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Although continuing nursing education is crucial to improve professional and patient outcomes, programs in oncology nursing remain scarce, piecemeal, and focused on one modality of treatment, which limits the effectiveness of education interventions. The objectives of this paper are to describe the development and implementation of a longitudinal specialized oncology nursing education pathway program, and the evaluation results of a year-long pilot of the first stage of the program at a large university-affiliated cancer centre. Preliminary findings indicated that participants' perceived competence in health assessment and symptom management was improved after one year of enrolment in the education pathway. Next steps following this pilot, including implications for participants with regards to attaining oncology certification are also discussed.

Background: The worldwide burden of cancer warrants more effective and efficient cancer care management strategies (World Health Organization, 2003). Model of ambulatory care, in particular, has tremendous implications on patient and administrative outcomes (Knight, 2007; Lynch, Marcone & Kagan, 2007; Moore, Johnson, Fortner & Houts, 2008). Nevertheless, little is known about the pattern of practices and the clinic operations in this setting. As part of the hospital's ambulatory redesign program, this survey aims to: a) review and describe existing models of ambulatory care employed by key national and international cancer centres; b) identify models or elements within the models that are appropriate to be adopted for best practice., Methods: Semi-structured interviews with 10 senior management members at 10 centres (N = 10) were conducted. Participants were asked to describe: a) model of ambulatory care employed by their institution (e.g., scope and model of ambulatory nursing practice); and b) strategies used to manage common patient care related issues in their institutions. Interviews were recorded and analyzed according to the objectives of this survey., Results: A majority of cancer centres employed models of care similar to the existing Hospital model of ambulatory care and are encountering similar challenges in care delivery. Therefore, it was not deemed appropriate to adopt any models from participating centres., Conclusion: It is crucial for administrators to report and share best practices to ensure high-quality care. The survey of current practice did not yield sufficient data to adequately support the implementation of any specific models at the hospital's ambulatory care settings. Nevertheless, findings from the present review support the principles proposed for the new hospital model of ambulatory care.

In the breast cancer literature, "delayed presentation" is defined as a delay of > 3 months from the self-detection of a new breast cancer symptom until presentation to a health care provider. It has been established that early detection of breast cancer is associated with better health outcomes. The purpose of this qualitative study was to explore reasons why women delay seeking care for their breast cancer symptoms by asking both women and family physicians for their perspectives. Narrative analysis was used to reveal the ways in which people make sense of their experiences and which parts of their stories are most important to them. We found differences in the explanatory narratives of women versus those of family physicians when it came to understanding delay. Suggestions to promote earlier presentation include improving physician-patient communication and encouraging physician and health care professional neutrality in making attributions about women's delay.