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.     

Veterinary school consortia as a means of promoting the food-supply veterinary medicine pipeline

Ideas about centers of emphasis and veterinary medical teaching consortia have resurfaced to attract students into food-supply veterinary medicine (FSVM). From 1988 to 2000 a multiple veterinary school consortium approach to food-animal production medicine (FAPM) teaching was conducted to handle regional differences in case load, faculty strengths, and student interests. Six universities developed a memorandum of understanding to provide a wide variety of in-depth, species-specific clinical experiences in FAPM to balance their individual strengths and weakness in addressing food-animal agriculture, to provide for student exchange and faculty development, and to conduct research in food safety. Changes in leadership, redirection of funds, failure to publicize the program to faculty and students, and a focus on research as opposed to teaching led to dissolution of the consortium. However, this approach could work to improve recruitment and retention of students in FSVM if it focused on student exchange, fostered a more integrated curriculum across schools, encouraged faculty involvement, garnered institutional support, and used modern technology in teaching. Private veterinary practices as well as public/corporate practices could be integrated into a broader food-animal curriculum directed at building competency among FSVM students by providing the in-depth training they require. Requirements for the success of this type of program will include funding, marketing, leadership, communication, coordination, integration, and dedicated people with the time to make it work.     

Factors that influence the decision to pursue an internship: the importance of mentoring

The purpose of the present study was (1) to determine if students from one veterinary school who participated in a mentoring/employment program with clinical faculty were more likely to pursue internship training than their peers and (2) to determine factors via survey that were influential to veterinary interns in making their decision to pursue post-graduate clinical training. Our hypothesis was that a mentoring relationship with clinical faculty was an important influence on the decision to participate in an internship. From 2006 to 2010, graduating students who participated in a mentoring/employment program with a clinical faculty member were 6.3 times more likely than non-participating students to pursue an internship. The majority of the participating students (90%) were initially hired/mentored as first- or second-year veterinary students. In the survey, interns ranked clinical faculty as having a greater influence than basic science faculty, private practice veterinarians, or house officers on their decision to pursue an internship; 82.8% reported that clinical faculty were most responsible for encouraging them to apply for an internship. Employment by their veterinary teaching hospital (41.5%) or directly by clinical faculty (26.2%) was commonly reported. Most interns (37%) decided to pursue an internship during their fourth year of veterinary school, 29.2% decided during their first year, and 15.3% decided in their second year. These results suggest that clinical faculty play a key role in a student's decision to pursue an internship and that it might be valuable to inform students about internships early in the veterinary curriculum.     

Increased student self-confidence in clinical reasoning skills associated with case-based learning (CBL)

Second-year veterinary students were surveyed at the beginning and end of a 15-week semester regarding their confidence in performing three clinical reasoning skills: (1) making Problem Lists; (2) making Rule-Out Lists; and (3) selecting appropriate diagnostic tests. Each week during the semester, these skills were practiced in small-group case discussions. Changes in self-confidence were analyzed and studied in light of faculty assessments of student competence in performance of the three skills. RATIONALE: The purpose of the study was to determine if students' self-confidence in performing three clinical reasoning skills increased with practice. METHODOLOGY: On the first and last days of class, students rated their confidence in each of the three skills on a scale of 0 to 10. Mean confidence scores for the whole class both for time points and for each of the three skills were analyzed. RESULTS: There were significant increases in students' self-confidence in all three clinical reasoning skills over the semester each year. A greater percentage of students expressed improved confidence in selecting appropriate diagnostic tests than in the other two skills in three of the four years studied. CONCLUSIONS: Students' self-confidence in performing three clinical reasoning skills improved over the course of a semester in which they practiced the skills in a CBL format. Subjective faculty assessment of students' competence in these skills generally indicated improvement. However, no meaningful conclusions about the correlation of skill competence and student confidence could be drawn because of inadequacies in the measurement of student performance.     

Two students' reflections on their training in animal handling at the University of Sydney

Basic animal-handling skills are essential for any veterinary practitioner to work safely and confidently. This short article offers the reflections of two students who undertook training in basic animal-handling skills at the University of Sydney as part of the Veterinary Science degree program. Several students attending their final-year clinical rotation at the University of Sydney were asked to informally assess their own basic animal-handling skills at the beginning of the course and in their final year. These perceptions were matched to career choices and demonstrated the positive effect of skills training in career choice. As with any skills-based training program, limitations such as time and finances place restrictions on student learning, and there is a continual need to assess and, where possible, make improvements to the program.     

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.     

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.     

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.     

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.     

Training evidence-based veterinary medicine by collaborative development of critically appraised topics

In current veterinary education, skills such as retrieving, critically appraising, interpreting, and applying the results of published scientific studies are rarely taught. In this study, the authors tested the concept of team-based development of critically appraised topics (CATs) in training students in evidence-based veterinary medicine (EBVM). The 116 participants were in their fifth year and attending the clinical rotation at the Clinic for Animal Reproduction. Students developed 18 CATs of varying quality on topics of their choice. Preparing the CATs in teams stimulated discussion on the topic and the quality of the retrieved papers. Evaluation of the project revealed that more than 90% of the students endorsed training in critical appraisal of information in veterinary education. In addition, more than 90% considered the development of CATs an effective exercise for assessing the quality of scientific literature. A provided literature evaluation form was perceived as a useful tool for systematically summarizing a publication's quality. In conclusion, team-based development of CATs during clinical rotations is highly valuable for training in EBVM. Learning and intrinsic motivation seem to be enhanced by creating a situation similar to veterinary practice because the task is embedded into an authentic clinical problem. This approach to clinical training helps to prepare students to integrate evidence from literature into practice.     

Assessment of clinical reasoning skills in veterinary students prior to and after the clinical year of training

OBJECTIVE: To examine the effect of various clinical tracks within the veterinary medical clinical curriculum at Texas A&M University on clinical diagnostic proficiency as determined by pre- and post-training assessment. We expected that the clinical track chosen by the student would impact their measured outcome with bias toward higher scores in their chosen field. DESIGN: Prospective cohort study. STUDY POPULATION: 32 students from the College of Veterinary Medicine and Biomedical Sciences at Texas A&M University. PROCEDURES: By use of standardized, written case scenarios, clinical reasoning was assessed twice: once prior to the clinical (fourth) year of the curriculum and again at completion of the clinical year. Students demonstrated their abilities to collect and organize appropriate clinical data (history, physical examination, and laboratory findings), determine clinical diagnoses, and formulate and implement acceptable treatment modalities. Data from clinical assessments were compared for a given cohort and correlated with other measures (eg, grades, standardized test scores, and species-specific curricular track). RESULTS: Differences were detected in clinical diagnostic proficiency among students in different clinical tracks and for different species groups in the case scenarios. Tracking by species group in the clinical veterinary curriculum appeared to affect development of clinical reasoning and resulted in differential proficiency among cases for differing species groups. CONCLUSIONS AND CLINICAL RELEVANCE: Differences in clinical experiences between small animal tracks and all other track opportunities (large animal, mixed animal, and alternative) influenced the development of clinical proficiency in fourth-year veterinary students during their clinical training period.     

Preparing students for careers in food-supply veterinary medicine: a review of educational programs in the United States

The real and/or perceived shortage of veterinarians serving food-supply veterinary medicine has been a topic of considerable discussion for decades. Regardless of this debate, there are issues still facing colleges of veterinary medicine (CVMs) about the best process of educating future food-supply veterinarians. Over the past several years, there have been increasing concerns by some that the needs of food-supply veterinary medicine have not adequately been met through veterinary educational institutions. The food-supply veterinary medical curriculum offered by individual CVMs varies depending on individual curricular design, available resident animal population, available food-animal caseload, faculty, and individual teaching efforts of faculty. All of the institutional members of the Association of American Veterinary Medical Colleges (AAVMC) were requested to share their Food Animal Veterinary Career Incentives Programs. The AAVMC asked all member institutions what incentives they used to attract and educate students interested in, or possibly considering, a career in food-supply veterinary medicine (FSVM). The problem arises as to how we continue to educate veterinary students with ever shrinking budgets and how to recruit and retain faculty with expertise to address the needs of society. Several CVMs use innovative training initiatives to help build successful FSVM programs. This article focuses on dairy, beef, and swine food-animal education and does not characterize colleges' educational efforts in poultry and aquaculture. This review highlights the individual strategies used by the CVMs in the United States.     

Teaching the didactic aspects of ophthalmology and dermatology using an off-site instructor

A shortage of veterinary educators in various clinical disciplines is requiring faculty at veterinary schools to develop novel approaches to teaching professional students a core of information in each major clinical discipline. This article presents experiences at Washington State University (WSU) College of Veterinary Medicine in the teaching of the didactic components of ophthalmology and dermatology over four years using pre-prepared lectures developed by off-site instructors. The methodology of lecture preparation and presentation and various perspectives of student satisfaction with this teaching/learning method are presented.     

Evaluation of the expectations, learning and competencies of surgical skills by undergraduate veterinary students performing canine ovariohysterectomies

Objectives : To investigate the development of surgical skills of veterinary undergraduates and determine the number of canine ovariohysterectomies required to achieve competency and reduce levels of student concern. This was compared to student expectations and that of employers regarding surgical ability and provision of support to new graduates. Methods : A questionnaire regarding surgical concerns was sent to final year veterinary students enrolled within the University of Bristol, UK. A questionnaire was also sent to 200 UK veterinary practices regarding their impressions of surgical competence of new graduates and their provision of supervision. The responses were compared. Eleven additional final year students performed five canine ovariohysterectomies and graded their concerns. The number of supervised canine ovariohysterectomies required until competency was determined. Results : 80·4% of final year veterinary undergraduates replied that the surgical procedure which they were most concerned about their ability to perform was canine ovariohysterectomy. Students and veterinary practitioners differed in their opinions regarding whether they considered canine ovariohysterectomy to be a “day one skill” and what were desirable levels of supervision. Completing a minimum of four canine ovariohysterectomies led to 81·8% of students being assessed as competent. Clinical Significance : An unrealistically high expectation of competency by students may be a source of stress and concern. Employers should aim to provide hands‐on support whilst new graduates complete at least four canine ovariohysterectomies. Postoperative haemorrhage is uncommon but is the main concern for students.     

A historical overview of African American veterinarians in the United States, 1889- 2000

The annals of veterinary medical history rarely mention the presence of African American veterinarians and other minorities. Between 1889 and 1948, records show, a meager 70 African Americans graduated from veterinary schools in the United States and Canada. It was not until the veterinary school at Tuskegee (Institute) University was established in 1945 that a significant increase in the number of African American veterinarians occurred in the United States, and over the ensuing years their participation in every facet of the profession has been striking. Their employment in various areas of the profession and their successful performance in the workforce have done much to dispel stereotypical perceptions about minorities. Despite demographic data indicating that the United States is moving rapidly toward a multicultural society, recruitment programs to increase the number of African American students and faculty at the 27 US veterinary colleges have not kept pace with the declared goals of ethnic diversity. If the needs of a changing culture are to be met, veterinary medical education must look toward more ethnic inclusion in the student body and faculty. To that end, the Iverson C. Bell Symposium has consistently advocated the adoption of new and creative methods for increasing minority student enrollment and expanding faculty opportunities in the nation's veterinary colleges.     

Developing and fostering a dynamic program for training in veterinary pathology and clinical pathology: veterinary students to post-graduate education

Recent reports project a deficiency of veterinary pathologists, indicating a need to train highly qualified veterinary pathologists, particularly in academic veterinary medicine. The need to provide high-quality research training for veterinary pathologists has been recognized by the veterinary pathology training program of the Ohio State University (OSU) since its inception. The OSU program incorporates elements of both residency training and graduate education into a unified program. This review illustrates the components and structure of the training program and reflects on future challenges in training veterinary pathologists. Key elements of the OSU program include an experienced faculty, dedicated staff, and high-quality students who have a sense of common mission. The program is supported through cultural and infrastructure support. Financial compensation, limited research funding, and attractive work environments, including work-life balance, will undoubtedly continue to be forces in the marketplace for veterinary pathologists. To remain competitive and to expand the ability to train veterinary pathologists with research skills, programs must support strong faculty members, provide appropriate infrastructure support, and seek active partnerships with private industry to expand program opportunities. Shortages of trained faculty may be partially resolved by regional cooperation to share faculty expertise or through the use of communications technology to bridge distances between programs. To foster continued interest in academic careers, training programs will need to continue to evolve and respond to trainees' needs while maintaining strong allegiances to high-quality pathology training. Work-life balance, collegial environments that foster a culture of respect for veterinary pathology, and continued efforts to reach out to veterinary students to provide opportunities to learn about the diverse careers offered in veterinary pathology will pay long-term dividends for the future of the profession.     

The complex role of veterinary clinical teachers: how is their role perceived and what is expected of them?

The purpose of this study was to identify personal attributes in veterinary clinical teachers that are valued most by members of their work environment (fellow faculty, clinical training scholars [CTS; residents], undergraduate students, and referring veterinary surgeons) and to determine whether the opinions of these subgroups differed. Faculty (n=50), CTS (n=35), students (n=200), and referring veterinary surgeons (n=25) were presented with a list of 15 potentially desirable attributes. Respondents were asked to rank the three most important and the three least important attributes of effective clinical teachers. Respondents were also asked to select in which of the three main activities (clinical service, teaching, or research) in which clinical teachers currently invest the most and the least effort and in which they should invest the most and the least effort. All respondent groups agreed that "competence-knowledge" was among the most desirable attributes. Faculty, undergraduate students, and referring veterinary surgeons additionally included "enthusiasm" in the top three, whereas CTS regarded "respects independence" as more important. All respondent groups consistently chose "scholarly activity" as one of the three least important characteristics. A similar number of faculty members (38%) expressed that the greatest effort should be invested in clinical service or teaching, and the greatest proportions of CTS (44%) and students (56%) felt that most emphasis should be put on teaching alone. The differences in opinion between respondent groups regarding importance of attributes and emphasis of activity indicate that what is perceived as effective performance of clinical teachers differs depending on the role of those who engage with them.     

The scientific component of residency training

This article focuses on the role of veterinary teaching hospitals (VTHs) at public and private colleges and universities in the growth and nurturing of today's veterinary clinician scientists, who will assume the ranks of tomorrow's veterinary academic faculty. Virtually all residency programs offer some level of scientific education and training concurrently or sequentially with professional clinical training; approximately half (51%) include, or at least offer, the opportunity to obtain advanced scientific degrees (MS/MSc and/or PhD). If veterinary schools and colleges are the gatekeepers for the veterinary profession, then VTHs are the gatekeepers for the profession's scientific development, defining the future role of veterinary medicine in society. Although struggling to find their place in a financially challenging and competitive environment fueled by the demand for more and better clinical services, VTHs are in a potentially strong position to capitalize on the uniqueness of their faculty and academic resources and thus make an unparalleled contribution to the scientific evolution of the veterinary profession.     

USE OF A NOVEL BOARD GAME IN A CLINICAL ROTATION FOR LEARNING THORACIC DIFFERENTIAL DIAGNOSES IN VETERINARY MEDICAL IMAGING

When confronted with various findings on thoracic radiographs, fourth‐year veterinary students often have difficulty generating appropriate lists of differential diagnoses. The purpose of this one‐group, pretest, posttest experimental study was to determine if a game could be used as an adjunct teaching method to improve students’ understanding of connections between imaging findings and differential diagnoses. A novel board game focusing on differential diagnoses in thoracic radiography was developed. One hundred fourth‐year veterinary students took a brief pretest, played the board game, and took a brief posttest as a part of their respective clinical radiology rotations. Pretest results were compared to posttest results using a paired t‐test to determine if playing the game impacted student understanding. Students’ mean scores on the posttest were significantly higher than mean pretest scores (P < 0.0001). Thus, results indicate that playing the board game resulted in improved short‐term understanding of thoracic differential diagnoses by fourth‐year students, and use of the board game on a clinical rotation seems to be a beneficial part of the learning process.