ABSTRACT
Student participation and engagement are central to learning, yet behaviours that indicate participation and cognitive engagement can differ in online and face-to-face classes. This difference became apparent in 2020, when universities around the world transitioned from face-to-face classrooms to wholly online classes. With this move, tutors' perceptions of participation and engagement changed. Based on written reflections by 13 tutors who teach at an Australian university, we found that tutors recognised new/different indicators of engagement in the classZoom. In addition, the tutors observed that issues around student diversity and access greatly influence how students participate in the classZoom. Tutors also learnt not to assume that students were not participating and engaging online if they did not enact the same behaviours expected of them in face-to-face classes. Using active learning theories, this paper argues that participation and engagement can be understood and fostered online with particular attention to student diversity and digital access. These understandings enrich current pedagogical perceptions and inform educators to `design in' more active forms of engagement in the classZoom. What has been learnt through this experience has salience beyond the confines of COVID lockdowns and into hybrid modalities of online and face-to-face teaching practices.
ABSTRACT
The value of genetic counseling and testing to cancer prevention, early detection, and treatment options to ensure optimal outcomes is widely acknowledged by providers, payers and patients. However, many individuals who should receive genetic counseling are never offered this service. All patients with early onset (<=age 45), triple negative (<=60) and metastatic HER2 negative breast cancer should be offered genetic counseling and testing (GC/GT) per National Comprehensive Cancer Network guidelines. A quality improvement project to actively identify and offer genetic counseling to all women with early onset, triple negative and metastatic breast cancer was implemented. Baseline information on the number of early onset (<=45), triple negative and metastatic HER2 negative breast cancers diagnosed January 2018-June 2019 was collected and cross-referenced with the Cancer Genetics Risk Assessment patient database and the electronic health record (EHR) to see how many had GC/GT in our department or the breast surgeons' office. We developed questions for an electronic screening tool used by the navigation team when meeting with patients for the first time, screening for personal or family history criteria that would flag patients at increased risk for hereditary cancer. If any questions were flagged, the patient was asked by the navigator if they would be interested in a genetic counseling appointment to consider genetic Stesting. Training was provided to the navigation team so that they could answer basic questions, biweekly meetings were set up to discuss patients, and a flier and informational videos were made available to patients who wanted more information about GC/GT. If a patient was agreeable to genetic counseling, an automated email was triggered to the genetics team, who contacted the patient for an appointment. A standing order was obtained from willing breast surgeons and oncologists within our network to streamline the referral process. In the 18-month baseline period, there were 126 patients diagnosed with early onset, 36 with triple negative <=60 and 30 with metastatic HER2 negative breast cancer. Of these, 57.1% of early onset, 66.7% triple negative and 3.3% of those with metastatic breast cancer had documentation of GC/GT. A paper screening tool was implemented in July 2019 with implementation of an electronic version in November 2019. In the 18-month intervention period, there were 100 patients diagnosed with early onset, 39 with triple negative and 22 patients with metastatic breast cancer. Of these, 86% of early onset, 87.2% of triple negative and 31.8% of metastatic breast cancer patients had documented GC/GT.A limitation of this project is that some patients leave the system to be treated elsewhere after diagnosis and some may have been tested in their private practitioner's office that does not connect with our EHR. Additionally, some may have been offered GC/GT but declined or were unwilling/unable to complete an appointment. Finally, the pandemic likely had an impact on this project, since fewer women were undergoing mammography screening due to COVID-19 restrictions, resulting in fewer diagnoses of breast cancer. By leveraging the navigation team's interaction with breast cancer patients, we were able to improve identification and referral of more patients with early onset, triple negative <=60 and metastatic HER2 negative breast cancer for GC/GT. One barrier to genetic counseling that has been previously identified is a lack of physician referral. Active engagement with a breast navigator can circumvent this barrier. De-identified aggregate data from this quality improvement project was shared with the Association for Community Cancer Centers as part of a larger project, supported by a grant from Pfizer.
ABSTRACT
This article seeks to answer the question: What is God doing at this time of pandemic crisis in our Churches and communities? Through qualitative enquiry and the lens of liberation theology, data from Anglican parishes in South West England is explored and analysed. Four basic themes emerge: Bible, Liturgy, Lament, and Liberation;for each of these, rich data extracts are provided, including the author's own account. I conclude that while it is much easier to ascertain what the Churches are doing, it still is possible to say something provisionally about God: that in the gaps between a search for meaning and the chaos and discomfort of actual experience, God may be opening to humankind a glimpse of a different life. A reorientation towards care for the vulnerable neighbour, and new models for community may provide the hope that resurrection follows the darkness of crucifixion.