Communicating without words: Measuring nonverbal communication between veterinarians and farmers during routine herd health consultations

Uptake of advice and the ability to facilitate change on-farm are key elements for successful veterinary practice. However, having the necessary clinical skills and knowledge is not enough to achieve this: effective communication skills are essential for veterinarians to realize their advisory role by exploring and understanding the farmer's worldview. Research of verbal aspects of veterinarian communication supports the use of a relationship-centered communication style; we next need to study how veterinarian-farmer nonverbal communication (NVC) can influence interactions and their outcomes, which has been examined in medical and companion animal practice. In this study, we considered which aspects of NVC should be measured, and how, to provide an essential first step toward understanding the significance of NVC for veterinarians working in dairy practice, which should be of interest to researchers, veterinary educators, and practitioners. Eleven video recordings of routine consultations in the UK were analyzed for farmer and veterinarian NVC. The NVC attributes with established links to positive patient and client outcomes from medical and social science studies were chosen, and a methodology developed for their measurement, by adapting measures typically used in NVC research. Each consultation was segmented into intervals defined by the main activity and location on farm: introduction, fertility examination, discussion, and closing. This approach allowed us to analyze the content more consistently, establish which aspects of NVC featured within each interval, and whether the activity and location influenced the observed NVC. We measured 12 NVC attributes, including body orientation, interpersonal distance, head position, and body lean, which have been shown to influence empathy, rapport, and trust: key components of relationship-centered communication. Future research should seek to establish the significance of NVC in effective communication between veterinarian and farmer, building on our findings that show it is possible to measure nonverbal attributes. Veterinarians may benefit from becoming skilled nonverbal communicators and have more effective conversations during routine consultations, motivating farmers to make changes and improve herd health.

The Art and Science of Consultations in Bovine Medicine: Use of Modified Calgary – Cambridge Guides, Part 2

This article, part 2 of a 2-part series, describes the next two steps in the application of the Modified Calgary-Cambridge Guides (MCCG) to consultations in bovine medicine, ‘explanation and planning’, and ‘closing the consultation’, and introduces concepts that are associated with all the components of the guide, ‘building the relationship with the client’ and ‘providing structure to the consultation’. Part 1 introduced the aim and framework of the MCCG which enables the practitioner to gain an insight into the client’s understanding of the problem, including understanding aetiology, epidemiology and pathophysiology. Part 2 introduces the framework that provides the opportunity to understand the client’s expectations regarding the outcome, their motivation and willingness to adhere to recommendations. It also describes how to engage and acknowledge the client as an important part of the decision-making process, how to establish responsibilities of both the client and practitioner, and how to reach out to the client at the conclusion of the consultation to make certain that the client’s expectations were met.

Facilitating Development of Problem-Solving Skills in Veterinary Learners with Clinical Examples

Simple Summary

This review seeks to open discussion on the teaching of problem-solving skills in veterinary learners. Before a veterinary learn-er can solve a problem, they need to be able to recognize the problem. Then, information is gathered and economically viable solutions determined. To make problem-solving easier, we suggest a process with 5 elements: (1) define the problem list; (2) create an associated timeline; (3) describe the (anatomical) system involved or the pathophysiological principle applicable to the case; (4) propose management for the case; and (5) identify unique features of the case. In order to put the above into context, we end the review with an example case scenario showing the approach of teaching of problem-solving.

Abstract

This paper seeks to open discussion on the teaching of problem-solving skills in veterinary learners. We start by defining the term problem before discussing what constitutes problem-solving. For veterinary medical learners, problem-solving techniques are similar to those of decision-making and are integral to clinical reasoning. Problem-solving requires the veterinary learner to organize information logically to allow application of prior or new knowledge in arriving at a solution. The decision-making must encompass choices that provide the most beneficial and economical approach. In a modification of an existing protocol, we suggest the inclusion of the 5 elements: (1) define the problem list; (2) create an associated timeline; (3) describe the (anatomical) system involved or the pathophysiological principle applicable to the case; (4) propose management for the case; and (5) identify unique features of the case. During problem-solving activities, the instructor should take the role of facilitator rather than teacher. Skills utilized in the facilitation of problem-solving by learners include coaching, differential reinforcement, effective feedback, modelling and ‘think out loud’. Effective feedback must inform learners of their progress and performance, as this is fundamental to continued learning and motivation to succeed. In order to put the above into context, we end with an example case scenario showing how we would approach the teaching of problem-solving to veterinary learners.

Communication skills training and assessment of food animal production medicine veterinarians: A component of a voluntary Johne's disease control program

In food animal production medicine (FAPM), the success of control programs for infectious diseases that have serious animal health and economic consequences frequently rely on the veterinarian's effective communication and producer adherence to veterinary recommendations. However, little research has been conducted on communication skills of practicing FAPM veterinarians. During this study, we developed a communication training workshop intervention to support the Atlantic Johne's Disease Initiative. Seventeen FAPM veterinarians across 10 clinics practicing within Maritime Canada participated in a pre-post intervention study design. Communication skills were evaluated utilizing 3 assessment tools; an objective structured clinical exam (OSCE), standardized client feedback, and an instrument designed for veterinary participants to assess their self-efficacy. Study results showed that before training, communication skills of participating veterinarians had limitations, including skill deficits in communication tasks strongly associated with increased adherence to veterinary recommendations. Based on the 3 assessment tools, communication skills of participating veterinarians improved with the training provided. Significant increases were detected in pre- to postintervention self-efficacy percentage scores, OSCE percentage and global scores from expert raters, and OSCE percentage and global scores from standardized client feedback. These improvements emphasize the importance of communication skills training specific to FAPM.

Effective Veterinary Clinical Teaching in a Variety of Teaching Settings

This review explores different modalities for clinical teaching of veterinary learners globally. Effective clinical teaching aims to prepare graduates for a successful career in clinical practice. Unfortunately, there is scant literature concerning clinical teaching in veterinary medicine. Our intent for this review is to stimulate and/or facilitate discussion and/or research in this important area. We discuss the different forms that veterinary clinical teaching can take, depending on their setting, which can be university-based clinical activities, work-based in commercial clinical practices, or in a traditional academic setting with little to no real-time exposure to clients and patients. We suggest that each of these modalities has a place in clinical teaching of veterinary learners at any point in the curriculum but that a mix of these approaches will likely provide an improved experience for the learner. Further, we discuss strategies to improve clinical teaching in these different settings. Potential strategies related to the teaching skills of clinical instructors could include training in delivery of clinical teaching in a variety of learning settings, and instructors’ official recognition, including opportunities for career progression. Potential strategies to improve clinical teaching in different teaching settings would vary with the learning settings. For example, in traditional academic settings, case-based learning with incorporation of simulation models is one proposed strategy. The involvement of learners in ‘teach-others’ is a strategy for both traditional academic and clinical settings. Finally, clearly addressing Day One competencies is required in any clinical teaching setting.

Factors associated with dairy farmers' satisfaction and preparedness to adopt recommendations after veterinary herd health visits

Herd health and production consultancy are important aspects of the modern dairy veterinary practice; therefore, veterinary farm visits will likely be more successful if veterinary practitioners communicate effectively and meet farmers' expectations. Objectives were to assess dairy farmers' satisfaction with veterinary advisors and their perceived preparedness to adopt veterinary advice. Furthermore, we assessed whether farmers' satisfaction and preparedness to adopt advice were associated with specific predictor variables; that is, general (demographic) factors of veterinarians or farmers, communication tools used by veterinarians, and veterinarians' affective attributes during the farm visit. Audio-video recordings of 14 dairy veterinarians during 70 herd health and production management farm visits were analyzed using the Roter interaction analysis system. Demographic data, farmers' satisfaction, and farmers' preparedness to adopt advice were obtained by using questionnaires. Overall, farmers were satisfied with their veterinarian's communication during farm visits and 58% of farmers felt "absolutely" prepared to follow veterinary recommendations. Based on multivariable regression analysis, farmers' satisfaction was positively associated with their level of education and the amount of talk the veterinarian dedicated to counseling the farmer. However, satisfaction was negatively association with the ratio between veterinarian talk and farmer talk. In addition to various demographic variables, farmers' preparedness to adopt veterinary advice was positively associated with their satisfaction. Other predictor variables for farmers' preparedness to follow recommendations included increased veterinary counseling and frequent herd data discussions, whereas there was a negative relationship between number of farmer questions and dominance of the veterinarian during the farm visit. Identification of factors influencing farmers' satisfaction and preparedness to adopt advice will make veterinary communication more effective and could inform training of veterinarians in communication.