Historically, students were placed clinically before there was any formal educational development. Until the 1970s, schools of nursing were less than responsive to the health needs of inmate populations (Felton, Parsons, & Satterfield, 1987). “The nursing literature in the 1970s indicated that prisons were not often considered when nursing faculty chose sites for undergraduate clinical experience” (Fontes, 1991, p. 300). Even though the American Nurses Association’s Position Statement on Psychiatric Nursing Practice in 1967 validated the appropriateness of a prison as a learning laboratory (Bridges, 1981), clinical placements for nursing students in correctional institutions did not commonly occur in Canada and the United States until the 1980s.

Criminology and victimology courses may have been forerunners to forensic nursing course development. Nurses who had electives in basic and advanced programs often took courses like criminology and victimology because of an interest in forensic issues in society and in forensic-specific vulnerable populations (Kent-Wilkinson, 2006). Courses in criminology and victimology became popular options for transfer credits that would contribute to a nursing degree. In the 1980s, victimology and criminology courses were created because of the strong social emphasis on the human rights issues of the 1960-1970s, including victims’ rights, women’s rights, offenders’ rights, and civil rights. Although victimology courses may have been the precursors to clinical forensic and SANE courses, criminology courses were the predecessors to forensic psychiatric/correctional courses. Once forensic nursing became a specialty that covered both victims and perpetrators, formal courses were in demand.

The continuing education departments (CEDs) of universities were the birthplaces of many specialty educational courses. Packed curricula did not allow room for specialty courses; therefore, a backdoor was created to offer options courses through continuing nursing education. Nursing colleges often had not accepted the idea of developing a separate forensic nursing course or program, and individuals with the expertise frequently were only welcomed and used as guest speakers. Therefore, some of the courses and programs were housed in forensic science facilities rather than in nursing departments (Kent-Wilkinson, 2008). In 1988, a general forensic nursing course was offered for the first time through the Department of Medicine in a continuing education program in the United States (P. Speck, personal communication, March 31, 2006). At that time, forensic nurses taught residents and nurses about sexual assault, domestic violence, and elder abuse. CEDs often provided a foot in the door or an initial home for specialty forensic nursing education. With the successful offerings of forensic nursing courses in the CEDs, similar courses were added to the nursing curriculum in many universities. Later, certificate programs at the postgraduate level and whole tracks at the graduate level were developed.

The development of SANE programs began when healthcare providers realized that the standard of care was inadequate for sexual assault victims admitted into hospital emergency departments. Because victims of sexual assault had to withstand long waiting times before seeing a physician in emergency departments, nurses wanted to provide the necessary examination and follow-up counseling themselves in the emergency departments or in clinics (Kent-Wilkinson, 2006). In 1976, the first SANE program was established in Memphis, Tennessee. In September 1977, the Sexual Assault Resource Service began in Minneapolis, Minnesota (Ledray, 1992). In 1978, the sexual assault nurse clinician program began in Amarillo, Texas (Ledray & Arndt, 1994).

By the 1980s, various formal and informal educational programs began to be developed for those interested in forensic nursing. However, none if any were sustained. In 1983, the School of Nursing at the Catholic University of America in Washington, D.C., was “awarded a grant from the National Institute of Mental Health to prepare forensic psychiatric nurses as clinical nurse specialists at a graduate level to function in all areas of the correctional system” (Bernier, 1986, p. 21). This may have been the first forensic nursing course offered. Reportedly, it was designed as a subspecialty for psychiatric nursing but survived only one year. Psychiatric programs, although known to be among the first specialties in schools of nursing, have struggled to maintain their important status in the nursing curriculum (D. Shelton, personal communication, January 5, 2004).

In 1986, a forensic nursing graduate program at the University of Texas at Arlington commenced. However, with a change in administration, the new forensic nursing program did not survive (V. Lynch, personal communication, August 5, 1997). In the early years of forensic nursing educational development, both the expertise of clinicians and the support of administrators were needed to maintain programs that were new and not yet recognized as up-and-coming mainstay programs.

In the 1990s, educational programs were established for nurses interested in the specialty of forensic nursing. Forensic nursing education included certificate programs and option courses for credits toward a degree. In the early to mid-1990s, two or three introductory general nursing courses and programs came on the scene in Canada and the United States. They developed into complete programs, addressing all the subspecialties of forensic nurses who worked with victims, offenders, the deceased, and their families (Kent-Wilkinson, 2006). Also in the mid-1990s in the United States, face-to-face postgraduate-level education began with a focus on forensic science and forensic behavioral science at Fitchburg State College in Massachusetts in the east, Beth El College in Colorado in the west, and the University of Calgary, Alberta, Canada, in the north. About the same time, specific forensic mental health and psychiatric courses were launched in the United Kingdom, Australia, and New Zealand (Kent-Wilkinson, 2006).

Considering that the first Web-based course, in California, did not begin until 1995 (Bates & Poole, 2003), forensic nursing education made its online appearance on the global scene relatively quickly. Forensic nursing educators, supported by progressive administrators, used the technology to offer the first online forensic course in January of 1997, at Mount Royal College (MRC) in Calgary, Alberta, Canada (Kent-Wilkinson, Mckeown, Mercer, McCann, & Mason, 2000). By 2001, MRC established a full certificate program of forensic studies with six online courses; a theoretical sexual assault course was added soon thereafter (Kent-Wilkinson, 2006).

In the United States, Bader (2005) noted “four accredited universities offer doctorate level forensic nursing degrees” (p. 23). To date, Canada has well-established forensic certificate programs but does not have forensic nursing graduate or doctoral programs. This could be because fewer forensic nurse educators at the Ph.D. level are required to teach these programs; in addition, a smaller percentage of the country’s population has requested this specialized curriculum.

Since 1995, there has been a move toward Web-based learning modalities for nursing education. In an increasingly technology-sophisticated world, it is important for nurse educators to take full advantage of this technology to enhance their learning. A study was commissioned in Canada on the technical and content design characteristics of online forensic nursing courses and the reasons for taking them (Harvey, 1998). The study found that most of the participants surveyed chose to enroll in the courses because of their interest in the forensic subject matter. More than half of the participants chose the courses because of the full online delivery, which was innovative at that time. Personal enrichment and reasons related to career opportunities or enhanced current career status were most often cited as reasons for taking the forensic courses.

Research findings on forensic psychiatric nursing and multidisciplinary training done in the United Kingdom offer conceptual guidance or directions for educational course development in this specific focus of forensic nursing. Brooker and Whyte (2000), in a United Kingdom report aimed at multidisciplinary teamwork in secure psychiatric settings, argued that interprofessional training should take place at the clinical interface. They added that it should focus on client-centered, problem-based learning exercises that allowed for reflexive learning.

Mason and Carton (2002), in their effort to determine if common areas of multidisciplinary training in forensic mental health practice existed, reviewed literature and curriculum documents. They found that professional training took a diffused approach, with each profession formulating areas of study for appropriate forensic expertise, usually involving basic training that pertained to the profession followed by postgraduate studies. Mason and Carton advocated that this method of training was unclear and may not be appropriate. Thus, it was necessary to identify what the required skills were to care for or manage this patient population, as well as establish whether the skills were evidence based and to what extent they could be measured. With the trend toward interprofessional education, findings from the multidisciplinary studies are important.

The IAFN Education Committee explored how to develop forensic healthcare information for use in undergraduate nursing programs. Typically, undergraduate programs of study were packed with required content that supported the students as they prepared for nursing board examinations. Programs allowed little flexibility for adding new content, despite the fact that the forensic content was in high demand. Forensic nursing was a specialty that students characteristically desired to pursue, but more important, “the information related to all areas of nursing practice, from pediatrics to geriatrics, from psychiatric mental health to the perioperative area” (Crane, 2005, p. 4).

First, the IAFN Education Committee discussed the best approach for integrating forensic content into undergraduate programs and the most efficient method of providing the information to students or to the faculty who taught it. Second, forensic information and case studies in content modules were discussed as potentially useful tools for educators who had the desire but limited time to teach new content. Third, the committee developed and refined a brief survey of IAFN members to determine if nurses were taught general and forensic nursing content and which forensic topics were included in their programs (Crane, 2005). “Of the 534 respondents to the survey, 338 (63.3% of them) were involved in nursing education” (p. 4). The statistical analysis delineated how many educators were teaching general and forensic content. “In addition, 202 faculty members provided continuing nursing education courses with forensic nursing content” (p. 4).