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

How can better calf care be realized on dairy farms? A qualitative interview study of veterinarians and farmers

Improving health and welfare outcomes for replacement and surplus dairy calves is important for the sustainability of the dairy industry. Dairy farmers and veterinarians hold expertise in calf management and have valuable perspectives on how to practically motivate improvements. The objective of this study was to determine strategies that could improve the care calves receive on dairy farms from the perspective of dairy farmers and their herd veterinarians. Two veterinary clinics specializing in dairy practice in British Columbia, Canada, and 21 of their client dairy farms participated in the project. Following a meeting in which calf colostrum management was discussed between farmers and their herd veterinarian, participant interviews were conducted. Separate interviews were conducted for the farmers (n = 27 farmers from 21 farms) and their herd veterinarians (n = 7, with 1 to 5 farms that each vet worked with enrolled in the study) using tailored semi-structured question guides. Interviews (n = 42) were transcribed and coded following inductive thematic analysis methodology. The themes identified included strategies for farmers, veterinarians, and calf buyers, as well as contexts that influenced the dairy farmers' internal motivation to provide good calf care. Results indicated that farmers could optimize their calf management through fostering engagement of calf care personnel or by enlisting technology. Veterinarians could provide support to farms by being actively involved in calf monitoring, assisting in developing operating protocols, and setting goals, and especially by using farm-specific data to guide their management recommendations. Calf buyers could communicate with and provide accountability to farmers and improve their purchasing strategies to encourage farms to raise more vigorous surplus calves. Farmers' personal values, social networks, and relationships with different dairy industry stakeholders influenced their concern about the standards of their calf care practices. These findings provide guidance on how dairy farmers could achieve or be prompted to achieve improvements in their calf care practices.

Perceptions of biosecurity in a Canadian dairy context

The objective of this review was to outline current implementation of biosecurity, the impact of biosecurity on the industry, and producers' and veterinarians' perceptions of biosecurity with a focus on the Canadian dairy industry. Biosecurity is an important aspect of farm safety by reducing the spread of pathogens and contaminants, improving animal health and production, and maintaining human safety. Implementation of biosecurity practices range between farms and countries. Since Canada's supply management system is different compared with other countries, different barriers and perceptions of biosecurity may exist. Producers have various perspectives on biosecurity, many of which are negative, such as being expensive or time consuming. Producers are motivated and deterred from biosecurity implementation for many reasons, including perceived value, disease risk, and financial incentives or deterrents. Additionally, with veterinarians being a trusted source of information, veterinarians' approach to discussions on biosecurity implementation are important to understand. Veterinarians and producers appear to have differing opinions on the importance of biosecurity and the approach to discussing biosecurity. Improving biosecurity implementation requires a multifactorial approach, such as individualized education and awareness for producers, further research into efficacy of and barriers to biosecurity, and development of effective communication strategies between veterinarians and producers.

Use of an online gaming tool, the Veterinary DialogueTrainer, for teaching clinical communication skills to bovine veterinary practitioners

Effective clinical communication is essential for bovine veterinary practitioners to establish and maintain positive client relationships. When applied properly in herd health consultancy, it increases client satisfaction and adherence to veterinary advice, and improves patient health and welfare. Although communication skills are often taught by providing feedback on simulated conversations, this has limitations, including time constraints, subjective assessments, and cost. The Veterinary DialogueTrainer (VDT) is an online serious game platform using 'digital role-play' with avatars, recently developed to enhance and assess learning outcomes, improve use of learned skills, and increase cost-effectiveness of communication training. The objective was to evaluate its suitability and applicability. Finnish (n = 24) and Swedish (n = 21) bovine veterinarians participated in communication training using VDT for training and assessment. Participants completed the provided scenario at least twice. After playing a bovine health communication simulation, participants received their scores and feedback on selected conversation options. VDT scores measured multiple aspects of communication on a 0-100% scale, based on motivational interviewing methodology and Calgary-Cambridge guidelines. Mean (±SD) number of attempts participants played the scenario was 4.1 (±2.6, Finland) and 3.9 (±1.3, Sweden), with highest total score reached after a mean of 3.5 (±2.1, Finland) and 3.1 (±1.1, Sweden) attempts. On the first attempt, 39 participants (87%) scored <50% of the highest possible score, whereas most (n = 34, 76%) achieved a higher score on the second attempt. Mean total score increased from 15 (±14) to 77% (±33) for Finish participants and from 40 (±22.0) to 87% (±19.4) for Swedish participants. The majority (n = 33, 73%) of participants reached a score >80% after 4.0 (±1.6, Finland) or 2.8 (±1.0, Sweden) attempts. Net Promoter Score of the training was +89 (Finland), +88 (Finland) and + 83 (Sweden) on a scale from -100 to +100, indicating that most participants were very likely to recommend the training to other veterinarians. Use of VDT increased communication skills scores but whether it will improve communication skills in practice requires further study. We concluded there is a likely benefit of using the VDT in teaching and monitoring veterinary communication competencies and preparing for offline role-plays and real-life conversations in veterinary practice.

Factors within A Veterinarian-Cattle Farmer Relationship That May Impact on Biosecurity Being Carried out on Farms: An Exploratory Study

Veterinarians (vets) appear to be one of the main gateways to biosecurity information for cattle farmers, and therefore are likely to affect the implementation of these measures. The aim of this study was to explore factors within the vet-farmer relationship that may impact on biosecurity being carried out on cattle farms in England. Interviews were conducted with cattle farmers and large-animal vets, with a focus on individuals deemed to implement good levels of biosecurity or those working with said individuals. The questions explored how each stakeholder felt the communication occurred between the groups and the perceived consequential influence each had on the other. Inductive Thematic analysis was used to explore participants' experience of vet-farmer interactions with a focus on areas of reciprocity between the two groups. Five primary themes were identified. Factors within the vet-cattle farmer relationship, such as trust and familiarity, which were interconnected with time spent with each other, appeared to influence the uptake of biosecurity measures on cattle farms. These factors purportedly impacted the ability of vet-farmer pairs to have cooperative discussions and enter into shared decision-making. In order to enhance animal and human health and welfare, these relationship factors might be key to the development of sustainable optimisation frameworks.

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

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

Barriers and facilitators to implementing a new regulation restricting antimicrobial use in dairy production in Québec, Canada: A qualitative study

With the emergence of antimicrobial resistance (AMR), many countries are implementing restrictive regulations to reduce antimicrobial use (AMU) in animal production. Although these measures are effective at the national level, their implementation may generate challenges for producers and veterinarians. The objective of this study was to explore the barriers and facilitators of implementing a new regulation restricting the use of antimicrobials of very high importance for human health in the dairy production sector in the province of Québec, Canada. Individual interviews were conducted with fifteen veterinarians and twenty-seven dairy producers. Thematic analysis was performed based on the COM-B model of behavior change (capability-opportunity-motivation-behavior). Our results indicated that the lack of availability of alternative treatments, the long delays related to diagnostic tests and the fear of economic consequences were major barriers to the implementation of the regulation. A small number of producers also perceived that the regulation negatively impacted the health and wellbeing of their animals. Additionally, participants acknowledged the importance of early education and training to better understand the purpose of the regulation and increase its acceptability. Lastly, most participants reported that they had not only reduced their use of antimicrobials of very high importance for human health following the regulation, but they had also increased preventive practices on their farm. This study reveals that the implementation of restrictive regulations to reduce AMU in animal production can lead to multiple challenges in practice. Our results highlight the need for better communication and training of producers and veterinarians before and during the implementation of similar regulations in the future and underline the importance of measuring the direct and indirect impacts of those regulations on productivity and on animal health and wellbeing.

Investigating Ontario dairy farmers motivations and barriers to the adoption of biosecurity and Johne's control practices

For the control of Johne's disease (JD), management practices to minimize disease transmission must be implemented and maintained. Once infected, animals will enter a latent phase and will typically only manifest clinical symptoms years later. As young calves are the main susceptible group on farm, the observed effects of management practices geared toward minimizing their exposure to infective material may not be realized until years later. This delayed feedback limits the sustained implementation of JD control practices. Although quantitative research methods have demonstrated changes to management practices as well as their association with changes to JD prevalence, dairy farmers can offer insights into the current challenges relating to JD implementation and control. Thus, this study aims to use qualitative methods and in-depth interviews (n = 20) with Ontario dairy farmers who had previously been engaged in a Johne's control program to explore their motivations and barriers to the implementation of JD control practices and general herd biosecurity. A thematic analysis using inductive coding was completed generated the following 4 overarching themes: (1) the hows and whys of Johne's control, (2) barriers to general herd biosecurity, (3) barriers to Johne's control, and (4) overcoming barriers. Farmers no longer believed JD was an issue on their farm. Johne's was low on their list of concerns due to little public discourse, absence of animals displaying clinical signs, and no financial support for diagnostic testing. Producers who were still actively engaged in JD control cited animal and human health as their primary motivations. Financial support, targeted education, and promoting engagement through discourse may help encourage producers to reconsider their participation in JD control. Government and industry collaboration with producers may help to develop more effective biosecurity and disease control programs.

Assessment of a joint farmer-veterinarian discussion about biosecurity using novel social interaction analyses

Veterinarians are trusted by farmers and play an important role in assisting them to implement biosecurity. More research is needed that particularly focuses on the impact of joint farmer-veterinarian discussions to further understand the role of communication in altering biosecurity behaviours. The aim of this study was to analyse joint dairy cattle farmer-veterinarian discussions about the adoption of on-farm biosecurity using novel social interaction methodologies. Farmer and veterinarian stakeholders were invited to take part in a face-to-face meeting. Introductory presentations were given, followed by separate facilitated veterinarian and farmer discussions. All stakeholders were brought together for a final facilitated group discussion which was audio recorded. Corresponding transcripts from the recordings were analysed via thematic and conversation analyses. Conversation analysis assessments such as turn taking, repair, sequence organisation, overlap and asymmetry were employed to investigate the nature of the conversation. Thematic analysis identified the negative repercussions of conflicting information or ineffective communication surrounding biosecurity implementation. The type of, and importance of, the relationship farmers had with veterinarians and other stakeholders was highlighted. The need to provide personalised biosecurity protocols on farms was identified. Four key factors were identified via conversation analyses. These included: 1) how the conversation facilitated agreement, 2) how the conversation allowed the farmer and veterinarian participants to learn from one another in real time, 3) how the discussion enabled participants to expand upon points they were making, and 4) how participants were able to obtain a greater understanding of the other participants' opinions, even without total resolution. Debate around the effective implementation of biosecurity measures on farms, explored using novel techniques, demonstrated the potential for utilising a discussive approach between veterinarians and farmers to lead to solutions not previously considered. Because of the nature of the discussion, conversation analysis resulted in an informative approach to encapsulating the nuanced dialogue between stakeholders, highlighting the potential of this analysis framework.

Veterinarians' use of shared decision making during on-farm interactions with dairy and beef producers

BACKGROUND

The objectives of this study were to explore the level of shared decision making (SDM) between veterinarians and dairy and beef producers during on-farm interactions and to identify factors associated with veterinarians' use of SDM behaviours.

METHODS

A cross-sectional sample of food-animal veterinarians and their clients were recruited in Ontario, Canada. Their on-farm interactions were audio-video recorded. The recordings were analysed using the 'Observing Patient Involvement in Decision Making' (observer OPTION5 ) instrument to determine the level of SDM utilised during preference-sensitive decisions. A logistic regression model was developed to assess factors associated with a preference-sensitive decision occurring. Meanwhile, a linear regression model was developed to identify factors associated with the level of SDM used.

RESULTS

Forty-one veterinarians participated, and 186 unique veterinarian-producer interactions were audio-video recorded and OPTION5 score was calculated. SDM scores were low and comparable to other studies using the OPTION5 instrument. The only factor associated with whether a preference-sensitive decision occurred was the length of the veterinarian and producer's relationship (in years). As the length of their relationship increased, a preference-sensitive decision was less likely to occur. The use of SDM behaviours was found to decrease as veterinarian burnout score increased. These findings demonstrate that SDM behaviours are being used by food-animal veterinarians, yet an opportunity exists to further implement more producer-centred SDM skills into on-farm interactions.

LIMITATIONS

Small portions of veterinarian-producer conversation occurred outside of audio-video-recorded interactions and were not included in the analysis.

CONCLUSION

The results of this study aid in further understanding on-farm interactions between veterinarians and producers and can help to further improve veterinary communication curricula.

Trust, agreements, and occasional breakdowns: Veterinarians' perspectives on farmer-veterinarian relationships and use of antimicrobials for Swedish dairy cattle

Studies have shown that farmer-veterinarian relationships influence antimicrobial use (AMU) in livestock, though how they do so is unclear. On the one hand, research shows that well-established veterinarian-farmer relationships are positive for implementation of antibiotic stewardship and restrictive AMU. On the other hand, studies also show that farmer demands can increase antimicrobial prescribing and that prescribing antimicrobials can strengthen the veterinarian's relationship with farmer clients. In the present study, we focus on veterinarians' perspectives on the relationships between dairy cattle farmers and veterinarians in Sweden and explore what characterizes these relationships when restrictive AMU is described as unproblematic and when AMU becomes a matter of tension or conflict. The study draws on semistructured interviews with 21 veterinarians working with livestock in Sweden. Interviews were analyzed thematically. The study shows that from the perspectives of veterinarians, well-established veterinarian-farmer relationships generally facilitate restrictive AMU in 3 slightly different but related ways: (1) they create trust in the veterinarian and their prescribing decisions; (2) they create shared understanding concerning when antimicrobials are needed and not needed; and (3) they facilitate constructive discussions between veterinarians and farmers on AMU. To make the farmer feel listened to and to come to an agreement on AMU was described as central for the veterinarians. However, the veterinarians described agreements on restrictive AMU as sometimes requiring strategic work, such as discussions to motivate the farmer and leave the door open for antimicrobials later if needed. Such work takes time and energy and is easier within well-established relationships according to the veterinarians. We also identified examples where veterinarians explained that they occasionally make compromises with farmers concerning antimicrobials-compromises that, according to the veterinarians, facilitate the relationship with the farmer, which in turn facilities restrictive AMU in the longer term. The examples in our interviews where antimicrobials became a matter of tension and even conflict between veterinarians and farmers could, with a few exceptions, be traced to absence of well-established relationships. However, some veterinarians also described AMU as a matter of tension within well-established relationships, especially with older farmers who do not trust new treatment strategies. We also found a small number of examples where disagreements on antimicrobials made a relationship with specific farmers impossible. Thus, even though the interviewed veterinarians generally meant that their restrictive antimicrobial prescribing did not threaten the relationship with the farmer, our study also, to some extent, confirms research showing that restrictive AMU can harm the relationship with some clients who simply choose another, less restrictive, veterinarian. In summary, our study supports that decisions on AMU cannot be reduced to the individual prescriber's behavior, nor to a strict medical judgment. Antimicrobial use for dairy cattle needs to be understood as taking form in relationships in which both veterinarians and farmers are active parts.

Integrating Communication Skills, Awareness of Self and Others, and Reflective Feedback into One Inclusive Anatomical Representation of Relationship-Centered Health Care

The American Veterinary Medical Association Council on Education mandates in standard 11 that all accredited colleges of veterinary medicine must develop and deliver formal processes by which students are observed and assessed in nine competencies. The eighth competency combines clinical communication and sensitivity toward soliciting and understanding individual narratives across a diverse clientele to facilitate health care delivery. Several frameworks have been designed to structure health care consultations for teaching and coaching purposes. The Calgary-Cambridge guide (CCG) provides an evidence-based approach to outlining the flow of consultations, incorporating foundational communication skills and elements of relationship-centered care into a series of sequential tasks. Although the CCG was intended for use as a flexible tool kit, it lacks visible connections between concrete experiences (e.g., the consultation) and reflective observation (e.g., the feedback). This teaching tip describes the development of a novel anatomical representation of the consultation that integrates process elements of the CCG with other core curricular concepts. By combining knowledge, technical skills, critical thinking, reflection, cultural humility, and self-awareness into a skeletal consultation model, linkages are established between communication and intergroup dialogue skills, diversity and inclusion (D&I). This model has been further adapted as feline, caprine, porcine, equine, avian, and reptilian versions for in-class use as strategic visual aids that highlight key areas of focus for Professional Skills class sessions. Future developments by the authors will explore how to link species-specific consultation models to assessment rubrics to reinforce the connection between content (what) and process (how).

Managing organic dairy herd health: Current roles and possible future roles for veterinarians with organic dairy clientele

This study aimed to understand the veterinary-client relationship and perspectives in organic dairy production systems. Twenty-three organic dairy producers and 12 veterinarians were interviewed using semi-structured, one-on-one interviews. Consultation with local veterinarians was typically infrequent, as there was greater reliance on other producers and organic industry professionals for advice on dairy herd health management, perhaps due to a shared focus on organic farming principles. Organic producers generally consulted local veterinarians most frequently to develop vaccine protocols, address animal health emergencies, and gain reproductive services. Common reasons organic producers cited for not regularly consulting a local veterinarian included the cost of veterinary services and a perception that local veterinarians have limited experience with organic systems and products. Some producers also expressed the idea that infrequent veterinarian usage is indicative of a healthy herd. Meanwhile, local veterinarians reported that organic dairy producers often delayed consulting them about individual cases until animal health problems were severe. Local veterinarians also identified challenges in servicing organic herds, such as the lack of standardized regulations between different organic certifiers and limited safety and efficacy data for many herd health products used by organic producers. In addition, their formal training generally did not include organic herd health strategies. Organic dairy clients were typically a small fraction of the overall workload for local veterinarians, which precluded their ability to accumulate experience. In contrast, a handful of specialized veterinarians in the organic milk processing industry work more frequently with organic producers and have published most of the available resource materials on organic dairy herd health. Veterinary-client partnerships could be improved through more open communication and discussion of the challenges identified in this study and through participatory research and outreach engagement that includes local veterinarians, organic certifiers, organic industry veterinarians, and producers.

Dairy herd health management activities in relation to training of veterinarians in motivational interviewing

Communication has been identified as one constraint for cattle veterinarians to act as proactive health consultants. Motivational Interviewing (MI), an evidence-based client-centered communication methodology, may therefore be a useful tool in veterinary herd health management (VHHM). The aim of this exploratory study was to investigate associations between training in MI and different measures of performance in VHHM. MI skills of 36 Swedish cattle veterinarians randomly assigned to two groups - MI veterinarians (n = 18) who had received six-months training in MI and control veterinarians (n = 18) who were not trained - were assessed using the MI Treatment Integrity coding system. Skills were categorized as untrained, trained_poor, trained_near moderate and trained_moderate. Veterinarians each visited two to six cattle farms for VHHM consultations and revisited the same farms three to six months later to document implementation of recommendations. A gamma model and logistic or ordered logistic regression models were used to evaluate associations between MI training and performance measured as: a) proportion of consultations resulting in written herd health plans, b) proportion of recommended measures fully or partially implemented, c) Likert scores of different estimates of client satisfaction and d) total time during 6 months allocated to VHHM visits on cattle farms. We found no evidence of any significant effects of MI training on the eight performance variables analyzed. However, a pattern of numerically higher values (better performance) in trained veterinarians with poor or moderate MI skills than in untrained veterinarians was observed in most variables. Clients were highly satisfied with veterinarians' attitude, competence and time efficiency. Farms implemented a median of 66.7% (interquartile range: 50-100) of the measures partially or fully. Veterinarians allocated little time to VHHM visits (median: 2.2; interquartile range: 0.65-4.1 h per week of full-time work within cattle). Veterinarians with moderate skills spent 2.14 times more time on VHHM visits than untrained veterinarians, but the confidence interval was wide (0.88-5.21). The pattern of numerically higher values in trained veterinarians supported findings from other studies in the same project indicating a positive effect of MI training on VHHM. Our observations suggest a considerable potential to increase veterinarians' engagement in VHHM.

Anthelmintic resistance in ruminants: challenges and solutions

Anthelmintic resistance (AR) is a growing concern for effective parasite control in farmed ruminants globally. Combatting AR will require intensified and integrated research efforts in the development of innovative diagnostic tests to detect helminth infections and AR, sustainable anthelmintic treatment strategies and the development of complementary control approaches such as vaccination and plant-based control. It will also require a better understanding of socio-economic drivers of anthelmintic treatment decisions, in order to support a behavioural shift and develop targeted communication strategies that promote the uptake of evidence-based sustainable solutions. Here, we review the state-of-the-art in these different fields of research activity related to AR in helminths of livestock ruminants in Europe and beyond. We conclude that in the advent of new challenges and solutions emerging from continuing spread of AR and intensified research efforts, respectively, there is a strong need for transnational multi-actor initiatives. These should involve all key stakeholders to develop indicators of infection and sustainable control, set targets and promote good practices to achieve them.

Producer Perceptions Toward Prevention and Control of Lameness in Dairy Cows in Alberta Canada: A Thematic Analysis

Lameness in dairy cattle poses both an animal welfare and economic threat to dairy farms. Although the Canadian dairy industry has identified lameness as the most important health issue, lameness prevalence in the province of Alberta has not decreased over the last decade. Factors related to lameness have been reported, but the prevalence remains high. Therefore, this study was conducted to investigate dairy producers' perceptions on lameness and how these perceptions influence lameness prevalence in their cows. Qualitative interviews with open-ended questions were conducted with nine dairy producers in Alberta, Canada presenting farms with a wide variety of lameness prevalence. Thematic analysis of these interviews revealed five major themes, as well as five distinct types of producers regarding their perceptions. All nine producers mentioned similar challenges with lameness prevention and control. Identifying lameness, taking action, delays in achieving success, various approaches to prevention and control strategies, and differences between farms were the challenges encountered. However, producers' attitudes when dealing with these challenges varied. We concluded that understanding producers' perceptions is essential as no “one size fits all”, when advising them regarding how to address lameness, as guidance and support will be most successful when it is aligned with their viewpoint.

Benefits of Veterinary Herd Health Management on German Dairy Farms: Status Quo and Farmers' Perspective

Veterinary Herd Health Management plays an important role in veterinary medicine on dairy farms and has also been mandatory at the European Union level since April 21, 2021. Despite the increasing importance of VHHM, little is known about the extent of utilization of VHHM by dairy farmers and their view on this type of collaboration. Therefore, this cross-sectional study aimed to determine the status quo of the currently practiced VHHM in Germany. For this purpose, an online survey was conducted among dairy farmers in November and December 2020. From 216 analyzed questionnaires, about half (n = 106) of the surveyed dairy farmers used VHHM at different scopes. However, regardless of the group, the term “veterinary herd health management” generally was given most relative importance by the participants as a veterinary service for herd fertility improvement, rather than the actual definition of a holistic approach. In contrast to this, the actual motivation of the VHHM participants, to take part in such a program was primarily based on the desire to safeguard animal health by employing preventive measures, that is, to avoid the occurrence of diseases via improved management and to improve farm performance (and profitability). Dairy farmers who opted for VHHM tended to manage larger higher yielding herds than those who did not. Additionally, the farmers in latter farms were more likely to make joint animal health decisions with their veterinarians. Using a latent class analysis, two groups of farmers among farms that were not currently using VHHM were identified, one of which expressed great interest in using VHHM while the other did not. Since the new legal basis makes the topic even more relevant than before, dairy farmers, animals, and veterinarians might benefit from the study to exploit hidden opportunities for VHHM collaboration.

Dairy producer satisfaction and knowledge transfer with the veterinary-administered risk assessment and management plan in a voluntary Johne's disease control program

The Atlantic Johne's Disease Initiative (AJDI) aims to control Mycobacterium avium ssp. paratuberculosis infection by using veterinary-administered risk assessments to identify high-risk management practices and prompt changes in management behavior. Objectives for this study were to measure producer satisfaction with the veterinary-administered risk assessment and management plan (RAMP) process in a voluntary Johne's disease (JD) control program, compare RAMP-specific satisfaction results based on herd JD status, and measure knowledge transfer from certified veterinarians to producers during the RAMP. A satisfaction questionnaire was adapted to the RAMP process in the AJDI to measure producer satisfaction. The questionnaire included 9 RAMP-specific producer satisfaction items, 1 global RAMP satisfaction item, and 16 questions to assess producer knowledge and knowledge translation about JD, bovine viral diarrhea (BVD), and bovine leukosis virus (BLV) during the RAMP (BVD and BLV used for comparison purposes). A total of 133 dairy producers in the AJDI (79.6% response rate) completed the questionnaire by telephone. The RAMP-specific satisfaction was high among the AJDI producers surveyed, and these results were not found to differ based on herd JD status. The lowest satisfaction scores and the highest number of "unable to assess" responses were for the item relating to cost. Factors that contributed to RAMP-specific producer satisfaction were not identified from the demographic and herd information available in this study. The knowledge scores indicated moderate knowledge about JD and fair knowledge about BVD and BLV. Evidence of knowledge translation from the RAMP was mixed in this study. Bovine viral diarrhea knowledge scores were not found to differ based on whether or not the certified veterinarian discussed BVD during the preceding RAMP, but BLV knowledge scores were higher among dairy producers that discussed BLV during the preceding RAMP. Strengths and gaps in producer knowledge about these 3 infectious diseases were identified. By using this producer questionnaire, interventions aimed at improving the content, delivery, and satisfaction of RAMP in JD control programs, such as the AJDI, can be developed.

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

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

Exploring farmers' understanding of and responses to endemic animal health and welfare issues in the UK

BACKGROUND

This paper uses two endemic health conditions to explore farmer understandings of and responses to livestock health and welfare issues.

METHODS

The findings are based on a survey of 42 livestock farmers in the north of England, exploring how they manage lameness in sheep and cattle and bovine viral diarrhoea in cattle. We identify similarities and differences in their approaches.

RESULTS

Two themes emerge. (1) The importance of difference between animal types (i.e., beef cattle, dairy cattle and sheep), which highlights the 'complex' and 'multifactorial' nature of animal health and welfare. It is necessary to unpack this to understand the interplay of animal, resource and management issues in farmer responses. (2) Previous research has identified 'lack of knowledge' as a key welfare issue. Our findings reveal farmers are in fact seeking, acquiring and sharing knowledge on practices related to the management of animal health however individual circumstance and context influence how this translates in practice.

CONCLUSION

Our research highlights the importance of integrating different perspectives and knowledges as a way of understanding and responding to animal health and welfare concerns. Facilitating knowledge exchange both within and between different groups and sectors is vital in achieving this.

Factors influencing how Canadian dairy producers respond to a downer cow scenario

Understanding how downer cattle are managed allows for the evaluation of strengths and weaknesses in these practices, which is an important step toward improving the care these animals receive. The objective of this cross-sectional study was to analyze factors associated with the care and management of downer cattle by Canadian dairy producers. Data were obtained from the 2015 National Dairy Study, and analysis was limited to the 371 respondents completing the downer cow scenario. The scenario described a downer cow that the producer wanted to keep in their herd but must be moved, and was followed by questions addressing the cow's care and management. Using multivariable logistic regression models, associations between respondent demographics and farm characteristics, and the presence of downer cow protocols, we assessed decisions regarding euthanasia and use of behavioral prognostic indicators. Written downer cow protocols were reported by 18.2% of respondents, 67% indicated that they had a nonwritten protocol, and 14.8% reported that they did not have a protocol (either written or nonwritten). Respondents from western provinces were more likely to have a written protocol than those from Ontario. Nineteen percent of the respondents with a written or unwritten protocol reported veterinary involvement in developing their downer cow protocol, which occurred more commonly on farms with more frequent herd health visits and a good producer-veterinarian relationship. An area to move a downer cow to was present on 88% of farms, with respondents who were farm staff being less likely to report having knowledge of a designated area than respondents who were the farm owner. In addition, approximately half (45%) of respondents reported moving downer cattle with hip lifters as their most common method. Behavioral prognostic indicators chosen by respondents were associated with the respondent's geographic region, age, farm size, and education. Most notably, older respondents were more likely to use appetite, and less likely to use attitude, as a prognostic indicator compared with younger respondents. Using perceived pain as a prognostic indicator was more common among respondents from western and Atlantic provinces compared with respondents from Ontario, and more common among respondents with a college or university education. These results highlighted herd and farmer demographics that were associated with how Canadian dairy producers managed downer cattle in 2015 and could be used as a benchmark for evaluating how these management practices compare with those currently implemented.

Why isn't the transition period getting the attention it deserves? Farm advisors' opinions and experiences of managing dairy cow health in the transition period

During the transition period three weeks before and after calving the dairy cow is at greater risk of developing disease, to the detriment of welfare and production. An understanding of the reasons why and how farmers and their advisors engage in efforts to control metabolic disease during the transition period is required if these diseases are to be more successfully controlled. The study reported here, based on interview research, investigates the opinions and behaviours of farm advisors on transition cow management and nutrition, their experiences of working with their respective farm clients, and interactions with other farm advisors to help manage transition cow health and productivity. Semi-structured interviews were conducted with 12 veterinary advisors and 12 non-veterinary advisors (nutritionists, feed company representatives and independent consultants) in England. A key theme emerging from this qualitative data was a perceived lack of focussed transition management advice provided by advisors. Reasons for suboptimal or lack of appropriate advice included: time pressures for advisors to visit as many farms as possible; avoiding the investigation of areas of potential improvement, for fear of not meeting transition health and performance targets; financial disincentives for nutritionists, as the sales commission attributed to transition cow feeding was small relative to the main milking herd; and a lack of confidence in the subject. Other aspects included the responsibility of providing transition advice which was perceived to be high-risk, a lack of cooperation between veterinarians and nutritionists, and the perceived varying competencies of nutritionists. The findings demonstrate the importance of the varied influences of 'people factors' on transition cow health such as the nature of the advisor-farmer relationship, advisor-farmer communication and herd-level advisor collaboration on transition cow health and management.

Dairy cow health and management in the transition period: The need to understand the human dimension

During the transition from the dry period to lactation the dairy cow undergoes a period of physiological, metabolic and immunological change, and is at greater risk of developing disease, to the detriment of health, welfare and production. Many studies have been undertaken to determine appropriate management strategies to improve health and welfare during the transition period, however the incidence of disease, particularly metabolic disease, in this period remains high. To date, a lack of research attention has been paid to the social factors which may affect the management of transition dairy cows. An understanding of farmer and advisor attitudes and behaviour, and the challenges they face in managing transition cows, may help to direct farmers towards more effective disease prevention and control. It is also possible that transition cow morbidity may be due to complex interactions that are difficult to manage, despite efforts to implement best practice. This review paper provides a brief overview of some of the management factors that may influence herd health during the transition period. It then investigates how social influences may relate to the uptake of transition management practices by exploring the use of qualitative interviews investigating farmer and stakeholder attitudes and behaviour in relation to cattle health and welfare, before focussing more specifically on farmer behaviour. Additionally, this paper explores farm advisor behaviour, and how that has been shown to influence farmer adherence to advice, which has particular relevance to transition cow management. It then suggests potential research strategies to investigate the human influences affecting the scale of the problem that may provide solutions to tackle the challenge of improving dairy cow health and welfare.

Dairy veterinarians' perceptions and experts' opinions regarding implementation of antimicrobial stewardship on dairy farms in the western United States

OBJECTIVE

To explore veterinarians' perceptions and veterinary experts' opinions regarding antimicrobial stewardship (AMS) on dairy farms in the western United States.

SAMPLE

20 dairy veterinarians and 9 AMS experts.

PROCEDURES

3 focus group discussions involving 20 dairy veterinarians from California, Idaho, and Washington and an expert opinion study involving 9 North American AMS experts were conducted. During focus group discussions, participants were asked open-ended questions regarding implementation of AMS programs on dairy farms. Discussions were recorded and transcribed for thematic analysis. An asynchronous nominal group process was used for the expert opinion study. Participants were asked to complete a series of 3 online surveys consisting of open-ended questions. Expert opinion data underwent thematic analysis and were compared with results obtained from focus group discussions.

RESULTS

Veterinarian-perceived barriers to implementation of AMS on dairy farms included variable relationships with clients and farm employees, ensuring AMS provided value to the farm, and uncertainty about regulations for monitoring on-farm antimicrobial use (AMU). Veterinarians were willing to accept additional responsibility for AMU provided that protocols were adopted to ensure them more complete control of on-farm AMU and they were compensated. The AMS experts indicated that effective implementation of AMS on dairy farms requires producer buy-in and tools to facilitate treatment protocol development and monitoring.

CONCLUSIONS AND CLINICAL RELEVANCE

Additional veterinary oversight of AMU on dairy farms will require engagement by both veterinarians and producers and practical value-added methods for AMS. Continuing education programs should address treatment protocol development, AMU monitoring strategies, and employee training.

Comparison of food-animal veterinarians' and producers' perceptions of producer-centered communication following on-farm interactions

BACKGROUND

Human medicine has demonstrated that a patient-centered physician-patient relationship is more effective than the traditional physician-centered model. Objectives were to explore food-animal veterinarians' and producers' perceptions of producer-centered communication (VPPC and PPPC), during on-farm interactions and examine associated factors.

METHODS

A cross-sectional sample of food-animal veterinarians and their clients were recruited in Ontario, Canada. Immediately following on-farm veterinarian-producer interactions, the producer and veterinarian independently completed a questionnaire assessing PPC. Symmetry of paired responses between veterinarians and producers was examined. Employing listwise deletion, independent mixed linear regression models were developed to determine factors associated with PPPC and VPPC, respectively.

RESULTS

Two hundred and three paired veterinarian and producer survey responses were analysed. Significant asymmetry (p-value < 0.05) was observed, with veterinarians assessing PPC lower than producers. Based on data from 32 veterinarians and 159 producers, the only factor associated with PPPC was veterinarian burnout (PPPC decreased with burnout). Based on data from 32 veterinarians and 155 producers, factors positively associated with VPPC included veterinarian compassion satisfaction (VPPC increased with compassion satisfaction), length of interaction (VPPC increased with length of interaction) and producers identifying as female (VPPC higher with female producers).

CONCLUSION

Producer's positive PPPC is encouraging, yet veterinarians should be aware that mental health parameters may impact producers' and their own perceptions of PPC. Further examining veterinarians' delivery of PPC is important for food-animal practice.

Exploring Farmers' Reasons for Antibiotic Use and Misuse in Pig Farms in Brazil

Stressful management that makes farmed pigs susceptible to infections is associated with high antibiotic use (AMU) and resistance (AMR). Pig farmers are key stakeholders to support the international agenda pushing AMU restrictions. We interviewed 58 pig farmers on AMU/AMR, biosecurity, veterinary assistance, disease prevention and treatment, aiming to understand practices and attitudes towards the AMU/AMR problem. Farmers described a reliance on antibiotics to prevent and treat disease while neglecting biosecurity measures. We identified inappropriate AMU practices (high use of broad-spectrum antibiotics, incorrect dosage or treatment length) and unrestricted access to antibiotics, which encouraged imprudent AMU. Nevertheless, most farmers considered this AMU legitimate to guarantee herd productivity and showed unpreparedness and resistance to changing AMU practices, perceiving limitations (economic, sanitary and inspection) more easily than alternatives to reduce AMU. Agro-industries and foreign markets were mentioned, and internal consumers dismissed as potential motivators for behavioral changes. Importantly, farmers' economic, technical and social factors may limit their autonomy to change practices. We conclude that the observed distancing of pig farmers from the AMU/AMR problem limits the efficiency of policies aiming for a prudent AMU. Our study indicates a need for education, training and behavior change nudging that should include other stakeholders beyond farmers.

Communication and animal observation in livestock farming - pilot study of a teaching project in veterinary education

Objective: Within the scope of a teaching project, students of veterinary medicine are to study animal and environmental observation and how to communicate with the persons responsible for animals on pig farms. They will be prepared to reflect on conversational behavior, identify difficult conversational situations and solve them in a goal-oriented way. In addition to piloting, the the aim of the study is to evaluate the teaching project by the students and the teaching staff. Methodology: Animal observation is trained using a virtual tour of a stock farm based on pictures and videos. The didactic approaches Design Thinking and the creative Walt Disney method are used in order to work on a previously prioritized problem. A typical conflict situation in pig farming is simulated in a role-play. Acquired skills are put into practice during a stock examination on the practice day, where the students communicate their observations. Evaluation is conducted using paper-based questionnaires and feedback interviews. Results: Evaluations of the students are generally positive. The desire to include communication studies in the curriculum was expressed several times. For the theoretical teaching units, a larger group of participants is needed to achieve higher interaction through diversity. The acquired knowledge is reliably applied and utilized on the practice day. Conclusion: The theoretical teaching units extensively prepare the students for the practical stock examination and teach basic skills of communication. Some adjustments to the procedure and focus should be made regarding the practical part. Generally, the conveyed information and methods are considered to be important by the students.

Survey of communication challenges that impact relationships between veterinarians and dog or cat breeders and proposed solutions for retaining breeders as clients

OBJECTIVE

To characterize communication challenges between veterinarians and dog or cat breeders and elicit their perspectives on how professional relationships between the two might be improved.

SAMPLE

793 dog breeders, 540 cat breeders, and 514 veterinarians.

PROCEDURES

Veterinarians, cat breeders, and dog breeders were recruited through social media and electronic newsletters from breed registries to complete online surveys about their professional interactions with one another and proposed strategies for improving dialogue. Data used for the study were gathered as categorical or free-text responses.

RESULTS

Dog breeders commented that an apparent lack of training in theriogenology among veterinarians was a primary concern. Both dog breeders and cat breeders felt sidelined from patient care when veterinarians were dismissive, made assumptions about their character or motivation for breeding, or expressed disapproval of mating companion animals for profit. Breeders also wanted veterinarians to learn more about reproductive health and disease. Veterinarians expressed disinterest in working with breeders who seemed arrogant, argumentative, or inflexible. Financial constraints and breeders' apparent tendencies to trust anecdotal reports over evidence-based medicine contributed to veterinarians' biases about breeders and presented additional challenges. Each group proposed that communication challenges could be overcome through mutual engagement in active listening, eliciting perspective, assessing knowledge, offering partnership, and withholding judgment.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that veterinarians and dog and cat breeders are more alike than dissimilar in terms of communication preferences that facilitate a positive veterinarian-breeder relationship. Understanding how to improve interactions is an important step toward dialogue that facilitates patient care.

Sheep farmers' attitudes towards lameness control: Qualitative exploration of factors affecting adoption of the lameness Five-Point Plan

In 2014, best-practice recommendations to treat and control lameness in sheep in the UK were consolidated into a national program, the Five-Point Plan (5PP). As recent evidence suggests that only the minority of sheep farmers are implementing all management practices listed in the 5PP, qualitative investigation is vital to ensure future promotion is aligned with psychological and contextual factors affecting farmers’ decision-making. This qualitative study sought to explore farmers’ attitudes and the factors affecting uptake of best-practice measures listed in the 5PP. Semi-structured interviews were conducted in 2019 with 12 sheep farmers from England and Wales. In accordance with Thematic Analysis and the principles of Grounded Theory, data collection and analysis were performed iteratively. Two overarching themes, delineated by subthemes, emerged during analysis; (1) Barriers to adoption of 5PP measures and (2) Motivation to adopt 5PP measures. Various farmer-centric factors and physical resources were identified as key barriers or obstacles that limited farmers’ ability to implement 5PP measures outright, or restricted their ability to make changes to facilitate future adoption. Conversely, internal and external influences were identified to increase farmers’ willingness and motivation to implement practices listed on the 5PP. Heterogeneity in farmer perceptions, attitudes, experiences and circumstances identified in this study highlights the difficulty in promoting a one-size-fits-all lameness control plan, where a unique combination of intrinsic factors, social influences, and physical restrictions affect implementation. Future initiatives should focus on removing barriers by changing farmers’ perceptions and mindset towards lameness control, and building farmers’ confidence in their ability to implement practices. Furthermore, farmers’ social licence to farm and their desire to improve their reputation within society, presents an important opportunity to further engage farmers in implementing control practices. Increasing peer-to-peer knowledge transfer opportunities and effective farmer-veterinarian communication and rapport could help establish 5PP measures as normative behaviours.

Pet owners' and veterinarians' perceptions of information exchange and clinical decision-making in companion animal practice

One of the most complex aspects of the veterinarian-client-patient interaction is the clinical decision-making process. Research suggests that the approach to communication used by veterinarians can impact veterinary clients’ involvement in the decision-making process and their ultimate satisfaction. Using different approaches to the decision-making process may affect how information is exchanged and consequently how decisions are made. The objective of this study was to determine pet owners’ expectations with respect to information exchange and decision-making during veterinarian-client-patient interactions and to compare veterinarians’ perceptions of those expectations and the challenges they face in meeting them. Five pet owner focus groups (27 owners) and three veterinarian focus groups (24 veterinarians) were conducted with standardized open-ended questions and follow-up probes. Thematic analysis of the transcribed data was conducted to identify trends and patterns that emerged during the focus groups. Three pet owner-based themes were identified: 1) understanding the client; 2) providing information suitable for the client; and 3) decision-making. In addition, three barriers for veterinarians affecting information exchange and decision-making were identified: 1) time constraints; 2) involvement of multiple clients; and 3) language barriers. Results suggest that pet owners expect to be supported by their veterinarian to make informed decisions by understanding the client’s current knowledge, tailoring information and educating clients about their options. Breakdowns in the information exchange process can impact pet owners’ perceptions of veterinarians’ motivations. Pet owners’ emphasis on partnership suggests that a collaborative approach between veterinarians and clients may improve client satisfaction.

Factors associated with food-animal producer visit-specific satisfaction following on-farm interaction with a veterinarian

BACKGROUND

Effective communication has been found to have positive associations with client satisfaction, client adherence and veterinarian satisfaction in companion animal medicine. Better understanding the role of communication on these outcomes, specifically producer satisfaction, is likely to benefit food-animal medicine. Objectives were to identify factors associated with producer visit-specific satisfaction following on-farm veterinarian-producer interactions and evaluate the validity of the Client Satisfaction Questionnaire for use in food-animal medicine.

METHODS

A cross-sectional sample of practicing food-animal veterinarians and their producer clients were recruited in Ontario, Canada. Immediately following the veterinarian-producer interaction, producers completed a questionnaire that assessed their visit-specific satisfaction and their perception of the producer-centeredness of the interaction. Veterinarians completed a questionnaire that assessed their perception of the interaction's producer-centeredness. A linear regression model was developed to identify factors associated with producer visit-specific satisfaction.

RESULTS

Forty-one veterinarians and 207 producers participated. Factors associated with producer visit-specific satisfaction included producer age (satisfaction decreased with age), producer gender (males less satisfied) and producer perception of producer-centeredness score (satisfaction increased with producer perception of producer-centeredness score).

CONCLUSION

Findings raise awareness of the importance of a producer's perception of producer-centeredness in food-animal practice and encourage its use by food-animal veterinarians in working towards positive outcomes.

Point-of-care tests for bovine clinical mastitis: what do we have and what do we need?

Mastitis, inflammation of the bovine mammary gland, is generally caused by intramammary infection with bacteria, and antimicrobials have long been a corner stone of mastitis control. As societal concern about antimicrobial use in animal agriculture grows, there is pressure to reduce antimicrobial use in dairy farming. Point-of-care tests for on-farm use are increasingly available as tools to support this. In this Research Reflection, we consider available culture-dependent and culture-independent tests in the context of ASSURED criteria for low-resource settings, including convenience criteria, scientific criteria and societal criteria that can be used to evaluate test performance. As tests become more sophisticated and sensitive, we may be generating more data than we need. Special attention is given to the relationship between test outcomes and treatment decisions, including issues of diagnostic refinement, antimicrobial susceptibility testing, and detection of viable organisms. In addition, we explore the role of technology, big data and people in improved performance and uptake of point-of-care tests, recognising that societal barriers may limit uptake of available or future tests. Finally, we propose that the 3Rs of reduction, refinement and replacement, which have been used in an animal welfare context for many years, could be applied to antimicrobial use for mastitis control on dairy farms.

Dairy veterinarians' skills in motivational interviewing are linked to client verbal behavior

Veterinarians often give advice in a persuasive form, a style that has been shown to evoke resistance to change in clients experiencing psychological ambivalence (i.e. those who see both advantages and disadvantages to changing). With this style of communication, veterinarians run the risk of counteracting their purpose to encourage clients to follow recommendations. Motivational interviewing (MI) is a client-centered communication methodology that aims to facilitate clients’ internal motivation to change. In MI, Change Talk represents clients’ own statements expressing consideration of, motivation for or commitment to behavior change and has been shown to be strongly correlated with behavior change. Sustain Talk is corresponding statements related to maintaining the status quo. The aim of this exploratory study was to evaluate the potential of MI to facilitate behavior change in veterinary herd health management (VHHM) by investigating the effect of dairy cattle veterinarians’ MI skills on client Change and Sustain Talk. We recorded VHHM consultancies on 170 Swedish cattle farms performed by 36 veterinarians, randomly distributed into 2 groups: MI veterinarians (n = 18) had received 6-month training in MI and control veterinarians (n = 18) had not received any training. Veterinarians’ MI skills were assessed using the Motivational Interviewing Treatment Integrity coding system 4.2.1 and categorized as poor_untrained, poor_trained, near moderate and moderate. Client communication was coded using the Client Language Easy Rating coding system. The effect of MI skills on Change Talk, Sustain Talk and Proportion of Change Talk(Change Talk divided by the sum of Sustain Talk plus Change Talk) was investigated using cross-classified regression models with random intercepts for veterinarian and client (farm). The models also included additional explanatory variables (e.g. type of veterinarian and client’s satisfaction with the consultation). The veterinarian’s MI skills were associated with the client’s Change Talk, but results regarding Sustain Talk or Proportion of Change Talk were inconclusive. Clients of veterinarians reaching the highest (i.e. moderate) MI skills expressed 1.5 times more Change Talk than clients of untrained veterinarians. Clients of general large animal practitioners expressed less Sustain Talk than clients of animal health veterinarians and had higher Proportion of Change Talk. Results indicate that learning to practice MI may be one means to improve adherence to veterinary recommendations and to improve efficiency in VHHM services.

Training in motivational interviewing improves cattle veterinarians' communication skills for herd health management

BACKGROUND

Communication skills to promote changes in management routines are especially important in veterinary herd health management (VHHM). Motivational interviewing (MI) is a communication methodology shown to be effective in stimulating client behaviour change. This study aimed to evaluate a 6-month MI-training programme for veterinarians.

METHODS

Thirty-eight cattle veterinarians gathered in groups of four to eight at six workshops separated by 3-4 weeks, during which they read literature and practised their skills. MI skills were evaluated before and after training using audio recordings of role-play conversations with professional actors. Recordings were coded using the MI Treatment Integrity Code (MITI) V.4.2.1. The effect of training was evaluated by 16 regression models. Participants filled in questionnaires about their experiences.

RESULTS

All participants improved their MI skills after training in at least one parameter and significant improvements were found in all but 3 of the 16 statistically evaluated MITI variables. The mean (25th-75th percentiles) ratings of the veterinarians' perceived relevance of MI skills in their work was 4.9 (4.0-6.0) and of their satisfaction with the programme was 5.1 (5.0-6.0) on a 6-point Likert scale.

CONCLUSIONS

Results show that MI training was perceived to be useful and relevant and successfully improved veterinarians' communication skills in VHHM.

The Complex Relationship Between Veterinarian Mental Health and Client Satisfaction

A relatively high risk of poor mental health has been described among Canadian veterinarians, but no published studies have explored the impact that veterinarian mental health may have on veterinary clients and patients. In order to investigate the association between veterinarian mental health and veterinary client satisfaction, veterinarians were randomly sampled and recruited throughout southwestern Ontario, Canada, from November, 2017, through January, 2019. Sixty participating veterinarians completed an enrollment survey that included psychometric scales measuring resilience, perceived stress, anxiety, depression, emotional distress, emotional exhaustion, depersonalization, personal accomplishment, burnout, secondary traumatic stress, and compassion satisfaction. Nine hundred and ninety-five companion animal clients of these veterinarians were recruited in-clinic over 2–3 days and completed a post-appointment survey including the Client Satisfaction Questionnaire. The associations between clients' satisfaction scores (as the outcome variable) and each of the veterinarians' mental health measures (as the explanatory variables) were assessed using separate, multilevel, multivariable linear regression models. The associations between client satisfaction and veterinarian mental health measures were non-linear and complex; in several of the models, relatively higher client satisfaction was unexpectedly associated with poor veterinarian mental health states, while lower client satisfaction was associated with mental health scores suggesting wellness. Given that client satisfaction may impact client adherence to medical recommendations, client loyalty, and business income, the association with veterinarian mental health may have broad implications and warrants further investigation.