nursing have occurred, including discussion about the subsequent ethical and practical concerns. For example, the IAFN’s 2011 symposium included concerns about the purpose for photographic documentation and extrapolating established standards for children to adult patient populations. Posts on general member and sub-specialty area discussion boards for the International Association of Forensic Nurses have raised concerns about the use of photodocumentation (Personal Knowledge). In addition, a limited number of articles have explored the use and purpose of digital imaging technology (White & DuMont, 2009, Brennan, 2006). Much of this formal and informal discourse has been anecdotal. There is a lack of knowledge about current practice surrounding clinical forensic photodocumentation including forensic nurses’ use of digital imaging for photodocumentation, variations in practice across jurisdictions and populations, and forensic nurses’ concerns involving photodocumentation practices using digital imaging technology. 58 Problem Statement For developing best practices, policy statements, or guidelines, and to address ethical concerns surrounding the use of digital imaging technology and the resulting digital photodocumentation in clinical forensic nursing practice, information about current practice is needed beyond anecdotal accounts. To meet this need, forensic nurses were surveyed about their current practices across populations, systems, and roles surrounding photodocumentation. This paper describes the development of a survey to assess current photodocumentation practice and findings from this survey. The goal of this paper is to initiate a dialog about the professional responsibilities and ethical practices surrounding digital photodocumentation in the forensic setting and to set a foundation for future research related to clinical forensic photodocumentation. Methods Design and Data Collection To assess current practices around digital photodocumentation, a descriptive, crosssectional design was used with a national sample. To assess forensic nursing practice around photodocumentation, a survey was developed called the Forensic Nursing Photodocumentation & Digital Imaging Study (FN-PDIS) survey. Initial items were developed by a content expert in the area of forensic nursing (RE) based on a review of the literature and expert knowledge of forensic nursing practice and clinical photodocumentation. Each item was then reviewed two ways. First, subject matter experts in forensic nursing practice and digital forensic imaging reviewed all items for content, missing items, and appropriateness of imaging and forensic practice terminology. Second, each item was evaluated with the Question and Understanding Aid (QUAID) tool for readability and clarity. The QUAID tool assists in recognizing unfamiliar 59 technical terms, vague or imprecise relative terms, vague or ambiguous noun phrases, complex syntax and working memory overload for respondents. Results from the QUAID analysis and expert reviewer feedback were used to revise survey items. Following revision, the survey was reviewed again by the original subject matter experts. Based on feedback, minor modifications were made. The resulting FN-PDIS survey is a 96-item web-based survey designed to capture data on digital photodocumentation practices, concerns and potential ethical issues related to practice, and non-identifying personal characteristics of respondents. Survey items are grouped into three sections. First, 25 fixed response and open-ended items on current clinical practice for digital imaging and photodocumentation. Second, 53 Likert-scale, fixed response and open ended items related to occurrence and levels of concern involving specific digital imaging and photodocumentation situations for four specific patient populations served (i.e. prepubescent, pubescent/adolescent, adult, older adult). Respondents are able to answer the subsections for population/s they serve. The third section includes 18 fixed response and open-ended items related to personal characteristics of respondents. The FN-PDIS survey was converted to a web-based design using an online research survey product, Web-Q. Conditional skip-logic, or branching, was used where appropriate (e.g., questions related to population served) to create custom pathways through the survey. When applied, respondents were directed to a relevant destination question based on response to the previous question. This allowed respondents to skip questions that were not relevant to their individual clinical practice. The survey was disseminated electronically using the anonymous security option. 60 Study Population Members of the International Association of Forensic Nurses (IAFN) whose occupation was identified as nursing and who had an active email address were invited to complete the survey. There were no exclusions to participation. Email invitations included an introduction to the survey and instructions for participating in a study incentive. The study incentive was a drawing for either an iPad2 or a forensic medical library from STM Learning. Participation in the drawing for the incentive required providing identifying information such as name and email address. Therefore, respondents who wished to participate were directed to a