No abstract

No abstract

Rural school leaders are met with serious challenges and opportunities to lead rural schools in times of normalcy, but these challenges are amplified during a crisis. Rural school principals in the United States faced an unprecedented crisis when school buildings closed in spring 2020 due to the COVID-19 pandemic. The measure of rural school principals and their response to this crisis is exemplified through their leadership practices. Through qualitative methods, we examined the leadership practices of rural principals through the initial months of the COVID-19 pandemic and quarantine, and we found that rural principals exhibit the practices of caretaker leadership. From the findings, we used a meta-leadership frame to discuss the caretaker leadership practices of rural school principals.

Purpose The aim of this study was to develop priority recommendations for the service level implementation of patient-reported outcomes (PROs) into clinical cancer care. Methods Development of draft guidance statements was informed by a literature review, the Knowledge to Action (KTA) implementation framework, and discussion with PRO experts and cancer survivors. A two-round modified Delphi survey with key stakeholders including cancer survivors, clinical and research experts, and Information Technology specialists was undertaken. Round 1 rated the importance of the statements and round 2 ranked statements in order of priority. Results Round 1 was completed by 70 participants with round 2 completed by 45 participants. Forty-seven statements were rated in round 2. In round 1, the highest agreement items (>90% agreement) included those that focused on the formation of strong stakeholder partnerships, ensuring ongoing communication within these partnerships, and the use of PROs for improvement and guidance in clinical care. Items ranked as the highest priorities in round 2 included assessment of current staff capabilities and service requirements, mapping of workflows and processes to enable collection, and using collected PROs to guide improved health outcomes. Conclusions This stakeholder consultation process has identified key priorities in PRO implementation into clinical cancer care that include clinical relevance, stakeholder engagement, communication, and integration within the existing processes and capabilities. Implication for Cancer Survivors Routine adoption of PRO collection by clinical cancer services requires multiple implementation steps; of highest priority is strong engagement and communication with key stakeholders including cancer survivors.

In this article, we describe the challenges faced by a network of universities embarking on program improvement to navigate the inclusion of powerful learning experiences (PLEs) in existing curriculum. We find that embedding PLEs requires more than structural adjustments to existing curriculum and that the tools we have been using to consider such changes may need refining. Our findings suggest that curriculum changes necessitate new ways of working together and of structuring time within faculty work; yet, many faculty members are not prepared to make such adjustments and are not provided the types of resources that are necessary for success.