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Purpose: Clinical pathways are a means of translating universal clinical guidelines into local protocols to inform clinical practice. This study aimed to evaluate the effectiveness of using a blended learning approach for providing instruction and building competency on the development of breast cancer clinical pathways, using the guidelines from the National Cancer Control Network (NCCN). Methods: A one-group pretest-post test design was used for this study. Participants included healthcare providers and students in Nigeria, who were recruited through social media and professional organizations. The intervention was an online course delivered through Google Classroom, followed by two-day workshops at three locations. Data collection involved pre and post-tests scores from the online course, self-reported evaluation, as well as objective grading of in-person group projects. Results: Over 400 individuals joined the online course while 90 participated in the in-person workshops. Most participants (259/408, 63%) had no prior experience with online education, with an average age of 27.46 (±9.25) years. Data analysis revealed significant increases in mean knowledge scores across all groups from pretest (M=12.76, SE = 0.60) to post test (M =17.25, SE =0.38) p<0.001. Self-reported evaluation showed higher scores regarding chemotherapy administration for blended learning participants. Objective competence scores in developing clinical pathways ranged from 63% to 87%, across three sites. Conclusion: Findings reveal that both an online course alongside in-person workshops can be effective strategies for improving the knowledge and competence respectively of healthcare professionals on clinical pathways development. Participants in the blended learning component demonstrated significantly greater improvement in self-reported confidence scores. We recommend further studies to compare the relative strengths and limitations of these strategies.

Background: Choriocarcinoma is a rare clinical condition, and its diagnosis may be difficult, especially in resource-limited settings. Case Presentation: A 38-year old para 2 woman is with a 4-month history of intractable vaginal bleeding and offensive vaginal discharge, but without antecedent pregnancy. She had previously been managed at various tertiary medical institutions where several pelvic ultrasound scans and even histology of endometrial curette could not clinch the diagnosis. The diagnosis of choriocarcinoma was made by a serial strip-based pregnancy testing, which was still positive at 1:200 dilutions. She was treated with chemotherapy involving Adriamycin, Cyclophosphamide, Methotrexate and Folinic acid. Conclusion: The diagnosis of choriocarcinoma may be difficult especially when it develops ab initio without preceding abortion, molar or term pregnancy. In settings where serum hCG assay may be not available, the simple strip-based pregnancy test in dilution could be helpful in its diagnosis and treatment monitoring.

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Background: Breast cancer is the second most common malignancy affecting Nigerian women, and contributes the highest cancer-related mortality in this population. Despite the rising prevalence of breast cancer, Nigerian healthcare professionals do not have adequate resources in screening, diagnosing, treating and follow up of women with breast cancer. The objective of this study was to understand how the development and implementation of a state-wide clinical pathway alongside a patient navigation program will impact the care providers and care receiver (beast cancer patients). Methods: This mixed methods, cross-sectional study will develop and deploy a multidisciplinary clinical pathway focused on breast cancer management. Trained patient navigators will facilitate the implementation of the pathway and to support patients. An electronic medical record system will be deployed to document the use of the pathway. Mixed methods data will be collected periodically, including patient satisfaction, treatment adherence, psychosocial outcomes, and quality of life. Qualitative data will provide contextual details.Anticipated Result and Discussion: This research will potentially structure the management of breast cancer in a way that optimizes available resources while reducing delays in Abia state, Nigeria.