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.     

Quality documentation challenges for veterinary clinical pathology laboratories

An increasing number of veterinary laboratories worldwide have obtained or are seeking certification based on international standards, such as the International Organization for Standardization/International Electrotechnical Commission 17025. Compliance with any certification standard or quality management system requires quality documentation, an activity that may present several unique challenges in the case of veterinary laboratories. Research specifically addressing quality documentation is conspicuously absent in the veterinary literature. This article provides an overview of the quality system documentation needed to comply with a quality management system with an emphasis on preparing written standard operating procedures specific for veterinary laboratories. In addition, the quality documentation challenges that are unique to veterinary clinical pathology laboratories are critically evaluated against the existing quality standards and discussed with respect to possible solutions and/or recommended courses of action. Documentation challenges include the establishment of quality requirements for veterinary tests, the use or modification of human analytic methods for animal samples, the limited availability of quality control materials satisfactory for veterinary clinical pathology laboratories, the limited availability of veterinary proficiency programs, and the complications in establishing species-specific reference intervals.     

Using the World Wide Web to enhance the problem-solving skills of third-year veterinary students

A Web site was created for the small animal problem-solving elective at Virginia Tech. In addition to signalment, history, physical examination findings, and results of routine laboratory tests, students were able to view images of cytologic and histologic specimens, radiographs, and endoscopic findings and hear examples of breath and cardiac sounds. Students commented that the availability of Web-based case materials allowed them increased opportunities to practice problem-solving skills.     

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

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

Effects of formal training in communication skills on the ability of veterinary students to communicate with clients

All UK veterinary schools have recently introduced small group teaching of communication skills for undergraduates. This study evaluates the effectiveness of this approach in improving the ability of students to communicate with clients in clinical situations. Three groups of clinical veterinary students with either no training or different levels of formal training in communication skills were assessed on their ability to communicate with clients at a local charity clinic. The students' communication skills were assessed quantitatively by direct observation during the consultation and by subsequent questioning of the clients. The accuracy of the clients' recall of relevant information about the animal's condition, medication and management was also analysed. The student groups were then compared on the basis of the scores they obtained. There was a significant improvement in the students' communication skills with increasing levels of training (P<0.0001). The group with the highest level of training consistently achieved higher rankings and median scores than the other two. When appraised by clients, this group significantly outranked both the other groups, but there was no difference between the group with no training and the group with an intermediate level of training. The clients' recall of information given in the consultation was more variable; but the group with the highest level of training achieved higher rankings in all the areas of client recall except for the animal's medication.     

Assessment of first-year veterinary students' clinical skills using objective structured clinical examinations

The DVM program at the University of Calgary offers a Clinical Skills course each year for the first three years. The course is designed to teach students the procedural skills required for entry-level general veterinary practice. Objective Structured Clinical Examinations (OSCEs) were used to assess students' performance on these procedural skills. A series of three OSCEs were developed for the first year. Content was determined by an exam blueprint, exam scoring sheets were created, rater training was provided, a mock OSCE was performed with faculty and staff, and the criterion-referencing Ebel method was used to set cut scores for each station using two content experts. Each station and the overall exam were graded as pass or fail. Thirty first-year DVM students were assessed. Content validity was ensured by the exam blueprint and expert review. Reliability (coefficient α) of the stations from the three OSCE exams ranged from 0.0 to 0.71. The three exam reliabilities (Generalizability Theory) were, for OSCE 1, G=0.56; OSCE 2, G=0.37; and OSCE 3, G=0.32. Preliminary analysis has suggested that the OSCEs demonstrate face and content validity, and certain stations demonstrated adequate reliability. Overall exam reliability was low, which reflects issues with first-time exam delivery. Because this year was the first that this course was taught and this exam format was used, work continues in the program on the teaching of the procedural skills and the development and revision of OSCE stations and scoring checklists.     

Faculty expectations of veterinary students in clinical rotations

Expectations of veterinary students during clinical rotations should be developed with the goal of bettering the veterinary profession as a whole. This article outlines five areas of expectations for the veterinary professional: treating colleagues with respect, providing excellent care for patients and clients, developing and maintaining skill sets to support intellectual curiosity and continued professional development, and improving upon and using self-care and life-balance skills.     

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 veterinary clinical pathology to undergraduate students: an integrated European project

BACKGROUND: Veterinary clinical pathology is a relatively new and emerging discipline in Europe that has gained momentum with the recent establishment of a specialty college. In this situation, veterinary faculties may face challenges in understanding and defining what clinical pathology is and how it can best be integrated into existing curricula. In addition, many schools in Europe may not yet have available a critical mass of suitably qualified faculty capable of teaching in all areas of clinical pathology. OBJECTIVE: The main purpose of this report is to describe the goals, procedures adopted, teaching material produced, and proposed future activities of a major European initiative designed to develop a veterinary clinical pathology curriculum. METHODS: Four working subgroups were formed to establish a list of course objectives and topics and prepare a series of lectures. These contents were reviewed and discussed several times at a series of general meetings. RESULTS: An undergraduate course on veterinary clinical pathology was designed with course objectives, a list of topics and a CD-ROM consisting of 24 lectures. CONCLUSIONS: The results of this project could be useful in the establishment or improvement of training programs in veterinary clinical pathology at the undergraduate level in Europe and in other places around the world. The provision of teaching resources for faculty could help to instill in veterinary students a strong understanding of the discipline and promote development of advanced training programs and career opportunities in clinical pathology in Europe.     

Effective use of simulations for the teaching and acquisition of veterinary professional and clinical skills

Simulation technology will feature prominently in this exciting, yet challenging, time for veterinary medicine. The profession is evolving to keep pace with rapid changes in clinical practice, scientific discovery, and educational strategy, while ensuring that it follows the public mandate to produce competent veterinarians. Among the challenges to meeting this educational goal are limitations-due to important issues such as animal welfare-on the availability of real patients for training. Drawing chiefly on the experience in human medicine, this article explores the use of simulations in veterinary medical education to provide safe and ethical alternative opportunities for learners to practice essential clinical and professional skills.     

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.