Evaluation of a Hemostasis Model for Teaching Basic Surgical Skills

The need for alternative methods of teaching veterinary medicine and surgery has increased in recent years because of increasing costs and changing public opinion. For these reasons a hemostasis model was developed that mimics the arteries and veins of the peripheral vascular system, and can be used to teach the basic skills involved in blood vessel ligation and division. This study evaluated the effectiveness of the fluid hemostasis model compared with using live animals for teaching these skills. Forty sophomore veterinary students participated in the study. Two groups of 20 students each received identical instruction in the basic techniques required for vessel ligation and division. The students then completed various exercises using inanimate models to objectively evaluate their psychomotor skills. Both groups then practiced the techniques for equal time periods; one group used the hemostasis model and the other performed a splenectomy on live dogs. After the practice session, the students were videotaped (for later evaluation), as they performed vessel ligations and divisions. The students then repeated the exercises using the inanimate models for evaluation of skills improvement. Questionnaire responses before and after the project were obtained to determine the students' views on the need for inanimate models for teaching purposes. Results of this study indicate that the hemostasis model was as effective as live animals for teaching the basic skills involved in blood vessel ligation. The students' opinions regarding the use of properly designed inanimate models for teaching these skills were dramatically changed.     

Teaching surgery to the veterinary novice: the Ohio State University experience

Surgical training in veterinary medicine has evolved rapidly over the past several decades. Catalysts for change include pressure from concerned students and the public to reduce the use of live animals in teaching; less-than-effective preparation of students for live surgery experience; an overall reduction in faculty time and effort devoted to skills training; college budgetary reallocations mandating reductions in expensive group laboratory experiences; and more specialized case-load patterns in clinical rotations, which have reduced students' exposure to common surgical conditions. In response to these trends, methods for surgery educators to reduce, refine, and replace live animals in surgery training courses at veterinary schools have received broad attention. When these methods are used effectively in a curriculum, it is no longer necessary to sacrifice animals for adequate student training. This article describes a successful and ethical surgical training program used at the Ohio State University College of Veterinary Medicine (OSU-CVM). This program provides early exposure to skills training using surgical simulators and auto-tutorials, ensures that basic skills are mastered before students are exposed to cadaver practice, and requires application of model-based skills to cadavers, with final matriculation to intensive exposure to multiple live-animal procedures via a collaborative surgery program with a local shelter.     

If you build it,they will learn: A review of models in veterinary surgical education

Surgical skills are learned through deliberate practice, and veterinary educators are increasingly turning to models for teaching and assessing surgical skills. This review article sought to compile and review the literature specific to veterinary surgical skills models, and to discuss the themes of fidelity, educational outcomes, and validity evidence. Several literature searches using broad terms such as “veterinary surgery model,” “veterinary surgical model,” and “veterinary surgical simulator” were performed using PubMed, CAB abstracts, and Google scholar. All articles describing a model created and utilized for veterinary surgical training were included. Other review articles were used as a source for additional models. Commercially available models were found using review articles, internet browser searches, and communication with veterinary clinical skills educators. There has been an explosion of growth in the variety of small animal surgical task trainers published in the last several decades. These models teach orthopedic surgery, ligation and suturing, open celiotomy and abdominal surgery, sterilization surgeries, and minimally invasive surgeries. Some models were published with accompanying rubrics for learner assessment; these rubrics have been noted where present. Research in veterinary surgical models is expanding and becoming an area of focus for academic institutions. However, there is room for growth in the collection of validity evidence and in development of models for teaching large animal surgery, training surgical residents, and providing continuing education to practitioners. This review can assist with evaluation of current surgical models and trends, and provide a platform for additional studies and development of best practices.     

Attitudes of veterinary medical students and medical students toward collaborative learning: an experiment

This study measured the attitudes of 55 medical students and 30 veterinary medical students as they participated in an experiment of collaborative teaching and learning about basic surgical skills. Two parallel forms of an attitude questionnaire were developed, with three subscales: confidence in one's own surgical skill; collaboration with the other type of student; and inter-professional collaboration in general. These attitude scales were administered before and after an experiment involving the veterinary medical students teaching the medical students incision and exploratory laparoscopy in a laboratory setting using live rabbits. After the experiment, measures of the medical students' attitudes had increased significantly on all three subscales. Measures of the veterinary students' attitudes increased significantly on two subscales but declined on the subscale of inter-professional collaboration.     

Teaching veterinary students using shelter animals

Veterinary teaching hospitals (VTHs) are experiencing case-load trends that have negatively affected efforts to prepare students for entry-level veterinary practice, particularly in the area of technical skills training. This article examines the clinical training available to veterinary students through a variety of collaborative shelter models. Benefits and potential problems related to initiating a collaborative shelter clinical training program are reviewed. Collaborative efforts between animal shelters and veterinary schools can provide crucial opportunities for outreach teaching initiatives, particularly for teaching medical and surgical skills.     

Evaluation of Video Tape and a Simulator for Instruction of Basic Surgical Skills

Twenty first-year veterinary students with no prior participatory experience in surgery were randomly paired and assigned into two study groups. Ten students (group V) viewed a hemostatic technique video tape until they thought they could competently perform and assist in performing a hand-tied ligature on a blood vessel in a live animal. Ten students (group VS) wer also given a simulator for technique practice. Paired students were video recorded and blindly evaluated on their ability to perform and assist proper ligation of a bleeding vessel. Inexpensive hemostasis models were very helpful for teaching students essential surgeon and assistant skills involved in hand-tied ligature placement. Students who practiced with simulators performed significantly better as surgeon and assistant, and in total psychomotor skill evaluation, then students watching the video only. Students using simulators performed ligation with significantly more accuracy and tended to be more expeditious at this task. Further training is needed for students to acquire skills necessary for efficient bleeding vessel exposure and isolation.     

The attitudes of minority junior high and high school students toward veterinary medicine

There is a documented lack of racial diversity in veterinary medicine. It has been suggested that lack of animal ownership by minorities, cultural and ethnic biases relating to animals, and a lack of role models of color within the veterinary profession are reasons for the lack of racial diversity in veterinary medicine. The purpose of this study was to survey the attitudes of minority junior high and high school students toward veterinary medicine. It was hypothesized that African American and Latino students in New York City (NYC) would have limited experience with veterinary medicine and would not have a favorable attitude toward the profession. In fact, the survey, which was sent to several NYC schools, found that minority students have a positive view of animals and of veterinary medicine. The survey also showed that a deficiency of minority role models for students, a lack of interest in and enjoyment of veterinary medicine on the part of students, a perception on the part of students that veterinary medicine does not provide a satisfying lifestyle, and inadequate student exposure to the profession are key factors in the lack of racial diversity in veterinary medicine.     

The role of final year extramural placements in the undergraduate veterinary curriculum

OBJECTIVE: To examine the role of a final year program of extramural placements in the undergraduate veterinary curriculum. DESIGN: An online questionnaire was made available to all students who completed the first lecture free final year of clinical placements offered by the Faculty of Veterinary Science, University of Sydney in 2004. The questionnaire collected information regarding the effectiveness of preparation for veterinary practice through: rating the usefulness of tasks and processes in achieving final year learning outcomes; collecting students' opinions on attributes vital to success as a veterinary practitioner and the value of extramural placements in developing these attributes; and rating the value of extramural placements in preparing students for veterinary practice. RESULTS: The most useful tasks or processes as evidenced by the percentage of students rating these tasks or processes as either very useful or useful were receiving feedback (80%) and completing case logs (78%). The main attribute considered vital to success as a veterinarian was communication skills and extramural placements were generally rated as very valuable in developing this competency. This program was considered to be particularly successful in facilitating the link between theory and practice, enabling the recognition and treatment of a range of diseases and developing interpersonal skills. CONCLUSION: The model for extramural placements implemented was generally regarded by students to be valuable in preparing them for veterinary practice.     

Use of drama in teaching the human side of veterinary practice

Objective To describe a teaching experiment in which fifth year veterinary students were given the opportunity, using dramatic scenarios, to consider ways of dealing with emotive issues relevant to veterinary practice, that demand good communication skills.
Design Workshops were devised using dramatised scenarios of several critical incidents in practice, including euthanasia. A clinical psychologist and several veterinary practitioners participated in discussions. Both live performances and video scenarios were presented to fifth year veterinary students and were followed by group discussions. Each workshop was evaluated and modifications were made where necessary.
Results The teaching format involving drama was well received. The combination of drama and discussion was more effective than a formal talk and discussion, provoking animated participation and maintaining audience attention. The majority of students considered that comments and advice from attending veterinarians were the most useful parts of the workshops in preparing them for veterinary practice. The large audience (up to 45 attendees) was considered to be desirable for enhancing discussion. Requests for more similar sessions were made by students.
Conclusion Drama was found to be a satisfactory modality in teaching communication skills in preparing veterinary students for practice.     

Survey of veterinary technical and professional skills in students and recent graduates of a veterinary college

OBJECTIVES: To determine perceptions of veterinary technical and professional skills among veterinary students and recent graduates. DESIGN: Cross-sectional study. SAMPLE POPULATION: 281 students and 142 recent graduates from the Ontario Veterinary College. PROCEDURE: A survey was designed and administered to first- through fourth-year students and veterinarians who had graduated either 1 or 6 years before survey administration. RESULTS: Overall response rate was 70%. Learning about technical and professional skills was highly valued. Most participants felt they had not received instruction about professional skills, but those who had felt more competent about them. Perceptions of competence increased slightly with increased comfort discussing emotional veterinary issues with instructors. Neither gender nor increased age was related to increased feelings of competence. Almost all fourth-year students felt competent and comfortable about examining an animal with the client present, assessing suffering, diagnosing parvovirus infection, performing surgery, and working as group members. However, many did not feel competent or comfortable about delivering bad news, setting time limits yet providing quality service, helping clients with limited funds make treatment decisions, dealing with demanding people, and euthanasia. Feelings of competence and comfort were closely related but were not identical. CONCLUSIONS AND CLINICAL RELEVANCE: In the interests of best preparing entry-level veterinarians, technical and professional skills need to be emphasized in a learning environment where students feel comfortable discussing emotional veterinary issues. A professional skills curriculum addressing underlying self-awareness, communication, and interpersonal issues, as well as procedural matters, would likely increase the proportion of fourth-year students who feel competent and comfortable about professional skills by the end of their undergraduate training.     

Lumbo-sacral epidural anaesthesia as a complement to dissociative anaesthesia during scrotal herniorrhaphy of livestock pigs in the field

Background

In Sweden, scrotal or inguinal herniorrhaphy of livestock pigs in the field has traditionally been an important part of the surgical skills training of veterinary students. Few substances meet the legal requirements for field anaesthesia of production animals in the European Union but a protocol based on azaperone-detomidine-butorphanol-ketamine does. Unfortunately the anaesthesia is characterised by unpredictable duration and depth and of abrupt awakenings which is not acceptable from an animal welfare perspective and impedes surgical training. Lumbo-sacral epidural analgesia is proven to provide sufficient analgesia to allow abdominal surgery, but there are few reports on the field use of this loco-regional technique. The study aim was to evaluate whether lumbo-sacral anaesthesia can be safely and successfully used in the field by a veterinary student and whether the combination of dissociative and lumbo-sacral epidural anaesthesia improves analgesia and anaesthesia to guarantee animal welfare during herniorrhaphy in livestock pigs, enabling surgical skills training.

Results

Pigs in the control-group (placebo) responded significantly stronger to surgery, with five out of 11 requiring additional doses of detomidine and ketamine. There were no significant differences between groups in respiratory rate, heart rate, blood pressure, SpO₂ or blood gases. SpO₂ levels <94 % were recorded in several pigs in both groups. No post-injection complications were reported at follow-up.

Conclusions

The results from this study showed that lumbo-sacral epidural anaesthesia with lidocaine could successfully be administered during dissociative anaesthesia of livestock pigs by a veterinary student and without reported post-injection complications. It improved analgesia and anaesthesia during herniorrhaphy of sufficient duration to enable surgical skills training. The risks and consequences of hypoxaemia and hypoventilation should be considered.     

Animal handling as an integrated component of animal and veterinary science programs at the University of Queensland.

Students in animal science and veterinary science at the University of Queensland (UQ) have similar introductory courses in animal handling in year 1 of their degree programs. Veterinary students take animal-handling instruction in farm and companion animals, whereas animal science students are instructed in handling farm animals, horses, and rodents. Veterinary students are introduced to rodents, and animal science students to dogs and cats, in subsequent years of the curriculum. Both cohorts receive additional training, with clinical emphasis for veterinary students in years 3, 4, and 5 of their five-year curriculum. The introductory course is well received by students; both student cohorts appreciate the opportunity provided and the effort that goes into the animal-handling classes. Undergraduates realize that acquiring animal-handling skills will increase their proficiency in their subsequent careers; veterinary graduates recognize that their handling prowess will give their clients confidence in their abilities. Most clients cannot judge the competence of a veterinarian's diagnosis or treatment but will judge their ability based on their handling skills. Ongoing practice allows students to become competent in animal handling.     

A Comparison of Surgical Training with Live Anesthetized Dogs and Cadavers

Cadavers were compared with live anesthetized dogs for their effectiveness as models for surgical training of veterinary medical students. One group of students was trained using cadavers, and a peer group was trained using live anesthetized dogs. Both groups then performed an intestinal anastomosis using a live subject. The time to completion of the procedure was recorded. The anastomoses and celiotomy closures were evaluated. Each anastomosis was isolated and pressure tested. Reviewers blindly scored each surgical team's performance based on actual inspection of the surgical site and on viewing videotapes of the procedure. The participants' attitudes toward the use of live animals in teaching and research were documented before and after training. No statistically significant differences could be detected between the two groups. The results suggest that some substitution of cadavers for live dogs in surgical training might be feasible.     

Evaluation of a hemostasis model for teaching ovariohysterectomy in veterinary surgery

OBJECTIVE: To evaluate the efficacy of a reusable plastic model mimicking the anatomy and hemodynamics of the canine female genital tract for teaching basic surgical skills and ovariohysterectomy. SAMPLE POPULATION: 40 veterinary students of the class of 1998. STUDY DESIGN: Prospective study. METHODS: Students'confidence level and experience in private practice was evaluated via questionnaire before training. Students in 2 groups performed an ovariohysterectomy on cadavers (group C, n = 20) or on the model (Group M, n = 20) for 2 hours. Students' psychomotor and basic surgical skills were objectively assessed by the following tests: ligation of a foam cylinder, passing a needle through the eyelets of an electronic suture board, and ligating latex tubing. Results were compared before and after training and within and between groups. The ability of students to perform an ovariohysterectomy in a live dog after training was compared between groups with a scoring system. RESULTS: Students in both groups had similar surgical experience and basic skills before training. The results of the psychomotor and basic surgical skills tests were better in group M after training than group C. The improvement of each student in performing these tasks also increased when students were trained with the model. Scores assigned to students performing an ovariohysterectomy in a live dog were higher in group M (31.45 +/- 1.15) than in group C (20.7 +/- 1.42). CONCLUSION: The model was more effective than cadavers in teaching basic surgical skills and ovariohysterectomy in dogs.     

How does emotional intelligence fit into the paradigm of veterinary medical education?

The term 'emotional intelligence' (EI) has become very popular in the business world and has recently infiltrated veterinary medical education. The term purports to encompass those qualities and skills that are not measured by IQ tests but do play an important role in achieving success in life. Veterinary medical educators often incorporate these in a category called 'non-technical competencies' (which includes, for example, communication skills) and acknowledge that veterinarians need more training in this area in order to be successful. Although EI looks promising as a means for teaching these non-technical competencies to students and practitioners, there are some challenges to its application. To begin with, there are three competing models of EI that differ in definition and measuring instruments. Although some research has suggested that high EI is associated with success in school and in business, there are no studies directly correlating high EI with greater success in the veterinary profession. Nor have any studies confirmed that increasing a student's EI will improve eventual outcomes for that student. It is important that educators approach the implementation of new techniques and concepts for teaching non-technical competencies the same way they would approach teaching a new surgical technique or drug therapy. EI is an intriguing and promising construct and deserves dedicated research to assess its relevance to veterinary medical education. There are opportunities to investigate EI using case control studies that will either confirm or discredit the benefits of incorporating EI into the veterinary curriculum. Implementing EI training without assessment risks wasting limited resources and alienating students.     

高职高专中兽医教学改革与创新初探

高职高专中兽医教学的目的是使学生掌握中兽医的基本理论和技能,初步具备运用中兽医诊疗技术对畜禽疾病进行临床诊断、预防和治疗的实际工作能力。针对高职高专人才培养的要求和畜牧兽医高职高专教育自身的特点,以＂培养实用型、应用型人才＂为目标,对中兽医课程教学进行了大胆的改革与探索,突破了原有本科式《中兽医学》的课程体系和教学模式,重组教学内容,构建适宜于高职高专的理论和实践教学体系。在教学设计上充分考虑高职特点,本着＂理论够用＂的原则,突出技能培养和强化实践性教学为特色,旨在探索和创新一种全新的高职高专中兽医教学模式。     

Developments in undergraduate teaching of small-animal soft-tissue surgical skills at the University of Sydney

This article discusses recent developments in soft-tissue surgery teaching at the University of Sydney, Faculty of Veterinary Science. An integrated teaching program was developed for Bachelor of Veterinary Science (BVSc) students with the aim of providing them with optimal learning opportunities to meet "Day One" small-animal soft-tissue surgical competencies. Didactic lectures and tutorials were introduced earlier into the curriculum to prepare students for live-animal surgery practical. In addition to existing clinics, additional spay/neuter clinics were established in collaboration with animal welfare organizations to increase student exposure to live-animal surgery. A silicon-based, life-like canine ovariohysterectomy model was developed with the assistance of a model-making and special effects company. The model features elastic ovarian pedicles and suspensory ligaments, which can be stretched and broken like those of an actual dog. To monitor the volume and type of student surgical experience, an E-portfolio resource was established. This resource allows for the tracking of numbers of live, student-performed desexing surgeries and incorporates competency-based assessments and reflective tasks to be completed by students. Student feedback on the integrated surgical soft-tissue teaching program was assessed. Respondents were assessed in the fourth year of the degree and will have further opportunities to develop Day One small-animal soft-tissue surgical competencies in the fifth year. Ninety-four percent of respondents agreed or strongly agreed that they were motivated to participate in all aspects of the program, while 78% agreed or strongly agreed that they received an adequate opportunity to develop their skills and confidence in ovariohysterectomy or castration procedures through the fourth-year curriculum.     

Veterinary students' views on animal patients and human clients, using Q-methodology

Veterinarians serve two masters: animal patients and human clients. Both animal patients and human clients have legitimate interests, and conflicting moral claims may flow from these interests. Earlier research concludes that veterinary students are very much aware of the complex and often paradoxical relationship they have and will have with animals. In this article the views of veterinary students about their anticipated relationship with animal patients and human clients are studied. The main part of the article describes discourses of first-year and fourth-year students about their (future) relationship with animals and their caretakers, for which Q-methodology is used. At the end of the article, the discourses are related to the students' gender and their workplace preferences.     

Evaluating the curriculum of the veterinary school of Firat University, Turkey, in terms of professional and technical skills

A significant portion of the problems faced by veterinarians is related to communication. These problems are intensely experienced between veterinary practitioners and animal owners; yet no lectures or courses aiming to improve professional skills are available in the curriculum of veterinary schools in Turkey. In this study, all students currently enrolled at, and 1992 and 1998 graduates of, the Veterinary School of Firat University (VSFU), Turkey, were surveyed to evaluate the attitudes of veterinary students and graduates toward technical and professional skills. Data were collected from 581 students and 61 recent graduates via personal interviews with students and questionnaires mailed to graduates; information was obtained about participants' technical and professional skills. The overall response rate was 85%. The results show that learning about technical and professional skills is highly valued; competence and comfort in skill sets are associated with comfort in establishing communication with instructors. Positive correlations were also noted between feeling comfortable with and feeling competent in both skill sets. In conclusion, it appears to be essential to introduce courses addressing improvement of professional skills to the curriculum of veterinary schools in Turkey, given that a successful veterinarian profile requires feeling competent in and comfortable with both technical and professional skills.