather than researchers) already rooted in their communities. Indigenous interventions have strong ecological validity, but their effectiveness is often unknown because so few are rigorously evaluated. The goal of this project was to use Kelly and Trickett's ecological theory as a conceptual framework for evaluating an indigenous intervention and its mediating mechanisms of effectiveness.

The linkage between secondary victimization by law enforcement and rape case outcomes.

Prior research has suggested that almost half of rape victims are treated by law enforcement in ways that they experience as upsetting (termed secondary victimization). However, it remains unknown why some victims have negative experiences with law enforcement and others do not. The purpose of this study is to explore victims' experiences with secondary victimization by detectives, comparing how these experiences vary in cases that were ultimately prosecuted by the criminal justice system to those that were not prosecuted.

Understanding rape survivors' decisions not to seek help from formal social systems.

Few rape survivors seek help from formal social systems after their assault. The purpose of this study was to examine factors that prevent survivors from seeking help from the legal, medical, and mental health systems and rape crisis centers. In this study, 29 female rape survivors who did not seek any postassault formal help were interviewed about why they did not reach out to these systems for assistance.

A comparative study of the prosecution of childhood sexual abuse cases: the contributory role of pediatric Forensic Nurse Examiner (FNE) programs.

This study used a rigorous quasiexperimental design to compare prosecution outcomes for childhood sexual abuse (CSA) cases examined in a pediatric Forensic Nurse Examiner (FNE) program (the "intervention group") (n= 95) to a comparison sample of CSA cases examined by non-FNE medical professionals prior to the inception of the FNE program (the "comparison group") (n= 54). The types of cases in the intervention and comparison groups were different such that the FNE program had significantly more cases with younger victims where it was unknown or ambiguous whether they had penetration and/or fondling. Multivariate logit modeling was used to explore what factors predict legal case outcomes.

A participatory evaluation project to measure SANE nursing practice and adult sexual assault patients' psychological well-being.

This paper describes a collaborative project between a team of researcher-evaluators and a Sexual Assault Nurse Examiner (SANE) program to develop an evaluation survey of SANE nursing practice and patient psychological well-being. Using a participatory evaluation model, we followed a six-step process to plan and conduct an evaluation of adult sexual assault patients treated in one Midwestern SANE program. Our collaborative team developed a logic model of "empowering care," which we defined as providing healthcare, support, and resources; treating survivors with dignity and respect; believing their stories; helping them reinstate control and choice; and respecting patients' decisions.

Sexual Assault Nurse Examiner (SANE) program goals and patient care practices.

Purpose: To examine Sexual Assault Nurse Examiners (SANE) programs' goals and guiding philosophies and how they influence patient care practices for sexual assault victims.

Design: Data were collected from a national random sample of SANE to examine whether programs differed significantly in their goals and patient care practices.

Methods: Iterative cluster analysis was used to identify types of programs distinct in their stated goals.

The effectiveness of sexual assault nurse examiner (SANE) programs: a review of psychological, medical, legal, and community outcomes.

In sexual assault nurse examiner (SANE) programs, specially trained forensic nurses provide 24-hour-a-day, first-response medical care and crisis intervention to rape survivors in either hospitals or clinic settings. This article reviews the empirical literature regarding the effectiveness of SANE programs in five domains:(a) promoting the psychological recovery of survivors, (b) providing comprehensive and consistent post-rape medical care (e.g.