Owner compliance in canine epilepsy.

BACKGROUND: Poor medication compliance by human epilepsy patients is one of the leading causes of treatment failure and increased seizure frequency. The aim of this cross-sectional study was to analyse owner compliance in pharmacological treatment of canine idiopathic epilepsy and to identify factors associated with poor compliance. METHODS: The number of antiseizure drug tablets was recorded to determine if the patient received sufficient tablets to cover the time period between prescriptions and to assess compliant prescription cycles. Additionally, compliance was assessed by an online survey of owners. RESULTS: For the prescription monitoring data from 94 cases from three small animal practices in the United Kingdom revealed an overall median compliance of 56%. Thirt-three per cent of owners were >80% compliant, while 21% were 100% compliant. During a non-compliant prescription cycle, a patient missed a median of 6 days (0.11-519 days) of treatment. Patients on polytherapy had higher compliance rates than on monotherapy (p = 0.031). The survey (229 respondents from online canine epilepsy groups) showed that low daily dosing was associated with better compliance (p = 0.049). CONCLUSION: Owner compliance was subpar in this study and could represent a significant issue in epilepsy management, which needs to be considered by veterinary surgeons when treating canine epilepsy.

Use of Inductive, Problem-Based Clinical Reasoning Enhances Diagnostic Accuracy in Final-Year Veterinary Students.

Despite tremendous progression in the medical field, levels of diagnostic error remain unacceptably high. Cognitive failures in clinical reasoning are believed to be the major contributor to diagnostic error. There is evidence in the literature that teaching problem-based, inductive reasoning has the potential to improve clinical reasoning skills. In this study, 47 final-year veterinary medicine students at the Royal Veterinary College (RVC) were presented with a complex small animal medicine case. The participants were divided into two groups, one of which received a prioritized problem list in addition to the history, physical exam, and diagnostic test results provided to both groups. The students' written approaches to the case were then analyzed and assigned a diagnostic accuracy score (DAS) and an inductive reasoning score (IRS). The IRS was based on a series of predetermined characteristics consistent with the inductive reasoning framework taught at the RVC. No significant difference was found between the DAS scores of each group, indicating that the provision of a prioritized problem list did not impact diagnostic accuracy. However, a significant positive correlation between the IRS and DAS was illustrated for both groups of students, suggesting increased use of inductive reasoning is associated with increased diagnostic accuracy. These results contribute to a body of research proposing that inductive, problem-based reasoning teaching delivered in an additive model, can enhance the clinical reasoning skills of students and reduce diagnostic error.

Retrospective study of the diagnostic utility of Spec fPLin the assessment of 274 sick cats.

BACKGROUND: Serum feline pancreatic lipase immunoreactivity (fPL) commonly is used in the assessment of sick cats suspected to have pancreatitis but its diagnostic utility is debated. OBJECTIVES: To evaluate the diagnostic utility of the Spec fPL test and selected serum biochemistry tests in the diagnosis of pancreatitis in cats. ANIMALS: Two hundred seventy-four client-owned cats presented to a university teaching hospital in the United Kingdom, from April 2013 to May 2017, in which Spec fPL was measured. METHODS: Cats were classified into 1 of 4 groups based on clinical signs (all cats), ultrasonographic findings (all cats) and histopathological or cytological assessment of the pancreas where available (9 cats) regardless of Spec fPL concentration. The groups were (a) definite pancreatitis (n = 9), (b) probable pancreatitis (n = 49), (c) possible pancreatitis (n = 139), and (d) unlikely pancreatitis (n = 77). Spec fPL and selected serum biochemistry test results were compared among groups. RESULTS: Serum fPL concentrations >5.3 µg/L were classified as positive and concentrations <3.5 µg/L were classified as negative. There was a significantly (P = .03) lower proportion of false-positive results (cats unlikely to have pancreatitis, n = 77, with a positive fPL, n = 8, 10%) than false-negative results (cats with definite or probable pancreatitis, n = 58, with a negative fPL result, n = 14, 24%). None of the selected biochemical tests were helpful diagnostically. CONCLUSION AND CLINICAL IMPORTANCE: A positive Spec fPL result indicates that pancreatitis is a probable diagnosis, but the test cannot be used to rule the diagnosis out.

The influences of curriculum area and student background on mindset to learning in the veterinary curriculum: a pilot study.

A student's mindset influences their achievement and response to challenge, with a 'fixed mindset' encouraging disengagement from challenging tasks and avoidance of learning and feedback opportunities. These behaviours resemble those reported for professional and non-clinical curriculum areas, which are important for employability and resilience in veterinary practice. Students with a 'growth mindset' to learning are more persistent when faced with challenges and actively seek more demanding tasks. They also demonstrate higher levels of psychological well-being. The objectives of this study were to explore whether variation in veterinary students' mindset to learning exists across different curriculum areas, and to identify whether students' backgrounds influence their learning mindset. The mindsets of veterinary students at a UK veterinary school were measured using an adapted version of the Implicit Theories of Intelligence Scale. The survey was constructed to compare mindset in clinical reasoning, professional reasoning (incorporating ethics and critical thinking), communication skills and reflection. More students demonstrated a growth mindset to communication skills (59%), reflection (84%) and clinical reasoning (83%) than to professional reasoning (34%). There were more students with a fixed mindset to professional reasoning (10%) than in other areas (0-5%). Students' background (international or non-traditional university access) did not appear to influence mindset to learning. Disengagement from professional studies curricula may be a consequence of students lacking a growth mindset in professional reasoning. Curriculum interventions that encourage engagement and the development of a growth mindset to learning non-clinical competences may be beneficial.

Veterinary e-CPD: a new model for providing online continuing professional development for the veterinary profession.

Continuing professional development (CPD) is widely recognized as an important element in effective lifelong learning for veterinary surgeons. Traditional methods of CPD do not suit all learners, as issues such as location, time, cost, and structure sometimes prevent individuals from completing the required number of CPD study hours per year. The rapid development of the Internet, and with it the increasing scope and sophistication of e-learning, provides new opportunities to address some of these constraints on the provision of CPD. This article describes one way in which e-learning has been deployed effectively to support veterinary surgeons in practice. Since 2003, a series of six-week e-CPD courses has been offered by the Royal Veterinary College (RVC) in an online format, with no face-to-face teaching component. Participants enrolled in courses from May 2006 to January 2007 were found to come from 23 different countries. Analysis of feedback forms indicates a general satisfaction with this new way of studying, with a significant majority of participants stating that they would wish to use this approach again in future. The feedback indicates that e-learning can offer an effective alternative to traditional face-to-face courses and that its popularity is likely to grow in future as veterinarians become increasing familiar with and confident about working online.