Advanced imaging: use and misuse

SUMMARY: The primary purpose of diagnostic imaging is to enable clinicians to make correct decisions about a patient's diagnosis and severity of its condition and, thereby, to contribute to effective and efficient treatment. Advanced imaging modalities are inherently better detectors of morphological lesions than radiography; hence, they offer the possibility of more accurate diagnosis and staging, with correspondingly better patient outcomes. However, there is a lack of evidence that better outcomes are being realised for veterinary patients. Furthermore, increased use of advanced imaging carries the possibility of increased misuse, primarily through unnecessary studies that contribute little to patient management other than increased costs. SCOPE: This article is intended to be relevant to all veterinary species. Advanced imaging of cats is not sufficiently developed as a specific discipline that a balanced review could be based purely on feline examples or references.     

The building blocks in the professional education process that lead to best practices and quality medicine

It is time for the faculty of veterinary colleges to take responsibility for the veterinary curriculum, to move beyond the debate over teaching styles, and to understanding what a curriculum needs to accomplish. Our challenge is to engage students, faculty, and all veterinary professionals in evidence-based medicine and medical outcomes assessment and to identify best practices and continually improve the quality of veterinary health care. The education program of students must lay the foundation for this essential approach to veterinary practice.     

Quality commitment and management in veterinary education

This article provides an overview of how quality assurance is developing as a major component of the evaluation of establishments of veterinary education in Europe and, hence, of the evaluation of the veterinary training provided. Also discussed are the ways in which education in veterinary medicine in Europe is currently regulated and assessed and how this assessment is evolving. Major attention is paid to quality indicators, quality-assurance implementation, the development of a culture of quality in veterinary education within Europe, quality assurance for certification or accreditation of such schools, and promoting the development of a global network of evaluation of veterinary education.     

Education of veterinary medical and other public health providers: linking interventions with health outcomes

A systematic literature review was performed to summarize the nature, implementation, outcomes, and long-term impacts of previously instituted interventions and programs aimed at educating veterinary public health providers. A logic model was developed to direct the literature search strategy, provide a framework for evaluating the relationship between veterinary public health professional education and their associated population health outcomes, and guide future training development and recommendations for the education of veterinary health professionals. Our literature review indicates that there is a relative lack of published literature that connects veterinary public health educational interventions to population health outcomes. Reasons for the lack of evidence to connect educational programs and population health outcomes include the evaluation of outcomes on a short-term rather than intermediate- or long-term basis, a lack of experimental studies, and infrequent grounding in population health or educational theory. Future intervention recommendations as suggested in the reviewed articles are also summarized.     

Basic concepts in statistics for veterinary ophthalmologists

Abstract This review article provides a comprehensive coverage of basic statistical procedures commonly used in biologic experiments and is intended to be a basic guide to the selection of appropriate tests and also to aid the reader in the evaluation of published studies. The focus is on the use, interpretation and presentation of the main statistical tests and their key concepts for the practicing veterinary ophthalmologist. Several examples derived from actual ophthalmic research are presented in the text. Lastly, the article discusses computer-based statistical analysis, provides a list of different software available and gives a practical example of a 'real life' statistical analysis.     

Accreditation of veterinary schools in Australia and New Zealand

Veterinary schools in Australia and New Zealand are assessed for accreditation purposes every six years by the Veterinary Schools Accreditation Advisory Committee (VSAAC), which is a standing committee of the Australasian Veterinary Boards Council (AVBC).1 Prior to undertaking an assessment, VSAAC requests a Self Evaluation Report from the school and subsequently spends a week on site to collect additional information. The committee also takes into consideration other quality assurance procedures within the university and aims for a process that complements other evaluation activities. Internal evaluation procedures within VSAAC are designed to reflect the process and outcomes of each visit and lead to annual revisions of the publication Policies, Procedures and Guidelines publication. The committee has close links with the Royal College of Veterinary Surgeons (RCVS), and there is a routine exchange of observers on all visits in the United Kingdom and Australasia. In recent years VSAAC has become increasingly interested in looking at ways to place greater emphasis on the outcomes of veterinary education and, eventually, to reduce our reliance on input measures. There has been good progress in identifying desirable attributes for veterinary graduates, but further work is needed to establish the reliability of assessment procedures. The Australasian accreditation system is very supportive of recent moves to achieve greater compatibility of veterinary accreditation systems in different parts of the world because we believe it has the potential to assist globalization of animal disease control and veterinary education.     

Veterinary practice management education in the Association of American Veterinary Medical Colleges member colleges during 1999

Most veterinary students enrolled at AAVMC member institutions take at least 1 VPM course prior to graduation. These courses are characterized by widespread involvement of outside lecturers with business expertise, which likely adds to their strength. However, it remains that wide variation in VPM education exists across the AAVMC with regard to the topics addressed, the specific business expertise of faculty and administrative course specifics. As such, the situation provides several key opportunities. Foremost among these is the immediate need for profession-wide discourse on VPM education to define reasonable expectations with regard to the business skills of veterinary graduates. In addition, outcomes assessment would provide information on which of the widely varying approaches to VPM education is most likely to produce successful graduates. The opportunity also exists for development of academic research programs to support VPM education directly by strengthening the related disciplinary knowledge base. Effective leadership for these efforts will be crucial to their success.     

An alumni survey to assess self-reported career preparation attained at a US veterinary school

The American Veterinary Medical Association (AVMA) Council on Education (COE) has challenged veterinary schools to improve self-assessment of curricular outcomes. One way to assess the quality of education is to gather feedback from alumni. To successfully gather feedback using a questionnaire, questions must be pertinent to veterinary education and include quantifiable responses. Several principles must be applied in questionnaire development to ensure that the questions address the intended issues, that questions are interpreted correctly and consistently, and that responses are quantifiable. The objectives of the questionnaire for alumni of Mississippi State University's College of Veterinary Medicine (MSU-CVM) were twofold: (1) to determine whether graduates were comparable to their US peers in terms of work opportunities and salary, and (2) to evaluate how well the CVM curriculum prepared students to begin their veterinary careers. Demographic categories used by the AVMA and published knowledge, skills, attitudes, and aptitudes of veterinary graduates were used in developing the questions. College-specific questions, such as those relating to student activities and impressions of college resources, were also incorporated. Questionnaires were mailed to participants, who could respond via the World Wide Web. Questionnaire results allowed leaders within the college to determine which aspects of alumni's experiences were exceptionally positive, which needed immediate response, and which might require further study. This article describes the application of principles in developing, administering, and analyzing responses to a questionnaire regarding veterinary education.     

Workplace-based assessment in a primary-care setting

Workplace-based assessment (WBA) is the process of directly observing students' work within a clinical setting, assessing their performance, and providing specific, goal oriented feedback. Assessment methods used for workplace-based assessment include tools developed for clinical interaction (e.g., the mini clinical evaluation exercise [mini-CEX]), for procedural or technical skills (e.g., the direct observation of procedural skills [DOPS]), and multi-source feedback tools to assess interpersonal and technical skills. While several of these assessment methods are being adopted by veterinary schools to evaluate students' progress through their clinical rotations, there is little reported at this time about their utility and effectiveness within the veterinary context. This article provides an introduction to the use of these tools and offers guidance in selecting appropriate methods for assessment in the primary health care setting.     

Personal and professional development in undergraduate health sciences education

During the last decade, 'medical professionalism' has been scrutinized as a consequence of pressures from within and outside the health sciences professions. In response, professional organizations have reviewed ethical principles and developed explicit guidelines for the behavior of their members. Medical educators have revised undergraduate curricula with a view to supporting the development and maintenance of these essential professional behaviors. This article outlines perspectives on professionalism before describing the evolution of personal and professional development curricula in undergraduate health science education. While the bulk of data on personal and professional development in the health sciences has come from human medicine, the principles are being recognized as applying to the breadth of the health professions. In the veterinary profession, the dyad of the physician-patient relationship of human medicine is expanded to the triad of the veterinarian-patient-client relationship, and this brings with it an added set of professional relationships and responsibilities. In order to be faithful to the primary literature and not expand beyond the various authors' data and conclusions, this article is presented principally in the terms of human medical education. For those in veterinary education, it is hoped that the inferences and applications will be readily apparent. In this article, challenges associated with defining content and educational methods are outlined, as well as selection criteria for medical school and promoting the value of PPD to students. Approaches to assessment, implementation, and evaluation of PPD curricula are also discussed. Two case studies are presented. The article concludes with suggestions for curriculum development.     

Assessment of quality of life in equine patients

Reasons for performing study: Assessing patients' quality of life (QOL) is a core part of clinical decision making. Various methodologies for assessing patients' QOL have been developed in human medicine and small animal veterinary disciplines. In contrast, the lack of aids for QOL assessment in equine veterinary practice leaves practitioners reliant on subjective assessments of QOL, which may be prone to avoidable errors. Objectives: This paper suggests pragmatic ways in which QOL may be enhanced, while remaining appropriate for the time, financial and owner‐based constraints within equine practice. Methods: Through interdisciplinary research, this paper identifies, adapts and applies insights from several areas of research and practical experience in order to develop an overarching approach to making QOL‐based decisions in clinical cases. Results: The paper identifies 6 steps involved in QOL‐based decision making and provides examples of how these steps may be practically applied. These include deciding what each clinician feels is important; deciding how to evaluate it, including taking owners' views into consideration; making decisions about each case and achieving the desired clinical outcomes. Conclusions: Practitioners can draw their own conclusions on how they may improve QOL assessment in practice and may usefully share these with colleagues. Reporting cases and sharing practical examples of QOL tools used on the ground are vital to the development of this field and appropriate methodologies. Potential relevance: Improvements in QOL assessment are relevant to all areas of equine veterinary practice, and several areas of research. Further research may develop QOL assessment in practice, but more important are the personal improvements that each practitioner may achieve. See also correspondence by Grove     

An overview of veterinary medical education in China: current status, deficiencies, and strategy for improvement

Especially in developing countries, the profession of veterinary medicine is closely tied with agriculture and government economic development, the national structure of education, and national public health. Currently, the Chinese veterinary medical educational system and accreditation standards are distinctly different from those of some more developed countries, such as the United States, Japan, or the countries of the European Union. Chinese veterinary education is still closely based on traditional Chinese education approaches and standards, which has led to some deficiencies in the Chinese system. With the development of a stronger economy in China and the growing trend toward globalization, and particularly since China joined the World Trade Organization (WTO), some important questions about China's system of veterinary education are being raised: How can veterinary science develop more rapidly in China? How can it meet the needs of the growing Chinese society? How can China bring its veterinary medical practice more in line with that of other, more advanced countries? This article describes some of the realities of veterinary medical education in China, discusses several existing problems, and puts forward some ideas for possible reforms. It is hoped that by this means those outside China may gain insight into our veterinary education program and that this, in turn, will lead to helpful input from international educators and other professionals to help improve our programs.     

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.     

ASVCP quality assurance guidelines: control of general analytical factors in veterinary laboratories

Owing to lack of governmental regulation of veterinary laboratory performance, veterinarians ideally should demonstrate a commitment to self-monitoring and regulation of laboratory performance from within the profession. In response to member concerns about quality management in veterinary laboratories, the American Society for Veterinary Clinical Pathology (ASVCP) formed a Quality Assurance and Laboratory Standards (QAS) committee in 1996. This committee recently published updated and peer-reviewed Quality Assurance Guidelines on the ASVCP website. The Quality Assurance Guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports on 1) general analytic factors for veterinary laboratory performance and comparisons, 2) hematology and hemostasis, and 3) clinical chemistry, endocrine assessment, and urinalysis. This report documents recommendations for control of general analytical factors within veterinary clinical laboratories and is based on section 2.1 (Analytical Factors Important In Veterinary Clinical Pathology, General) of the newly revised ASVCP QAS Guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimum guidelines for quality assurance and quality control for veterinary laboratory testing. It is hoped that these guidelines will provide a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts.     

Compliance: crafting quality care.

The concept of compliance involves the consistency and accuracy with which a client follows the regimen recommended by the veterinarian or other veterinary health care team member. Contrary to common belief, most compliance failures are not the direct result of a client's unwillingness to comply. This article will help the reader better appreciate the critical importance of effective communication by the entire veterinary health care team in achieving compliance. Success is predicated on an alliance between the practice team and the client. Certain paradigms surrounding compliance in veterinary practice are discussed, and the positive outcomes of compliance, including optimal patient care, exceptional client service, employee career growth, and economic ramifications, are explored.     

Experiences and difficulties encountered during a course on veterinary public health with students of different nationalities

Veterinary public health (VPH) issues have received increased attention over the last few years as a result of the rising threat of emerging zoonoses (i.e., those due to globalized trade in animal and animal products and to changes in livestock production systems and the environment). The international dimension of VPH is gradually becoming recognized, and there is a growing need for veterinarians with experience in this field. In order to familiarize (future) veterinarians with the international dimension of VPH, the Department of Public Health and Food Safety of the Faculty of Veterinary Medicine, Utrecht University, has been organizing a course in Veterinary Public Health and Animal Production for over the last 10 years. This course has been intended for Dutch as well as foreign final-year veterinary students and recent veterinary graduates. By bringing together participants from different countries, the course reinforces the international dimension of the issues addressed through the exchange of experiences by the participants themselves. The present article provides information about this course on Veterinary Public Health (VPH): it discusses logistics, didactical approaches, the course program, and the use of information and communication technology (ICT). Special attention is given to the intercultural aspects of higher education, all of which play an important role in the efficient exchange of knowledge between lecturers and students. International courses are an important tool to enable participants to interact in a multicultural environment and address issues that demand international cooperation and a global public health focus.     

Veterinary public health in a problem-based learning curriculum at the Western University of Health Sciences

As detailed in the Association of Schools of Public Health / Association of American Veterinary Medical Colleges 2007 Joint Symposium on Veterinary Public Health, veterinary public health (VPH) can no longer be viewed as a unique sub-specialty of veterinary medicine. Rather, its practice pervades nearly every aspect of the veterinary profession, regardless of whether the practitioner is engaged in small-animal, large-animal, research, corporate, or military practice. In congruence with the practice of VPH, the teaching of VPH should also pervade nearly every aspect of veterinary education. Accordingly, at Western University of Health Sciences, College of Veterinary Medicine (WU-CVM), public health is not simply taught as an individual course but, rather, is interwoven into almost every aspect of the curriculum, continually emphasizing the relevance of this discipline to the practice of veterinary medicine. This article outlines the teaching philosophy of WU-CVM, provides an overview of the curriculum, and describes the integral nature of public health throughout all four years of the educational program.     

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.     

Current perspectives on distance education in veterinary medicine

A brief review of technologies currently used in distance-education endeavors in veterinary curricula is presented. The article provides the results of a survey on how distance education has been used in veterinary curricula.     

The use of information and communication technology in veterinary education

The internet provides new opportunities to deliver distance and e-learning to the veterinary profession both at undergraduate and postgraduate levels. There are now numerous examples of successful computer-based educational projects in UK higher education, which provide useful models for veterinary science. This will present challenges for academics who will need to adapt their teaching methodologies and students who will have to develop new ways of learning. The future of Information and Communication Technologies (ICT) in the veterinary sector is difficult to predict but it is likely to have far reaching effects on the profession.