Improving referrals to survivorship: A patient-driven initiative.

44 Background: Patients often feel lost in the transition from cancer patient to survivor. As cancer treatment improves, the number of survivors in the US is expected to approach 22 million by the year 2029. Smaller increases in the MD workforce coupled with long-term effects of new treatments necessitate the creation survivorship clinics led by advanced practice providers (APP) who are disease-specialized and specifically trained to manage unique survivor needs. Although the institutions Survivorship program was established more than a decade ago, the average referral rate to the program is only 30%. Given the high levels of patient satisfaction with the program, we sought to understand and address clinician awareness and referral obstacles. Methods: Based on patient input, members of our Patient & Family Advisory Council for Quality (PFACQ) put forth a proposal aimed at increasing referrals to the Survivorship program. A multidisciplinary working group comprising patients, clinicians, administrators and process engineers was assembled. Process Improvement training was conducted, and a primary goal was developed: increase Survivorship referrals by 25%. Central to the approach was engagement with referring physicians and APPs on a service-by-service basis. A four-question survey was developed to address timing of initial discussion, challenges to referring, knowledge of visit elements, and materials needed to support referrals. A customized ‘roadshow’ presentation was created and delivered by a PFACQ member at a faculty meeting. Highlights included: the importance of Survivorship care to patients and details of the visit, survey responses, and additional faculty discussion and input. Results: Four roadshows were completed from August 2020-June 2021: Gynecologic Surgery, Endocrine, Breast Medicine and Lymphoma. Based on survey responses and dialogue with providers, new material to support patient discussions and education have been developed: a patient-facing brochure, clinician- & patient-facing video, and clinician talking points. Methods to facilitate identifying eligible patients were also discussed, as well as automatic referrals to Survivorship for selected services. Data reveal a significant increase in referral rates from GYN and Endocrine services (follow up > 6 months) of 63% and 228%, respectively. (Breast Medicine and Lymphoma with shorter follow up will be reported.) Engagement with other services is underway. Conclusions: Results have exceeded the goal of increasing referral rates to the program. This process suggests that ongoing engagement with referring clinicians is essential to achieving and maintaining higher referral rates. The patient voice throughout this process has been a powerful tool in raising clinician awareness of their experiences and expectations for comprehensive follow up care, which can be delivered on a greater scale by survivorship providers.

ASSESSMENT STRATEGIES FOR EDUCATIONAL WARGAMES

Purposeful integration of assessment within educational wargame design is increasingly essential as military education expands those activities within its curriculum. This multimethod case study examines key challenges and strategies for assessment within educational wargaming practice. Drawing insights from faculty interviews, academic documents, and faculty meeting observations, the study identifies six key assessment challenges: gamesmanship, lack of control, multiple faculty roles, receptiveness to feedback, evaluation of individuals in teams, and fairness of evaluation. It then discusses how experienced faculty mitigate these challenges throughout the assessment design process from identifying outcomes to ensuring the quality of evaluation.

Bona fides and ubuntu – A response to Dale Hutchison

This paper is a response to Dale Hutchison’s recent arguments about the role of fairness in contract law after the Constitution. From the point of view of transformative constitutionalism, the paper argues that the fairness ‘debate’ in the South African law of contract should be approached as what it so patently is, namely, as evidence of a deep ideological conflict that has existed in our law of contract for a very long time, and that this debate now exists within the context of a larger debate about the appropriate transformative reach of the Constitution. The argument takes the form of two ‘dangerous supplements’ to Hutchison’s discourse. The first of these supplements contends that indeterminacy is a symptom of the common law itself, rather than a result of contract law’s contact with the Constitution. The second dangerous supplement suggests a responsible judicial engagement with bona fides and ubuntu, one that can exploit the strengths of both the common law and the Constitution and that understands good faith and ubuntu to be ‘inter-linking’ constitutional values that should be enlisted in unison or at least in resonance when it comes to the question of fairness in our contemporary law of contract. In conclusion, I offer a reading of Hutchison’s own politics of contract law and contend that his is an altruistic politics committed to the standard form. I contend that this politics of contract law is consistent with a transformative understanding of the post-apartheid legal order. ‘Law, like every other cultural institution, is a place where we tell one another stories about our relationships with ourselves, one another, and authority. In this, law is no different from the Boston Globe, the CBS evening news, Mother Jones, or a law school faculty meeting. When we tell one another stories, we use languages and themes that different pieces of the culture make available to us, and that limit the stories we can tell. Since our stories influence how we imagine, as well as how we describe, our relationships, our stories also limit who we can be’.

MANAGEMENT ACTIVITY OF IP LVOV IN THE POSITION OF HEAD OF THE DEPARTMENT OF PEDAGOGY OF THE CHERNIGIV PEDAGOGICAL INSTITUTE (1952–1958)

The article shows I. P. Lvov, сhairman of the Department for pedagogy of Chernihiv Pedagogical Institute. I. P. Lvov worked as the Head of the Department of Pedagogy from 1952 to 1958. He developed didactic materials on pedagogy, logic and psychology. The curriculum for the second semester was analyzed, where the main tasks were students' educational work, advanced training of teachers and realization of рublic works under the teachers. At the faculty meeting, the lecturers approved the Individual work plans of the members of the department, monitoring the lectures and pedagogical lessons from the point of view of scientific and methodological execution, control over the work of a laboratory assistant, review and approval of the work plan of pedagogical practice of students. I. P. Lviv had intended to purchase a separate room for conducting psychological experiments. Unfortunately, the intention failed for unknown reasons. He controlled the quality of lectures and seminars on pedagogy, lectures on psychology, and reported on the visit by the directorate of the institute and individual members of the chair they reviewed. In 1952, a pedagogical circle was formed at the department of pedagogy. I. P. Lviv was group leader of the circle at one of the meetings read a report "Modern problems of restructuring the science of psychology in the academician I. P. Pavlov". I. P. Lviv appreciated the work of the laboratory assistant of the department of G. P. Svirid, pointing to her faithful discharge of her duties: providing students with educational and recommended literature. The content of the documents of I. P. Lvov on an administrative post was analyzed and he was found that he made some comments in the report at the meeting of the pedagogy department of the Chernihiv Pedagogical Institute, as well as at the meeting of the Institute council concerning the issues that were in the report "On the condition of pedagogical science and eliminating its backlog" on the resolution of I. A. Kairov. In 1955 I. P. Lvov was the head of the commission on State examinations of the correspondence department of the Russian language and literature of the Chernihiv Pedagogical Institute. Analysis of students' answers in pedagogy, according to I. P. Lvov, showed that most were positive answers, but some students had satisfactory grades, they did not possess good material in pedagogy.

Retaining International Faculty: Meeting the Challenge

<p><em></em><em><em>The benefits of the presence of international faculty on university campuses are widely acknowledged. Their integration into campus life creates a global atmosphere and provides rich resources to encourage globalization efforts on campus. We set out to explore the perceptions of the challenges faced by our international faculty, with the further goal of meeting these challenges and increasing their retention. To probe these perceptions and address the challenges they identified, we created and disseminated a survey and interviewed our international faculty. The results of the study will be used to increase the retention of international faculty at our institution. The actions we propose will be to create more opportunities to socialize, provide more legal support, recruit more international students, offer mentorship based on cultural affinity, and make English language support and speech modification services available to international faculty and encourage them to take advantage of these services.</em></em><em></em></p>