Education Society Research Articles

The Impact of Physical Therapy Postprofessional Education Programs on Productivity in a Large Academic Medical Center.

Emerging evidence shows positive impact of postprofessional physical therapy education (residency and fellowship) specific to participants; however, outcomes on organizational impact are largely unknown. The purpose of this project was to describe the impact residency and fellowship training has on financial metrics. A secondary purpose of this case study was to describe trends associated with higher productivity. Previous studies have demonstrated positive professional behavior and generalized operational impact of postprofessional education. No studies have evaluated the impact of residency and fellowship training on individual physical therapist (PT) productivity. Individual productivity from 191 PTs was collected over a 10-year time frame from a large, ambulatory, rehabilitation department within an academic medical center. Productivity was compared between 4 groups: nonresidency- or fellowship-trained clinicians; residency-trained clinicians; fellowship-trained clinicians; and dual residency and fellowship-trained clinicians. Physical therapists' productivity data were manually extracted retrospectively from operational reports over a 10-year period. Additional data elements extracted included the following: board specialty certification and years employed at the medical center. Data were then categorized as nonresidency/fellowship -trained, residency trained, fellowship trained, or dual residency and fellowship trained. Data were analyzed using descriptive statistics and 1-way analysis of variance (ANOVA). Forty-five clinicians with postprofessional training collectively produced $253,617 more in financial annual return to the organization. Fellowship-trained clinicians demonstrated the highest productivity followed by residency-trained and dual residency and fellowship-trained clinicians. Specialty board certification also positively increased productivity regardless of postprofessional training. Postprofessional training within physical therapy continues to be evaluated in the spectrum of professional development. Evidence supports positive professional behaviors and patient outcomes; however, little is known regarding its impact on productivity metrics. Although no significance was found between the groups with and without postprofessional training, meaningful financial return was demonstrated in clinicians with postprofessional training. The lack of significance may have been influenced by compression because of departmental productivity guidelines. This preliminary data may assist organizations in justifying resources for sustaining and sponsoring future programs.

Opinion & Special Articles: Beyond Pronouns-Educating Trainees on the Impact of Language on Gender Inclusivity in Neurologic Practice.

Language plays an important role in ensuring gender inclusivity within neurology. Despite progress in language inclusivity, such as the emergence of explicit pronouns, more remains to be done. Historically, sex and gender have been used interchangeably, but they are, in fact, distinct concepts. This is an important distinction particularly in the care of transgender and gender diverse (TGD) individuals, whose assigned sex and gender are incongruent. In the health care setting, TGD individuals frequently report misgendering, identity invalidation, and gender pathologizing, which have led to health care avoidance and mistrust. Ultimately, to ensure effective integration of gender-affirming language into clinical care, training should be introduced early in neurology residency and fellowship education. Through 3 case studies in epilepsy, multiple sclerosis, and stroke, we discuss language use in neurology and provide recommendations to support trainees in the use of gender-affirming language. We underscore the importance of gender-affirming language in health care equity and cultivating a safe, inclusive clinical environment. It is crucial for residents and fellows to not only be informed on cultural humility and gender-affirming terminology but also learn to avoid assumptions and seek clarification about gender identity when needed. Ultimately, trainees proficient in these skills cultivate trust in clinical relationships, reduce discrimination against TGD populations, and improve patient health outcomes in neurologic care.

Participation in a pre-registration student interprofessional education (IPE) society: influence on subsequent professional practice

Participation in a pre-registration student interprofessional education (IPE) society: influence on subsequent professional practice

Unpacking the complexity of English language teacher-tutor identities in Kazakhstan: a qualitative inquiry

ABSTRACT Research on English private tutoring (EPT) is still in its infancy despite its global impact on education systems and society. Informed by the poststructuralist view of identity, this qualitative study investigates the relatively underexplored area of the complex identities of English language teacher-supplied EPT in Central Asia. The data were collected from two rounds of semi-structured individual interviews with 22 English language teachers from five mainstream schools in Astana, Kazakhstan. The findings suggest that most participants identified economic benefit as the main reason for providing EPT, embodying multiple identities such as ‘commercialised education providers,’ ‘Robin Hood’ teachers (offering free tutoring to selected students), and individuals entangled in ‘unethical practices’ (confronting moral dilemmas related to tutoring their students). The participants reported ethical and professional conflicts stemming from the lack of effective monitoring of the tutoring market in Kazakhstan. These conflicts include accommodating requests from tutored students’ parents and encouraging their students to attend EPT with them or to enrol in a tutorial centre where they worked. This study stresses the need for policymakers to improve the quality of teaching in mainstream education and implement effective regulatory measures for the tutoring industry while also examining the nature and effectiveness of fee-free tutoring.

Challenges and Outlook of Veterinary Education in Iran: A Survey of Veterinary Students at Urmia University During the COVID-19 Pandemic.

Veterinary science remains a challenging and less appreciated subject in the Iranian higher education system and society. This survey aimed to assess the satisfaction and outlook of veterinary students at Urmia University, one of the major veterinary faculties in Iran. The survey was conducted during the COVID-19 pandemic, which also significantly impacted veterinary education. A questionnaire was used to gather the opinions of 292 students. The results revealed that 50.2% of respondents were either completely unsatisfied or less satisfied with the quality of teaching. Poor clinical training, the curriculum and distance learning were identified as the primary reasons. In addition, 40.3% of students expressed a desire to change their major. Most students (82.6%) expressed a desire to continue their education after completing their undergraduate course. Regarding future employment, 45.8% of participants wanted to start their own business or practice, whereas 54.2% preferred employment opportunities. A significant 81.6% of participants said they would consider emigrating to pursue better career prospects. The study highlighted various challenges in veterinary education in Iran, including dissatisfaction with the quality of teaching, an oversupply of trained veterinarians and limited career options. The COVID-19 pandemic and distance learning further exacerbated these issues.

The contribution of education and cultural diplomacy to strengthening civil society in the Republic of Moldova

Our study aims to explore the dynamics and transformations of civil society in the Republic of Moldova, taking into account the post-communist realities, which lay its foundations as a soft power. Civil society is represented by the social and civic institutions and organizations that form the foundation of a functioning democracy. Civil society organizations are involved in decision-making on social development or decisions of public interest. Civil society can include the media, churches, trade unions, non-governmental organizations, educational associations, etc. What is the link between cultural diplomacy, education and civil society? Based on Bordieu's theory, which provides us with a conceptual and analytical perspective suitable for a critical understanding of the role of civil society in making cultural diplomacy more effective, in our study we tried to establish what role cultural diplomacy in turn plays in the social distribution of local/national/international power in the form of an awareness of interdependence. We also try to follow in our analysis: what is the role of civil society in the Republic of Moldova in the accession process?; in the implementation of its tasks, does the EU-Moldova CSP envisage the use of culture and education, implicitly cultural diplomacy, in the EU accession process?; what role does cultural diplomacy play in the social distribution of power?; in the regional context given by the war in Ukraine, can cultural diplomacy and education help civil society in solving problems related to the judiciary, public administration, the fight against corruption, public finance management and freedom of the press? The methodological framework of the paper is structured around the analysis of the "EU-Moldova Civil Society Platform", in order to underline the role of the EU-Moldova Civil Society Platform and other civil society organizations in the development of civil society, internally, and of cultural diplomacy, externally, in favor of the state interests of the Republic of Moldova, both being seen as soft powers, necessary to fulfill the political and economic interests of the state.

Time for an education revamp? A nationwide survey of Fellowship in Minimally Invasive Gynecologic Surgery program directors' and fellows' didactics experiences.

A desire for curriculum standardization in obstetrics and gynecology residencies has been identified. No prior investigation of educational experiences in Fellowship in Minimally Invasive Gynecologic Surgery (FMIGS) programs has been completed. The purpose of this study was to determine the state of FMIGS didactic education and the perceptions that fellowship directors and fellows have regarding a standardized curriculum. National survey SETTING: Web-based survey platform PARTICIPANTS: AAGL FMIGS program directors and fellows INTERVENTIONS: N/A RESULTS: A total of 87 out of 151 fellowship directors responded to the survey resulting in a response rate of 57.6%. A total of 58 of 97 fellows responded to the survey with a response rate of 59.8%. When participants were asked if their programs had structured didactic education curriculums, 98.9% of fellowship directors replied yes while only 77.6% of fellows responded yes (p<.001). Approximately 97% fellowship directors reported that structured didactic time is protected from clinical duties. However, only 67.2% of fellows reported that didactic time was protected (p<.001). Participants (71.3% of fellowship directors and 84.5% of fellows) strongly agreed/agreed that their didactic education could be improved. A large majority of participants agreed that all MIGS fellows should learn the same content in their didactics curriculums, that fellows should have access to the same educational resources and that participating in a standardized didactic curriculum would allow for better transition into independent practice. Fellowship directors and fellows are aligned in the desire for improvement in their current didactic education programs and the need for a centrally located, structured, and standardized fellowship education curriculum.

중학교 가정과 교육과정과 교과서에 수록된 사회문제 내용분석

The purpose of this study is to analyze the types and description styles of social problems included in middle school Home Economics(HE) curriculum and HE text books. In this study, content analysis standards were established for social problems in HE through a literature review and analyzed the HE curriculum and HE textbooks of middle school to find out the proportion of social problems covered in HE by types and description styles of social problems. The results of this study are as follows. First, the types of social problems covered in the HE curriculum and textbooks are problems related to quality of life(environment, population, health care) and family and generational problems(family, women, youth, elderly). Types of social problems with low emphasis are structural social problems(urban, poverty, crime). Second, the 2015 revised HE curriculum and textbooks mainly deal with crime, family, and health care problems, while problems of youth, population, environment, and women are slightly covered. Social problems of excessive consumption, dehumanization, information society and social problems of elderly, education, urban, and poverty are hardly covered. In contrast, the 2022 revised HE curriculum deals with problems of environment problems of excessive consumption, dehumanization, information society, youth, health care, crime, family, and women in order. Third, the most common style of describing social problems in the HE curriculum was solutions, followed by simple mentions, causes and results, and actual situations. Descriptive styles for conceptualization and generalization were rarely addressed.

Curbing Teenage Pregnancy in South Africa's Schools

Teenage pregnancy in South African schools presents a significant challenge to the education system and society as a whole. This study seeks to investigate the strategies implemented to decrease teenage pregnancy in South African schools. It is based on qualitative secondary sources such as expert analysis, teacher input, civil society, and testimonies from teenagers. The data was collected from public online sources, including audio, YouTube videos, and written testimonies. The findings indicate that teenage pregnancy has reached a crisis point. Socioeconomic challenges such as poverty, unemployment, peer pressure, cultural and societal norms around sexuality, and related challenges are at the center of child pregnancy in South Africa.

Implementasi Kebijakan Pondok Pesantren Ramah Anak: Tantangan dan Peluang di Era Modern

Islamic boarding schools as religious-based educational institutions have a very strategic role in forming children's character and spiritual values. This research aims to explore the implementation of policies regarding Child-Friendly Islamic Boarding Schools, as well as the challenges and opportunities faced in the modern context. This research method uses literature study by collecting several journals related to the title and focus of the research raised. By analyzing various academic sources and related policies, this research identified that the challenges faced include: lack of understanding of child protection, understanding of gender, and limited access to information in remote areas. On the other hand, there are opportunities that arise from increasing public attention to children's rights, support for government policies, and technological innovation that can support the sustainability of education. The study results show that collaboration between educational institutions, government and society is very important to optimize the implementation of this policy. In this way, it is hoped that Islamic Boarding Schools can be transformed into places that are child-friendly, comfortable and successful in supporting their growth. Keywords: Boarding School, Policy, Child Friendly

BUILDING ACTIVE LEARNING IN MEDICAL EDUCATION: HOW TO BRIDGE VISION WITH REAL PRACTICE?

Introduction: This manuscript explores the role of active learning in medical education, focusing on innovative strategies that bridge theoretical knowledge with practical skills essential for future healthcare professionals. With insights from both global and local applications, the paper highlights the implementation of active learning techniques to improve competencies in medical, pharmaceutical, and nursing education. Methods: A review of current student-centered active learning methodologies was conducted using guidelines from leading medical education societies. Practical applications of simulation-based, problem-based, game-based learning, and other interactive approaches were examined to understand their impact on skill acquisition and knowledge retention. Results: Active learning fosters critical clinical reasoning, communication, and teamwork skills. Techniques like simulation exercises, case-based discussions, and flipped classrooms enhance students’ abilities to tackle real-world clinical scenarios. Additionally, integrating interdisciplinary and preventive medicine elements supports a holistic understanding of healthcare. Incorporating online tools and gamification has further enhanced student engagement and motivation for independent learning. Conclusion: The active learning model effectively equips students with essential medical competencies, preparing them for complex clinical environments. By bridging theoretical concepts with practical experiences, active learning promotes lifelong learning, critical thinking, and adaptability, ultimately advancing the quality of healthcare training.

Factors Affecting the Mastery of English Language Skills Among University Students in Somalia: A Case at Benadir University

The purpose of the study was to investigate the factors influencing the mastery of English language abilities among university students in Hodan district, Somalia, with Benadir University serving as the case study. The study was fully qualitative, with respondents being first-year students engaging in the English proficiency program at Benadir University’s Centre for Languages. Using the saturation principle, the researchers selected a sample of 17 respondents to provide firsthand opinions based on their experiences as students in Somali educational institutions. Findings show that many students have low command of the English language despite efforts to teach them English due to factors emerging from their educational background, learning environment, culture, society, English policy, and teachers. However, the most frequently reported barrier is the influence of Somali, which trumps English not only in class but also in the community. As a result, students are taught English in Somali, and they lack opportunities to practice English because everyone around them speaks Somali. The language of instruction is also not streamlined, as lecturers continue to deliver lectures primarily in Somali, with the exception of a few cases, the majority of which are for international lectures who do not speak Somali. These factors undermine efforts to create equitable and inclusive learning opportunities for Somali students both nationally and internationally. Finally, the researchers recommend a policy review to streamline the language of instruction, monitoring, and regulation. Innovations, such as using Literature to improve English language abilities, should be implemented. Finally, there is a need to embrace teacher refresher workshops, substantial research, sensitization, and international benchmarking for best practices in managing English proficiency programs. These recommendations could create more inclusive and equitable learning environments for Somali students.

A Sustainable and Inclusive University on the Paradigm of Student Learning Satisfaction, Teacher Leadership, and Professional Disposition: The Case of Mongolian Universities

The leadership of the university teacher has the most important role in the development of the educational institution and society. Universities are facing rapid societal changes and the need for innovative pedagogical approaches, including the potential for faculty members to emerge as leaders both within and beyond their classrooms, becomes increasingly salient. Teacher leadership in this context represents a collaborative ethos, where educators engage in shared decision making, curriculum development, and pedagogical innovation, thereby enhancing both academic and institutional outcomes. University teachers play a crucial role in achieving the 4th Sustainable Development Goal by leveraging their leadership skills to provide inclusive, equitable, and high-quality education. Teacher leadership and student satisfaction are considered to be interconnected but, in turn, teacher leadership is influenced by teacher disposition. The intricate interplay between professor leadership and student satisfaction within higher education institutions (HEIs) reveals significant implications for both faculty and student experiences. This study investigated two aspects: firstly, the effect of teacher dispositions, especially motivation, communication, conscientiousness, teacher efficacy and willingness to learn, teacher leadership, and secondly, how teacher leadership affects student learning satisfaction. A survey was developed using questionnaire structural equation analysis using SmartPLS 4.0. Three hundred eighty-nine students studying in public universities in Mongolia participated in the survey. The research results show that teacher dispositions such as motivation, communication, and conscientiousness positively affect teacher leadership. In addition, it was proven that teacher leadership positively affects student learning satisfaction.

Women in Physical Education and their Career Development: Current Trends and Issues

Participation in physical education (PE) is a fundamental right for every student (UNESCO, 2012). The quality of learning in PE depends on several factors, including access to facilities, learning opportunities, well-designed curricula, and effective teaching by qualified professionals. While PE teaching is a career open to both genders and protected by policies that ensure equal working opportunities, female professionals often face unique challenges in pursuing and advancing in this field. This study examines the career choices of female PE professionals, focusing on the social constraints they encounter and their implications for women pursuing careers in the field. It also investigates gender-specific perceptions of Quality Physical Education (QPE) to identify differences across key dimensions of QPE. This study draws on data from a global survey on QPE conducted between 2020 and 2021. Using a 49-item questionnaire developed by the International Society for Physical Education and Sport (ISCPES) research team, the study engaged 5,680 professionals comprising 2,431 women and 3,249 men. Respondents were primarily from Asia, the Middle East, and Central and South America, with fewer participants from Europe and Africa. This study employed the boundary concept and compromising practice framework to analyse trends in women’s career choices, social and professional challenges, and prospects in PE careers. Findings revealed that both genders exhibited similar attitudes toward QPE development, with no significant differences in the overall score by gender. Nevertheless, women expressed more positive perceptions of QPE at the primary level than men.

An educated society is an ideas‐informed society: A proposed theoretical framework for effective ideas engagement

AbstractThe term ‘ideas‐informed society’ describes democracies in which citizens believe in the value of staying well‐informed and up‐to‐date with current affairs. They also put these beliefs into action: critically engaging with new ideas and perspectives, delving into scientific discoveries or emerging technologies and exploring aspects of history and culture. Likewise, they stay abreast of political, economic and health‐related events, new products, new forms of media and so on. While ideas engagement can, in theory, lead to citizens becoming better informed, better able to engage in effective decision‐making and better able to understand the world around them, these benefits do not reach everybody. Likewise, in the ideas ecosystem generally, we can often see ‘dark’ ideas winning through: resulting in less optimal outcomes for both citizens and nations. While interest in the notion of the ideas‐informed society is burgeoning, we argue that, if future research is to be effectively positioned to support meaningful ideas engagement, what is now required is a theoretical frame to guide this research moving forward. We use this paper to argue for such a framework based on three principal elements: (1) whether individuals possess a prospective mindset, enabling them to value ideas engagement, as well as become more likely to commit to behaviours concomitant with ideas that have optimal and wide‐reaching outcomes; (2) the features of individuals' social networks, and how these impact on citizens' access to ideas and the nature of their ideas engagement; and (3) individuals' levels of education and the extent to which the education people receive allows them to engage with ideas critically. As well as setting out the case for our proposed framework, we conclude by proposing future research to enable us to further specify and verify this framework as well as develop instruments to test it nationally and internationally.

Our Unrealized Imperative: Integrating Mental Health Care into Hospice and Palliative Care.

The field of Hospice and Palliative Medicine (HPM) has its roots in the principles, promulgated by Dame Cicely Saunders, that patient and family are the unit of care and that comprehensive integration of physical, psychological, social, and spiritual care is necessary to address suffering in all its dimensions. Although we aspire to provide comprehensive care for our patients, most hospice and palliative care (HPM) physicians lack basic competencies for identifying and managing patients with psychological distress and mental health distress and disorders, a growing segment of our clinical population. In this article, I argue that we are not living up to the founding values of our field in how we practice, how we educate our trainees, our research, and in how we pursue our own professional development as faculty. The history of our field, the nature of our clinical workforce, the culture of PC, and our educational programs all contribute to our current practice model, which is not adequate to meet the mental health needs of our patients. I propose strategies to address these challenges focused on enhancing integration between psychiatry/psychology and HPM, changes in fellowship education and faculty development, addressing the stigma against people with mental health diagnoses, and addressing system and cultural challenges that limit our ability to provide the kind of comprehensive, integrative care that our field aspires to.

COMPARATIVE ANALYSIS OF EMOTIONAL REGULATION: HAPPINESS AMONG STUDENTS IN MODERN EDUCATION VS. GURUKULAM EDUCATION SYSTEMS

Education shapes individuals and society, evolving through diverse philosophies and methods. From ancient Gurukulam teachings to modern digital pedagogies, education reflects tradition and innovation, philosophy, and technology. By comparing students from Modern Education System (MES) and Gurukul Education System (GES), we explore the impact of Gurukul-inspired education on emotional regulation and happiness, alongside examining the foundational principles and historical significance of the ancient Gurukul system in India. Methodology: Sixty students, aged between 16 and 25 years, participated in this study, with 30 students each from Gurukul Education System (GES) and Modern Education System (MES). Both GES and MES groups were evenly divided into sub-groups of 15 males and 15 females. Discussion: The 0.7 difference in average emotional intelligence scores between Gurukulam Education System (GES) and Modern Education System (MES) students suggests that GES students, rooted in philosophy, show higher emotional intelligence compared to MES students influenced by technology. This highlights the impact of educational paradigms on emotional development, indicating the potential benefits of philosophical grounding. Further investigation is needed to understand underlying factors and implications for student growth. Conclusion: In conclusion, Gurukul Education System (GES) students scored higher in emotional intelligence compared to Modern Education System (MES) students. This underscores the potential advantage of incorporating philosophical teachings, as seen in GES, into contemporary education for better emotional development.

Determination of Priorities for Lung Transplant Education for Pulmonary and Critical Care Medicine Fellows.

In the United States, a growing number of lung transplants are performed each year, necessitating an increased number of general and transplant pulmonologists skilled in the care of these complex patients. However, pulmonary and critical care medicine (PCCM) fellowships across the country do not universally have dedicated lung transplantation curricula, and there is scarce literature in this area. We describe the generation of a content outline for curriculum development created through modified electronic Delphi methodology. To identify "must know" topics in lung transplantation for a graduating PCCM fellows. We developed expert consensus on "must know" lung transplant topics and subtopics ("items") for a graduating fellow through three survey rounds from July 2023 to October 2023. Thirty-three panelists were asked to rank author-provided items as "must know," "nice to know," or "not necessary to know" and to generate new items in round 1 to be submitted for ranking in subsequent rounds. "Must know consensus" was defined as ≥50% must know responses. Survey response and completion rates across rounds were 58-70% and 96-100%, respectively. In round 1, panelists were provided eight topics and 30 subtopics for initial ranking. Panelists generated 82 new items in this round, of which 19 were included in round 2 for ranking after author review, together with one item from round 1 that required reranking. From round 2, only two items required reranking, and these items comprised round 3. Seven topics were identified as "must know": transplant immunology, evaluation of a lung transplant candidate, surgical and peri/postoperative management, rejection, immunosuppression, infections, and other complications, together with 36 subtopics. Self-identified lung transplantation experts obtained consensus on seven "must know" topics and 36 subtopics in lung transplantation for graduating PCCM fellows. The findings serve as a starting point for future curriculum development.

A Graduate Medical Education Fellowship in Climate Change and Human Health: Experience and Outcomes From the First 5 Years.

Background Climate change is affecting health and health care, but most physicians lack formal training on climate change. There is a need for graduate medical education (GME) programs that prepare physician leaders to address its health impacts. Objective To describe the development and iterative piloting of a GME fellowship in climate change and health and to assess fellows' academic output and public engagement before and after fellowship matriculation. Methods A GME training program was developed and implemented at an emergency medicine department in a US teaching hospital in collaboration with affiliated academic centers. Participants consisted of emergency physicians from the United States and abroad. Program duration and format were adjusted to meet individual career goals. Outcomes assessed include program completion, postgraduation professional roles, and academic outputs and public engagement before and after fellowship matriculation (2019-2023), compared via paired t tests. Results Five fellows have matriculated; 2 have graduated, while 3 remain in training. Costs and in-kind support include salaries, faculty time, research support, travel to conferences, and tuition for a public health degree. Fellows averaged 0.26 outputs per month before matriculation (95% CI 0.01-0.51) and 2.13 outputs per month following matriculation (95% CI 0.77-3.50); this difference was significant via 2-tailed t test (alpha=.05, P=.01). Subanalyses of academic output and public engagement reveal similar increases. Following matriculation, 186 of 191 (97.4%) of outputs were related to climate change. Conclusions For the 5 fellows that have enrolled in this GME climate change fellowship, academic and public engagement output rates increased following fellowship matriculation.

The Impact of Long-Term International Experiences on Career and Technical Educators: A Phenomenological Examination of the International Agricultural Education Fellowship Program

In 2020, the Norman Borlaug Institute for International Agriculture and Development established the International Agricultural Education Fellowship Program (IAEFP) funded by the U. S. Department of Agriculture, Foreign Agricultural Service. The IAEFP provided an opportunity for nine fellows to live in Ghana and implement the school-based agricultural education system, originally based on the vocational agricultural education model from the 1917 Smith Hughes Act. A phenomenological qualitative approach examined the impact of a 10-month international fellowship experience on the fellows and their perceived impact on the rural communities they served from 2021-2022. This study examined the participants' cultural awareness, agricultural enhancement, and professional formation as a result of participating in a long-term international experience. Through analysis, six themes emerged including programmatic adjustments, international development, challenges, personal and professional growth, and personal positivity's. Recommendations from results include for future like-programs to provide intentional and timely training to match context, increase host community and school communication, use reflection and mental health services, carefully outline emergency protocols to participants, adapt participants' roles and responsibilities to match location, and ensure programmatic location sustainability.