"It was the best of times, it was the worst of times". A perspective on the KPMG study

Clinical preceptor evaluation of veterinary students in a distributed model of clinical education

The study reported here investigates the reliability and validity of a standardized evaluation form used to assess students' knowledge, clinical skills, interpersonal skills, and professionalism during fourth-year clinical rotations in a distributed model of veterinary education. A form designed to assess veterinary knowledge (5 items), clinical skills (7 items), interpersonal skills (3 items), and professionalism (6 items) was used by clinical preceptors to evaluate student performance across different rotations. For the period January--May 2007, 218 evaluations were completed for 81 students; each student was assessed in at least two rotations. Mean scores across the 21 items ranged from 3.42 (SD = 0.61) to 3.87 (SD = 0.37). Construct validity was assessed using exploratory factor analysis. The 21 items loaded on three underlying factors, professionalism, knowledge and clinical skills, accounted for 70.35% of the variance. Internal consistency (Cronbach's alpha) of each subscale was high, ranging from 0.88 for clinical skills to 0.94 for professionalism and 0.96 for the entire tool. Correlations between subscales were significant (p < 0.01), ranging from r = 0.62 to r = 0.76. Preliminary analysis suggests that the evaluation tool has good internal reliability. Construct validity analysis suggests that certain items relating to interpersonal skills and clinical skills were assessing either knowledge or professionalism. Clinical preceptors could differentiate between different skill levels for knowledge and clinical skills. Challenges associated with the assessment of professionalism are discussed.

Part II: directions and objectives of curriculum structure at veterinary medical and other health professions schools

This article surveys reports on various models and methods of curriculum structure and directions of health professions schools in North America over the past 20 years, with particular emphasis on veterinary and allopathic medical schools. The importance of administrative and faculty leadership, a clear sense of vision, recognition that curricula must change to meet societal needs, and continual, extensive communication and collaboration are discussed as important keys to successfully navigating curriculum reform. The advantages of central versus departmental management of the curriculum are noted with respect to implementing curricular change. Investment in faculty development is essential to ensure sustained cultural and curricular change. As instructional methodology changes, new and better methods of assessing student performance must be developed, with timely and appropriate feedback. Barriers to curriculum change are inevitable; effective strategies must be designed and implemented to navigate these barriers. The future of education in the health professions is clearly in the hands of the educators who prepare future health professionals.

Addressing disappointment in veterinary practice

Disappointing experiences are not uncommon in the increasingly complex setting of veterinary practice. Managing these situations requires that health care teams be sensitive to client disappointments; accept responsibility for engaging with clients to resolve them; and act ethically, sensitively, and flexibly to reach the best resolutions possible while learning from the experience to reduce the potential for recurrence. The reward for their efforts is an enhanced capability to rebuild rapport, trust, credibility, and loyalty after disappointments and adverse outcomes. Success should translate into a more satisfying practice that builds and maintains its client base and minimizes its liability risks.