The role of lectures in veterinary education

OBJECTIVE: To study the role of lectures from the perspective of staff and students involved in the veterinary course at The University of Queensland. METHODS: The Nominal Group Technique of Delbecq et al, which provides the maximum opportunity for group members to put forward points, was used to help develop a questionnaire which was completed by 351 students (a response rate of 84%) and 35 staff (76%) from the five years of the veterinary course, and was analysed using the SAS System for Windows. RESULTS: Almost all the staff and students agreed that lectures should fulfil many roles including stimulating and motivating students and encouraging them to think, as well as presenting ideas and concepts and an indication of the structure and relevance of the material. They should provide a guide for effective deep learning, but not encourage rote (or superficial) learning. A smaller percentage of staff and even fewer students agreed that lectures did fulfil these roles, especially those directed at encouraging students to look beyond simple memorisation of facts. The perceived disparity between reality and the ideal was greater amongst the older, clinical students than amongst their more junior colleagues. CONCLUSIONS: The focus of attention in lectures needs to change from the superficial, rote learning of information to deep, active learning directed at using information to solve problems that are perceived by the students to be relevant. If done in a stimulating and interesting way, this should develop skills in reasoning and critical analysis as well as providing a framework for storage and recall. It should also increase the motivation towards learning both during the veterinary course, and over the professional lifetime. Furthermore, the place of the lecture in veterinary education needs to be reassessed regularly in the face of newly-emerging educational technology.     

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.     

Observations of veterinary medicine students' approaches to study in pre-clinical years

RATIONALE FOR THIS STUDY: This study has two purposes. The first is to explore an instrument of evaluation of the approaches to study (deep, strategic, and surface) adopted by students in the pre-clinical years of their veterinary degree program. The second is to examine relationships between these approaches and a broad range of further factors deemed relevant to the veterinary medicine context. We envisage that a greater knowledge of how these students learn will aid curriculum reform in a way that will enrich the learning experience of veterinary students. METHODOLOGY: A questionnaire consisting of the 52-question Approaches to Study Inventory (ASI) and an additional 49 questions relating mainly to teaching, assessment, and study skills was distributed to 215 veterinary medicine (MVB) students in their pre-clinical years of study. Factor analysis was used to ensure that the ASI section of the questionnaire maintained previously reported structure. The internal reliability of the approaches measured was tested using Cronbach alpha analysis. The approaches were described as frequency distributions. Associations between the parameters (deep, strategic, and surface) and 49 additional context-specific factors were investigated using loglinear analysis. RESULTS: (1) Factor analysis revealed that the integrity and structure of the instrument in this context was generally comparable to previous studies. (2) The impact of a high workload was evident in the surface approach, with fear of failure becoming a strong motivating factor and syllabus boundness a widely used strategy. (3) Associations made between the approaches and 49 context-specific factors showed strong associations between both workload and lack of prior knowledge with the surface approach. (4) Grades were associated positively with both the deep and strategic approaches but negatively with the surface approach. (5) A range of learning and study skills were associated positively with the deep and strategic approaches and negatively with the surface approach. CONCLUSION: The ASI proved to be a reliable and insightful instrument, highlighting specific surface learning tendencies present in the group as well as a deep learning approach, the pattern of which deviates from previous studies on this subject. This study also confirms the value of some teaching practices as a means of supporting deep learning and perhaps challenging surface learning strategies. The prevalent perception of a high workload is notable, as is its positive association with surface learning.     

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.     

Coaching and feedback: enhancing communication teaching and learning in veterinary practice settings

Communication is a critical clinical skill closely linked to clinical reasoning, medical problem solving, and significant outcomes of care such as accuracy, efficiency, supportiveness, adherence to treatment plans, and client and veterinarian satisfaction. More than 40 years of research on communication and communication education in human medicine and, more recently, in veterinary medicine provide a substantive rationale for formal communication teaching in veterinary education. As a result, veterinary schools are beginning to invest in communication training. However, if communication training is to result in development of veterinary communication skills to a professional level of competence, there must be follow-through with effective communication modeling and coaching in practice settings. The purpose of this article is to move the communication modeling and coaching done in the "real world" of clinical practice to the next level. The development of skills for communication coaching and feedback is demanding. We begin by comparing communication coaching with what is required for teaching other clinical skills in practice settings. Examining both, what it takes to teach others (whether DVM students or veterinarians in practice for several years) and what it takes to enhance one's own communication skills and capacities, we consider the why, what, and how of communication coaching. We describe the use of teaching instruments to structure this work and give particular attention to how to engage in feedback sessions, since these elements are so critical in communication teaching and learning. We consider the preconditions necessary to initiate and sustain communication skills training in practice, including the need for a safe and supportive environment within which to implement communication coaching and feedback. Finally we discuss the challenges and opportunities unique to coaching and to building and delivering communication skills training in practice settings.     

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.     

The role of veterinary medical librarians in teaching information literacy

This qualitative study seeks to determine the nature of the instruction librarians provide to veterinary medical students at all 28 United States veterinary colleges. A secondary goal of the study was to determine in what ways and to what extent librarians participated in other instructional activities at their colleges. Over half of the librarians formally taught in one or more courses, predominantly in the first two years of the veterinary curriculum. One presentation per course was most common. Over half of the librarians interviewed stated that evidence-based veterinary medicine was taught at their colleges, and about half of these librarians collaborated with veterinary faculty in this instruction. Many librarians participated in orientation for first-year veterinary students. The librarians also taught instructional sessions for residents, interns, faculty, graduate students, and practicing veterinarians. This study found that librarians teach information literacy skills both formally and informally, but, in general, instruction by librarians was not well integrated into the curriculum. This study advances several recommendations to help veterinary students develop information literacy skills. These include: encourage veterinary faculty and administrators to collaborate more closely with librarians, incorporate a broader array of information literacy skills into assignments, and add a literature evaluation course to the curriculum.     

Pharmacists in veterinary education: bridging the gap

Veterinary patients stand to benefit greatly from the collaboration of pharmacy and veterinary medicine, and there are many ways pharmacy and veterinary medicine can work in concert. The best efforts to revise and remodel veterinary and pharmacy education to fit an evolving world of clinical practice are grounded in an understanding of each profession. Veterinary education should impart to its students and residents the skills necessary to critically evaluate drug therapy, select therapies based on facts from drug information sources, and operate a veterinary practice that abides by the legal, regulatory, and operational requirements necessary to maintain and dispense drugs. The academic training environment of each profession must include information on the other, in order to better prepare professionals for a realistic practice environment. When armed with an understanding of what pharmacists can provide their patients, veterinarians can demand these skills where appropriate. With the ultimate goal of producing an optimal learning environment, veterinary curricula should allow both pharmacy and veterinary medicine to work together to build a path to quality patient care and educational superiority.     

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.     

Evaluation of a dental model for training veterinary students

Periodontal disease has deleterious effects on an animal's health and potentially serious implications for its welfare. Consequently, veterinarians frequently perform routine periodontal treatment in small-animal practice. One would therefore assume that small-animal dentistry would constitute a core component of a veterinary curriculum. However, most practitioners received little or no formal training in dentistry during their veterinary degrees, and the amount of instruction students currently receive is variable, often with limited opportunities to practice. At the Royal Veterinary College, a prototype dental model was developed to address the lack of practical training; it was made using ceramic tiles, silicone sealant, and grout to emulate teeth, gingiva, and calculus, respectively. A study was conducted with third-year veterinary students to compare the outcomes of learning to perform a professional dental cleaning using a model (group A) or a video (group B). Performance was assessed using an objective structured clinical examination. Students in group A scored significantly better than those in group B (p<.001). All students also completed a questionnaire evaluating attitudes toward the use of a dental model in learning dentistry-related skills. All students identified a model as a potentially valuable learning tool to supplement existing teaching methods and facilitate the acquisition of small-animal dentistry skills. The dental model has the potential to equip students with useful, practical skills in a safe and risk-free environment.     

Confidence as a barrier to the use of problem-based learning in veterinary undergraduate students

Problem-based or case-based learning is a popular method of instruction in clinical degrees such as veterinary science, nursing, and medicine. It is difficult, however, for students to adapt to this learning method, and this difficulty has been well described. The present study surveyed first-year undergraduate veterinary students at the University of Nottingham about the challenges they faced upon beginning problem-based learning sessions. A surprisingly large percentage of students (36% of females and 38% of males) reported a lack of confidence in speaking in front of the other students as a concern they experienced during their first term. Conversely, only 10% of the female students (and none of the male students) reported overconfidence as a problem. This is in contrast to the perceptions of the staff members who facilitated the sessions who reported that 14% of the students exhibited underconfidence and 14% exhibited overconfidence. The difference between the female and male students' responses as well as the difference between the perceptions of students and those of facilitators is statistically significant (G-test p<.05).     

Integrated Case-Based Applied Pathology (ICAP): a diagnostic-approach model for the learning and teaching of veterinary pathology

Integrative Case-Based Applied Pathology (ICAP) cases form one component of learning and understanding the role of pathology in the veterinary diagnostic process at the Faculty of Veterinary Science, University of Sydney. It is a strategy that focuses on student-centered learning in a problem-solving context in the year 3 curriculum. Learning exercises use real case material and are primarily delivered online, providing flexibility for students with differing learning needs, who are supported by online, peer, and tutor support. The strategy relies heavily on the integration of pre-clinical and para-clinical information with the introduction of clinical material for the purposes of a logical three-level, problem-oriented approach to the diagnosis of disease. The focus is on logical diagnostic problem solving, primarily using gross pathology and histopathological material, with the inclusion of microbiological, parasitological, and clinical pathological data. The ICAP approach is linked to and congruent with the problem-oriented approach adopted in veterinary medicine and the case-based format used by one of the authors (PJC) for the teaching and learning of veterinary clinical pathology in year 4. Additionally, final-year students have the opportunity, during a diagnostic pathology rotation, to assist in the development and refinement of further ICAPs, which reinforces the importance of pathology in the veterinary diagnostic process. Evidence of the impact of the ICAP approach, based primarily on student surveys and staff peer feedback collected over five years, shows that discipline-specific learning, vertical and horizontal integration, alignment of learning outcomes and assessment, and both veterinary and generic graduate attributes were enhanced. Areas for improvement were identified in the approach, most specifically related to assistance in the development of generic teamwork skills.     

Senior veterinary students' perceptions of using role play to learn communication skills

Recent studies of veterinary practice have suggested a correlation between well-developed communication skills and job satisfaction, career retention, customer satisfaction, decreased lawsuits, and financial remuneration for veterinarians. Veterinary educators are under growing pressure to teach functional communication skills to veterinary students; however, the methods employed have not been well evaluated. In this study we have evaluated veterinary student's attitudes to learning communication skills by participating in role play. The study indicates that experiential learning modalities such as role play are perceived as effective by students, despite reluctance to participate and some discomfort surrounding participation.     

Veterinary students' perceptions of their day-one abilities before and after final-year clinical practice-based training

The present study evaluated the impact of final-year clinical practice-based training on veterinary students' perceptions of competence in "Day One" abilities by administering a pre- and post-training self-assessment checklist. This study also investigated the influence of student demographics on their perceptions of satisfaction about their own knowledge and skills and preparedness for practice. Perceptions regarding the usefulness of the checklist as a self-audit tool were also sought. Final year students (N=85) were surveyed on commencement and upon completion of the training using a checklist that had been adapted from the list of essential new-graduate abilities that was developed by the Royal College of Veterinary Surgeons and adopted by the Australasian Veterinary Boards Council. Significant improvements in student perceptions of competence were observed for 38 of the 41 abilities. Students' satisfaction with their knowledge and skill base and their perceptions of preparedness for practice were only weakly correlated with overall perceptions of competence for individual ability items and did not vary significantly with student age, gender, background, intended field and location of work, or with their work experience as veterinary nurses-if any-while studying. Two thirds of students believed that access to the self-assessment checklist on commencement of the training helped them identify areas for improvement before graduation. This article concludes that clinical practice-based training results in considerable improvement in senior veterinary students' perceptions of competence in Day One abilities and that a self-assessment checklist may help students guide their learning. Results from the present study may be useful for veterinary schools as they develop or enhance strategies used for outcomes assessment.     

ATLes: the strategic application of Web-based technology to address learning objectives and enhance classroom discussion in a veterinary pathology course

A case-based program called ATLes (Adaptive Teaching and Learning Environments) was designed for use in a systemic pathology course and implemented over a four-year period. Second-year veterinary students working in small collaborative learning groups used the program prior to their weekly pathology laboratory. The goals of ATLes were to better address specific learning objectives in the course (notably the appreciation of pathophysiology), to solve previously identified problems associated with information overload and information sorting that commonly occur as part of discovery-based processes, and to enhance classroom discussion. The program was also designed to model and allow students to practice the problem-oriented approach to clinical cases, thereby enabling them to study pathology in a relevant clinical context. Features included opportunities for students to obtain additional information on the case by requesting specific laboratory tests and/or diagnostic procedures. However, students were also required to justify their diagnostic plans and to provide mechanistic analyses. The use of ATLes met most of these objectives. Student acceptance was high, and students favorably reviewed the online 'Content Links' that made useful information more readily accessible and level appropriate. Students came to the lab better prepared to engage in an in-depth and high-quality discussion and were better able to connect clinical problems to underlying changes in tissue (lesions). However, many students indicated that the required time on task prior to lab might have been excessive relative to what they thought they learned. The classroom discussion, although improved, was not elevated to the expected level-most likely reflecting other missing elements of the learning environment, including the existing student culture and the students' current discussion skills. This article briefly discusses the lessons learned from ATLes and how similar case-based exercises might be combined with other approaches to enhance and enliven classroom discussions in the veterinary curriculum.     

Building on existing models from human medical education to develop a communication curriculum in veterinary medicine

Communication is a core clinical skill of veterinary medicine and one that needs to be taught and learned to the same degree as other clinical skills. To provide this education and essential expertise, veterinary schools in many countries, especially including North America, the United Kingdom, and Australia, have begun to develop programs and communication curricula. Human medical education, however, has 30 years' experience in developing communication curricula, and is thus an excellent resource upon which veterinary educators can build and shape their own communication programs. This article describes a skills-based communication course that has been successfully implemented for veterinary medical education at Ontario Veterinary College (OVC) and was based on the University of Calgary Faculty of Medicine's well-established program. The Calgary-Cambridge Guides and supporting textbooks provide the scaffolding for teaching, learning, and evaluation in both programs. Resources such as space and materials to support the OVC program were also patterned after Calgary's program. Communication skills, and the methods for teaching and learning them, are equally applicable for the needs of both human medicine and veterinary medicine. The research evidence from human medicine is also very applicable for veterinary medicine and provides it the leverage it needs to move forward. With this extensive base available, veterinary medicine is in a position to move communication skills training forward rapidly.     

Implementing a simulated client program: bridging the gap between theory and practice

INTRODUCTION: This paper outlines the design and implementation of an innovative communication skills training program at the Ontario Veterinary College (OVC). Based upon the body of research in human medical education reporting effective results through the use of standardized patients (SPs) for this type of training, an experiential learning laboratory using simulated clients (SCs) and patients was introduced to first-year veterinary students. METHOD: One hundred and four first-year students were assigned to 12 groups of eight or nine students plus a facilitator. Each student interacted with a simulated client and a patient while being observed by peers and a facilitator. The Calgary-Cambridge Observation Guide (CCOG) was used to guide students and facilitators with performance standards and feedback. Assessment strategies were utilized. RESULTS: Implementation of this program required extensive resources, including funding, expertise, facilitator training, time allotment in an already overburdened curriculum, and administrative and faculty support. Preliminary assessment revealed high student and facilitator satisfaction. The potential of this program for student education and assessment was recognized, and it will be expanded in years 2 and 3 of the DVM (Doctor of Veterinary Medicine) curriculum. CONCLUSIONS: Medical educators have created resources, including skills checklists and experiential learning modalities, that are highly applicable to veterinary medical education. Ongoing evaluation of the program is essential to determine whether we are meeting expectations for communication competency in veterinary medicine.     

Undergraduate veterinary education at University College Dublin: a time of change

The final-year Bachelor of Veterinary Medicine (MVB) class of 2005 were the first cohort of students to complete the new curriculum at the Faculty of Veterinary Medicine, University College Dublin (UCD). The new curriculum is a fundamental departure from the traditional curriculum that had served the veterinary profession in Ireland over many years. The change was not a precipitate action but the outcome of a prolonged and thorough examination of the realities of veterinary medicine, its science and its art, in the first decade of a new millennium. Over recent decades, rapid and fundamental changes have been witnessed in the economic, cultural, and ethical environment in which the veterinary profession operates, and these changes, coupled with the "information explosion," dictated an examination of the educational paradigm. The new curriculum exposes the first-year class to veterinary information technology and problem-based learning (PBL). In the second year, students are instructed in clinical examination, history taking, and client communication skills, in addition to further exposure to PBL. The third and fourth years are now systems-based, with coordinated input from microbiologists, parasitologists, pathologists, and clinicians in teaching each body system. The first lecture-free final year in the 104-year history of veterinary education in Ireland consists of clinical rotations and a four-week elective pursued within the faculty or at other recognized institutions. Students must also complete a minimum of 24 weeks' extramural studies (EMS). Critically, the development and assessment of all courses in the new undergraduate degree program has been driven by carefully thought out learning outcomes. The new curriculum will provide graduates with the essential knowledge and skills required for entry into the veterinary profession. Society expects these qualities from veterinarians in the interests of the communities they serve during their professional careers. In addition, the curriculum should foster the ability to adapt to changing circumstances, instill the desire and ability to work in teams, and develop life skills. It is hoped that the academic innovations will arouse the intellectual curiosity and commitment to lifelong learning that future graduates will require if they are to retain the confidence of the society in which they work in the future.     

A comparison of responses to group learning between first-year Asian and first-year Australian veterinary science students

INTRODUCTION: Group learning has been used to enhance deep (long-term) learning and promote life skills, such as decision making, communication, and interpersonal skills. However, with increasing multiculturalism in higher education, there is little information available as to the acceptance of this form of learning by Asian students or as to its value to them. METHODOLOGY: Group-learning projects, incorporating a seminar presentation, were used in first-year veterinary anatomical science classes over two consecutive years (2003 and 2004) at the School of Veterinary Science, University of Queensland. Responses of Australian and Asian students to survey forms evaluating the learning experience were analyzed and compared. RESULTS: All students responded positively to the group learning, indicating that it was a useful learning experience and a great method for meeting colleagues. There were no significant differences between Asian and Australian students in overall responses to the survey evaluating the learning experience, except where Asian students responded significantly higher than Australian students in identifying specific skills that needed improving. CONCLUSIONS: Group learning can be successfully used in multicultural teaching to enhance deep learning. This form of learning helps to remove cultural barriers and establish a platform for continued successful group learning throughout the program.