separate, secure link. Incentives were awarded within 4 weeks of the study being closed to participation. Invitations to participate in the study were sent by email to 2,900 regular members of the IAFN between June 26 and August 3, 2013 (Figure 1). Three email invitations were returned as undeliverable. Each IAFN member received an initial invitation to participate followed by two reminder emails. A total of 563 completed surveys were returned. Figure 1 2900 IAFN Members Received Invitation Email 3 Emails Undeliverable 563 Responses 19% Return Rate Two Reminder Emails Sent 61 Human Subjects Protection All study procedures and instruments were approved by the Human Subjects Division of the University of Washington, Seattle, Washington prior to subject recruitment and data collection. Analysis The Statistical Package for Social Science (IBM SPSS, New York, NY), Statistics GradPack was used to analyze survey responses using descriptive statistical procedures. Results Description of Sample Surveys were completed and returned by 563 forensic nurses, nearly 20% of the total population of forensic nurses who were current members of their professional organization, IAFN. Personal characteristics of the respondents are presented in Table 1. The majority of respondents were licensed to practice in the United States. Respondents ranged in years of nursing practice from 2 - 53 years (n=526) with over half reporting 20 or more years of experience as nurses. The range for forensic nursing practice was 1 - 29 years (n=528) with twothirds reporting less than 10 years of experience perhaps reflecting the newness of the specialty. The majority of respondents (88%, n=488) identified a clinical role in forensic nursing with 68% (n=330) reporting a clinical role in combination with a second forensic nursing role (e.g., administrator, non-academic educator, consultant, academic educator, or researcher). Over a quarter of respondents (28%) skipped the survey item inquiring about career total of patients seen as a forensic nurse, yet all survey participants (N=563) provided an estimate of how many patients they had seen as a forensic nurse in the past 12 months. Of those responding to career total (n=408), the majority appear to have limited experience, reporting less than 250 62 patients across their forensic nursing career. Just over a quarter of all respondents provided services to 10 or fewer patients in the past 12 months, suggesting low volume settings or services. On a programmatic level, patient volume was reported as 150 or fewer patients per year for half of the forensic nursing programs that the respondents were associated with, again suggesting relatively low volume settings. Persons in custody and students (i.e., university/academic settings) were poorly represented across communities served by these respondents. The educational distribution of survey respondents was representative of the IAFN general membership with nearly one third of respondents holding a graduate degree in nursing (31%) [IAFN, personal communication). In addition to the personal characteristics presented in Table 1, information was obtained regarding source of forensic nursing education, special training regarding photodocumentation and types of violence or trauma experienced by the populations served. These data are summarized here. Approximately three-fourths of respondents reported some type of certification related to their forensic nursing practice with 71% (n=389). The majority of respondents reported nonacademic forensic education including being self-taught (18%, n=101), obtaining on the job training (61%, n=343), attending lectures and/or presentations (82%, n=462), or attending conferences (75%, n=419). For photodocumentation training, the majority of respondents are self-taught and/or receive on the job training with 2% reporting no photodocumentation training. Respondents sought lectures/presentations and/or photodocumentation trainings/workshops to learn photodocumentation skills (72%, n=405 and 66%, n=372 respectfully). Almost one-third of respondents (32%, n=151) have <8 hours of photodocumentation training and 29% (n=140) have 8-15 hours of training. 63 Respondents were also asked about the mix of their patient population. The majority of respondents served living patients (89%, n=497), while less than 1% worked only with deceased persons, and 11% (n=59) served a combination of living and deceased patients. The types of exams performed by respondents varied. Just under half (45%) reported engaging in a generalized clinical forensic practice, serving patients who had suffered all forms of injury, abuse, neglect or harm. A slightly larger group (54%) served a narrower sub-specialty practice involving populations only affected by sexual assault or sexual abuse. 64 Table 1: Personal and professional characteristics of survey respondents (N=563) Variable Percent n Country of professional licensure United States 93 525 Canada 5 29 Other ><2 8 Years of nursing practice >< 5 years 4 23 5-9 years 14 72 10-19 years 29 152 >20 years 53 279 Years of forensic nursing practice < 5 years 32 170 5-9 years 32 170 10-19years 30 154 >20 years 6 34 Number of patients served as a forensic nurse in past 12 months < 10 26 144 11-50 44 247 51-150 19 109 >151 9 52 Don’t know 2 11 Number of patients served as a forensic nurse in career <50 29 120 50–249 38 153 250-999 25 104 >1000 8 31 Number of patients served by forensic nursing program in past 12 months <50 24 136 51-150 26 142 151-300 20 111 301-500 12 69 >501 11 60 Don’t know 7 40 Communities served as a forensic nurse Urban 67 373 Rural 53 297 Military 14 78 Native/Indigenous/Inuit 7 37 Other 2 11 Highest degree completed Associate or diploma 28 141 Bachelor 41 227 Master 25 141 Doctorate 6 34 65 Table 2: Photodocumentation practices reported by forensic nurses (N=491) Variable Percent n Types of forensic medical examinations/evaluations completed All forms or injury, abuse, neglect or harm 45 254 Unintentional or accidental injury <1 3 Self-harm 1 7 Emotional abuse/neglect 3 15 Physical abuse/neglect 14 77 Sexual abuse/assault 54 301 Other 5 26 Age of populations served Prepubescent children 64 314 Pubescent children/adolescents (><18 years of age) 91 444 adults (18-64 years of age) 93 452 older adults (>64 years of age) 90 437 Purpose of photodocumentation Forensic medical photodocumentation 100 487 Evidence for law enforcement 81 395 Peer or case review 66 321 Education 50 242 Second opinions or consultations 42 204 Research 9 42 Types of images collected during