"Catching flies with honey": the management of conflict in Sexual Assault Response Teams

The Working Relationship Between Emergency Room Nurses and Medical Rape Victim Advocates: A Qualitative Examination of Nurses' Perceptions of the Influence of Nurse Training and Experience on Nurse-Advocate Interactions

Nurses and medical advocates respond to sexual assault survivors seeking hospital services. Ideally, both providers work collaboratively. However, this does not always happen. Extant research on the nurse-advocate relationship focuses on Sexual Assault Nurse Examiners (SANEs). This study examines how ER nurses perceive their training and experience influence the working relationships between emergency room (ER) nurses (not exclusively SANEs) and medical advocates. Key findings indicate nurses perceive increased training improves (a) role understanding, (b) trust, (c) respect, (d) rapport, and (e) appreciation. Less training was associated with poorer role understanding and trust.

Physicians and nurses professional relationship with criminal investigation in dealing with survivors of sexual abuse: a scoping review

Survivors of sexual abuse and their families seek help from criminal law enforcement agencies and health professionals to obtain justice and health care. Many communities have implemented multi-professional collaborative models so that the victim's well-being is assured and the truth is established. However, there is a general lack of evidence on how to best articulate these teams with the healthcare professionals caring for the survivors.Therefore, this Scoping Review was conducted in order to analyze and to map the barriers and facilitators of the relationship between health professionals and the criminal investigation team in the care of survivors of sexual abuse. The methodology proposed by the Joanna Briggs Institute for Scoping Reviews was used, and the Bronstein five dimension model of interprofessional collaboration served as the basis for the analysis of barriers and facilitators. Quantitative, qualitative and mixed studies, primary and secondary sources, text and opinion documents were included. Content analysis was performed on the main findings of the collected studies. Twelve articles were identified and analyzed. Collaboration, communication, hierarchy, skills, confidentiality, and leadership emerged as key themes. Multidisciplinary Sexual Assault Nurse Examiner (SANE) and Sexual Assault Response Teams (SARTs) were implemented to coordinate care, but conflicting goals and values among professionals posed challenges. Communication failures and inadequate information sharing hindered collaboration. Neutral leaders who coordinate teams, minimize groupthink, and improve decision-making were found to be valuable. Engaging across disciplinary boundaries and addressing power dynamics were challenging but could be addressed through facilitation and conflict resolution. This review highlights the importance of effective collaboration and interaction within teams and with other professionals in the care of sexual abuse survivors.

Impact of a Remote Virtual Reality Curriculum Pilot on Clinician Conflict Communication Skills

OBJECTIVES

Conflict management skills are essential for interprofessional team functioning, however existing trainings are time and resource intensive. We hypothesized that a curriculum incorporating virtual reality (VR) simulations would enhance providers' interprofessional conflict communication skills and increase self-efficacy.

METHODS

We conducted a randomized controlled pilot study of the Conflict Instruction through Virtual Immersive Cases (CIVIC) curriculum among inpatient clinicians at a pediatric satellite campus. Participants viewed a 30-minute didactic presentation on conflict management and subsequently completed CIVIC (intervention group) or an alternative VR curriculum on vaccine counseling (control group), both of which allowed for verbal interactions with screen-based avatars. Three months following VR training, all clinicians participated in a unique VR simulation focused on conflict management that was recorded and scored using a rubric of observable conflict management behaviors and a Global Entrustment Scale (GES). Differences between groups were evaluated using generalized linear models. Self-efficacy was also assessed immediately pre, post, and 3 months postcurriculum. Differences within and between groups were assessed with paired independent and 2-sample t-tests, respectively.

RESULTS

Forty of 51 participants (78%) completed this study. The intervention group (n = 17) demonstrated better performance on the GES (P = .003) and specific evidence-based conflict management behaviors, including summarizing team member's concerns (P = .02) and checking for acceptance of the plan (P = .02), as well as statistical improvements in 5 self-efficacy measures compared with controls.

CONCLUSIONS

Participants exposed to CIVIC demonstrated enhanced conflict communication skills and reported increased self-efficacy compared with controls. VR may be an effective method of conflict communication training.

Partnering With Oppressive Institutions for Social Change: Roles, Ethics, and a Framework for Practicing Accountability

Community psychology is driven by the values of social justice, action, and accountability to oppressed groups, with a large body of literature devoted to understanding how to work in partnership with communities through participatory methodologies (e.g., community-based participatory research, participatory action research). However, some community psychologists may work in partnership with oppressive institutions (e.g., the criminal justice system) in order to transform these institutions toward greater equity and justice. In this conceptual review, I explore the unique challenges and opportunities of partnering with oppressive institutions for social change. First, I define oppressive institutions as those that are hierarchy-enhancing under social dominance theory and draw on theories of social change to explain when and why we might choose to partner with these institutions in research and action. I then review case studies of the ethical dilemmas community psychologists have faced in such partnerships. Finally, I propose a conceptual framework for practicing accountability when partnering with hierarchy-enhancing institutions. This framework includes specific practices that research/evaluation teams might incorporate into their relationships with institutional partners and communities impacted by the institution.

A Qualitative Examination of Collaborative Infrastructure within Sexual Assault Response Teams

Sexual assault response teams (SARTs) are multidisciplinary interventions that seek to improve the response to sexual assault in their community. SARTs bring together relevant stakeholders (e.g., sexual assault advocates, medical/forensic examiners, police, prosecutors) to coordinate the response to sexual assault and improve survivors' help-seeking experiences. SARTs may adopt various infrastructures to guide their team (e.g., case review, subcommittees), but little is known about how infrastructure influences SART effectiveness. Therefore, this qualitative study examined the helpful versus challenging aspects of SART infrastructure. Interviews from a national random sample of 169 SART leaders revealed helpful versus challenging aspects of mission statements, formal protocols, subcommittees, team roles, trainings, meetings, and case review. Participants believed infrastructures have positive influences on interdisciplinary relationships, team efficiency, and creating improvements in responding to sexual assault. However, certain infrastructures were difficult to implement for some teams. Additionally, some infrastructures can have unintended consequences, such as exacerbating team conflict. Findings suggest that SARTs may benefit from first focusing on infrastructures that build trusting interdisciplinary relationships and widespread buy-in prior to implementing accountability-focused measures (e.g., protocols, case review).

What can Campuses Learn From Community Sexual Assault Response Teams? Literature Review of Teams' Purpose, Activities, Membership, and Challenges

Sexual assault is a public health issue, with college-age students reporting high levels of victimization. Following an increase in national attention and federal initiatives, college and universities' sexual assault response efforts are being examined. The practice of community sexual assault response teams (SARTs) may provide campuses with a model strategy to coordinate campus and community service delivery and planning, still underdeveloped or missing at many institutions. This literature review summarizes in side-by-side fashion the most current empirical literature about community SARTs and campus team approaches (CTAs) in four domains: (1) defined purpose, (2) activities to achieve purpose, (3) membership, and (4) challenges to functioning. Two searches were conducted. The community SART inclusion criteria were (a) an empirical study focusing on community SARTs as the level of analysis, (b) located in the United States, (c) published between 2010 and 2017, and (d) written in English. The inclusion criteria for the CTA were (a) an empirical study on CTAs to sexual assault and/or intimate partner violence as the level of analysis and (b) written in English. Eight articles met the criteria for community SARTs, and six articles met the criteria for CTAs. Differences between community SARTs and CTAs included community SARTs shared and more discretely defined purpose and subsequent activities. Further directions offered for the conceptual and practical development of a CTA to address sexual assault include the need for clearer definition of a team's purpose leading to response-focused coordination of activities.

Using Social Network Analysis to Identify Successful Relationship Patterns Within Sexual Assault Response Teams (SARTs)

The current study used social network analysis (SNA) to examine relationships within three effective Sexual Assault Response Teams (SARTs) that coordinate the response of legal, medical, and advocacy organizations to sexual assault. Within each SART, organizations reported on each other member organization valuing their role, serving as a resource to their work, and communication outside of official meetings. Across the SARTs, there was high connectedness and reciprocity and low to moderate dependence on one organization to drive relationships. However, there was dependence on a subgroup of organizations to drive additional communication relationships. Implications for managing relationships in SARTs are discussed.

The Influence of Community Sociocultural Context on Creating an Effective, Coordinated Response to Sexual Assault

Members of Sexual Assault Response Teams (SARTs) coordinate and improve the community response to sexual assault. A SART’s effectiveness is likely influenced by its sociocultural context, or the norms, values, and beliefs of the local community. However, this has yet to be empirically examined. We conducted a qualitative study to explore how sociocultural context may influence effectiveness within a sample of 169 leaders of 169 U.S. SARTs. SART leaders believed that specific norms and beliefs held by the general public in their community (rape myths and victim blame, denial of sexual assault happening locally, taboos against discussing sexual assault, and a male-dominated environment) delegitimized sexual assault as a problem that deserved public intervention. Leaders believed these led community members to resist the team’s efforts, by decreasing the community’s support and buy-in to the SART, interfering with efforts to make services accessible to survivors, and obstructing the SART’s ability to effectively respond to cases. And some leaders believed highly interconnected communities compromised the accessibility and objectivity of systems that respond to sexual assault. SARTs need to carefully tailor their efforts to improve accessibility of systems, and the response to sexual assault cases, to their unique local sociocultural context.

Exploring the Sexual Assault Response Team Perception of Interprofessional Collaboration: Implications for Emergency Department Nurses

There is little research on the dynamics of the sexual assault response team (SART) members' interprofessional collaboration (IPC) practice. The study purposes were to (1) explore the perceptions of IPC among SART members; (2) evaluate the use of Perception of Interprofessional Collaboration Model Questionnaire with the SART; and (3) discuss the implications of the Interprofessional Core Competencies for emergency department nurses and sexual assault nurse examiners. This cross-sectional mixed-methods study (n = 49) was implemented using 4 SART teams in a mid-Atlantic state. There were no statistically significant differences in the subscales within the group level using analysis of variance but offered some valuable insight and content analysis. Emergency department nurses collaborate with different agencies and discipline within their working environment. Understanding the basics of IPC and the perception of IPC within the SART may open doors to further appreciate the dynamics of this team.