Development and evaluation of a high-fidelity canine patient simulator for veterinary clinical training

High-fidelity human patient simulators have been used for decades in medical education to provide opportunities for students to practice technical skills, diagnostic and therapeutic planning, and communication skills in a safe environment. A high-fidelity canine patient simulator (CPS) was developed using components from a human patient simulator and a low-fidelity foam core canine mannequin. Ninety-six veterinary students participated in cardiopulmonary arrest scenarios in groups of three to five students. Afterwards, participants were asked to complete an anonymous online survey describing their experiences. A total of 70 students (73%) completed the survey. All of the students (100%) felt that the simulator session expanded their cardiopulmonary resuscitation (CPR) knowledge base, and 97% responded that their skills and abilities had improved. Students also expressed positive opinions about the CPS, with 89% agreeing or strongly agreeing that the CPS was realistic and 73% agreeing or strongly agreeing that the scenarios generated emotions similar to real clinical situations. Most participants (98.5%) agreed or strongly agreed that the simulator was an engaging learning experience. Students commonly commented that the simulations allowed them to practice communication and teamwork skills and were more effective than paper-based, problem-oriented learning opportunities and lecture. Students also commented that they wanted more opportunities to participate in simulation exercises. These results suggest that high-fidelity veterinary simulation is an engaging educational methodology that addresses some limitations of other forms of problem-based learning. More studies are needed to quantitatively determine the effectiveness of this novel veterinary educational technology in comparison with more traditional approaches.     

Information technology in veterinary pharmacology instruction

Veterinary clinical pharmacology encompasses all interactions between drugs and animals and applies basic and clinical knowledge to improve rational drug use and patient outcomes. Veterinary pharmacology instructors set educational goals and objectives that, when mastered by students, lead to improved animal health. The special needs of pharmacology instruction include establishing a functional interface between basic and clinical knowledge, managing a large quantity of information, and mastering quantitative skills essential to successful drug administration and analysis of drug action. In the present study, a survey was conducted to determine the extent to which veterinary pharmacology instructors utilize information technology (IT) in their teaching. Several IT categories were investigated, including Web-based instructional aids, stand-alone pharmacology software, interactive videoconferencing, databases, personal digital assistants (PDAs), and e-book applications. Currently IT plays a largely ancillary role in pharmacology instruction. IT use is being expanded primarily through the efforts of two veterinary professional pharmacology groups, the American College of Veterinary Clinical Pharmacology (ACVCP) and the American Academy of Veterinary Pharmacology and Therapeutics (AAVPT). The long-term outcome of improved IT use in pharmacology instruction should be to support the larger educational mission of active learning and problem solving. Creation of high-quality IT resources that promote this goal has the potential to improve veterinary pharmacology instruction within and across institutions.     

Veterinary education in the era of information technology

SUMMARY A major innovation in the delivery of the veterinary curriculum is being implemented at The University of Melbourne using the subject of systematic bacteriology and mycology as a pilot project. Students receive course information as interactive, multimedia databases. These consist of text and an associated library of catalogued digital images, movies and sounds. The databases employ a hypermedia information system to achieve efficient integration within and between subjects. The new delivery method encourages greater autonomy and more active learning roles for students than occurs in traditionally taught courses. Students will use their databases as the principal resource of information for undergraduate studies. A unique feature of this system for delivering the curriculum is that students will modify and expand their databases during the course. The ultimate aim is for students at graduation to receive, on disc, a copy of their own databases, adapted by themselves to their particular future professional needs. As graduate veterinarians they will continue to use their databases as a major resource for information and learning, thus providing continuity from undergraduate to continuing postgraduate education.     

Rethinking the learning and evaluation environment of a veterinary course in gross anatomy: the implementation of an assessment and development center and an E-learning platform

Today's students belong to an interactive generation and receive information through multiple channels. In addition, veterinary medicine curricula are changing due to trends such as student-centered education and competence-based learning. In consequence, we were stimulated to rethink the way in which veterinary gross anatomy was taught and assessed. As a first step, the learning goals for the students participating in the veterinary gross anatomy course were clearly defined. Students had to acquire knowledge of and insight into the structure, the function, and the interrelationships of gross anatomical structures in various species. They also had to be competent in observing, palpating, and exposing the anatomical structures. Additionally, they had to attain some general skills and attitudes. Next, a learning environment was developed enabling students to accomplish these goals. The three main components of this new environment were, first, the reorientation of classic cadaveric dissections towards attaching an increased importance to the attainment of course-specific and general skills and attitudes; second, the incorporation of an e-learning platform; and third, an increase in the number of student-lecturer interactions during lecture hours. Finally, the assessment and examination were adjusted to complement the goals defined earlier and the redesigned learning environment. An assessment and development center (ADC) was introduced, where students demonstrated their skills and insights by completing job-relevant assignments within a set time limit. This ADC was used as a means of evaluating students as well as of giving them feedback. Students were enthusiastic about this way of teaching although they experienced it as difficult.     

Piloting interprofessional education interventions with veterinary and veterinary nursing students

Interprofessional education (IPE) has received little attention in veterinary education even though members of the veterinary and nursing professions work closely together. The present study investigates veterinary and veterinary nursing students' and practitioners' experiences with interprofessional issues and the potential benefits of IPE. Based on stakeholder consultations, two teaching interventions were modified or developed for use with veterinary and veterinary nursing students: Talking Walls, which aimed to increase individuals' understanding of each other's roles, and an Emergency-Case Role-Play Scenario, which aimed to improve teamwork. These interventions were piloted with volunteer veterinary and veterinary nursing students who were recruited through convenience sampling. A questionnaire (the Readiness for Interprofessional Learning Scale [RIPLS]) was modified for use in veterinary education and used to investigate changes in attitudes toward IPE over time (pre-intervention, immediately post-intervention, and four to five months afterward). The results showed an immediate and significant positive change in attitude after the intervention, highlighting the students' willingness to learn collaboratively, their ability to recognize the benefits of IPE, a decreased sense of professional isolation, and reduced hierarchical views. Although nearly half of the students felt concerned about learning with students from another profession before the intervention, the majority (97%) enjoyed learning together. However, the positive change in attitude was not evident four to five months after the intervention, though attitudes remained above pre-intervention levels. The results of the pilot study were encouraging and emphasize the relevance and importance of veterinary IPE as well as the need for further investigation to explore methods of sustaining a change in attitude over time.     

Stress in veterinary science students: a study at the University of Queensland

This paper reports on the results of a survey of selected University of Queensland (UQ) veterinary students aimed at elucidating factors causing stress during the five undergraduate years of the program. Students from each of the five years were asked to form six- or seven-member focus groups. Each focus group was then interviewed and their opinions sought on causes of ongoing stress and the ranking of those causes into predetermined categories. They were also asked to give their opinions on counseling services available within the university and what, if any, services they would like to see in place to help students with stress-related problems. Students in the first, third, and fourth years of the program rated academic issues as the most likely causes of ongoing stress, while students in the second and fifth years of the program ranked lifestyle and financial issues as more likely to cause ongoing stress. In most cases, students coped well with these causes of stress and tended not to use counseling services available to all UQ students. When faced with stressful issues, students looked to their classmates or family members for help and not to university counseling services. Students were also happy to approach staff members in the Veterinary School when faced with a problem. The authors nevertheless conclude that mechanisms set in place at the undergraduate level to help veterinary students cope with stress should particularly benefit those students when they become new graduates and are faced with the stresses of veterinary practice.     

Use of critical interactive thinking exercises in teaching reproductive physiology to undergraduate students

In higher education, increasing emphasis is being placed on the use of new technologies in the classroom. However, the emphasis needs to be placed on methods that truly enhance understanding and knowledge retention. Class discussions help students understand and retain information previously presented in lecture format. Furthermore, if students are challenged to critically evaluate, communicate, and defend their ideas, knowledge retention and understanding will increase even more. Critical interactive thinking exercises (CITE) were employed at two different universities to enhance student knowledge retention and promote the development of critical thinking. Applicability of CITE to undergraduate learning was assessed over a 3-yr period in the undergraduate reproductive physiology courses at Michigan State University and the University of Missouri-Columbia. For each exercise, students were challenged to prepare a one-page, double-spaced composition addressing an incompletely understood phenomenon or problem-solving situation related to the reproductive system. In preparing their compositions, students were encouraged to use information previously presented in lecture plus outside information to develop their ideas. Students were required to formulate and defend a hypothesis or approach to the problem presented. At the subsequent class period, students were divided into groups of three to four, in which they interactively discussed their ideas. Each group member was challenged to defend his or her hypothesis and explanation and to persuade other group members to adopt their ideas. Each group then arrived at a consensual opinion that was presented during a discussion by the entire class. The class then debated the merits of each group's hypothesis or explanation and the supporting arguments presented. At first, the students were apprehensive about the CITE, particularly about communicating and defending ideas with their classmates. However, course evaluations showed that 131 out of 137 students considered the CITE a positive experience that enhanced learning. Additionally, 131 out of 137 students reported that the CITE enhanced their critical thinking skills. We feel that the use of CITE in teaching reproductive theory to undergraduate students fosters critical thinking skills, communication skills, and knowledge retention. The general concept can be readily applied to courses in other subject areas in the animal sciences.     

Effectiveness of a computer-based tutorial for teaching how to make a blood smear

BACKGROUND: Computer-aided instruction (CAI) was developed to teach veterinary students how to make blood smears. This instruction was intended to replace the traditional instructional method in order to promote efficient use of faculty resources while maintaining learning outcomes and student satisfaction. OBJECTIVES: The purpose of this study was to evaluate the effect of a computer-aided blood smear tutorial on 1) instructor's teaching time, 2) students' ability to make blood smears, and 3) students' ability to recognize smear quality. METHODS: Three laboratory sessions for senior veterinary students were taught using traditional methods (control group) and 4 sessions were taught using the CAI tutorial (experimental group). Students in the control group received a short demonstration and lecture by the instructor at the beginning of the laboratory and then practiced making blood smears. Students in the experimental group received their instruction through the self-paced, multimedia tutorial on a laptop computer and then practiced making blood smears. Data was collected from observation, interview, survey questionnaires, and smear evaluation by students and experts using a scoring rubric. RESULTS: Students using the CAI made better smears and were better able to recognize smear quality. The average time the instructor spent in the room was not significantly different between groups, but the quality of the instructor time was improved with the experimental instruction. CONCLUSIONS: The tutorial implementation effectively provided students and instructors with a teaching and learning experience superior to the traditional method of instruction. Using CAI is a viable method of teaching students to make blood smears.     

Effects of a pilot training program on veterinary students' pain knowledge, attitude, and assessment skills

The prevention and management of pain is fundamental to the practice of both human and veterinary medicine. The recognition and treatment of pain represents an important indicator of the quality of care delivered in human hospitals and veterinary hospitals. Yet, both human and veterinary health care professionals have cited inadequate knowledge as a significant barrier to effective pain management. The aims of this pilot study were twofold: (1) to gauge veterinary medical students' current attitudes regarding their training in pain management and (2) to assess the impact of training and practice on the use of a canine acute pain assessment teaching tool. Participants, third-year professional veterinary medical students, completed a 16-item survey questionnaire before a 30-minute training session on pain assessment using the teaching tool and completed it again after training and a one-week practice period. Questions related to canine pain, assessment of canine pain, pain management education in the professional veterinary curriculum, and an example case presentation (video) were included in the survey. The analysis of survey results indicated that professional veterinary medicine students find value in didactic and clinical training in canine pain assessment. Additionally, use of the canine acute pain teaching tool in conjunction with a training program improved students' knowledge and skill in assessment while pointing out the importance of further training. Differences with regard to gender and tracking were found and warrant further exploration.     

What is it like to be an international student at veterinary school? Perception and performance in first year-a case study at a UK veterinary school

Transition into higher education requires students to adjust to a new environment while showing greater independence in managing their own academic and personal life. This is often more difficult for international students who have to adjust to a different country, culture, and potentially another language. A cohort of first-year veterinary medicine students (17% international students) was investigated at a UK university using qualitative and quantitative questionnaires rating first-year experience and support services and statistical analysis of students' assessment performance. While the overall undergraduate perception was that they had learned a lot and progressed well, students in both groups struggled to cope with the workload. The non-UK educated students and students with English as a foreign language also struggled more with teaching delivery in lectures and participation in self-directed group learning and were more likely to feel that the veterinary degree program was too difficult. There was no statistical difference in how British and international students perceived the support system, although it was noticeable that the level of tutorial support was perceived as tutor-dependent. The international students particularly struggled with the assessments in early modules and also with the spot assessment method. However, in the practical assessments, using observed, structured practical exam stations, international and British students performed equally well. Increased support in the initial transition time, especially with regard to communication skills and confidence required for interactive teaching and learning environments such as small-group teaching, as well as increased time for specific assessment types, might benefit the needs of many international students.     

Teaching histology to first-year veterinary science students using virtual microscopy and traditional microscopy: a comparison of student responses

Virtual microscopy (VM) is a comparatively recent innovation that is revolutionizing both the teaching of microscopic structure in human medicine and the concept of online diagnosis and telemedicine. The interactivity of the various commercially available browsers attempts to simulate the experience of looking down a microscope while offering advantages over traditional microscopy that include clarity of image, reduced infrastructure, and high flexibility, as the images are accessible online. We developed our own VM system, including customized software and a browser that was simple and intuitive to use, with the added advantage of further modifications possible to assist student learning. In this article, we report on a preliminary study wherein VM was introduced to veterinary science students in one course and directly compared to traditional microscopy to determine whether students would readily accept this new technology and which aspects of VM were advantageous. Responses from a survey form showed that students rated VM significantly higher than traditional microscopy as a tool to learn histology because it offers clearer images, the ability to learn collaboratively, more effective use of time, and the flexibility of online learning. Students also indicated a strong preference for the use of VM in future courses. These results suggest that VM is a flexible and enjoyable resource that could be useful to enhance the learning of microscopic structure in veterinary science courses.     

Information-seeking behaviors of first-semester veterinary students: a preliminary report

Although emphasis in veterinary education is increasingly being placed on the ability to find, use, and communicate information, studies on the information behaviors of veterinary students or professionals are few. Improved knowledge in this area will provide valuable information for course and curriculum planning and the design of information resources. This article describes a survey of the information-seeking behaviors of first-semester veterinary students at Purdue University. A survey was administered as the first phase of a progressive semester-long assignment for a first semester DVM course in systemic mammalian physiology. The survey probed for understanding of the scientific literature and its use for course assignments and continuing learning. The survey results showed that students beginning the program tended to use Google for coursework, although some also used the resources found through the Purdue libraries' Web sites. On entering veterinary school, they became aware of specific information resources in veterinary medicine. They used a small number of accepted criteria to evaluate the Web site quality. This study confirms the findings of studies of information-seeking behaviors of undergraduate students. Further studies are needed to examine whether those behaviors change as students learn about specialized veterinary resources that are designed to address clinical needs as they progress through their training.     

Use of simulated clients in training veterinary undergraduates in communication skills

A course in communication skills has been developed specifically for veterinary students, based on those delivered at many medical schools, and making extensive use of professional actors as simulated clients. Its aim is to raise awareness of the importance of communication among veterinary undergraduates at all stages of the curriculum, and it allows them to role-play in acted-out scenarios. Facilitated small groups provide an environment in which students can receive feedback on their own performance and also give feedback to their colleagues. An independent evaluation suggests that the opportunity to role-play increased the students' confidence in communicating with others. They were able to identify their personal strengths as communicators and gain insights into the aspects of communication they could improve. Feedback and subsequent discussions were highly valued, with the actors playing a crucial role in providing feedback from the client's perspective. Students were able to use the knowledge they acquired when consulting with real clients. Most of the students suggested that the course should continue in its current format, but with more time provided for it in the curriculum.     

Evaluation of veterinarian and veterinary student knowledge and clinical use of pulse oximetry

We hypothesized that veterinarians and veterinary students may lack key knowledge about pulse oximetry, which may result in this type of patient monitor not being used on appropriate patient populations or to its full capabilities. A questionnaire was developed to assess an individual's knowledge and understanding of pulse oximetry. Residents and specialists in anesthesiology and critical care at several academic institutions were surveyed first to assess the questionnaire for clarity and to serve as a control group. General veterinary practitioners (GPs) attending continuing education courses at the University of Georgia were surveyed over a 24-month period. Students entering their senior year anesthesiology rotation at the University of Georgia were also surveyed. Residents and specialists (69% correct responses) scored significantly higher than senior students (46%), who scored significantly higher than GPs (34%). Only 15% of GPs and 21% of senior students reported that they had received training in pulse oximetry in school. Those who had received training scored significantly higher than those who did not. Many GPs did not report using a pulse oximeter on their critical patients under anesthesia, a group that would be expected to benefit from its use. Veterinarians have a poor understanding about how pulse oximetry works, the information provided by pulse oximetry, and how to best apply it to their patients. Furthermore, the respondents did not use pulse oximeters in a manner that would derive the most information and result in the greatest benefit to the patient relative to the cost of the instrument. Didactic training in veterinary curricula and during continuing education opportunities continues to be necessary in order to produce veterinarians, who have an understanding of the technologies available that can be used to improve patient care.     

Teaching veterinary radiography by e-learning versus structured tutorial: a randomized, single-blinded controlled trial

Case-based e-learning may allow effective teaching of veterinary radiology in the field of equine orthopedics. The objective of this study was to investigate the effectiveness of a new case-based e-learning tool, compared with a standard structured tutorial, in altering students' knowledge and skills about interpretation of radiographs of the digit in the horse. It was also designed to assess students' attitudes toward the two educational interventions. A randomized, single-blinded, controlled trial of 96 fourth-year undergraduate veterinary students, involving an educational intervention of either structured tutorial or case-based e-learning, was performed. A multiple-choice examination based on six learning outcomes was carried out in each group after the session, followed by an evaluation of students' attitudes toward their session on a seven-point scale. Text blanks were available to students to allow them to comment on the educational interventions and on their learning outcomes. Students also rated, on a Likert scale from 1 to 7, their performance for each specific learning outcome and their general ability to use a systematic approach in interpreting radiographs. Data were analyzed using the Mann-Whitney test, the t-test, and the equivalence test. There was no significant difference in student achievement on course tests. The results of the survey suggest positive student attitudes toward the e-learning tool and illustrate the difference between objective ratings and subjective assessments by students in testing a new educational intervention.     

Balancing veterinary students' and house officers' learning experiences in veterinary teaching hospitals

Veterinary students at two large veterinary referral teaching hospitals were surveyed on their perceptions of competition with interns and residents for learning experiences during clinical instruction. Their responses led to an additional survey of a cohort of clinical educators on how this competition might be managed, what impedes effective management, and how progress toward an improved clinical learning environment might be measured. This article describes the results of the survey and discusses the nature of the competition and factors affecting the competitive learning environment. The results of this study should be expanded to include a larger cohort of veterinary students and an assessment of house officers' and faculty members' perceptions.     

Evaluating of veterinarians' and veterinary students' knowledge and clinical use of pulse oximetry

RATIONALE FOR THE STUDY: We hypothesized that veterinarians and veterinary students may lack key knowledge about pulse oximetry, which may result in this type of patient monitor not being used on appropriate patient populations or to its full capabilities. METHODOLOGY: A questionnaire was developed to assess an individual's knowledge and understanding of pulse oximetry. Residents and specialists in anesthesiology and critical care at several academic institutions were surveyed first to assess the questionnaire for clarity and to serve as a control group. General veterinary practitioners (GPs) attending continuing education courses at the University of Georgia were surveyed over a 24-month period. Students entering their senior-year anesthesiology rotation at the University of Georgia were also surveyed. RESULTS: Residents and specialists (69% correct responses) scored significantly higher than senior students (46%), who scored significantly higher than GPs (34%). Only 15% of GPs and 21% of senior students reported that they had received training in pulse oximetry in school. Those who had received training scored significantly higher than those who had not. Many GPs did not report using a pulse oximeter on their critical patients under anesthesia, a group that would be expected to benefit from its use. CONCLUSIONS: Veterinarians have a poor understanding of how pulse oximetry works, the information it provides, and how best to apply it to their patients. Furthermore, the respondents did not use pulse oximeters in a manner that would yield the most information and result in the greatest benefit to the patient relative to the cost of the instrument. Didactic training in veterinary curricula and during continuing education opportunities continues to be necessary in order to produce veterinarians who have an understanding of the technologies available to improve patient care.     

Understanding veterinary students' use of and attitudes toward the social networking site, Facebook, to assist in developing curricula to address online professionalism

Social media is an increasingly common form of communication, with Facebook being the preferred social-networking site among post-secondary students. Numerous studies suggest post-secondary students practice high self-disclosure on Facebook. Research evaluating veterinary students' use of social media found a notable proportion of student-posted content deemed inappropriate. Lack of discretion in posting content can have significant repercussions for aspiring veterinary professionals, their college of study, and the veterinary profession they represent. Veterinarians-in-training at three veterinary colleges across Canada were surveyed to explore their use of and attitude toward the social networking site, Facebook. Students were invited to complete an online survey with questions relating to their knowledge of privacy in relation to using Facebook, their views on the acceptability of posting certain types of information, and their level of professional accountability online. Linear regression modeling was used to further examine factors related to veterinary students' disclosure of personal information on Facebook. Need for popularity (p<.01) and awareness of consequences (p<.001) were found to be positively and negatively associated, respectively, with students' personal disclosure of information on Facebook. Understanding veterinary students' use of and attitudes toward social media, such as Facebook, reveals a need, and provides a basis, for developing educational programs to address online professionalism. Educators and administrators at veterinary schools may use this information to assist in developing veterinary curricula that addresses the escalating issue of online professionalism.     

DEVELOPMENT OF INTERACTIVE PATIENT-BASED MULTIMEDIA COMPUTER PROGRAMS IN VETERINARY ORTHOPEDIC RADIOLOGY

Three computerized multimedia programs on large and small animal veterinary orthopedic radiology were developed and implemented for the radiology curriculum as an alternative to traditional film-based laboratory learning. Programs utilized "hot words" (colored text words that displayed an overlaid image label that highlighted lesions) and interactive quizzes which responded appropriately to selected answers. "Hot words" helped students develop confidence in accurate lesion detection and the interactive quizzes transformed learning from a passive to an active process. Multiple examples were provided for reinforcement and concepts were incorporated from other clinical disciplines for curriculum integration. Programs were written using a presentation software program, Toolbook® for DOS based platform, and contained radiographic images made by laser-scanning digitization. Multiple students could simultaneously access the programs through a network server. These pilot programs were implemented successfully and computerized multimedia presentation proved to be well suited to teaching radiology. Development of the programs required attention to a number of hardware, software, time and cost factors.     

Subject-based problem-based learning in the veterinary science course at the University of Queensland

Objective
To assess students' perceptions of subject-based problem-based learning in the fourth year of the veterinary science course at the University of Queensland.
Design
A questionnaire-based study.
Procedure
Subject-based problem-based learning was introduced into parts of two fourth year subjects in a 5-year veterinary science course. The problem-based learning exercise used modified clinical cases and was computer-assisted. Students worked in groups of two to four, and small group discussion sessions were tutorless. Lectures were replaced by large group discussion and feedback sessions, led by the teacher, with approximately 85 students.
Results
There was a significant increase in the percentage of students who strongly agreed that they had better understanding of the subject, and had learned to apply principles from this class in new situations. The only consistent criticism by students was directed at the extra time required compared to traditional lecture-based subjects.
Conclusion
Students' perceptions of the learning outcome were very favourable for problem-based learning when compared to the lecture-based subject.