Teaching and assessing veterinary professionalism

Examining the Motivational Climate and Student Effort in Professional Competency Courses: Suggestions for Improvement

The attainment of professional competencies leads to essential skills for successful and employable veterinarians. However, the inclusion of professional competencies in veterinary curricula is often underdeveloped, and it is sometimes less appreciated by students than the science/technical skill curricula. The aim of this study was to better understand students' motivation within professional competency courses (PC courses) by (a) comparing students' motivational perceptions in PC courses to those in science/technical skill courses (ST courses), (b) determining the extent to which students' motivational perceptions predict their course effort, and (c) identifying teaching strategies that could be used to improve PC courses. Participants included students from eight courses enrolled in their first or second year of a veterinary college at a large land-grant university in the United States. A partially mixed concurrent dominant status research design was used to collect quantitative and qualitative data. Students completed closed- and open-ended survey items regarding their effort and the motivational climate in their courses. Compared to ST courses, students put forth less effort in PC courses; rated PC courses lower on empowerment, usefulness, and interest; and had higher success expectancies in PC courses. Although students' perceptions of empowerment, usefulness, interest, and caring were significantly correlated with their effort, interest was the most significant predictor of effort in both PC and ST courses. Based on students' responses to the open-ended questions, specific motivational strategies are recommended to increase students' effort in PC courses, such as intentionally implementing strategies to increase students' interest and perceptions of usefulness and empowerment.

A Qualitative Study of How On-Campus Faculty and Off-Campus Preceptors Evaluate Veterinary Students' Professionalism

Professionalism is defined and described in a variety of ways that differ considerably in details and quantity. While professionalism has become increasingly important, educators' opinions regarding the types of professionalism vary. The objective of this qualitative study was to evaluate faculty and preceptors' perspectives regarding veterinary medical students' professionalism during their clinical rotations. A thematic content analysis was performed to classify 2,014 comments. Five main themes emerged: (a) work ethic and attitude; (b) effective interactions with clients and delivering patient care; (c) effective interactions with health care professionals; (d) punctuality, task completion, and organization; and (e) commitment to improving competency in self and others. The importance of professionalism was stressed by both groups of faculty and preceptors through written comments; however, the magnitude of each theme differed. The results indicate that without understanding professionalism elements, the lack of conceptual clarity and consensus related to expected behaviors and attitudes would make it challenging to assess professionalism appropriately. The themes identified can be used to begin a discussion about expected behavior among faculty, preceptors, and students, therefore prompting a reasonable assessment of professionalism, as well as avoiding unprofessional behavior.

Professional Skills Teaching within Veterinary Education and Possible Future Directions

Once ignored for their potential to take up precious time within the veterinary curriculum at the expense of hard science and technical competencies, professional skills such as ethical conduct, professional conduct, and communication skills are now considered essential in the creation of successful and employable graduates. Despite the requirement to include professional skills in veterinary curricula, limited communication among colleges and inconsistent documentation of curricular developments have led to a wide range of teaching and assessment methods with no consistent standards existing among colleges. Integration of professional competency teaching into the general curriculum is lauded widely, but barriers such as faculty buy-in have kept many colleges from moving toward a standard in which professional competencies are integrated into the general curriculum. The aim of this article is to provide veterinary educators and curriculum designers with an understanding of the rationale for including professional skills teaching within the curriculum while also presenting currently used, as well as recommended, strategies for effective instruction of professional skills.

Identifying the Barriers to Incorporating Reflective Practice into a Veterinary Curriculum

A portfolio with good reflective content can play a large role in learning and setting up the lifelong learning practice required by veterinary surgeons in practice or in research. The aim of this project was to investigate students' experience with their reflective diaries within an electronic portfolio (e-portfolio). Focus groups were conducted with veterinary students at the University of Liverpool in years 1-4 to explore student perceptions of the e-portfolio, with an emphasis on reflection. Three themes emerged from the qualitative analysis: assessment, understanding the assignment (i.e., is it a useful and fair exercise?), and student well-being (i.e., stress, professional accountability, anxiety). Students had clear concerns about the assessment and did not see the relevance of the reflective diaries to their future career and learning. This has led the university's School of Veterinary Science to restructure the reflections on professional skills in the portfolio.

Exploring Student Experiences of an Undergraduate Certificate in Veterinary Medical Education

The ability to teach is recognized as a core skill for many professionals, including veterinarians, but undergraduate opportunities to develop this skill are not always available. A complementary teaching certificate offered during the clinical years of an undergraduate veterinary program was evaluated to investigate student experiences of the program and the perceived benefits and challenges of participating. The study used a mixed methods approach with questionnaires to provide an overview of the participant experience and semi-structured interviews to gain a deeper insight into students' experiences of the program. Two cohorts completed questionnaires comprising Likert-style and open-ended questions on the 3-year teaching certificate, the first cohort after 1 year of the program and the second cohort at completion. Interviews with participants from both cohorts were thematically analyzed to identify recurring themes. An average of 27% of students per academic year enrolled in the certificate program, most of whom completed it. Additionally, four to six students per cohort applied for Associate Fellow of the Higher Education Academy (AFHEA), and 19 students have achieved this recognition. Key themes from the data included that students felt the certificate built their confidence, increased their veterinary knowledge, and helped them become better teachers, with time management and reflection the biggest challenges. The Undergraduate Certificate of Veterinary Medical Education was seen as a good teaching foundation, while working toward the AFHEA provided some insight into higher education and academic careers. A structured teaching program offers students the opportunity to develop their learning and reflection both as students and future educators.

Connection and conflict: influence of the hidden curriculum on veterinary residents' professional identities within the specialty of laboratory animal medicine

OBJECTIVE

To explore the role of the hidden curriculum in residents' development of professional identity during postgraduate training in laboratory animal medicine.

SAMPLE

24 residents enrolled in 1 of 7 laboratory animal medicine training programs in the eastern US.

PROCEDURE

24 qualitative, semistructured interviews were conducted and recorded. Deidentified transcriptions were analyzed by each author using open and axial coding. Constant comparative methodology was used to develop themes and subthemes. Member checks were performed to verify trustability of the conclusions drawn.

RESULTS

3 themes and their related subthemes emerged from the qualitative analysis: 1) building relationships through competent communication (building rapport, practicing clinical empathy, overcoming language barriers, communicating in the "authorized" way, and navigating email limitations), 2) tension within the process of identity formation (acting as the middleman among stakeholders, overcoming the stigma of the policing role, experiencing a lack of power to impact change, and managing a culture of conditional value of veterinary knowledge), and 3) outlets for tension in identity formation (reliance on residency mates, limitations of venting).

EDUCATIONAL RELEVANCE

Our findings suggest that residents are navigating professional identity formation under challenging circumstances that include conflicting stakeholder needs, conditional value of veterinary knowledge, and lack of power to influence change. Residents have limited outlets for relieving the discord between their ideal professional role and their lived experiences. These results provide an important background for refining curricula and creating effective support systems for residents.

Assessing Moral Judgements in Veterinary Students: An Exploratory Mixed-Methods Study from Germany

Simple Summary

On the one hand, veterinary ethics is a required part of veterinary education. On the other hand, the success of ethics teaching and the students’ skills concerning judgements in morally demanding situations are hardly evaluated systematically. This article presents an innovative tool to evaluate those skills in veterinary students in a first case of application. One group of students in this case had taken ethics classes, the other had not. The participants were asked to fill in a questionnaire with different scenarios from veterinary practice and answer additional free-text questions. Students who had taken ethics classes did not answer generally different from those students who had not taken ethics classes. However, there were many overall differences between the students’ answers, decisions, attitudes, and explanations. The tool is therefore suggested for further evaluations of ethics teaching and moral judgement skills in veterinary students.

Abstract

Although veterinary ethics is required in veterinary curricula and part of the competencies expected of a trained veterinary surgeon according to the European Association of Establishments for Veterinary Education (EAEVE), knowledge concerning the effects of ethics teaching and tools evaluating moral judgement are scarce. To address this lack of tools with a mixed-methods approach, a questionnaire with three case scenarios presenting typical ethical conflicts of veterinary practice was administered to two groups of veterinary students (one had taken ethics classes, one did not). The questionnaire contained both open-ended and closed questions and was analysed qualitatively and quantitatively. The qualitative part aimed at revealing different argumentation patterns between the two groups, whereas the quantitative part focused on the students’ approval of different roles and attitudes possibly relating to veterinarians. The results showed no major differences between both groups. However, answering patterns suggest a clear diversity among the students in their perception of morally relevant factors and the veterinary profession. Awareness of morally challenging elements of their profession was presented by students of both groups. With this exploratory study, the application of an innovative mixed-methods tool for evaluating the moral judgement of veterinary medical students is demonstrated.

Fostering the Development of Professionalism in Veterinary Students: Challenges and Implications for Veterinary Professionalism Curricula

The importance of professional skills teaching and assessment within veterinary education has recently been highlighted in the veterinary education literature. This academic discourse follows the acknowledgement by both veterinary employers and graduates themselves that new graduates often lack the professional skills and attitudes needed for success in clinical veterinary practice. Traditionally, veterinary curricula have focused solely on teaching content knowledge and clinical skills; however, veterinary education curricula clearly must also contain dedicated instruction in veterinary professionalism. This must include instruction in communication skills, emotional intelligence, cultural awareness, teamwork abilities, dispute resolution strategies and the awareness that multiple approaches may be required to resolve challenges. It has become unrealistic to expect students to rely on observation and role modelling to foster the development of professionalism. There is a need to incorporate explicit learning activities that reinforce the knowledge, attitudes, values, and behaviours that characterise veterinary professionalism. While role modelling remains a key aspect of the veterinary professionalism learning that takes place through the informal/hidden curriculum, many students have often had more experiences with negative role models than with positive ones. This can lead to the development of a tolerance or normalisation of negative behaviours and a decline in students’ perceptions of professionalism. This article aims to continue recent conversations on professional skills teaching within veterinary education, define what is meant by veterinary professionalism and consider the plethora of terminology used when trying to establish a definition, highlight those attributes of veterinary professionalism deemed important by veterinary stakeholders for career success and employability, and explore the challenges of incorporating the teaching and assessment of professional traits into veterinary education.

Using the critical incident technique to determine veterinary professional competencies important for enhancing the veterinarian-client interaction

BACKGROUND

While previous research has examined components of professionalism that veterinary employers and clients expect in veterinarians, little attention has been paid to practising clinical veterinarians' opinions on important professional competencies that help to enhance the veterinarian-client relationship. This study used a phenomenological approach and critical incident technique to gather the narratives of practising veterinarians in New Zealand about positive and negative veterinarian-client interactions. The intention was to identify the underlying principles of professionalism that resulted in the positive/negative outcomes of those interactions.

METHODS

Twenty-two practising veterinarians were interviewed, and each respondent was asked to recollect and narrate a significant positive and a significant negative critical incident in their career that involved a veterinarian-client interaction within a clinical setting. The professional competencies that the veterinarian believed contributed to a successful or an unsuccessful outcome were elucidated using thematic analysis.

RESULTS

Thematic analysis of the critical incident narratives revealed four major themes under the overarching theme of 'building a relationship between the veterinarian and the client': 'accountability and integrity', 'effective communication skills', 'personal wellbeing' and 'quality of care'.

CONCLUSION

The description of the important professional competencies that helped to enhance the veterinarian-client relationship provides a reference for the practising profession to help improve the likelihood of veterinarians enjoying satisfied and successful careers.

What Do Veterinary Students Value about Service Learning? Insights from Subsidized Clinics in an Urban Environment

To promote accessible veterinary care in the community and to help students refine their communication skills, the University of Calgary, Faculty of Veterinary Medicine (UCVM) partnered with the Calgary Urban Project Society (CUPS), a human services organization, to develop the UCVM-CUPS Pet Health Clinics. These clinics are a service-learning experience where third-year students provide services to those facing barriers to veterinary care in Calgary, Alberta. The clinics are offered at CUPS for 6 weeks at 1 day per week. Each student participates in one 4-hour lab; running two 90-minute appointments. In this mixed-methods article, the question was asked: How does a communication-based veterinary service learning program impact students' perception and knowledge of their skills and their perceived role in community outreach to underserved populations and their animals? All third-year veterinary students (N = 30) participated in the 2018 UCVM-CUPS Pet Health Clinics. Students completed a demographics survey, and a pre- and post-clinic questionnaire. Statistical analysis was used to compare pre- and post-clinic responses, and to determine relationships between questionnaire responses and the demographics survey data. Students were significantly more in agreement with statements that demonstrated confidence in their medical knowledge, technical abilities, and communication skills after participating in the program. There was significantly more disagreement to continue volunteering after graduation, but many planned on providing community outreach. Overall, students felt a strong sense of social responsibility and were motivated to help underserved populations. The findings suggest that communication-based, service-learning experiences are related to greater social awareness and enhance students' clinical skills including communication.

Client satisfaction in equine veterinary practice: A structured review and qualitative synthesis

BACKGROUND

The pressure on equine veterinarians to provide services that meet with a client's demands, that is, realizing client satisfaction, is considerable.

AIM

The aim of this paper is to analyze existing literature, with a view to distill the most relevant components for client satisfaction in equine veterinary practice.

MATERIALS AND METHODS

A structured literature search was conducted. Included papers were systematically organised and analysed using an inductive approach.

RESULTS

Seven components relevant to client satisfaction in equine veterinary practice were identified: quality of care, quality of service, horsemanship of the veterinarian, costs of service, interpersonal skills, professional attitude and transfer of knowledge.

DISCUSSION

The limited amount and variable quality of available records regarding client satisfaction in equine veterinary practice are the main limitations of this study.

CONCLUSION

The seven categories identified are likely to play a fundamental role in achieving client satisfaction in equine veterinary practice. Additional research is required to validate these categories and relate them to different types of clients as well as map their needs and expectations, so that they can be used to assist equine veterinary professionals in tailoring customer experience to the individual client.

"I Had No Idea That Other People in the World Thought Differently to Me": Ethical Challenges in Small Animal Veterinary Practice and Implications for Ethics Support and Education

Although veterinarians encounter ethical challenges in their everyday practice, few studies have examined how they make sense of and respond to them. This research used semi-structured interviews and a qualitative methodology (phenomenological and constructivist/interpretivist approaches) to explore ethical challenges experienced by seven small animal city veterinarians and their ethical decision-making strategies. Thematic analysis of the interview transcripts identified four broad ethical issues: The first concerned disagreements about the best interests of the animal; the second centered on clinical uncertainty about the most appropriate treatment for the animal; the third involved factors influencing ethical reasoning and decision making; and the fourth concerned how ethics education might prepare veterinary students for future ethical decision making. An overarching theme identified in the analysis was one of enormous personal distress. Furthermore, a sense of veterinarians being interested in how others might think and feel about ethical challenges came through in the data. The results give insight into how veterinarians experience and respond to ethical challenges. The research also provides empirical information about everyday practice to inform future education in ethics and ethical decision making for veterinary students.

Strategies to Improve Case Outcome When Referral Is Not Affordable

We conducted a survey-based study to determine whether on-site consultations and cost-effective protocols are beneficial to general practitioners handling challenging small animal internal medicine patients when owners cannot afford referral and whether fourth-year veterinary students benefit from training in this area. Fifteen general practices were visited over 12 months by a board-certified internist and students. On-site consultations for patients belonging to owners who could not afford referral were conducted by the internist. Students and general practitioners completed pre- and post-participation surveys. Students' surveys contained questions about comfort level with complicated cases on a budget and knowledge gained from, and perception of, the on-site consultations and protocol development. Practitioners' surveys contained questions about comfort level and experience with complicated internal medicine cases, the benefit of the consultations, and the cost-effective protocols, which were compiled into a booklet for practitioners. All students and practices completed the pre-survey, and 56 of 60 (93.3%) of the students and 13 of 15 (86.7%) of the practices completed the post-survey. Approximately 68% of students believed their comfort level with budget-limited cases improved and that they benefited from participation in the consultations and protocol development. Similarly, most general practitioners believed these strategies were highly beneficial. The cost of veterinary care, especially referral medicine, is unaffordable for many owners. Veterinary students should be exposed to these challenges and trained in cost-effective approaches. Similarly, general practitioners may be able to more successfully and efficiently diagnose and treat challenging internal medicine cases using the proposed strategies when owners decline referral.

Best Practice in Supporting Professional Identity Formation: Use of a Professional Reasoning Framework

Professional identity and professionalism education are increasingly important to veterinary education, but many of the concepts remain intangible to veterinary students, and engagement is a persistent challenge. While whole-curriculum integration is recommended for a successful professional studies program, this is complicated by clinical faculty's discomfort with the content. Where professional studies education is centered around professional identity formation, a key element of this is the multi-perspective nature of veterinary work, with the veterinarian negotiating the needs of multiple stakeholders in animal care. Constructing teaching around a framework of professional reasoning, which incorporates the negotiation of different stakeholder needs, ethical decision making, communication, teamwork, and outcome monitoring, offers the potential to make professional identity a concept more visible to students in veterinary work, and guides students in the contextualization of taught material. A framework is presented for veterinary professional reasoning that signposts wider curriculum content and helps illustrate where material such as veterinary business studies, animal welfare, the human-animal bond, and professional responsibility, as well as attributes such as empathy and compassion, all integrate in the decisions and actions of the veterinary professional. The aims of this framework are to support students' engagement in professional studies teaching and help them use workplace learning experiences to construct an appropriate professional identity for competence and resilience in the clinic. For faculty involved in curriculum design and clinical teaching, the framework provides a tool to support the integration of professional identity concepts across the extended curriculum.

Fostering Students' Collaborative Learning Competencies and Professional Conduct in the Context of Two Gross Anatomy Courses in Veterinary Medicine

Collaborative learning has been used in anatomy courses to support students' learning of challenging topics but the success of group work depends significantly on the students' ability to communicate in a professional manner. Veterinary students' experiences with tasks related to collaborative learning and professional conduct were studied by comparing learning collaborative competences and pedagogy, as well as perceived positive and challenging aspects, in two gross anatomy courses. Both qualitative and quantitative data were collected from students' experiences of course assignments and collaboration, as well as from self-evaluated collaboration competence development. Trying things out oneself, practical application and professional conduct were positively highlighted particularly in the first-year course (myology and arthrology) group work and learning from others more in the second year (topographical anatomy). Various group work challenges, often relating to practical matters or communication, were the key concerns for students. The main difference between the two courses in learning of collaborative knowledge work competencies appeared to relate to the nature of the group work assignment. The topography course included the element of collaboration in preparing a presentation and teaching session for the rest of the class. Interestingly, students on the myology and arthrology course gave more positive comments on professional conduct than the students on the topography course despite the fact that the latter course included more practical elements relating to their future profession.

Curriculum Mapping as a Tool for Review of the Professional Veterinary Medicine Curriculum at University College Dublin-Strategic and Organizational Considerations

Curriculum review and enhancement is a requirement of accredited veterinary medicine degree programs to ensure they are fit for purpose. This article presents a curriculum review process undertaken by the School of Veterinary Medicine, University College Dublin, Ireland. A four-dimensional curriculum review conceptual framework was adopted to analyze the undergraduate and graduate entry veterinary medicine programs. Curriculum mapping was chosen as the methodology to gather data and structure curriculum review activities. Curriculum mapping was considered a useful methodology to review the program for three of the four dimensions of the curriculum framework.

Communication identity in veterinary medicine: a grounded theory approach

It is well established that communication skills are a core competence in veterinary medicine. Most studies in the field of veterinary medicine have focused on communication as an interpersonal skill. Much less is known about communication in the context of professional identity formation. Semistructured interviews with practitioners from companion and farm animal practice, veterinary industry, veterinary research and government service were conducted in Germany in 2016. A grounded theory approach as described by Strauss and Corbin was used to identify characteristics associated with professional communication identity formation in veterinarians. According to the current study, the identity formation process occurs in three steps: existing personal communication identity, socialisation and professional communication identity. Essentials of interpersonal communication, communication interaction experiences at work, acquisition of communication skills and subjective clarification of veterinary communication ability and skills are the key factors associated with this formation process. Since communication skills are of uttermost importance for all fields of veterinary medicine, communication education, and supporting undergraduate students in the process of communication identity formation, should be an important part of the veterinary curriculum. Furthermore, integrating communication skills training in continuing education courses could foster professionalism in veterinary medicine.

Beyond Competence: Why We Should Talk About Employability in Veterinary Education

The purpose of this article is to explore employability as a complement to competency in defining the overarching objectives of veterinary education. Although the working usage of the term competency has evolved and stretched in recent years, and contemporary competence frameworks have expanded to better reflect the range of capabilities required of a veterinary professional, the potential remains for the dominance of competency-led discourse to obscure the aim of producing not only competent but also successful and satisfied veterinarians. Expanding the educational mission to include employability may provide this broader focus, by stretching the end point, scope, and scale of veterinary education into the crucial transition-to-practice period, and beyond. In this article we review available evidence from multiple stakeholder perspectives and argue that employability expands the focus beyond servicing the needs of the public to better integrate and balance the needs of all the stakeholders in veterinary education, including the graduates themselves. By refocusing the goal of veterinary education to include the richer end point of success, turning the attention to employability could enhance current attribute frameworks and result in veterinarians who not only better meet the needs of those they serve but are also better prepared to experience fulfilling and satisfying careers. Finally, we suggest one educational approach may be to conceptualize competency, professionalism, and employability as overlapping dimensions of the successful veterinary professional.

A theoretical framework for human and veterinary medical ethics education

In their practice, physicians and veterinarians need to resort to an array of ethical competences. As a teaching topic, however, there is no accepted gold standard for human medical ethics, and veterinary medical ethics is not yet well established. This paper provides a reflection on the underlying aims of human and veterinary medical ethics education. Drawing from published literature on ethics education in the health professions a theoretical framework common to the teaching of human and veterinary medical ethics is proposed, based on three concepts: professional rules, moral virtues and ethical skills. The rules approach relies on the transmission of professional and social values by means of regulatory documents and depends intimately on the knowledge that students have of those documents. The virtues approach involves the inculcation of moral values and virtues that will stimulate students to develop desirable behaviours. The main focus of this approach to ethics is to develop students' attitudinal competences. Finally, the skills approach is focused on equipping the students with the necessary moral reasoning abilities to recognise and respect the plurality of ethical views that make part of contemporary society. This framework can inform future curriculum development in human and veterinary medical ethics as well as in other health care professions.

Which professional (non-technical) competencies are most important to the success of graduate veterinarians? A Best Evidence Medical Education (BEME) systematic review: BEME Guide No. 38

BACKGROUND

Despite the growing prominence of professional (non-technical) competencies in veterinary education, the evidence to support their importance to veterinary graduates is unclear.

AIM

To summarize current evidence within the veterinary literature for the importance of professional competencies to graduate success.

METHODS

A systematic search of electronic databases was conducted (CAB Abstracts, Web of Science, PubMed, PsycINFO, ERIC, Australian and British Education Index, Dissertations & Theses) from 1988 to 2015 and limited to the veterinary discipline (veterinar* term required). Evidence was sought from consensus-based competence frameworks, surveys of stakeholder perceptions, and empirical evidence linked to relevant outcomes (e.g. employability, client satisfaction or compliance). Data extraction was completed by two independent reviewers and included a quality assessment of each source.

RESULTS

Fifty-two sources were included in the review, providing evidence from expert frameworks (10 sources), stakeholder perceptions (30 sources, including one from the previous category), and empirical research (13 sources). Communication skills were the only competency to be well-supported by all three categories of evidence. Other competencies supported by multiple sources of empirical evidence include empathy, relationship-centered care, self-efficacy, and business skills. Other competencies perceived to be relatively more important included awareness of limitations, professional values, critical thinking, collaboration, and resilience.

CONCLUSIONS

This review has highlighted the comparatively weak body of evidence supporting the importance of professional competencies for veterinary graduate success, with the exception of communication skills. However we stress this is more indicative of the scarcity of high-quality veterinary-based education research in the field, than of the true priority of these competencies.

The Life of Meaning: A Model of the Positive Contributions to Well-Being from Veterinary Work

We present a veterinary model of work-derived well-being, and argue that educators should not only present a (potentially self-fulfilling) stress management model of future wellness, but also balance this with a positive psychology-based approach depicting a veterinary career as a richly generative source of satisfaction and fulfillment. A review of known sources of satisfaction for veterinarians finds them to be based mostly in meaningful purpose, relationships, and personal growth. This positions veterinary well-being within the tradition of eudaimonia, an ancient concept of achieving one's best possible self, and a term increasingly employed to describe well-being derived from living a life that is engaging, meaningful, and deeply fulfilling. The theory of eudaimonia for workplace well-being should inform development of personal resources that foster resilience in undergraduate and graduate veterinarians.