Predictors of depression and anxiety in first-year veterinary students: a preliminary report

Historically, veterinary medical students' mental health has rarely been investigated, but recently there has been renewed interest in this topic. The present study evaluated depression and anxiety levels in a cross-sectional investigation of 93 first-year veterinary medical students enrolled at Kansas State University (KSU). During their first semester, students completed the Center for Epidemiological Studies Depression Scale (CES-D) and the Mental Health Inventory's Anxiety Scale (MHI-A). Results indicate that 32% of these first-year KSU veterinary students were experiencing clinical levels of depressive symptoms. Additionally, students reported elevated anxiety scores. Predictors of depression and anxiety levels include homesickness, physical health, and unclear instructor expectations. Areas of intervention with a focus on improving veterinary medical student well-being are discussed.     

Potential barriers to veterinary student access to counselling and other support systems: perceptions of staff and students at a UK veterinary school

Considerable evidence suggests that veterinary surgeons' mental health is often poorer than comparable populations and that the incidence of suicide is higher among veterinary surgeons than the general public. Veterinary students also appear to suffer from high levels of anxiety and stress, and may possess inadequate coping strategies when faced with adversity. Veterinary students may find it difficult to access central university support systems due to their heavy workload and geographical isolation on some veterinary campuses. A previous study of University of Edinburgh fourth-year veterinary students found that support services located several miles from the main veterinary campus was a barrier to students accessing counselling services. Consequently, a pilot project was initiated, which provided a counselling service at the University of Edinburgh's rural Easter Bush veterinary campus one afternoon a week during 2010. As part of the evaluation of this service, web-based questionnaires were delivered via e-mail to all veterinary staff and students towards the end of the 12-month pilot period to evaluate perceptions of barriers to student counselling and to investigate student-valued support services. Questionnaire responses were received from 35 per cent of veterinary students and 52 per cent of staff. Stigmatisation of being unable to cope was a potent inhibitor of seeking support within the veterinary environment, but counselling was perceived as valuable by the majority of staff and students. Provision of an on-site counselling service was considered important for increasing ease of access; however, students viewed friends and family as their most important support mechanism. Workload was cited as the main cause of veterinary student stress. The majority of staff and student respondents perceived veterinary students as having an increased need for counselling support compared with other students.     

Effects of a veterinary student leadership program on measures of stress and academic performance

Assuming leadership roles in veterinary student governance or club activities could be considered an added stressor for students because of the impact on time available for personal and academic activities. The study reported here evaluated the effects of participation in a leadership program and leadership activity across two classes of veterinary students on measures of stress, using the Derogatis Stress Profile (DSP), and on veterinary school academic performance, measured as annual grade-point average (GPA) over a three-year period. Program participants and their classmates completed the DSP three times across the first three years of veterinary school. On average, participating students reported self-declared stress levels that were higher and measured DSP stress levels that were lower than those of the general population. Students were more likely to assume elected or appointed leadership roles while in their first three years of the veterinary degree program if they participated in the optional leadership program and demonstrated lower stress in several dimensions. Some increased stress, as measured in some of the DSP stress dimensions, had a small but statistically significant influence on professional school GPA. The study determined that the most important predictors of students' cumulative GPA across the three-year period were the GPA from the last 45 credits of pre-veterinary coursework and their quantitative GRE scores. The results of the study indicate that neither participation in the leadership program nor taking on leadership roles within veterinary school appeared to influence veterinary school academic performance or to increase stress.     

STUDENT PERFORMANCE AND COURSE EVALUATIONS BEFORE AND AFTER USE OF THE CLASSROOM PERFORMANCE SYSTEM™ IN A THIRD‐YEAR VETERINARY RADIOLOGY COURSE

Effective teaching of veterinary radiology can be challenging in a traditional classroom environment. Audience response systems, colloquially known as “clickers,” provide a means of encouraging student interaction. The purpose of this study was to compare student performance and course evaluations before and after using the Classroom Performance System? in the third‐year (fifth semester) didactic radiology course at the University of Tennessee College of Veterinary Medicine. Overall student performance was assessed by comparing median numeric final course grades (%) between years without and with use of the Classroom Performance System?. Grades of students were determined for individual instructors’ sections. Student evaluations of the radiology course were compared for the years available (2007–2010). Student interactions were also evaluated subjectively by instructors who used the Classroom Performance System?. There was a significant difference (p = 0.009) between the median student grade before (2005 – 2008, median 82.2%; interquartile range 77.6–85.7%; range 61.9–95.5%) and after use of the classroom performance system (2009–2010, median 83.6%; interquartile range 79.9–87.9%; range 68.2–93.2%). There was no statistically significant difference in median student grades for individual instructors over the study period. The radiology course student evaluation scores were significantly higher in years where the Classroom Performance System? was used in comparison to previous years (P = 0.019). Subjectively, students appeared more involved when using clickers. Findings indicated that the Classroom Performance System? may be a useful tool for enhancing veterinary radiology education.     

Effects of formal training in communication skills on the ability of veterinary students to communicate with clients

All UK veterinary schools have recently introduced small group teaching of communication skills for undergraduates. This study evaluates the effectiveness of this approach in improving the ability of students to communicate with clients in clinical situations. Three groups of clinical veterinary students with either no training or different levels of formal training in communication skills were assessed on their ability to communicate with clients at a local charity clinic. The students' communication skills were assessed quantitatively by direct observation during the consultation and by subsequent questioning of the clients. The accuracy of the clients' recall of relevant information about the animal's condition, medication and management was also analysed. The student groups were then compared on the basis of the scores they obtained. There was a significant improvement in the students' communication skills with increasing levels of training (P<0.0001). The group with the highest level of training consistently achieved higher rankings and median scores than the other two. When appraised by clients, this group significantly outranked both the other groups, but there was no difference between the group with no training and the group with an intermediate level of training. The clients' recall of information given in the consultation was more variable; but the group with the highest level of training achieved higher rankings in all the areas of client recall except for the animal's medication.     

Study of the influence of veterinary medical education on the moral development of veterinary students

Although veterinary medicine endorses high moral character and adherence to a code of ethics, to our knowledge, virtually no studies have examined the influence of veterinary medical education on the moral development of its students. Using the Kohlberg standard moral judgment interview, this study examined that relationship in a sample of 20 veterinary medical students (16.0% of the veterinary college's student body). The students were tested at the beginning and at the end of their veterinary medical education to determine whether their moral reasoning scores had increased to the same extent as those of other postgraduate students. It was found that normally expected increases in moral reasoning did not occur over the four years of veterinary medical education for these students, suggesting that their veterinary medical educational experience somehow inhibited their moral reasoning ability rather than facilitated it. With a range of moral reasoning scores between 313 and 436, the mean increase from first year to fourth year of 12.5 points was not statistically significant. Statistical analysis revealed no significant correlations between the moral reasoning scores on age or gender, although there were significant correlations with Medical College Admissions Test scores and grade point average scores.     

Forecasting veterinary school admission probabilities for undergraduate student profiles

Increased competition for veterinary school admission has created a need to determine whether individual students are likely to be successful candidates for veterinary school admission early in their undergraduate careers. Students invest considerable time and money in pre-veterinary courses of study, hoping for acceptance into professional veterinary school. A forecasting model was developed to predict the likelihood of students with particular characteristics gaining acceptance. Characteristics such as gender, age, size of high school, and ACT, are known upon entrance into college and can be used to determine the likelihood of an individual's being accepted. Data were gathered from the Louisiana State University College of Veterinary Medicine (LSU-CVM) admissions for all students applying to veterinary school for the classes of 2006 through 2008 from the top two agricultural programs in the state in terms of quantity of applicants to veterinary school: Louisiana State University and Louisiana Tech University. A one-way ANOVA was used to examine whether there were any statistical differences between known demographic and performance variables and acceptance into veterinary school. A logit forecasting model was then estimated to predict the likelihood of gaining acceptance into veterinary school based only on variables known early in the student's undergraduate career. Age, gender, and ACT scores were determined to be important variables in determining the likelihood of gaining admission. Overall, the forecasting model is of use in assigning probabilities of acceptance into veterinary school for specific student profiles, which can assist in one-on-one assistance from advisor to student.     

Assessment of clinical reasoning skills in veterinary students prior to and after the clinical year of training

OBJECTIVE: To examine the effect of various clinical tracks within the veterinary medical clinical curriculum at Texas A&M University on clinical diagnostic proficiency as determined by pre- and post-training assessment. We expected that the clinical track chosen by the student would impact their measured outcome with bias toward higher scores in their chosen field. DESIGN: Prospective cohort study. STUDY POPULATION: 32 students from the College of Veterinary Medicine and Biomedical Sciences at Texas A&M University. PROCEDURES: By use of standardized, written case scenarios, clinical reasoning was assessed twice: once prior to the clinical (fourth) year of the curriculum and again at completion of the clinical year. Students demonstrated their abilities to collect and organize appropriate clinical data (history, physical examination, and laboratory findings), determine clinical diagnoses, and formulate and implement acceptable treatment modalities. Data from clinical assessments were compared for a given cohort and correlated with other measures (eg, grades, standardized test scores, and species-specific curricular track). RESULTS: Differences were detected in clinical diagnostic proficiency among students in different clinical tracks and for different species groups in the case scenarios. Tracking by species group in the clinical veterinary curriculum appeared to affect development of clinical reasoning and resulted in differential proficiency among cases for differing species groups. CONCLUSIONS AND CLINICAL RELEVANCE: Differences in clinical experiences between small animal tracks and all other track opportunities (large animal, mixed animal, and alternative) influenced the development of clinical proficiency in fourth-year veterinary students during their clinical training period.     

Evaluation of the expectations, learning and competencies of surgical skills by undergraduate veterinary students performing canine ovariohysterectomies

Objectives : To investigate the development of surgical skills of veterinary undergraduates and determine the number of canine ovariohysterectomies required to achieve competency and reduce levels of student concern. This was compared to student expectations and that of employers regarding surgical ability and provision of support to new graduates. Methods : A questionnaire regarding surgical concerns was sent to final year veterinary students enrolled within the University of Bristol, UK. A questionnaire was also sent to 200 UK veterinary practices regarding their impressions of surgical competence of new graduates and their provision of supervision. The responses were compared. Eleven additional final year students performed five canine ovariohysterectomies and graded their concerns. The number of supervised canine ovariohysterectomies required until competency was determined. Results : 80·4% of final year veterinary undergraduates replied that the surgical procedure which they were most concerned about their ability to perform was canine ovariohysterectomy. Students and veterinary practitioners differed in their opinions regarding whether they considered canine ovariohysterectomy to be a “day one skill” and what were desirable levels of supervision. Completing a minimum of four canine ovariohysterectomies led to 81·8% of students being assessed as competent. Clinical Significance : An unrealistically high expectation of competency by students may be a source of stress and concern. Employers should aim to provide hands‐on support whilst new graduates complete at least four canine ovariohysterectomies. Postoperative haemorrhage is uncommon but is the main concern for students.     

The first-year veterinary student and mental health: the role of common stressors

The present study evaluated the impact of academic and non-academic stressors on depression levels in a longitudinal investigation of 78 first-year veterinary medical students enrolled at Kansas State University (KSU). Students completed the Center for Epidemiological Studies Depression Scale during their first and second semesters to evaluate the dependent variable, depression. Students provided information about specific stressors and relevant demographic variables that yielded independent variables. One-third of veterinary medical students surveyed in their first and second semesters reported depression levels above the clinical cut-off; 15% of the sample experienced an increase in depression of at least one standard deviation, despite the apparent stability of the proportion of students experiencing significant depressive symptoms. Students whose depression scores increased by one standard deviation or who maintained scores above the clinical cut-off score were identified as struggling. Struggling students reported more first-semester homesickness and academic concerns, along with difficulty fitting in with peers and poorer perceived physical health during the second semester. This study helped to identify those students most prone to develop or maintain concerning depression scores. The discussion section addresses specific suggestions for intervening with struggling students.     

Comparison of student self-assessment with faculty assessment of clinical competence

At the University of Minnesota, fourth-year veterinary students assessed their clinical competence after completion of a small-animal, internal-medicine clinical rotation using the same rotation assessment form used by supervising faculty. Grades were compared between the two groups. Students identified by faculty as low-performing were more likely to overestimate their competence in the areas of knowledge, clinical skill, and professionalism than were students identified by faculty as higher performing. This finding mirrors research results in human health professional training. Self-assessment should not be used as the primary or sole measure of clinical competence in veterinary medical training without the introduction of measures to ensure the accuracy of student self-assessment, measures that include active faculty mentoring of student self-assessment, student goal-setting and reflection, and availability of subsequent opportunities to practice additional self-assessment.     

Stress management interventions for veterinary students

Two-hundred-and-eighty-nine veterinary students from all four years of the University of Tennessee, College of Veterinary Medicine (UTCVM) were invited to complete the Derogatis Stress Profile (DSP)1 and an original Demographic Data Profile (DDP). The DSP assessed the students' current experiences of perceived stress, and the DDP was designed to gather information about students' academic year, their living situations, their financial situations, their interest area within the veterinary medical profession, and their current methods of coping with stress. These data were gathered as a baseline measure of veterinary medical students' perceived level of stress and quality of life. In an earlier study, data were also collected from faculty and staff about the perceived quality of the climate and culture of the veterinary college. The results of the DSP and DDP suggest that, although veterinary students at UTCVM do not experience significant levels of stress overall, they do report higher levels of subjective stress, time pressure, and depression than the general population. The more companion animals that veterinary students cared for in their personal lives, the more likely they were to report higher levels of perceived stress. Lastly, there were significant differences between genders, with female veterinary students reporting higher levels of perceived stress than their male counterparts. The preliminary results of the climate and culture data suggest that faculty and staff of the veterinary college individually feel that they are cared for in the work environment and collectively believe that the college strives for excellence.     

Effect of different methods of selection on the background, attitudes and career plans of first year veterinary students

OBJECTIVES: To compare the family, educational and animal-related backgrounds and career aspirations of students who were selected on the basis of academic criteria with those selected using additional criteria. METHODS: Questionnaires were completed during class time in the first few weeks of enrolment by incoming veterinary students at the University of Sydney, who had been selected on the basis of academic background, and at Charles Sturt University, selected using more broadly-based criteria. The data were transferred to an Excel spreadsheet, and frequency distributions and chi2 statistics estimated using the SAS System for Windows 8. RESULTS: Students selected principally on academic criteria alone had higher average UAI scores, were more likely to have completed high school in a capital city, and to have parents with higher education levels than those selected using additional criteria. Both groups indicated that their choice of veterinary science was based largely on their affinity for animals and keenness to work in a veterinary practice. However, those at CSU placed much greater importance than those at Sydney on a desire to live and work in a rural area, and a desire to help farmers. The broad-based selection methods were the main reasons for students applying to CSU whereas the reputation of the university was the main attraction for Sydney students. Two-thirds of CSU students, but one-third of Sydney students, planned to enter rural mixed practice when they graduated, and most planned to stay for at least 10 years. Conversely, no CSU students, but 42% of those at Sydney, planned to enter small animal practice initially. The percentage planning to work full-time in the first, fifth and tenth year after graduation was not significantly different between the two groups. CONCLUSIONS: Criteria which included actual experience with farm animals have resulted in the selection of more students who plan to enter and remain in rural mixed practice. Further studies over the longer term will be necessary to assess the extent to which these plans are realized.     

Workplace stress, mental health, and burnout of veterinarians in Australia

Objective To determine the frequency of the states of depression, anxiety, stress and burnout using internationally validated methods and to relate these to the demographic characteristics of veterinarians in Australia. Methods A postal survey of registered veterinarians with at least one year's experience and whose address was available; 1947 returned the questionnaire providing data for analysis. Results Overall, veterinarians describe higher levels of depression, anxiety, stress and burnout than the general population. The severity of these states was determined by gender, background, type of practice and years after graduation. Conclusions Modifying the curricula of veterinary schools to include the teaching of personal cognitive and coping skills to undergraduate veterinary students, the provision of the opportunity to enhance these skills throughout their veterinary career and changes in the veterinary workplace could result in improved mental health, increased job engagement and work satisfaction.     

USE OF A NOVEL BOARD GAME IN A CLINICAL ROTATION FOR LEARNING THORACIC DIFFERENTIAL DIAGNOSES IN VETERINARY MEDICAL IMAGING

When confronted with various findings on thoracic radiographs, fourth‐year veterinary students often have difficulty generating appropriate lists of differential diagnoses. The purpose of this one‐group, pretest, posttest experimental study was to determine if a game could be used as an adjunct teaching method to improve students’ understanding of connections between imaging findings and differential diagnoses. A novel board game focusing on differential diagnoses in thoracic radiography was developed. One hundred fourth‐year veterinary students took a brief pretest, played the board game, and took a brief posttest as a part of their respective clinical radiology rotations. Pretest results were compared to posttest results using a paired t‐test to determine if playing the game impacted student understanding. Students’ mean scores on the posttest were significantly higher than mean pretest scores (P < 0.0001). Thus, results indicate that playing the board game resulted in improved short‐term understanding of thoracic differential diagnoses by fourth‐year students, and use of the board game on a clinical rotation seems to be a beneficial part of the learning process.     

Managing stress in veterinary students

The process of obtaining a veterinary medical education creates a number of potential cognitive, emotional, physical, interpersonal, and developmental stressors for veterinary students. Although most universities offer stress management interventions for their students, these programs are often directed toward undergraduate students or non-veterinary graduate students, whose educational programs differ significantly from those of veterinary students. There is a need for specific stress management programs tailored to the needs of veterinary students. This article summarizes research drawn from the psychology, medical, and veterinary medical literature about the causes of stress that veterinary students experience. Interventions are discussed, and several Oregon State University (OSU) programs and liaisons are described. Stress management resources are suggested.     

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.     

An electronic instructor for gross anatomy dissection

Gross anatomy is time consuming to teach and to learn. Because the process of dissection takes up so much student time, assistance in the form of an in-lab instructional DVD program might improve student performance. The DVD could be viewed with a portable device by individual dissection groups at their tables. Groups could dissect at their own pace, with access to step-by-step demonstrations and answers to frequently asked anatomical questions. We created an instructional DVD program demonstrating dissection of the canine ventral neck and thoracic limb. The effect on student exam scores of using the DVD versus not using it was measured in a controlled, two-sample study using incoming first-year veterinary students as volunteers. Volunteers were told the study was of two different dissection methods; the DVD was not specifically mentioned until after the students were separated into two groups (Blue/DVD group and Orange/No DVD group), and then only to volunteers in the Blue group. Except for the DVD, the two groups had the same resources. The difference in scores on an exam given after a single dissection period did not differ sufficiently to conclude that DVD use raised the mean score; however, 73% of the DVD group scored 60% or higher, while only 38% of the No DVD group scored 60% or higher. The difference in mean scores overall was 2.3 points out of a possible 49, suggesting that the DVD helped students, especially those with lower scores, to earn two to three more points than they would have otherwise.     

The effect of oxytetracycline on the severity of airsacculitis in chickens infected with Mycoplasma gallisepticum

Four groups of mycoplasma-free commercial broilers were challenged with the R strain of Mycoplasma gallisepticum (MG) at 14 days of age. Groups received feed containing either no medication, or 500 ppm or 1000 ppm oxytetracycline (OTC) beginning at age 13 days, or 1000 ppm OTC beginning at age 15 days. All broilers were vaccinated with a live mild Massachusetts infectious bronchitis vaccine at 17 days of age. Air sac lesions were scored at age 24 days. In two almost identical experiments, all OTC treatment groups had significantly lower mean air sac lesion scores than the unmedicated challenged controls. Groups that were fed 1000 ppm OTC in feed had significantly lower mean air sac lesion scores than groups that were fed 500 ppm OTC in feed. There was no significant difference in mean air sac lesion scores between the groups fed 1000 ppm OTC in feed beginning at 13 days of age and those fed 1000 ppm OTC in feed beginning at 15 days of age.     

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.