Problem-based learning in veterinary education

Apprendre l’anatomie radiographique en présentiel ou en ligne ? Une étude randomisée contrôlée

Résumé

L’enseignement de l’anatomie repose sur diverses techniques: les cours, les dissections, les modèles 3D ou encore les supports en ligne. Ces derniers sont généralement considérés comme des moyens d’apprentissage complémentaires. Cette étude vise à comparer les performances des étudiants vétérinaires (N=83) en anatomie radiographique (radioanatomie) après un apprentissage en ligne ou conventionnel, et de voir dans quelle mesure ces méthodes sont interchangeables. Trois stratégies sont comparées : apprentissage en ligne exclusif, apprentissage en ligne avec des os de chevaux, apprentissage sur radiographies conventionnelles avec des os de chevaux. Les performances au test de rotation mentale et au test de connaissance en radioanatomie sont similaires entre les 3 groupes à la base, lors du test préliminaire. Après l’apprentissage (test final), les scores de rotation mentale et de radioanatomie augment significativement de 6.7/40 points (CI : 5.2–8.2; p < .001) et de 5.1/20 points (CI: 4.3–5.9; p< .001). Il n’y a pas de différence entre les groupes pour les scores de rotation mentale et de radioanatomie après l’apprentissage. Le score de rotation mentale est influencé par le genre, et significativement plus élevé chez les hommes que chez les femmes au test préliminaire (M= 23.0, SD = 8.8 vs. M= 16.5, SD= 6.9; p= .001) et au test final (M= 32.1, SD= 5.5 vs. M= 22.7, SD= 8.6; p< .001). Les performances en radioanatomie ne sont pas influencées par le genre. Ces résultats suggèrent que l’enseignement de la radioanatomie peut être réalisé en présentiel avec des radiographies conventionnelles ou en ligne. Cette interchangeabilité entre apprentissage en présentiel et en distanciel est intéressante au regard des impératifs liés aux crises sanitaires, et des besoins d’adaptation rapide en distanciel.

This translation was provided by the authors. To view the original article visit: https://doi.org/10.3138/jvme-2021-0153

Virtual Clinics: A Student-Led, Problem-Based Learning Approach to Supplement Veterinary Clinical Experiences

The COVID-19 pandemic created an abrupt need for effective remote clinical experiences for senior clinical veterinary students. Subsequently, the authors created virtual clinics. This activity was derived from a problem-based learning (PBL) model wherein students designed clinical cases and participated through virtual role play as clients and clinicians. The purpose of this article is to describe virtual clinics and to report data from focus groups of participating students and faculty facilitators from two institutions regarding the positive and negative aspects of the shift in practice. A few common emerging themes included that case rounds were fun and engaging, students could learn at their own pace, and peer-to-peer learning opportunities had perceived value. Themes are reflected against the pedagogical literature to draw out areas that resonated. Students felt this activity was more engaging than listening to a discussion of a case they had no ownership of, and facilitators agreed that the peer-to-peer interactions added to student engagement. Additionally, students developed deeper knowledge about the underlying disease process and clinical presentation of their case, which required independent and self-directed learning, enabling students to think about a case from a client's perspective. By participating in these activities, students developed skills of classroom-to-clinic transitional value. While virtual clinics should not replace in-person clinical experiences, this activity might be useful to facilitate students' transition from a structured classroom setting to a less-structured clinical experience.

Can Online Teaching of Radiographic Anatomy Replace Conventional On-Site Teaching? A Randomized Controlled Study

Different modalities such as lectures, dissections, 3D models, and online learning are used for teaching anatomy. To date, online learning has been considered a useful additional didactic tool. This study aimed to compare veterinary students' performance in radiographic anatomy (radio-anatomy) after online or classroom-based teaching to assess the extent to which the two methods were interchangeable. Three strategies were compared in a cohort of 83 learners. Students were committed to online learning only, online learning with the use of specimen equine bones, or learning on conventional radiographs with specimen equine bones. At baseline (pre-test), scores from a mental rotation test and radio-anatomy knowledge test were similar between groups. After training (post-test), scores in mental rotation and radio-anatomy significantly increased by 6.7/40 units (95% CI: 5.2-8.2; p < .001) and 5.1/20 units (95% CI: 4.3-5.9; p < .001), respectively. There was no difference in scores for mental rotation and radio-anatomy knowledge between groups at post-test. Gender influenced the mental rotation, with men scoring significantly higher than women at pre-test (M = 23.0, SD = 8.8 vs. M = 16.5, SD = 6.9; p = .001) and post-test (M = 32.1, SD = 5.5 vs. M = 22.7, SD = 8.6; p < .001). However, radio-anatomy knowledge was not influenced by gender. These results suggest radio-anatomy teaching can be safely achieved with either conventional radiographs or online resources. This is of interest since, due to the COVID-19 outbreak, rapidly changing from on-site to online methods for teaching veterinary medical education proved necessary.

Impact of combination of short lecture and group discussion on the learning of physiology by nonmajor undergraduates

This study assessed the impact of an "active learning" strategy employed alone or in combination with traditional lectures on the learning of mammalian physiology by undergraduate students. The study investigated the impact of three teaching strategies, namely 1) traditional lecture, 2) group discussion alone, and 3) combination of lecture and group discussion. For all strategies, students were given homework in a textbook and they completed written assignments before each session. Every student led the discussion of at least one assigned theme during each group session. The students had no access to the textbook or notes during group discussions. Four examinations (3 in-semester and a final) assessed the students' knowledge of fundamental concepts of physiology of specific organ systems. Part of the final examination reassessed knowledge of previously tested topics. The results show that the teaching modality employed to introduce physiology topics influenced students' learning. The average marginal effect of the lecture + discussion modality (average improvement linked to lecture + discussion strategy) on students' performance was 6.45% [95% confidence interval (CI₉₅) (4.73, 8.16), P = 1.74 × 10^-13], and the average improvement associated with the discussion-only modality was 5.5% [CI₉₅ (3.84, 7.16), P = 7.84 × 10^-11]. On average, all class ranks performed better on materials covered under active learning settings than under lecture-only conditions. Moreover, students' performance under combined lecture and discussion conditions is predictive of their overall performance in the course. The results support the positive effect of student-centered learning and demonstrate the efficacy of a combination of lectures and group discussions on learning of physiology by nonmajor students.NEW & NOTEWORTHY The purpose of this study was to evaluate the effect of group discussion on the learning of mammalian physiology by nonmajor undergraduate students. Combining traditional lectures with group discussions increased the active participation of students in class and improved their learning of physiology, as measured by the results of in-semester and final examinations. The active learning technique benefited all class ranks on average.

The Use of Virtual-Problem-Based Learning during COVID-19 Pandemic Emergency: Veterinary Students' Perception

The COVID-19 global pandemic emergency forced us to replace the "traditional and in presence" clinical, pre-graduating, veterinary medical training with clinical virtual-problem-based learning (v-PBL). This prospective cross-sectional case-control study aimed to evaluate the students' perception of the v-PBLs compared to the traditional veterinary clinical training (t-VCT). The t-VCT consisted of supervised management of clinical cases admitted at the Veterinary Teaching Hospital and in the field. The v-PBL consisted of genuine clinical cases shared by tutors throughout an online platform. A survey was delivered to all the fifth-year students who completed the t-VCT or the v-PBL. The survey was completed by 49% of the students. Overall student satisfaction regarding the training experiences was high in both groups, but it was less in the v-PBL than in the t-VCT group. The students of the v-PBL group perceived that they could not improve their practical clinical skills through online sessions, and they emphasized how it could be employed as support for traditional practical activities. All the students are satisfied with the supervision and considered the training correctly focused on relevant learning objectives and the task clearly explained. Stimulating the integration of knowledge and lifelong learning skills replicating life experiences the v-PBLs represented an attractive curricular alternative for veterinary education.

The Efficacy of Online Case-Based Assignments in Teaching Veterinary Ophthalmology

Veterinarians are required to use clinical reasoning skills to successfully manage their patients with eye diseases. Case-based assignments can be an effective tool for teaching problem-solving skills. Very few models or online modules exist to deepen the instruction of veterinary ophthalmic clinical reasoning skills. The current study aims to assess the value of online case-based assignments given to students during the Ontario Veterinary College's Phase 4 ophthalmology rotation over a 4-year period. Nine case-based assignments were developed as an online module and provided signalment, history, ophthalmic database, and clinical photography. For each case, students were required to describe the ocular lesions, provide a diagnosis, and develop a short-term and long-term treatment plan. A grading rubric was created, and student feedback was collected using an online survey. A frequency analysis was conducted to evaluate final grades across each case. This analysis was also completed for grades of each question across all cases. A total of 285 students were graded individually. Students' grades were normally distributed across each assignment. Students performed better on lower-order cognitive skills (description of ocular lesions) but poorer on high-order cognitive skills (therapeutic plans). These results suggest that students tend to have difficulty with the analysis and interpretation of these cases. Student feedback reported case-based assignments were useful. Online case-based assignments may be a useful adjunctive teaching tool for students rotating through ophthalmology in their clinical year, and this tool could be considered for other specialized rotations.

Using an OSCE to Explore the Role of Structured Debriefing and Self-Directed Learning in Simulator-Based Clinical Skill Training in Production Animal Reproductive Medicine

Self-directed learning is associated with several benefits in simulation-based clinical skill training and can be complemented by feedback in the form of post-event debriefing. In this study, final-year veterinary medicine students (n = 111) were allocated into one of three groups and practiced four clinical skills from the domain of production animal reproductive medicine in a clinical skills laboratory. Group 1 completed an instructor-led practice session (I), group 2 completed a self-directed practice session with post-event debriefing (D), and group 3 completed a self-directed practice session without debriefing (control, C). Each practice session included two clinical skills categorized as being directly patient-related (patient) and two clinical skills involving laboratory diagnostics or assembling equipment (technical). Students evaluated the practice session using Likert-type scales. Two days after practice, 93 students took part in an objective structured clinical examination (OSCE). Student performance was analyzed for each learning station individually. The percentage of students who passed the OSCE did not differ significantly between the three groups at any learning station. While the examiner had an effect on absolute OSCE scores (%) at one learning station, the percentage of students who passed the OSCE did not differ between examiners. Patient learning stations were more popular with students than technical learning stations, and the percentage of students who passed the OSCE was significantly larger among students who enjoyed practicing at the respective station (90.9%) than among those who did not (77.8%).

Breaking barriers: The landscape of human and veterinary medical anatomy education and the potential for collaboration

Despite human (HUM) and veterinary (VET) medical institutions sharing the goal of educating future clinicians, there is little collaboration between them regarding curricular and pedagogical practices during the preclinical/basic science training years. This may be, at least in part, due to a lack of understanding of each type of curriculum. This study presents data about curricula, student populations, pedagogical methodologies applied, and anatomy educators' training at both HUM and VET institutions. Preclinical curricula, admissions criteria, and student demographics were analyzed for 21 institutions in the United States having both HUM and VET schools. This dataset was augmented by a questionnaire sent to anatomists internationally, detailing anatomy curricula, pedagogies applied, and anatomy educators' training. Many curricular similarities between both training programs were identified, including anatomy education experiences. However, VET programs were found to include more preclinical coursework than HUM programs. Students who matriculate to VET or HUM schools have similar academic records, including prerequisite coursework and grade point average. Median HUM class size was significantly larger, and the percentage of women enrolled in VET institutions was significantly higher. Training of anatomy educators was identical with one exception: VET educators are far more likely to hold a clinical degree. This study elucidates the substantial similarities between VET and HUM programs, particularly in anatomy education, underscoring the potential for collaboration between both types of programs in areas such as interprofessional education, bioethics, zoonotic disease management, and postgraduate training.

Evaluation of Veterinary Medical Student Retention of Pre-clinical Concepts with Various Experiential Learning Methods

Many veterinary medical colleges have undergone curricular changes that have moved away from traditional lecture-based teaching in favor of evidence-based, experiential methods of instruction. Such a curricular reinvention occurred in 2018 at Michigan State University's College of Veterinary Medicine, with individual courses using numerous instructional and learning methods. In the present study, three courses were assessed, two of which used a method of experiential learning, and the other utilizing a traditional lecture approach. The purpose of this study was to determine if the method of instruction impacted exam grades, content retention, and student perspective. Methods of teaching and learning were quantified for each course using the Classroom Observation Protocol for Undergraduate STEM. Following completion of each course, participants (n = 27) retook the same final examination and participated in a survey to evaluate their perspective 5 weeks later. Mean scores on the initial examinations in the experiential learning courses were significantly higher than the mean score of the traditional lecture course (p = .01). However, mean retake examination scores were similar for all courses (p = .76). Students reported more confidence with course materials and examinations in courses that incorporated active learning strategies. Although true retention is difficult to assess in veterinary medicine, evaluation of student perspectives suggests the use of experiential learning methods primarily or in combination with lecture-based material to support student learning of pre-clinical concepts. Future controlled studies are needed to evaluate veterinary students' short- and long-term learning and retention.

Transforming a Didactic Lecture into a Student-Centered Active Learning Exercise—Teaching Equine Diarrhea to Fourth-Year Veterinary Students

Problem-solving abilities, creative and critical thinking, communication skills, and teamwork are now recognized as fundamental determinants of professional success, especially in vocational professions, such as veterinary science. Tertiary education is now obliged to provide opportunities for students to become proficient in these qualities. With this in mind, the principal author, an equine science senior lecturer, attempted to increase student engagement by developing a new active learning, student-centered one-hour teaching episode on ‘equine diarrhea’, to replace the traditional didactic lecture format. The aim of the study, therefore, was to share the principal author’s journey in the development and implementation of this active learning episode and to explain why it represents a simple but effective method of promoting student engagement. In addition, the adaptation of this method into an online teaching and learning format is briefly discussed. The effectiveness of this active learning method is also explored by comparing it with the traditional didactic method of delivery. Students in the active learning class reported that the learning activity had enhanced their skills in clinical reasoning, problem-solving, and communication. They also described themselves as active participants in the learning process. Students in the traditional didactic class reported that they were satisfied with the time allocated to the lecture, felt that the lecture was well organized and managed, and subsequently felt adequately prepared to answer conventional examination questions relating to equine diarrhea. Other issues, such as student resistance to changes in teaching formats, the effectiveness of group work or teamwork, levels of student confidence within an active learning environment, and the importance of high-quality facilitation during active learning activities, are also discussed in this paper. Although the active learning method described is not novel, the authors hope that fellow educators, across any tertiary discipline, might find that the method described represents a quick and simple method of transforming a single didactic lecture into an enjoyable and engaging learning activity.

Proof of Concept: Game-Based Mobile Learning-The First Experience With the App Actionbound as Case-Based Geocaching in Education of Veterinary Neurology

Case-based learning is a valuable tool to impart various problem-solving skills in veterinary education and stimulate active learning. Students can solve imaginary cases without the need for contact with real patients. Case-based teaching can be well performed as asynchronous remote-online class. In time of the COVID-19-pandemic, many courses in veterinary education are provided online. Therefore, students report certain fatigue when it comes to desk-based online learning. The app “Actionbound” provides a platform to design digitally interactive scavenger hunts based on global positioning system (GPS)—called “bounds” —in which the teacher can create a case study with an authentic patient via narrative elements. This app was designed for multimedia-guided museum or city tours initially. The app offers the opportunity to send the students to different geographic localizations for example in a park or locations on the University campus, like geocaching. In this way, students can walk outdoors while solving the case study. The present article describes the first experience with Actionbound as a tool for mobile game-based and case-orientated learning in veterinary education. Three veterinary neurology cases were designed as bounds for undergraduate students. In the summer term 2020, 42 students from the second to the fourth year of the University of Veterinary Medicine Hannover worked on these three cases, which were solved 88 times in total: Cases 1 and 2 were each played 30 times, and case 3 was played 28 times. Forty-seven bounds were solved from students walking through the forest with GPS, and 41 were managed indoors. After each bound, students evaluated the app and the course via a 6-point numerical Likert rating scale (1 = excellent to 6 = unsatisfactory). Students playing the bounds outdoors performed significantly better than students solving the corresponding bound at home in two of the three cases (p = 0.01). The large majority of the students rated the course as excellent to good (median 1.35, range 1–4) and would recommend the course to friends (median 1.26, range 1–3). Summarizing, in teaching veterinary neurology Actionbound's game-based character in the context of outdoor activity motivates students, might improve learning, and is highly suitable for case-based learning.

Interaction Identified as both a Challenge and a Benefit in a Rapid Switch to Online Teaching during the COVID-19 Pandemic

The recent emergence and subsequent global spread of COVID-19 has forced a rapid shift to online and remote learning at veterinary schools. Students in a Bachelor of Veterinary Medicine program were taught using a real-time online platform for one semester, with recorded synchronous lectures and tutorials, virtual laboratories, and clinical skills classes where possible. Students in all years of the program were surveyed twice, 8 weeks apart to assess their perceptions of online teaching and to identify challenges they experienced. Using a 10-point Likert scale, students agreed that they could achieve their learning outcomes using online learning with no more difficulty than with face-to-face teaching, allocating average scores of 7.6 and 8.2 at each time point. Students were overwhelmingly positive about the impact of online teaching on time-management of their learning due to the loss of travel time. They enjoyed aspects of teaching such as recorded lectures, online polls quizzes, and chat boxes that allowed more student-focused learning. However, there were concerns about the reduction in face-to-face interactions including loss of classroom atmosphere and reduced interaction with peers. Students experienced technical problems in a median of 20% of lectures (range 10%-50%) at the first survey and 10% at the second (range 10%-50%). Increased use of strategies to optimize peer interactions is recommended to facilitate student learning using online platforms. Moving forward beyond the pandemic, allowing flexible time management and a shift toward student-centered learning using strategies such as flipped classrooms may be beneficial.

Clinical reasoning in feline vestibular syndrome: which presenting features are the most important?

OBJECTIVES

The aim of this study was to evaluate whether clinical variables from the history, clinical presentation, and physical and neurological examinations of cats with vestibular syndrome were statistically predictive of the underlying diagnosis.

METHODS

In total, 174 cats presenting with vestibular syndrome between January 2010 and May 2019 were investigated. Univariate statistical analysis of clinical variables was performed and those statistically associated with a diagnosis were retained for multivariable binary logistic regression modelling.

RESULTS

The seven most prevalent diagnoses represented 95% of vestibular presentations, which included: otitis media/interna (n = 48), idiopathic vestibular syndrome (n = 39), intracranial neoplasia (n = 24), middle ear polyp (n = 17), feline infectious peritonitis (n = 13), thiamine deficiency (n = 13) and intracranial empyema (n = 11). Idiopathic vestibular syndrome was commonly associated with non-purebred cats and had 17.8 times the odds of an improving clinical progression (95% confidence interval [CI] 1.3-250.0; P = 0.03). Intracranial neoplasia was associated with older age and chronic onset of clinical signs, and was significantly more likely to have a central vestibular neuroanatomical localisation (95% CI 8.5-344,349,142.0; P = 0.015) with postural deficits on neurological examination. Thiamine deficiency was more common in female cats, with 52.6 times the odds of a waxing and waning clinical progression (95% CI 1.2-1000; P = 0.038) and 6.8 times the odds of presenting with bilateral vestibular signs (95% CI 1.0-45.7; P = 0.047) and wide excursions of the head (95% CI 1.0-45.7; P = 0.047). Middle ear polyps were associated with 8.8 times the odds of presenting with Horner syndrome (95% CI 1.5-50.0; P = 0.015).

CONCLUSIONS AND RELEVANCE

Although it may be difficult to identify the underlying diagnosis in cats with vestibular syndrome from the presenting features alone, there are instances in which discrete clinical features may help to guide clinical reasoning when evaluating cats with vestibular presentations.

Development and Application of an Interactive Neuropathology iBook as a Complementary Learning Tool for Veterinary Medicine Students

Neuropathology is a challenging subject for most medical students. Delivering a gamified learning tool on this topic may motivate students and increase knowledge in the discipline. We report the development of such a tool in iBook format for the systemic pathology course delivered at Ross University School of Veterinary Medicine. Composed of 10 chapters (cases), this Neuropathology iBook (NP-iB) reviews basic clinical manifestations, neuropathology, and pathogenesis of common non-neoplastic conditions that cause brain disease in domestic animals. The goal of each chapter is to reach a diagnosis by interactively answering specific questions after reviewing relevant medical history, clinical pathology, and autopsy findings. Our hypothesis: the NP-iB improves students' ability to recognize these diseases, reflected in higher test scores. Using a post-test only control group design, data were gathered from all students enrolled in the course in two different semesters, fall 2017 and spring 2018 (n = 300). NP-iB users (n = 51, 17%) and usage time were identified by answers to multiple-choice questions embedded in the course assessments. Ninety percent of users had a positive perception although no statistically significant differences were found in median test scores between users and non-users. Statistically significant test score differences were found across how much time students used the NP-iB (p = .005); the lowest test score median values were found for neuropathology questions not related to the NP-iB, in students who used it for more than 3 hours. Unexpectedly, a low number of students preferred this digital learning tool, and its use did not improve their learning outcomes.

A Unique Approach to Project-Based Learning (PjBL) in a Veterinary Anatomy Course

INTRODUCTION

Project-based learning (PjBL) is a teaching methodology designed to engage students in solving real-world problems, acknowledging that students are active agents of their learning process. This methodology has historically been popular in architecture and industrial sciences; however, its use in teaching veterinary anatomy is scarcely published.

METHODS

Using information and communication technologies, the PjBL methodology was implemented in a first-year veterinary anatomy course. The methodology included teamwork and the selection of a routine object in the veterinary clinic at the beginning of the academic semester. The project's goal was to analyze the object and associate it with both a domestic animal species and an anatomical region, along with making and presenting a video or a simulation model about the object.

RESULTS

More than 80% of students prefer active learning classes compared to traditional classes. In addition, 66% and 86% of students indicate that PjBL allowed them to improve their understanding of theoretical content for the first and second years of post-implementation, respectively. Students' self-assessment indicates that more than 80% of the students (first and second year post-implementation) felt they were responsible for the execution of the project, able to conduct research, and able to develop autonomous learning skills. After 2 years of PjBL implementation, failure rates in the course decreased by 21%.

DISCUSSION

In general, PjBL results show that veterinary students prefer active learning activities that allow them to learn in a team-based learning process as well as to develop soft skills such as self-learning, responsibility, and teamwork.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-021-01205-1.

Students' Engagement in and Perceptions of Blended Learning in a Clinical Module in a Veterinary Degree Program

Blended learning has received much interest in higher education as a way to increase learning efficiency and effectiveness. By combining face-to-face teaching with technology-enhanced learning through online resources, students can manage their own learning. Blended methods are of particular interest in professional degree programs such as veterinary medicine in which students need the flexibility to undertake intra- and extramural activities to develop the range of competencies required to achieve professional qualification. Yet how veterinary students engage with blended learning activities and whether they perceive the approach as beneficial is unclear. We evaluated blended learning through review of student feedback on a 4-week clinical module in a veterinary degree program. The module combined face-to-face sessions with online resources. Feedback was collected by means of a structured online questionnaire at the end of the module and log data collected as part of a routine teaching audit. The features of blended learning that support and detract from students' learning experience were explored using quantitative and qualitative methods. Students perceived a benefit from aspects of face-to-face teaching and technology-enhanced learning resources. Face-to-face teaching was appreciated for practical activities, whereas online resources were considered effective for facilitating module organization and allowing flexible access to learning materials. The blended approach was particularly appreciated for clinical skills in which students valued a combination of visual resources and practical activities. Although we identified several limitations with online resources that need to be addressed when constructing blended courses, blended learning shows potential to enhance student-led learning in clinical courses.

Clinical reasoning in canine vestibular syndrome: Which presenting factors are important?

BACKGROUND

Although the use of clinical reasoning has been evaluated for several neurological presentations, this approach has not yet been investigated for dogs with vestibular syndrome.

METHODS

Two hundred and thirty-nine dogs presenting with vestibular syndrome were included in this retrospective study. Univariate analysis of variables (clinical history, signalment, clinical presentation and neurological examination findings) was performed. Variables with p < 0.3 were selected for logistic regression.

RESULTS

Ninety-five percent of dogs were represented by eight conditions: idiopathic vestibular disease (n = 78 dogs), otitis media interna (n = 54), meningoencephalitis of unknown origin (n = 35), brain neoplasia (n = 26), ischaemic infarct (n = 25), intracranial empyema (n = 4), metronidazole toxicity (n = 3) and neoplasia affecting the middle ear (n = 3). Idiopathic vestibular disease was associated with higher age, higher bodyweight, improving clinical signs, pathological nystagmus, facial nerve paresis, absence of Horner's syndrome and a peripheral localisation. Otitis media interna was associated with younger age, male gender, Horner's syndrome, a peripheral localisation and a history of otitis externa. Ischaemic infarct was associated with older age, peracute onset of signs, absence of strabismus and a central localisation.

CONCLUSIONS

Discrete clinical features can be used to identify the most likely diagnosis in dogs with vestibular syndrome.

What a veterinary graduate should know about basic and clinical pharmacology: A Delphi study to finalize day-1 competencies

The recent changes in curricula in veterinary medicine have changed the delivery and focus on veterinary pharmacology and therapeutics, resulting in a perceived lack of knowledge of pharmacology and therapeutic decision making in recent graduates. To aid veterinary pharmacologists and clinicians teaching clinical pharmacology, core competencies were drafted by a working group. Following this process, a Delphi study was performed to come to a consensus on day-1 competencies in veterinary pharmacology and therapeutics. The described competencies could be useful to a variety of stakeholders in veterinary pharmacology, including those teaching veterinary pharmacology worldwide. Secondly, they could form the basis of vertical alignment of the subject within schools and across the world, as well as serving to frame the integration of veterinary pharmacology and therapeutics into competency-based veterinary education.

How management of grief associated with ending the life of an animal is taught to Australasian veterinary students

OBJECTIVE

Veterinarians have an important role in supporting and understanding their clients' grief. Veterinary schools have a duty to teach students how best to manage grief - both that of the students/future veterinarians and the clients. This study explores how grief management, associated with ending the life of an animal, was taught to students in eight Australasian veterinary schools.

METHODS

A questionnaire-style interview guide was used by a representative at each university to conduct structured interviews with educators in a snowball sampling approach. Educators were interviewed about the teaching of grief management for four categories of animals: livestock, equine, companion and avian/wildlife. The terms used by participants to describe what they taught were grouped into common themes. Teaching was defined by individual participants and included structured and unstructured approaches. The stage in the degree (preclinical or clinical years) that grief management was taught in the veterinary curriculum and by whom (e.g. clinicians or psychologists) is also described.

RESULTS

Grief management was taught more in preclinical than clinical years. However, due to how grief was characterised, much of this teaching was general 'nonspecific' teaching that included all categories of animals. Client grief was taught more generically, whereas, grief of veterinarians was taught using specific examples given by clinicians.

CONCLUSION

A more robust end-of-life (EoL) management curriculum that includes all aspects of grief management is likely to increase job satisfaction, client happiness and professional satisfaction.

Educating the Future of Science and Medicine

For the past two decades, veterinary educators have been at the forefront of innovations in educational practices related to science and medicine. Many of the resulting methods have been translated and implemented as best practices across the breadth of disciplines in higher education. However, past World Organization for Animal Health (OIE) global conferences have highlighted the necessity for improving global harmonization of veterinary medical education. This underscores a growing need for even broader dissemination of best practices and assessment programs related to educating our veterinary workforce.

Veterinary parasitology teaching at London - Meeting the 'Day-One Competency' needs of new veterinarians

Over the past four decades, there has been an exponential increase in veterinary parasitology knowledge, coinciding with the advent of molecular biology in research. Therefore, it is unrealistic for teachers to expect students to graduate with an encyclopaedic knowledge of the subject. As a result, a new curriculum was introduced at The Royal Veterinary College (University of London) in 2007, designed to meet the needs of our new graduates, i.e. RCVS Day-One Competences. The aims of this curriculum are, inter alia, to ensure that new graduates have an up-to-date body of core knowledge and are able to apply such knowledge and newly-acquired information to scientific and clinical problem-solving. Veterinary parasitology is taught primarily in Year 2, following a brief introduction in Year 1; clinical aspects are covered in Year 3, with original research projects undertaken in Years 4 and 5. Parasitology is taught in parallel with other subjects, enabling both horizontal and vertical integration. Core material is provided in lectures supplemented by directed learning (DL) in small groups and interactive, clinical scenario-based practical classes. Student learning is supported by Moodle 3.2 (Virtual Learning Environment [VLE], RVC Learn) which provides access to an on-line study guide (annotated using Adobe Reader), PowerPoint presentations with synchronized lecturer commentary (Echo Active Learning Platform [ALP]), detailed feedback for DL and practical classes, parasite 'potcasts' and CAL packages, and a Clinical Skills Centre. A parasitology textbook has also been published recently to support courses taught at the College. Assessment of student learning is achieved using a variety of written formats (essay, problem-solving questions [PSQ], multiple choice questions [MCQ] and extended matching questions [EMQ]), integrated oral examinations and objective structured clinical examinations (OSCEs).

Approaches and Study Skills of Veterinary Medical Students: Effects of a Curricular Revision

The objective of this study was to determine if a revised, recently implemented curriculum, embracing an integrated block design with a focus on student-centered, inquiry-based learning, had a different effect on veterinary medical students' approaches to studying than the previous curriculum. A total of 577 students completed a questionnaire consisting of the short version of the Approaches and Study Skills Inventory for Students (ASSIST). It included questions relating to conceptions about learning, approaches to studying, and preferences for different types of courses and teaching. In addition, students were asked to respond to general questions regarding the design of the revised curriculum. The scores for the deep and strategic learning approaches were higher for students studying under the previous curriculum compared to the revised curriculum, despite the fact that the revised curriculum was specifically designed to foster deep learning. The scores for the surface learning approach were lower in the students studying the revised curriculum compared to students studying under the previous curriculum. We identified the following factors affecting student learning: alteration of learning activities, such as problem-based learning, from the recommended models; a lack of instructor support for the revised curriculum; assessments that were not aligned to encourage critical thinking; and directed self-learning activities that were too comprehensive to complete in the allotted time. The results of this study can be used to improve the implementation of student-centered and inquiry-based curricula by identifying potential problems that could prevent a deep learning approach in veterinary medical students.

Curricular Review and Renewal at Massey University: A Process to Implement Improved Learning Practices

Curriculum managers of the Bachelor of Veterinary Science program at Massey University have undertaken major curricular review every 5-10 years and also made adjustments to the program as a result of student and other stakeholder feedback. New curricula introduced in 2003 and 2013 aimed to address specific stakeholder requirements in the veterinary, agricultural, and allied industries. The new curricula initially sought to strengthen clinical skills but more recently focused on the core professional skill of client communication, the integration of knowledge and clinical skills, and a better understanding of the effects of herd health interventions on farm economics. The need for greater emphasis on the veterinarian's role in One Health at the intersection of humans, animals, and the environment was also recognized. The most recent curricular review was preceded by faculty enlightenment and discussion about innovative models of medical education with a focus on student-centered and integrated learning. A new curriculum was introduced from 2013 that presented more material in its clinical context, attempted to manage curriculum overload through a focus on Day One Competences, implemented vertical and horizontal integration of subjects, and introduced more problem-based and student-centered learning. Regular reviews of student workload were needed to ensure that the objectives were achieved, but student feedback has generally been positive.

Expectations of Graduate Communication Skills in Professional Veterinary Practice

Good communication skills are an important entry-level attribute of graduates of professional degrees. The inclusion of communication training within the curriculum can be problematic, particularly in programs with a high content load, such as veterinary science. This study examined the differences between the perceptions of students and qualified veterinarians with regards to the entry-level communication skills required of new graduates in clinical practice. Surveys were distributed to students in each of the four year levels of the veterinary science degree at the University of Melbourne and to recent graduates and experienced veterinarians registered in Victoria, Australia. Respondents were asked to rank the relative importance of six different skill sets: knowledge base; medical and technical skills; surgical skills; verbal communication and interpersonal skills; written communication skills; and critical thinking and problem solving. They were then asked to rate the importance of specific communication skills for new graduate veterinarians. Veterinarians and students ranked verbal communication and interpersonal skills as the most important skill set for an entry-level veterinarian. Veterinarians considered many new graduates to be deficient in these skills. Students often felt they lacked confidence in this area. This has important implications for veterinary educators in terms of managing the expectations of students and improving the delivery of communication skills courses within the veterinary curriculum.

Clinical reasoning in canine spinal disease: what combination of clinical information is useful?

Spinal disease in dogs is commonly encountered in veterinary practice. Numerous diseases may cause similar clinical signs and presenting histories. The study objective was to use statistical models to identify combinations of discrete parameters from the patient signalment, history and neurological examination that could suggest the most likely diagnoses with statistical significance. A retrospective study of 500 dogs referred to the Queen Mother Hospital for Animals before June 2012 for the investigation of spinal disease was performed. Details regarding signalment, history, physical and neurological examinations, neuroanatomical localisation and imaging data were obtained. Univariate analyses of variables (breed, age, weight, onset, deterioration, pain, asymmetry, neuroanatomical localisation) were performed, and variables were retained in a multivariate logistic regression model if P<0.05. Leading diagnoses were intervertebral disc extrusion (IVDE, n=149), intervertebral disc protrusion (n=149), ischaemic myelopathy (IM, n=48) and neoplasms (n=44). Multivariate logistic regression characterised IM and acute non-compressive nucleus pulposus extrusions as the only peracute onset, non-progressive, non-painful and asymmetrical T3-L3 myelopathies. IVDE was most commonly characterised as acute onset, often deteriorating, painful and largely symmetrical T3-L3 myelopathy. This study suggests that most spinal diseases cause distinctive combinations of presenting clinical parameters (signalment, onset, deterioration, pain, asymmetry, neuroanatomical localisation). Taking particular account of these parameters may aid decision making in a clinical setting.

Career attitudes of first-year veterinary students before and after a required course on veterinary careers

Careers in Veterinary Medicine is a required, one-credit-hour course at the North Carolina State University College of Veterinary Medicine (NCSU-CVM), which meets once weekly during veterinary students' first semester. Lectures in this course are presented by one or more veterinarians representing diverse career areas. A voluntary, anonymous survey was distributed before the first class meeting in 2011 (PRE) and at the end of the semester (POST) to assess if students' career interests changed during the semester. The survey collected basic demographic data and students' preferences (on a Likert scale) for 17 veterinary career paths. Out of 63 students, 36 (57%) in the POST survey said that their career interests had changed during the semester, and 17 of the 26 students (65%) who gave a reason credited the careers course as one factor in reconsidering their career choice. Only 3 of the 17 career paths had statistically significant PRE/POST survey differences in Likert response frequency (equine practice, pathology, and wildlife medicine), but both informal discussions with students and responses to open-ended survey questions indicated that many students valued the introduction to unfamiliar veterinary career areas. Careers in Veterinary Medicine is a vital component of recent career-planning initiatives in the college, which will be especially important to veterinary students as they face continued changes in the profession, such as the increased debt load of the new graduate and the threat of veterinary workforce oversupply.

Challenges and responsibilities of clinical teachers in the workplace: an ethnographic approach

This study aimed to explore the complex role of the clinical teacher in the workplace, with a view to identifying effective teaching practices. An ethnographic case-study approach was taken, including participant observations and semi-structured interviews with three participants that were selected from two participating veterinary institutions. The clinical teacher has several responsibilities, such as establishing a rapport with learners and maximizing the use of case-based learning opportunities to provide instruction and support to individual learners in a safe but challenging environment. Associated difficulties include balancing the competing demands of students' learning needs and patients' welfare, as well as maximizing the learning opportunities within available case material. Participants in this study demonstrated a reflective approach, adjusting their teaching approach "in action" and "on action" as appropriate.

Team-based learning increases active engagement and enhances development of teamwork and communication skills in a first-year course for veterinary and animal science undergraduates

Team-based learning (TBL) was implemented into a first-year course (Principles in Animal Behaviour, Welfare and Ethics) for BSc Veterinary Bioscience (VB) and Animal Science (AS) students. TBL is now used widely in teaching medical students, but has had more limited uptake in veterinary education. This study reports its use over 2 years with cohorts of 126 and 138 students in 2011 and 2012, respectively. Average individual marks for multiple-choice question (MCQ) tests in the Readiness Assurance component of TBL were higher for the teams than for individuals for each session, explicitly demonstrating the advantages of teamwork. Students reported that they felt actively involved and that TBL helped them both with their learning and in developing other important skills, such as teamwork and communication. Qualitative analysis of written feedback from the students revealed positive themes of discussion, application, revelation, socializing, engagement, clarification, and retention/revision. In 2011 negative comments included the need to shorten the TBL sessions, but in 2012 tightening of the timelines meant that this was no longer a major concern. Requests to provide better introductory and background materials and ambiguity in questions in the TBL activities were what students least liked about the TBL. However, most comments were positive rather than negative in nature, and many students preferred the TBL to lectures. With requirements for curricula to teach professional skills, such as communication and teamwork, and the positive results from TBL's implementation, it is hoped that this study will encourage others to trial the use of TBL in veterinary education.

Optimizing biomedical science learning in a veterinary curriculum: a review

As veterinary medical curricula evolve, the time dedicated to biomedical science teaching, as well as the role of biomedical science knowledge in veterinary education, has been scrutinized. Aside from being mandated by accrediting bodies, biomedical science knowledge plays an important role in developing clinical, diagnostic, and therapeutic reasoning skills in the application of clinical skills, in supporting evidence-based veterinary practice and life-long learning, and in advancing biomedical knowledge and comparative medicine. With an increasing volume and fast pace of change in biomedical knowledge, as well as increased demands on curricular time, there has been pressure to make biomedical science education efficient and relevant for veterinary medicine. This has lead to a shift in biomedical education from fact-based, teacher-centered and discipline-based teaching to applicable, student-centered, integrated teaching. This movement is supported by adult learning theories and is thought to enhance students' transference of biomedical science into their clinical practice. The importance of biomedical science in veterinary education and the theories of biomedical science learning will be discussed in this article. In addition, we will explore current advances in biomedical teaching methodologies that are aimed to maximize knowledge retention and application for clinical veterinary training and practice.

Information-seeking behaviors of first-semester veterinary students: a preliminary report

Although emphasis in veterinary education is increasingly being placed on the ability to find, use, and communicate information, studies on the information behaviors of veterinary students or professionals are few. Improved knowledge in this area will provide valuable information for course and curriculum planning and the design of information resources. This article describes a survey of the information-seeking behaviors of first-semester veterinary students at Purdue University. A survey was administered as the first phase of a progressive semester-long assignment for a first semester DVM course in systemic mammalian physiology. The survey probed for understanding of the scientific literature and its use for course assignments and continuing learning. The survey results showed that students beginning the program tended to use Google for coursework, although some also used the resources found through the Purdue libraries' Web sites. On entering veterinary school, they became aware of specific information resources in veterinary medicine. They used a small number of accepted criteria to evaluate the Web site quality. This study confirms the findings of studies of information-seeking behaviors of undergraduate students. Further studies are needed to examine whether those behaviors change as students learn about specialized veterinary resources that are designed to address clinical needs as they progress through their training.

An instructional intervention to encourage effective deep collaborative learning in undergraduate veterinary students

In recent years, veterinary education has received an increased amount of attention directed at the value and application of collaborative case-based learning. The benefit of instilling deep learning practices in undergraduate veterinary students has also emerged as a powerful tool in encouraging continued professional education. However, research into the design and application of instructional strategies to encourage deep, collaborative case-based learning in veterinary undergraduates has been limited. This study focused on delivering an instructional intervention (via a 20-minute presentation and student handout) to foster productive, collaborative case-based learning in veterinary education. The aim was to instigate and encourage deep learning practices in a collaborative case-based assignment and to assess the impact of the intervention on students' group learning. Two cohorts of veterinary students were involved in the study. One cohort was exposed to an instructional intervention, and the other provided the control for the study. The instructional strategy was grounded in the collaborative learning literature and prior empirical studies with veterinary students. Results showed that the intervention cohort spent proportionally more time on understanding case content material than did the control cohort and rated their face-to-face discussions as more useful in achieving their learning outcomes than did their control counterparts. In addition, the perceived difficulty of the assignment evolved differently for the control and intervention students from start to end of the assignment. This study provides encouraging evidence that veterinary students can change and enhance the way they interact in a group setting to effectively engage in collaborative learning practices.

Curriculum integration within the context of veterinary education

Curriculum integration has been applied across a range of educational levels as a means of attempting to improve learning outcomes, but there is a paucity of information that has defined and explored curriculum integration as it relates to the teaching of veterinary science. A definition of curriculum integration in the teaching of veterinary science is suggested, which places students as lifelong learners at the center of the educational model. Learning activities are designed to help students see connections among disciplines and topics, thus reinforcing their relevance and helping them to apply their knowledge to different contexts. Curriculum integration at James Cook University in the first three years of the program has been promoted through the design of assessment, the use of case studies, imaging, and palpable anatomy, learning of clinical skills, a research project, animal handling, and a personal professional development program. Advantages and disadvantages of curriculum integration are discussed. Further work is needed to determine if this mode of curriculum design is able to produce veterinary graduates who are better able to meet the challenges of a changing workplace in the twenty-first century.