Evaluation of a Student-Led Community-Based Veterinary Clinic for Disabled Low-Income Clients: A Case Study of the University of Florida PAWS Program.

People with disabilities experiencing low socioeconomic position are priority populations when considering access to veterinary care. In this population, intersectional inequities lead to adverse health outcomes for both those individuals and the companion animals they care for. Community-based veterinary clinics provide an opportunity to target these inequities from a culturally sensitive lens, intending to improve human and animal outcomes. We conducted a process evaluation of a student-led community-based clinic for this population to better understand client satisfaction, assess learning outcomes among veterinary students, and improve program delivery and services. During academic year 2020-2021, the monthly clinics had 162 appointments in total with a median 15 DVM candidates volunteering at each clinic. Clients and volunteers responded to survey questionnaires designed to elicit information about their experiences with the clinic, including open-ended questions for further elucidation of measurable indicators of client-, patient-, and student-level impact. Clients attributed enrollment in the clinic with improved quality-of-life and reduction of financial burden; the program saved clients approximately $2,050 per pet during the evaluation year. Furthermore, the clinic widely facilitated completion of the college's core Primary Care and Dentistry learning outcomes. Beyond curriculum-standard learning objectives, students also reported positive attitude changes and increased readiness to provide care to people with disabilities and people experiencing low socioeconomic position. The results of this evaluation have significant implications for both veterinary and public health pedagogy. Especially, they highlight the significance of community health practice in veterinary trainee education.

Specifications Grading in a Cardiovascular Systems Course: Student and Course Coordinator Perspectives on the Impacts on Student Achievement.

This study investigated students' and a course coordinator's perceptions about specifications (spec) grading in a cardiovascular systems course and assessed its effects on student performance. Spec grading was hypothesized to result in lower perceived student stress about the course, improved student performance, and less work for the course coordinator. The study used a mixed methods approach consisting of student pre-, peri-, and post-course surveys; student focus group interviews; analysis of student course evaluations; and course coordinator reflection. Participants were from a cross-section of one course in the veterinary professional curriculum. Results demonstrated significantly more A grades assigned to students than in the previous year's course, where traditional grading was used (p = .024). The focus group produced two primary themes: pros and cons. Pros included flexibility, student control over grades, generally lower perceived stress, opportunities to resubmit assignments, and more motivation to learn. Cons included confusion about the process, some disorganization, perceived higher workload for the professor, and communication concerns. The course coordinator's positive perceptions included students being less combative about grades than with the traditional system, students appreciating opportunities to resubmit assignments, and students demonstrating improved learning outcomes. Negative course coordinator perceptions were that reduced student stress was inconsistently achieved and that there was increased time commitment compared with traditional grading. Course evaluation themes included skepticism about spec grading in the beginning, varying stress experiences, improved learning, and increased workload. In conclusion, spec grading variably reduced student stress and did not result in less work for the course coordinator.

Veterinarians' Self-Reported Needs and Attitudes on the Atlantic Canada Veterinary College and Associated Teaching Hospital in Relation to Continuing Education, Research, and Clinical Referrals.

The relationship between veterinary colleges (VCs), associated veterinary teaching hospital referral centers (VTHs), and referring veterinarians (rVets) is important and complex. Despite this, there has been minimal research on rVets with respect to their regional VC and VTH. Our objectives were to evaluate rVets' attitudes and self-reported needs on their regional VC's VTH surrounding (a) continuing education, (b) collaborative research, and (c) referrals for specialty consultation and care. Participants (rVets) were invited to complete an online questionnaire (2018-2019). Respondents (n = 56) indicated multiple (24) unmet continuing education topic needs, of which dermatology and behavior were most selected. Many rVets (70%) reported an interest in collaborative research participation. Communication was frequently selected by respondents when asked what could be improved with respect to the VTH referral center process. Our work provides a benchmark attitudes and needs assessment, identifies areas for improvement, and may aid initiatives regionally, and likely externally, as adapted to other rVet-VC-VTH relationships.

A Retrospective Analysis of Pre-/Post-Test Scores of Students Participating in Online Asynchronous Shelter Surgery Coursework.

The University of Pennsylvania School of Veterinary Medicine first offered the elective Student Shelter Opportunities I (SSOI) course in 2016 to provide pre-clinical students with an opportunity to engage with shelter medicine and high-quality, high-volume surgery (HQHVS) concepts. The course utilized online asynchronous coursework to deliver content that was completed on a self-guided timeline by students. With most of the veterinary medical curriculum delivered in a traditional classroom format, it is important to assess learning in this unique course format. There is also limited information on educational experiences in online shelter medicine coursework. This retrospective study aimed to evaluate student learning in the asynchronous online portion of the SSOI elective course using paired pre- and post-test scores from a multiple-choice type assessment. The study investigated how students' pre-test and post-test scores compared and whether time to completion of material influenced student assessment performance. Paired assessments from 400 students were analyzed, and a statistically significant increase was found in post-test scores compared to pre-test following completion of the online coursework (p < .001). There was no significant difference in the mean change in score from pre-test to post-test for students who completed the online course material in 30 days or less compared to those who completed it in greater than 30 days. This study's findings support online asynchronous learning as an effective option to teach veterinary students and can be considered in the development of veterinary coursework, including for curricular adjustments to increase online learning during the SARS-CoV-2 pandemic.

Impact of Satisfactory/Unsatisfactory Grading on Student Motivation to Learn, Academic Performance, and Well-Being.

Satisfactory/unsatisfactory (S/U) grading is often proposed to ameliorate stress by reducing the competitive nature of letter grading. Though explored considerably in human medical programs, minimal literature focuses on the veterinary school setting. The purpose of this study was to evaluate the impact of S/U grading on veterinary students' motivation to learn, academic performance, and well-being. Cornell University's COVID-19 pandemic response provided a unique opportunity to compare S/U and letter grading on the same population of students during a single pre-clinical foundation course, with the first half being graded S/U (spring semester 2020), returning to letter grades in the second half (fall semester 2020). Students were retroactively surveyed on the effect of S/U vs. letter grading on their overall educational experience and well-being, with 67.8% class participation. The majority of respondents (71.3%) stated that S/U grading had a positive impact on their overall learning experience. More than half (53.8%) perceived that they learned the same amount of information and had the same level of motivation (58.8%), even though most (61.3%) stated that they spent less time preparing for S/U assessments than letter grade assessments. Positive impact factor effects for S/U grading included decreased stress, more time for self-care, improved learning, and increased learning enjoyment. S/U grading did not negatively impact academic performance. In conclusion, this study demonstrates that, in our particular study population and setting, S/U grading conferred well-being and learning experience advantages to students without any reduction in motivation for learning or academic performance.

Exploring the Mindset of Veterinary Educators for Intelligence, Clinical Reasoning, Compassion, and Morality.

Mindset theory describes whether an individual believes their intelligence can be honed and improved with effort or whether it is inherent and fixed. These two different perceptions are called growth and fixed mindsets, respectively. Previous research has shown that students with growth mindsets embrace challenges, strive for mastery, have better psychological well-being, and are more resilient than students with fixed mindsets. Mindset is contagious, and teachers' mindsets can influence students' mindsets, motivation, and feedback-seeking behaviors. This is the first study of the veterinary educator mindset. Previous research has shown that mindset can vary by subject or personal attributes, called domains. This study investigated mindset in four domains: intelligence, clinical reasoning, compassion, and morality. A survey was developed by combining two previously published mindset scales and was distributed electronically to the veterinary teaching faculty at St. George's University, Grenada. The survey participants (n = 38, response rate 56%) showed predominantly growth mindsets, with some variation by domain: for intelligence, 84.2% growth, 5.3% intermediate, 10.5% fixed mindset; for clinical reasoning, 92.1% growth, 5.3% intermediate, 2.6% fixed mindset; for compassion, 63.2% growth, 2.6% intermediate, 34.2% fixed; and for morality, 60.5% growth, 13.2% intermediate, and 26.3% fixed mindset. Fifteen participants (39.5%) had fixed mindsets in one or more domains. Twenty participants (52.6%) had growth mindsets in all four domains. There were no associations found between demographic variables and mindset. This study found that most of the veterinary teaching faculty at this university had growth mindsets in all domains investigated.

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).

Qualitative Research in Veterinary Medical Education: Part 1-Principles of Qualitative Design.

Qualitative methodologies are relative newcomers to health sciences education research. While they may look very different to their quantitative counterparts in terms of size and scope, when well-applied they offer a fresh perspective and generate valuable research findings. Although qualitative research is being increasingly conducted in veterinary medical education, there are few contextualized resources to assist those who would like to develop their expertise in this area. In this article, we address this by introducing the principles of qualitative research design in a veterinary medical education context. Drawing from a range of contemporary resources, we explore the types of research goals and questions that are amenable to qualitative inquiry and discuss the process of formulating a worthwhile research question. We explain what research paradigms are and introduce readers to some of the methodological options available to them in qualitative research. Examples from veterinary medical education are used to illustrate key points. In a second companion article, we will focus on the decisions that need to be made regarding data sampling, collection, and analysis. We will also consider how qualitative research is evaluated, and discuss how qualitative findings are applied. Taken together, the two articles build an understanding of qualitative research, illuminate its potential to contribute to the scholarship of teaching and learning in veterinary medical education, and equip readers with an improved capacity to appraise its value.

Qualitative Research in Veterinary Medical Education: Part 2-Carrying Out Research Projects.

This is the second of two articles that together comprise an orientation and introduction to qualitative research for veterinary medical educators who may be new to research, or for those whose research experience is based on the quantitative traditions of biomedicine. In the first article (Part 1-Principles of Qualitative Design), we explored the types of research interests and goals suited to qualitative inquiry and introduced the concepts of research paradigms and methodologies. In this second article, we move to the strategies and actions involved in conducting a qualitative study, including selection and sampling of research sites and participants, data collection and analysis. We introduce some guidelines for reporting qualitative research and explore the ways in which qualitative research is evaluated and the findings applied. Throughout, we provide illustrative examples from veterinary and human medical education and suggest useful resources for further reading. Taken together, the two articles build an understanding of qualitative research, outline how it may be conducted, and equip readers with an improved capacity to appraise its value.

Advancing Veterinary Medical Education Worldwide: Where Do We Go From Here?

Veterinary medicine is a global public good. A robust system of both public and private veterinary services is essential to protect animal health. Improved animal health leads to global food security and reduces poverty by increasing productivity, controlling transboundary diseases and expanding access to international markets. The quality of veterinary services is directly related to the quality of veterinary medical education, therefore, it is incumbent upon the entire global veterinary medical profession to support programs that improve education around the world.

Qualitative Research in Veterinary Medical Education: Part 1-Principles of Qualitative Design.

Qualitative methodologies are relative newcomers to health sciences education research. While they may look very different to their quantitative counterparts in terms of size and scope, when well-applied they offer a fresh perspective and generate valuable research findings. Although qualitative research is being increasingly conducted in veterinary medical education, there are few contextualized resources to assist those who would like to develop their expertise in this area. In this article, we address this by introducing the principles of qualitative research design in a veterinary medical education context. Drawing from a range of contemporary resources, we explore the types of research goals and questions that are amenable to qualitative inquiry and discuss the process of formulating a worthwhile research question. We explain what research paradigms are and introduce readers to some of the methodological options available to them in qualitative research. Examples from veterinary medical education are used to illustrate key points. In a second companion article, we will focus on the decisions that need to be made regarding data sampling, collection, and analysis. We will also consider how qualitative research is evaluated, and discuss how qualitative findings are applied. Taken together, the two articles build an understanding of qualitative research, illuminate its potential to contribute to the scholarship of teaching and learning in veterinary medical education, and equip readers with an improved capacity to appraise its value.

Inter-Institutional Partnerships to Develop Veterinarian-Investigators through the NIH Comparative Biomedical Scientist Training Program Benefit One Health Goals.

Limitations in workforce size and access to resources remain perennial challenges to greater progress in academic veterinary medicine and engagement between human and veterinary medicine (One Health). Ongoing resource constraints occur in part due to limited public understanding of the role veterinarians play in improving human health. One Health interactions, particularly through interdisciplinary collaborations in biomedical research, present constructive opportunities to inform resource policies and advance health care. To this end, inter-institutional partnerships between individual veterinary medical education programs (VMEPs) and several National Institutes of Health (NIH) intramural research programs have created synergies beyond those provided by individual programs. In the NIH Comparative Biomedical Scientist Training Program (CBSTP), interdisciplinary cross-training of veterinarians consisting of specialty veterinary medicine coupled with training in human disease research leading to a PhD, occurs collaboratively on both VMEP and NIH campuses. Pre-doctoral veterinary student research opportunities have also been made available. Through the CBSTP, NIH investigators and national biomedical science policy makers gain access to veterinary perspective and expertise, while veterinarians obtain additional opportunities for NIH-funded research training. CBSTP Fellows serve as de facto ambassadors enhancing visibility for the profession while in residence at NIH, and subsequently through a variety of university, industry, and government research appointments, as graduates. Thus, the CBSTP represents an inter-institutional opportunity that not only addresses critical needs for veterinarian-scientists in the biomedical workforce, but also simultaneously exposes national policy makers to veterinarian-scientists' specialized training, leading to more effective realization of One Health goals to benefit human and animal health.

Robust (and Ethical) Educational Research Designs.

Educational research can be quite confusing to individuals without formal training in educational research methods. Many educators trained in "high-consensus" fields such as the health and medical sciences often expect to utilize the same esteemed experimental and quasi-experimental designs in their educational research efforts, but are surprised to learn that this is often impossible for ethical reasons. This article presents five robust research designs that generally are compatible with education studies, and discusses how each design may be used in a variety of educational research scenarios.

Perceptions of the Veterinary Profession among Human Health Care Students before an Inter-Professional Education Course at Midwestern University.

Conflicts among health care professionals often stem from misperceptions about each profession's role in the health care industry. These divisive tendencies impede progress in multidisciplinary collaborations to improve human, animal, and environmental health. Inter-professional education (IPE) may repair rifts between health care professions by encouraging students to share their professional identities with colleagues in unrelated health care disciplines. An online survey was conducted at Midwestern University (MWU) to identify baseline perceptions about veterinary medicine among entry-level human health care students before their enrollment in an inter-professional course. Participation was anonymous and voluntary. The survey included Likert-type scales and free-text questions. Survey participants expressed their interest in and respect for the discipline of veterinary medicine, but indicated that their unfamiliarity with the profession hindered their ability to collaborate. Twenty percent of human health care students did not know the length of a Doctor of Veterinary Medicine (DVM) program and 27.6% were unaware that veterinarians could specialize. Although 83.2% of participants agreed that maintaining the human-animal bond is a central role of the veterinary profession, veterinary contributions to stem cell research, food and water safety, public health, environmental conservation, and the military were infrequently recognized. If IPE is to successfully pave the way for multidisciplinary collaboration, it needs to address these gaps in knowledge and broaden the definition of veterinary practice for future human health care providers.

Student-Initiated Feedback Using Clinical Encounter Cards during Clinical Rotations in Veterinary Medicine: A Feasibility Study.

Despite its critical role for successful student learning, providing adequate teacher feedback is still a major issue during clinical education. In human medical education, the implementation of clinical encounter cards (CECs) has led to more frequent, timely, and structured teacher feedback. The present study aimed to introduce student-initiated CECs in a veterinary medical setting (clinical rotations). A total of 24 students were randomly assigned to a control group (standard rotations) and an intervention group where they had to ask for teacher feedback using CECs. The feasibility of implementing CECs was evaluated by examining the content of the completed CECs and by using anonymous student and teacher questionnaires. In addition, acceptance of the intervention and changes in feedback behavior were examined from both the teachers' and students' perspectives. Overall, it was shown that using CECs is not only feasible in a veterinary clinical setting but also conducive to more frequent and constructive teacher feedback. However, some teachers postponed completing the CECs due to time pressure, leading to less direct and timely feedback. Moreover, students felt more comfortable asking for feedback from less experienced, younger teachers, and teachers' quantitative ratings and open commentaries seemed to be affected by leniency bias. Finally, a focus group including teachers and students discussed these results in light of their practical experiences. This led to a streamlining of the implementation process and optimizations to facilitate future large-scale implementation. The study has implications for veterinary educators wishing to improve feedback in their institution.

Adverse Childhood Experiences among Veterinary Medical Students: A Multi-Site Study.

This research explores Adverse Childhood Experiences (ACEs) among veterinary medical students across six academic institutions of veterinary medicine, and their relationship with depression, stress, and desire to become a veterinarian. Between April 1, 2016, and May 23, 2016, 1,118 veterinary medical students in all 4 years of the curriculum (39% response rate) completed an anonymous web-based questionnaire about ACEs, depression using the Center for Epidemiological Studies Depression scale (CESD), stress using the Perceived Stress Scale (PSS), and the age at which they wanted to become a veterinarian. Sixty-one percent (677) of respondents reported having at least one ACE. The most prevalent ACE reported was living with a household member with a mental illness (31%). Students who had experienced four or more ACEs had an approximately threefold increase in signs of clinical depression and higher than average stress when compared to students who had experienced no ACEs. The number of ACEs showed an overall graded relationship to signs of clinical depression and higher than average stress. There was no statistically significant relationship between age at which a student wanted to become a veterinarian and exposure to ACEs. Veterinary students report being exposed to ACEs before age 18 at a rate similar to that of other population-based studies. These findings do not suggest that veterinary students enter the veterinary medical education system more at risk for poor mental health due to ACEs than the general population.

Curricular Renewal at the Southern Tip of Africa: The 2016 Veterinary Curriculum at the University of Pretoria.

Four years after the institution of a new curriculum at the University of Pretoria's Faculty of Veterinary Science, a second major curricular renewal was initiated as a result of several pressing drivers, many of which were unique to the national and institutional context. During the project, South African higher education was disrupted by student protests prompted by financial pressures on students, the overt colonial structure of higher education, and the need to accelerate transformation of the sector. A structured curricular renewal process was followed, including the laying down of the principles, the structuring the macro-curriculum as a story, the design of a meso- and micro-curriculum, and the mapping of the curriculum to Day One outcomes. The resulting program is a 6-year bachelor's degree with a blend of discipline and species modules, with the first cohort graduating in 2016. There is a strong focus on skills embodied in a 62-week experiential component, managed using a unique custom-designed online platform for booking placements, documenting exposure, assessing competency, and providing feedback to students. The experiential training includes a large elective component. Several causes of loss of impetus during the process are discussed and proposals are made for avoiding these. The value of accreditation as a driver and a source of inputs is evident. The process has succeeded in producing a significantly reshaped curriculum that has been well received by external stakeholders.

Investigating Veterinary Medicine Faculty Perceptions of Lecture Capture: Issues, Concerns, and Promises.

Lecture capture technology is becoming more pervasive in today's classrooms. Students are demanding their lectures be recorded, but many instructors remain resistant. The goal of this study was to investigate faculty perceptions of lecture capture and to understand their concerns with the technology. Through a review of the existing literature, three common reasons for not recording were identified: impact on class attendance, incompatible pedagogy, and technical concerns. To test the hypotheses, an electronic survey was created and distributed to the faculty of a veterinary college in the southeastern US. The survey included both quantitative and qualitative questions. An invitation was emailed to all 134 faculty members, garnering 50 responses. Results were consistent with the hypotheses. Impact on class attendance, teaching styles, and technical considerations have dissuaded many instructors from adopting lecture capture technology. However, a fourth theme that emerged was faculty lack of awareness/familiarity. According to the qualitative responses, many faculty either did not know lecture recording was available in their teaching spaces or were not trained in how to use the technology. Recommendations for future research include distributing the survey campus-wide and providing more opportunities for faculty training. It would also be worthwhile to repeat the survey after providing more information and training materials to faculty, or after switching from an opt-in to an opt-out approach, to see whether perceptions have changed among the college's faculty.

Development and Evaluation of vetPAL, a Student-Led, Peer-Assisted Learning Program.

Based on an idea from a final-year student, Bristol Veterinary School introduced vetPAL, a student-led, peer-assisted learning program. The program involved fifth-year (final-year) students acting as tutors and leading sessions for fourth-year students (tutees) in clinical skills and revision (review) topics. The initiative aimed to supplement student learning while also providing tutors with opportunities to further develop a range of skills. All tutors received training and the program was evaluated using questionnaires collected from tutees and tutors after each session. Tutees' self-rated confidence increased significantly in clinical skills and for revision topics. Advantages of being taught by students rather than staff included the informal atmosphere, the tutees' willingness to ask questions, and the relatability of the tutors. The small group size and the style of learning in the revision sessions (i.e., group work, discussions, and interactivity) were additional positive aspects identified by both tutees and tutors. Benefits for tutors included developing their communication and teaching skills. The training sessions were considered key in helping tutors feel prepared to lead sessions, although the most difficult aspects were the lack of teaching experience and time management. Following the successful pilot of vetPAL, plans are in place to make the program permanent and sustainable, while incorporating necessary changes based on the evaluation and the student leader's experiences running the program. A vetPAL handbook has been created to facilitate organization of the program for future years.

Rater Errors in Clinical Performance Assessments.

Rater errors are some of the most significant validity threats to any performance assessment. Veterinary medical education routinely uses raters to assess student performance in a variety of scenarios (e.g., clinical assessments, OSCEs, etc.). The purpose of this "teaching tip" is to introduce veterinary medical educators to the notion of rater error, identify a list of common rater errors, and discuss how these errors can be addressed and minimized so as to produce accurate and defensible measures of student performance.