ABSTRACT
Summary: Social work field education has experienced major disruptions due to the COVID-19 pandemic, while also embracing new opportunities to grow. The Transforming the Field Education Landscape research partnership developed a cross-sectional web-based survey with closed- and open-ended questions to understand student perceptions of COVID-19's impacts on social work field education. The survey opened during the first wave of the pandemic from July 8 to 29, 2020 and was completed by 367 Bachelor of Social Work (BSW) and Master of Social Work (MSW) students across Canada. Quantitative and qualitative data were analyzed using descriptive statistics and thematic analysis. Findings: Respondents experienced reduced practicum hours and placements terminating early or moving online. Students were concerned about gaining adequate experience for future job prospects. They were generally positive about academic institutional responses to COVID-19 but described financial challenges with tuition costs and a lack of paid practica. Respondents were mostly satisfied with practicum supervision. They experienced negative impacts of COVID-19 on mental health with isolation and remote learning and described a lack of institutional mental health support. Students were concerned with missing direct practice skills, while some students reported more flexible hours, access to online events beyond their region, and increased research experience. They expressed a need for practicum flexibility and accommodation. Applications: Recommendations include an increase in flexibility and accommodations for practicum students, exchanges of promising and wise field education practices, and accessible postsecondary mental health supports. Professional development opportunities should support graduates who missed learning opportunities in their practicum.
ABSTRACT
BACKGROUND AND PURPOSE: The relative benefit of adjuvant radiotherapy (RT) alone in older women with low-risk early breast cancer (EBC) remains unclear. It is hypothesized that adjuvant RT-alone can improve outcomes of older patients with low-risk EBC, similar to endocrine therapy (ET) alone or combination of RT + ET. METHODS: In this population based study, we identified all women aged ≥70 with T1-2, N0, ER+ve, Her-2/neu-ve EBC treated with breast conserving surgery (BCS), followed by adjuvant treatments (RT-alone, ET-alone, or RT + ET combination) from 2005 to 2015. Primary outcome measures were recurrence-free survival (RFS), overall survival (OS), and breast cancer specific survival (BCSS). Treatment details were collected and Charlson Comorbidity Index (CCI) was calculated. RESULTS: A total of 1166 patients were identified. Median follow-up was 76.5 months. Adjuvant treatments: BCS only 130 (11%), RT 378 (32.5%), ET 161 (14%), and RT + ET 497 (42.5%). Less than 60% of women completed 5-years of ET. Compared to BCS alone, RT resulted in significant improvement in RFS (HR = 0.174; p < 0.001), similar to ET (HR = 0.414; p = 0.007) and RT + ET (HR = 0.236; p < 0.001). Determinants of OS were age, tumor grade, comorbidities, and adjuvant therapy. Increased comorbidity scores (0 vs. 1; 0 vs. ≥2) were associated with reduced OS (HR = 1.40; p = 0.013 and HR = 1.98; p < 0.001), without impact on RFS or BCSS. CONCLUSIONS: Adjuvant RT-alone is a reasonable alternative to ET or RT + ET for older women with biologically favorable EBC. No difference in RFS or BCSS was noted between RT, ET, and RT + ET. Comorbidity was independently associated with reduced overall survival.