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.     

Visuospatial skills are better predictors than dexterity for basic ultrasonographic and fluoroscopic skills in veterinary students

Radiological skills including ultrasonography and fluoroscopy, require a combination of manual dexterity and visuospatial skill to develop competency. The ability to detect veterinary students with an interest in radiology but who are deficient in these skills, may permit more individual adaptations to training programs, allowing for students training in radiology to achieve maximal potential. The objective of this cohort study was to investigate whether innate dexterity and visuospatial skill could be used to predict performance of basic ultrasound and fluoroscopic skills in veterinary students. Fifty veterinary students from the Ontario Veterinary College completed three tests of visuospatial ability, two tests of manual dexterity, a three‐dimensional mouse task, an ultrasound skill‐testing task, and a fluoroscopic skill‐testing task. Students who reported chopstick use completed the non‐dominant hand ultrasound task significantly faster than students who did not (P = 0.001). There was a significant positive association between scores on the Mental Rotations Test and time to complete the non‐dominant hand ultrasound task (P = 0.011) and fluoroscopy task (P = 0.029). No variables were associated with time to complete the dominant hand ultrasound task. The results of this study suggest that visuospatial skill, as assessed by the Mental Rotations Test, is a better predictor of baseline ultrasound and endovascular fluoroscopy skill than dexterity, with the exception of reported chopstick use, in veterinary students. Visuospatial skills can be developed and may be useful to include in the veterinary curriculum for students that are deficient, or students entering a field such as diagnostic imaging.     

Teaching nutrition to student veterinary technicians

Graduates of veterinary technology programs must have the knowledge and skills to understand, implement, and encourage owner compliance with appropriate feeding recommendations for healthy animals and therapeutic regimens to promote optimal health, enhance recovery, and manage chronic disease conditions. This article describes nutrition education for veterinary technology students at the College of Veterinary Medicine, Michigan State University. Veterinary technology students are novice learners in nutrition who prefer visual, applied, and experiential modes of instruction. The program uses the American College of Veterinary Nutrition's "Circle of Nutrition," concept maps, and case-based delivery and assessment.     

Predictors of employer satisfaction: technical and non-technical skills

Employers of 2007-2009 graduates from Iowa State University College of Veterinary Medicine were asked to respond to a survey regarding their overall satisfaction with their new employees as well as their new employees' preparation in several technical and non-technical skill areas. Seventy-five responses contained complete data and were used in the analysis. Four technical skill areas (data collection, data interpretation, planning, and taking action) and five non-technical skill areas (interpersonal skills, ability to deal with legal issues, business skills, making referrals, and problem solving) were identified. All of the skill area subscales listed above had appropriate reliability (Cronbach's alpha>0.70) and were positively and significantly correlated with overall employer satisfaction. Results of two simultaneous regression analyses indicated that of the four technical skill areas, taking action is the most salient predictor of employer satisfaction. Of the five non-technical skill areas, interpersonal skills, business skills, making referrals, and problem solving were the most important skills in predicting employer satisfaction. Hierarchical regression analysis revealed that all technical skills explained 25% of the variation in employer satisfaction; non-technical skills explained an additional 42% of the variation in employer satisfaction.     

Externship program for large animal clinical education at the University of Minnesota: description and evaluation.

In 1970, the College of Veterinary Medicine at the University of Minnesota started an externship program as part of their large animal clinical education program. The basic idea was to work in cooperation with practitioners, using their practice world as a teaching resource. During the 1973-1974 school year, this program was evaluated by the University of Minnesota Measurement Services Center. In this externship program, senior year students spend 1 or 2 weeks in practice that closely matches each student's career interest, eg, cow-calf, dairy, swine, or zoo. The participating veterinarians are charged with the responsibility of performing as teachers during the field experience and of assisting the student in preparing a seminar topic. This seminar topic is presented in a discussion format during the spring quarter to other externship students, faculty, and attending practitioners. Since 1970, a total of 176 students have taken externships, and every year 15 to 20 group practices have participated. The principal evaluation results were based on questionnaire responses from 36 students and 20 practices during the 1973-1974 academic year. Students and practitioners indicated that the externship had been a beneficial experience for them. Many felt that the period of externship should have been longer. In general, practitioners agreed that students were able to manage most diagnostic situations and manipulative procedures that occurred during the externship. The seminar was judged by students and practitioners to be a valuable part of the program, and faculty who participated in the seminar believed that it made them more aware of field situations facing practicing veterinarians.     

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.     

《兽医药理学》课程教学改革探析

为了提高学生学习兽医药理学的兴趣和实效性,对教学内容、教学方法和考核方式等方面的兽医药理学教学进行了探析。从合理规划教学重点、扩展教学内容、运用赏识教育、seminar教学法、网络平台以及丰富考核方法等方面对课程教学提出了建议与尝试,激发了学生的学习兴趣,提高了兽医药理学的教学水平和教学质量。     

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.     

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.     

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.     

Communication skills training at the Atlantic Veterinary College, University of Prince Edward Island

Communication skills are considered a core clinical skill in human medicine. Recognizing the importance of communication skills and addressing them in veterinary curricula, however, is just beginning. In the fall of 2003, the Atlantic Veterinary College, University of Prince Edward Island, markedly changed the way in which it approaches communication teaching. An intensive one-week elective rotation on client communication was offered in the senior year. This rotation made extensive use of experiential techniques through the use of role plays and videotaped real client interactions. A group of faculty and hospital staff members were trained as coaches to support students as they practiced their communication in various client scenarios. The skills taught were based on the Calgary-Cambridge Observation Guide, which outlines observable behaviors that contribute to effective medical communication. Student response to and feedback on the rotation have been very positive. As a result, the number of rotations given per year has been increased. Long-term plans include expanding communication skills teaching into other years of the DVM program and incorporating simulated clients into the teaching program. Challenges that lie ahead include the development of a fully integrated communication teaching program that spans the whole curriculum, addressing the ongoing need for the professional development of coaches, improving methods of student assessment, and recruiting/training a sufficient number of coaches.     

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.     

One medicine, one university: the DVM/MPH program at the University of Illinois

The University of Illinois at Urbana-Champaign College of Veterinary Medicine (UIUC-CVM) and the University of Illinois-Chicago School of Public Health (UIC-SPH) are in the fourth year of a collaborative Doctor of Veterinary Medicine and Master of Public Health dual-degree program. The two campuses, one urban and one rural, are 150 miles apart but are sister schools within the University of Illinois system. This article describes the origin of the program, how the program functions across two campuses, its academic focus, required coursework, and research projects designed to fulfill the program's capstone requirements. The article shows how two campuses can be linked through a combination of online and on-site didactic coursework, briefly describes innovative proposals for projects within the United States and abroad, and highlights faculty committed to educating cross-trained public-health professionals while addressing the national need for veterinarians trained in public health. The authors also discuss how the dual-degree program has led to the formation of the Illinois Center for One Medicine, One Health (ICOMOH), an intra-university collaboration focusing on the interface of human, animal, and ecosystem health.     

Public health education at the University of California, Davis: past, present, and future programs

This article reviews the history of public-health education at the University of California, Davis, from the inception of the Master of Preventive Veterinary Medicine Program in the School of Veterinary Medicine through the creation of the Master of Public Health Program offered jointly by the Schools of Medicine and Veterinary Medicine. The long history of collaborative teaching and research between the schools, as well as the university's close proximity to and relationship with numerous university-affiliated and state public-health agencies, has created remarkable opportunities for novel and creative public-health education. The university is already anticipating the approval of a School of Public Health on its campus, which will create even more educational opportunities in both human and veterinary public-health disciplines. Given the projected shortfall of veterinarians entering such fields, the opportunity of a novel Doctor of Public Health degree program specifically suited to the needs of veterinary medicine is also discussed as a means of addressing this shortage.     

Animal welfare education in Turkey

Veterinary medical education in Turkey began in 1842 and is now offered by 17 universities. Since 1895, topics related to animal welfare have been covered as part of the curriculum in courses titled Deontology, Health Inspection, and Laws of Veterinary Medicine. During the 2004/2005 academic year, for the first time, animal welfare was included as a separate course as part of the curriculum in two veterinary faculties. As a result of curriculum adjustment efforts at both national and international levels, the animal-welfare course is now expected to be required for all veterinary students in Turkey. This study reports on the development of animal-welfare curricula in veterinary medical education in Turkey and describes the historical events from which the appreciation of it arose.     

Clinical veterinary students' perceptions of a 'Day one' skills guide

Veterinary schools in the UK are required by the Royal College of Veterinary Surgeons to ensure that their students have attained essential 'Day one' skills (DOS) by graduation. To aid students' understanding of how they could satisfy this requirement, the Royal Veterinary College produced a DOS guide, which was distributed in the 2007 to 2008 academic year to students in the third and fourth years of the professional veterinary course. The same students were surveyed towards the end of the 2008 to 2009 session about the guide, when they were in the fourth and final years, to rate its usefulness and to indicate their perceived levels of competence, both currently and expected at graduation. Focus group discussions were subsequently conducted to explore the findings of the survey. Responses from 88 fourth-year (39 per cent) and 174 (87 per cent) final-year students revealed that while almost all respondents were aware of the DOS guide, their use of it was low. Final-year students rated themselves as being more competent than fourth-year students, but were less optimistic about their expected level of competence regarding several invasive procedures, which some students considered to be 'unattainable' by graduation, despite the apparent value of extramural studies and intramural rotations in providing opportunities for learning.     

The University of California Veterinary Student Leadership Program: comparison of a five-day with a three-day course

Leadership skills can be learned and leadership activities can be stimulated with an effective educational program. The University of California, Davis, School of Veterinary Medicine has demonstrated and previously reported on the enthusiasm for and outcomes of their five-day leadership program for incoming veterinary students. The course was altered and again offered as a five-day program to the next veterinary class but, because of timing and limited resources, was reduced to three days the following year. Thirty students were accepted each year on a first-come first-served basis. This article compares the five-day and three-day program curricula and post-program evaluations. Although the students decided whether or not to participate, short-term effects of the programs were the introduction of a new vocabulary, improved confidence to become leaders, and stimulation of student participation in veterinary student leadership roles. A course like this can get students off to a good start, but it is very likely that to achieve a long-term effect, continued exposure throughout the veterinary curriculum is needed.     

Using focus groups to engage veterinary students in course redesign and development

Students' perceptions about the quality of teaching have been shown to influence their approaches to learning and studying. The literature suggests that understanding student perceptions is critical to making informed decisions about curriculum development so that courses meet objectives, enhance engagement, and, ultimately, improve learning. However, the assessment of students' perceptions of their courses and the quality of teaching is frequently limited to an end-of-term course evaluation survey. While these course evaluations may be useful in providing a summative assessment, they do not typically provide insight into the reasons and influences that underlie student ratings. Achieving this type of understanding can be accomplished through qualitative methodology, which is a process of investigation used to reveal the depth, complexity, and nuances of perceptions and experiences. In the current article, we report the use of focus groups as a method of gaining in-depth understanding of student perceptions for course redesign. We present the redesign of the Art of Veterinary Medicine II course, a second-year core offering within the Doctor of Veterinary Medicine curriculum at the Ontario Veterinary College in Guelph, Canada. A series of student focus groups were held to gain greater insight into student perceptions of the course objectives, format, and content. Findings were then considered in the redevelopment of the course to better engage students and their various learning styles. Summative course evaluations as well as informal feedback before and after the focus groups indicate a notable improvement in student experiences and perceptions of the course format and content following the focus-group informed course redesign.     

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.     

Emergency medicine clerkship: a joining of private-practice referral veterinary medicine with an academic institution

Novel approaches to the clinical training of veterinary students in many disciplines are being sought by veterinary colleges. In 2004, the University of Florida College of Veterinary Medicine approached the Small Animal Department and Florida Veterinary Specialists (FVS) in Tampa with a proposal to jointly design and run an elective clerkship in emergency medicine. The program would focus on providing increased emergency case exposure in a real-world environment to interested third- and fourth-year veterinary students. The purpose would be to better prepare these students for emergent cases while increasing their overall level of clinical confidence. This article reviews in detail the clerkship structure, its objectives, and the logistics of training and support at FVS. In this instance, the academic-private institution partnership has been successful in providing effective learning for veterinary students over the last three years. This clerkship structure may serve as a template for other institutions exploring alternatives to the traditional clinical training of veterinary students.