Work-related stress in the veterinary profession in New Zealand

AIM: To investigate sources of work-related stress in the veterinary profession in New Zealand, perceptions of levels of stress being experienced, and the social support that veterinarians are using to manage work-related stress. METHODS: A postal survey was distributed to 1,907 veterinarians registered with the Veterinary Council of New Zealand (VCNZ). The survey collected information on respondents' age, gender, type and number of people in the workplace, stress levels, depression, suicidal thoughts and attempts, causes of stress and sources of support. RESULTS: Nine hundred and twenty-seven (48.6%) veterinarians returned useable responses. Veterinarians who were retired, working overseas or did not provide information about their type of work were excluded from the analysis, leaving data from 849 (44.5%) veterinarians. Women experienced more work-related stress and depression than men, veterinarians in small animal/mixed practice reported more stress and depression than those in other types of work, and younger veterinarians experienced higher levels of stress than older veterinarians. The main sources of stress were hours worked, client expectations, and unexpected outcomes. Respondents were also stressed by the need to keep up their knowledge and technical skills, and by personal relationships, finances and their expectations of themselves. Most respondents reported that they had good networks of family and friends to help them deal with stress. In general, respondents tended to rely on informal networks such as family and friends, other veterinarians and workmates to provide support. The small proportion of respondents who reported clinical depression or suicidal thoughts or attempts were more likely than respondents in general to have used health professionals, counselling, pastoral/spiritual support and the Vets in Stress phone line, but less likely to have sought support from employers and workmates. CONCLUSIONS: There is a need for a wide range of strategies to manage work-related stress among veterinarians. Sources of stress in the workplace must be identified and strategies developed to control those which present a significant hazard. Strategies may include attention to workloads and working hours, design of work processes, and increasing social support. Training in work-related skills such as communication, conflict management and stress management may be helpful where lack of these skills is contributing to stress. Support services such as help lines and mentor schemes are also available and information about these needs to be more accessible.     

The perceived and actual diagnostic utility of veterinary cytological samples

O bjectives : To establish the proportion of cytology samples sent to a commercial veterinary laboratory that yields diagnostically useful information in the context of current use and perceptions of cytology.
M ethods : Nine hundred and forty-five cytology submissions were retrospectively collected and categorised according to diagnostic utility. A survey into the use and perceptions of cytology was distributed at the British Small Animal Veterinary Association Congress 2008.
R esults : A specific diagnosis was reached in 23·1 per cent of samples and a cytological diagnosis in 35·3 per cent. 22·4 per cent of samples yielded some useful information, but 19·2 per cent were unacceptable. Seventy-four participants in the survey took an average of 3·9 cytological samples per week, of which they examined 27·0 per cent in-house only, 21·6 per cent in-house before sending to an external laboratory and 51·4 per cent were sent externally without prior examination. "To obtain a definitive diagnosis" was the principal reason cited for performing cytology.
C linical S ignificance : Results suggest that cytology is underused and may be applied in an inappropriate context in the UK. It is hoped that illustrating the diagnostic outcome of samples received by a commercial laboratory will encourage increased, appropriate use of cytology.     

Recommended guidelines for submission, trimming, margin evaluation, and reporting of tumor biopsy specimens in veterinary surgical pathology

Neoplastic diseases are typically diagnosed by biopsy and histopathological evaluation. The pathology report is key in determining prognosis, therapeutic decisions, and overall case management and therefore requires diagnostic accuracy, completeness, and clarity. Successful management relies on collaboration between clinical veterinarians, oncologists, and pathologists. To date there has been no standardized approach or guideline for the submission, trimming, margin evaluation, or reporting of neoplastic biopsy specimens in veterinary medicine. To address this issue, a committee consisting of veterinary pathologists and oncologists was established under the auspices of the American College of Veterinary Pathologists Oncology Committee. These consensus guidelines were subsequently reviewed and endorsed by a large international group of veterinary pathologists. These recommended guidelines are not mandated but rather exist to help clinicians and veterinary pathologists optimally handle neoplastic biopsy samples. Many of these guidelines represent the collective experience of the committee members and consensus group when assessing neoplastic lesions from veterinary patients but have not met the rigors of definitive scientific study and investigation. These questions of technique, analysis, and evaluation should be put through formal scrutiny in rigorous clinical studies in the near future so that more definitive guidelines can be derived.     

Reviewing the undergraduate veterinary curriculum in Finland for control tasks in veterinary public health

To review and develop the undergraduate veterinary curriculum on official control in veterinary public health, an electronic survey was sent to 204 Finnish veterinarians employed in the field of food hygiene in 2005. The response rate was 44%. Most frequently cited as strengths of the current curriculum were extensive education and good knowledge. Respondents considered the main challenges in their work to be a wide field of activity, organizational changes, financial resources, organization of substitutes, and collaboration with decision makers. Of the 23 items to be included in the undergraduate curriculum, therefore, respondents prioritized state and local decision making, the role of the public servant, and leadership and management in the area of social factors; in the field of practical control work, in-house control systems, organizations and responsibilities, control techniques, and planning and targeting of controls were prioritized. Of areas traditionally covered in the undergraduate curriculum, legislation; legal proceedings and implications of controls; risks to human, animal, and plant health; and hazards in feed, animal, and food production were stated to be the most important. Although respondents were generally content with their career choice, veterinary public health tasks were not their first choice of career path immediately after graduation. Based on these findings, more attention should be focused on social aspects and practical training in official control in the undergraduate veterinary curriculum. The survey results also highlight the contrasts between society's needs and veterinarians' motivations and career-path expectations, which pose a significant challenge for future curricula.     

Sources and frequency of use of pet health information and level of confidence in information accuracy, as reported by owners visiting small animal veterinary practices

OBJECTIVE: To gain a better understanding of sources and frequency of use of pet health information accessed by owners and assess the level of confidence in information accuracy as reported by pet owners who visit their veterinarians. DESIGN: Prospective study. SAMPLE POPULATION: 412 participants from 17 small animal veterinary clinics. PROCEDURES: Questionnaires pertaining to pet owners' habits related to pet health information (sources and frequency of their use and confidence in accuracy of information accessed) were distributed by front desk staff at 17 participating veterinary clinics. A cover letter was included with each survey that offered instructions for completion and assured respondents of their anonymity. All completed surveys were placed in an envelope and returned to the researchers for analysis. RESULTS: Results indicated that pet owners who visited their veterinarians acquired pet information from veterinarians via the telephone or in person and from family or friends more frequently than they acquired such information from the World Wide Web. Pet owners also reported more confidence in information received from veterinarians (in person and via telephone conversations), compared with information from any other accessible source. CONCLUSIONS AND CLINICAL RELEVANCE: The use of Web sites by owners as sources of pet health information will undoubtedly continue to grow. Veterinarians can play a more proactive role in helping pet owners to access reliable Web sites that provide useful pet health information, thereby providing a benefit to all parties.     

Survey of the large-animal diplomates of the American College of Veterinary Internal Medicine regarding knowledge and clinical use of polymerase chain reaction: implications for veterinary education

A questionnaire was developed to document the knowledge base of large-animal diplomates of the American College of Veterinary Internal Medicine (ACVIM) regarding polymerase chain reaction (PCR) technology and to identify the common use of this technology in equine practice. Ninety-three of the 278 mailed questionnaires were returned, for an overall response rate of 33.4%. Ninety respondents (99%) reported being familiar with the general principles of nucleic acid probe technology; however, only 52 (57%) knew the difference between conventional (traditional) and real-time (second-generation) PCR. The majority of the respondents (88%) emphasized the need for continuing education on molecular diagnostics. Eighty-four (92%) of the respondents regularly use PCR (conventional and/or real-time) for the detection of equine pathogens, and 80 (88%) commonly submit their samples to university/state veterinary laboratories. Blood, nasal swabs, and feces are the three equine specimens most commonly submitted for PCR analysis of Streptococcus equi, Lawsonia intracellularis, Neorickettsia risticii, equine herpesvirus 1/4, Rhodococcus equi, Sarcocystis neurona, and equine influenza virus. Diplomates reported costs associated with molecular diagnostics and unreliability of PCR as the most common limitations of PCR. Didactic training in veterinary curricula and during continuing-education opportunities continues to be necessary to produce veterinarians who have an understanding of the clinical applications of molecular diagnostics.     

Perceived importance and integration of the human-animal bond in private veterinary practice

OBJECTIVE: To determine perceptions of the human-animal bond (HAB) among veterinarians in private practice and evaluate how these veterinarians incorporate the HAB in their practices. DESIGN: Survey. SAMPLE POPULATION: 1,602 veterinarians in private practice in Washington state. PROCEDURE: Participants were contacted and asked to complete a survey. RESULTS: Response rate was 26% (415/1,602). Most respondents agreed that veterinarians will be more successful if they recognize and facilitate the HAB, that facilitating the HAB was important to their practices, that they actively evaluated the degree of bonding between clients and their animals, and that the bonding between a client and his or her animal affected the way they practiced medicine. However, > 50% of respondents did not train veterinary technicians and front office staff members in the HAB or encourage veterinary technicians or front office staff members to learn about the HAB. Fifty-one percent of respondents offered few or no HAB resources to clients. When asked to quantify the importance of 10 nontechnical skills associated with private veterinary practice, respondents ranked communication skills, ethical reasoning, and business management first, second, and third; the HAB was ranked fifth. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that for veterinarians in private practice in Washington state, there is a dichotomy between how important they consider the HAB to be in their practice and the degree to which they facilitate the HAB with regard to communication, training, and client resources. More research on the HAB is necessary to better understand what the HAB encompasses and its implications for private practitioners.     

Sexual harassment in the veterinary academic environment

OBJECTIVE: To survey faculty and house officers of clinical departments of colleges of veterinary medicine (CVM) to identify characteristics of sexual harassment (SH) in the veterinary academic environment, to report the opinions of survey respondents on how SH is being handled, and to determine how the process can be improved at veterinary academic institutions. PROCEDURE: On the basis of lists obtained from 25 CVM, a survey was mailed to 1,294 academic veterinarians. Four hundred seventy-eight completed surveys were returned. RESULTS: The prevalence of SH in the population of respondents was 31%. Nonphysical forms of SH were reported 6 times as often as physical forms of harassment, with the most common type reported being offensive sexual comments and unwanted attention. Fear of reprisal was the most prevalent reason cited by respondents for not confronting the harasser. Survey respondents rated the following as very important to improve the system of dealing with SH at their academic institution: guarantee of protection from retaliation, assurance of confidentiality, clear explanation of what will happen to you, and a clearer definition of SH. CONCLUSION: A clear definition of SH is the first step in preventing SH. Other cited steps include professional development programs to educate the academic population as to what constitutes SH, inform the entire academic population what the institution's SH policy is, and enforce this policy with sensitivity, fairness, confidentiality, and quick resolve to protect the victim.     

Evaluation of urine marking by cats as a model for understanding veterinary diagnostic and treatment approaches and client attitudes

OBJECTIVE: To obtain information regarding diagnostic and treatment approaches of veterinarians and attitudes and beliefs of clients about a common clinical problem, urine marking in cats. DESIGN: Cohort study. STUDY POPULATION: 70 veterinarians providing care for urine-marking cats and 500 owners of urine-marking cats. PROCEDURE: Veterinarians were interviewed via telephone regarding criteria for diagnosis of urine marking and recommended treatments. Cat owners who responded to recruitment efforts for a clinical trial for urine-marking cats were interviewed via telephone regarding whether and from what sources they sought help to resolve the marking problem. RESULTS: Almost a third of veterinarians did not seem to correctly distinguish between urine marking (spraying) and inappropriate urination. Those that did make this diagnostic distinction reported recommending environmental management and prescribing medication significantly more often that those that did not make this distinction. Seventy-four percent of cat owners sought help from their veterinarians for urine marking; other common sources of information were the Internet and friends. Among those who did not consult a veterinarian, the most frequently cited reason was that they did not think their veterinarian could help. Among cat owners who consulted their veterinarians, 8% reported receiving advice on environmental hygiene and 4% on environmental management (limiting intercat interactions), although veterinarians who correctly diagnosed urine marking reported giving such advice 100 and 83% of the time, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Results may serve as a model for obtaining information critical to developing veterinary continuing education and public outreach programs for animal owners for various diseases.     

The value of biomedical research training for veterinary anatomic and clinical pathologists

Veterinary pathologists traditionally have been actively engaged in research as principal investigators and as collaborators. Pathologists frequently obtain advanced training in research; however, it appears that in the last 10 years there has been a reversal of a previous trend toward increasing numbers of pathologists obtaining PhD degrees. This has arisen despite an established shortage of veterinarians engaged in research. This article evaluates the benefits of research training for individual pathologists, including a wide spectrum of professional opportunities and additional skill development beyond that usually provided by diagnostic pathology training alone. Various training models are discussed, including combined and sequential diagnostic residency and research degree training as well as the nondegree research fellowship programs more commonly pursued in human medicine. Best-practice recommendations for program infrastructure, mentorship, time management, and a team approach to research and research training are advocated to facilitate the development of successful programs and to encourage a continued emphasis on integrated training for pathologists as both clinical diagnosticians and experimentalists. This article is intended to help prospective and active pathology trainees, their mentors, and educational administrators optimize opportunities to ensure the future vitality of veterinary pathologists, and their contributions, in basic and applied research.     

Cytologic diagnosis of diseases of invertebrates.

Invertebrate medicine in the context of an exotic or zoo animal veterinary practice is in its infancy. Establishment of species-specific reference values and evaluation of the effectiveness of cytology for diagnosis of specific diseases are necessary. Despite the lack of normal reference parameters for most species encountered in clinical practice, important information may be obtained from cytologic examination of tissue imprints, aspirates, scrapings, and hemolymph. This information may be essential to establish a specific diagnosis, focus investigations, and influence treatments. It is hoped that this article stimulates veterinarians who work with invertebrates to use diagnostic cytology and disseminate the results of their experience.     

Evaluation of static telepathology in veterinary diagnostic cytology

BACKGROUND: Telepathology is the process of diagnostic pathology performed on digital images viewed on a display screen rather than by conventional light microscopy with glass slides. At present, electronic mail (e-mail) attachment is the most common communication medium for telepathology, because it is relatively simple and incurs minimal cost. OBJECTIVE: Our objective was to test whether telediagnosis through Internet e-mail could be applied to veterinary diagnostic cytology. METHODS: Using 20 cytology cases, on which a consensus diagnosis was reached by 3 experienced pathologists, a total of 130 images were digitized and sent as e-mail attachments from the Unit of Anatomic Pathology of the Faculty of Veterinary Medicine of Naples to the Unit of Pathology of the Faculty of Veterinary Medicine of Messina, Italy. The images were reviewed at the Unit of Pathology of Messina, where the consulting pathologist formulated his diagnoses by visualizing the images on the monitor of a computer. The telediagnoses were compared with the consensus diagnoses and with the consulting pathologist's interpretation using conventional light microscopy at a later date. RESULTS: The median time to capture images was approximately 30 minutes for each case. The median time to make a telecytodiagnosis was a few seconds for each case. Overall, there was good agreement (85%) between the consensus diagnosis and the consultant's telediagnosis. In 100% of the cases there was agreement between the consulting pathologist's telediagnosis and conventional glass slide diagnosis. CONCLUSION: Telepathology by e-mail provides acceptable efficacy and a faster turnaround time than post and can be applied to veterinary diagnostic cytology.     

Rural veterinary services in Western Australia: Part A. Government veterinary services

OBJECTIVE: To determine the status of rural veterinary services in Western Australia. PROCEDURE: Two questionnaires were mailed to eligible, registered veterinary surgeons in Western Australia in 2006. The first was mailed to government veterinarians and the second to private practitioners in rural practice. Part A presents the replies from government veterinary officers and Part B the replies from rural practitioners. Replies were transferred to Microsoft Excel for analysis. RESULTS: Sixty-seven per cent of government veterinary officers responded to the questionnaire. Eighty per cent of these had been in the service for 20 years or more and their average age was 54. Work with sheep and beef cattle occupied 75% of their time, with dairy cattle receiving 10% and pigs and poultry less than 10%. The majority of respondents reported changes in the attitude of farmers to the service as a result of rural recessions and the decision to make a direct charge for government veterinary services. Although most respondents thought that the government veterinary service would continue in the future there were differences of opinion as to what form that would take. CONCLUSION: Government veterinary services in Western Australia are undergoing major changes, with the service decreasing in size and scope. Recently the Department of Agriculture has been renamed the Department of Agriculture and Food and it is likely that the role of its veterinary officers will change accordingly.     

Survey of mistakes made by recent veterinary graduates

To investigate the incidence and types of mistakes made in veterinary practice, and to assess the impact the mistakes had on the veterinarians involved, a questionnaire was sent in November 2002 to all the veterinary graduates of the Universities of Bristol, Edinburgh, Glasgow, London and Liverpool in 2001. One hundred and eight (27 per cent) of 402 questionnaires were returned completed; 87 of 106 respondents (82 per cent) worked frequently or always unsupervised and only 46 (43 per cent) could always rely on support from other veterinarians in the practice. Since starting work, 82 of 105 respondents (78 per cent) stated that they had made a mistake, defined as an erroneous act or omission resulting in a less than optimal or potentially adverse outcome for a patient and in many cases these mistakes had had a considerable emotional impact on the veterinarians involved. The survey highlights that a large number of recently graduated veterinarians work with little supervision and that many veterinarians beginning their year in practice do not always have access to assistance from other veterinary colleagues.     

Nonspecific clinical signs in pigs and use of exclusion diagnosis for classical swine fever: a survey among pig farmers and veterinary practitioners

Outbreaks of Classical Swine Fever (CSF) occurred in spring 2006 in Germany close to the Dutch border. On 6th April Dutch pig farmers were given the possibility to submit blood samples directly via their veterinary practitioner to the National Reference Laboratory for CSF if their pigs had non-specific clinical symptoms or if pigs were being treated with antibiotics. The pig farm was not quarantined and was not visited by the veterinary authorities. Over a period of 9 weeks 156 pig farmers submitted whole blood samples via 50 different veterinary practices. All samples tested negative in the PCR test. These pig farmers and veterinary practitioners were asked to respond to a postal questionnaire with questions regarding their experience with this new diagnostic possibility, the distribution of the costs involved, a comparison with other instruments, such as official notification or use of a leukocyte count test, and their knowledge of clinical signs of CSF. 65 pig farmers (42%) and 33 veterinary practices (66%) returned the questionnaire. The main results indicated that pig farmers (72%) would use this type of exclusion diagnostics sooner than that they would approach the veterinary authorities (practitioners: 86%). Moreover the respondents considered the fact that the farm was not quarantined immediately to be an advantage (pig farmers, 79%; practitioners, 88%). 32 percent of the pig farmers were not aware that they were required to submit blood samples if pigs were being treated with antibiotics (practitioners: 11%). The majority of pig farmers and practitioners were not satisfied with the current distribution of the costs involved: in their opinion the costs of the PCR test, the costs of the veterinary practitioner and the costs for shipping the samples to the reference laboratory should be paid out of the Animal Health Fund (50% government and 50% industry) or by the government. If the current distribution of the costs is not changed, a large proportion of the pig farmers indicated that they would not use this form of exclusion diagnostics for CSF in the future. Pig farmers appeared to have a rather limited knowledge of the clinical signs of CSF: 33% of the pig farmers could mention maximally three clinical signs of CSF, and 7% could not mention a single clinical sign of CSF and said they were entirely dependent on the practitioners' ability to judge a CSF-suspect situation.     

Analysis of the costs of veterinary education and factors associated with financial stress among veterinary students in Australia

Objective

To investigate the course‐related and other costs involved in obtaining a veterinary education in Australia and how these costs are met. The study also aimed to identify sociodemographic and course‐related factors associated with increased financial stress.

Methods

Students from seven Australian veterinary schools were surveyed using an online questionnaire. A total of 443 students participated (response rate 17%). Responses to survey items relating to finances, employment and course‐related costs were compared with sociodemographic factors and prior research in the area of student financial stress.

Results

Respondents reported spending a median of A$300 per week on living costs and a median of A$2,000 per year on course‐related expenses. Over half of respondents received the majority of their income from their parents or Youth Allowance (56%). A similar proportion (55%) reported that they needed to work to meet basic living expenses. Circumstances and sociodemographic factors linked to perceived financial stress included requiring additional finances to meet unexpected costs during the course; sourcing additional finances from external loans; an expected tuition debt at graduation over A$40,000; being 22 years or older; working more than 12 hours per week; living costs above A$300 per week; and being female.

Conclusion

The costs involved in obtaining a veterinary education in Australia are high and over half of respondents are reliant on parental or Government income support. Respondents with certain sociodemographic profiles are more prone to financial stress. These findings may have implications for the psychological health, diversity and career plans of veterinary students in Australia.     

Survey of veterinary extension in the United States

OBJECTIVE: To assess veterinary extension in the United States as perceived by veterinary extension personnel. DESIGN: Cross-sectional survey. SAMPLE POPULATION: Extension veterinarians in the United States. PROCEDURE: 2 surveys were designed and mailed to extension veterinarians listed by the USDA and the American Association of Extension Veterinarians. RESULTS: 34 states had > or = 1 extension veterinarian. The majority (> 60%) of extension veterinarians did not commit time to resident education and were not involved in research activities. Paradoxically, 23% of responding extension veterinarians did not report extension work. Programs for food animal producers, horse owners, and companion animal owners were provided by 100, 63, and 37% of states, respectively. Continuing education (CE) programs were provided for food animal veterinarians, equine veterinarians, and companion animal veterinarians by 96, 63, and 52% of states, respectively. Challenges facing veterinary extension included limited recognition of veterinary extension activities by universities, lack of university personnel to support CE programs, and decreased support for companion animal extension programs. CONCLUSIONS AND CLINICAL RELEVANCE: Extension veterinarians need to identify and clearly articulate the mission of veterinary extension, develop more collaborative programs across regions, and continue to serve as catalysts to bring diverse constituents together. Extension veterinarians must distinguish their mission not solely as information transfer, which can be accomplished in a variety of ways outside of extension, but as a coherent and consistent program of education and policy developed on a national level and distributed locally.