Endoscopy Training in Small Animal Internal Medicine: A Survey of Residency Training Programs in North America.

Competency in multiple endoscopic techniques is a major goal of small animal internal medicine (SAIM) residency programs. Training relies predominantly on mentored supervision of procedures performed on patients. Supplementation of this apprenticeship model with classroom sessions and hands-on laboratories can be advantageous to trainees and patients. Few veterinary resources describe supplemental training options, and no single source exists for mentors to consult for program development. The purpose of this study was to describe the supplemental training opportunities currently available to SAIM residents at academic hospitals in the US and Canada and to compare their timing during the residency, resident and faculty time commitment, and perceived helpfulness. Data were collected by an electronic survey distributed to one faculty member per institution. The response rate was 80% (24/30). Most programs (22/24; 92%) offered some form of supplemental training, including classroom sessions (9/24) and hands-on laboratories using physical models (7/24), virtual reality simulators (2/24), and cadaver (2/24) and anesthetized (2/24) dogs. Fifteen programs provided residents with the opportunity to attend external endoscopy workshops. Only three programs required any training prior to residents performing procedures on patients. There was considerable variability in training between programs, precluding statistical comparisons. The survey identified topics for classroom sessions and several inexpensive physical models, rated very or extremely helpful, that would be suitable for programs with limited budgets. A human-based virtual reality simulator was also rated highly by two programs. Comprehensive, external workshops evoked numerous positive comments with perceived value ranging from somewhat to extremely helpful.

Evaluation of Veterinary Students' Communication Skills with a Service Dog Handler in a Simulated Client Scenario.

Effective communication skills serve as a key component of excellent veterinary care and provide a foundation for building trusting relationships with clients. While many veterinary clients value their pets for companionship, the focus of other relationships may be based on a partnership between the human and animal, as is the case with the handlers of service dogs. As the use of service dogs in the US continues to grow, it is important that veterinary professionals are educated on how best to meet the unique needs of service dogs and their handlers. This article evaluates the interactions of veterinary students with a service dog handler in a simulated client scenario. Ten videotaped interactions were coded to assess third-year students' communication skills (nonverbal communication, open-ended questions, reflective listening, and empathy), and their ability to discuss the diagnostic and therapeutic options for a dog with suspected intervertebral disk disease. Results showed that the majority of students demonstrated competence in the use of nonverbal communication skills and in discussing the biomedical aspects of the disease. Students require development in the use of open-ended questions, reflective listening statements, and expression of empathy, as well as building client rapport and discussing the psychosocial aspect of the disease on the client and patient. These findings suggest that veterinary students may benefit from targeted instruction on "best practices" in caring for service dogs and their handlers, including greater attention to the psychosocial aspects of a disease, and from additional communication practice using standardized clients with service dogs.

Evaluation of Veterinary Students' Communication Skills with a Service Dog Handler in a Simulated Client Scenario.

Effective communication skills serve as a key component of excellent veterinary care and provide a foundation for building trusting relationships with clients. While many veterinary clients value their pets for companionship, the focus of other relationships may be based on a partnership between the human and animal, as is the case with the handlers of service dogs. As the use of service dogs in the US continues to grow, it is important that veterinary professionals are educated on how best to meet the unique needs of service dogs and their handlers. This article evaluates the interactions of veterinary students with a service dog handler in a simulated client scenario. Ten videotaped interactions were coded to assess third-year students' communication skills (nonverbal communication, open-ended questions, reflective listening, and empathy), and their ability to discuss the diagnostic and therapeutic options for a dog with suspected intervertebral disk disease. Results showed that the majority of students demonstrated competence in the use of nonverbal communication skills and in discussing the biomedical aspects of the disease. Students require development in the use of open-ended questions, reflective listening statements, and expression of empathy, as well as building client rapport and discussing the psychosocial aspect of the disease on the client and patient. These findings suggest that veterinary students may benefit from targeted instruction on "best practices" in caring for service dogs and their handlers, including greater attention to the psychosocial aspects of a disease, and from additional communication practice using standardized clients with service dogs.

Evaluation of a Human Virtual-Reality Endoscopy Trainer for Teaching Early Endoscopy Skills to Veterinarians.

Competency in flexible endoscopy is a major goal of small animal internal medicine residency training programs. Hands-on laboratories to teach entry-level skills have traditionally used anesthetized laboratory dogs (live dog laboratory [LDL]). Virtual-reality endoscopy trainers (VRET) are used for this purpose in human medicine with the clear benefits of avoiding live animal use, decreasing trainee stress, and allowing repeated, independent training sessions. However, there are currently no commercially available veterinary endoscopy simulators. The purpose of the study was to determine whether a human VRET can be a reasonable alternative to a LDL for teaching early veterinary endoscopy skills. Twelve veterinarians with limited or no endoscopy experience underwent training with a VRET (n = 6) or a LDL (n = 6), performed two recorded esophagogastroduodenoscopies (EGD) on anesthetized dogs for evaluation purposes (outcomes laboratory), and then underwent training with the alternative method. Participants completed questionnaires before any training and following each training session. No significant differences were found between training methods based on: measured parameters from the outcomes laboratory, including duration of time to perform EGD; evaluators' assessment of skills; and, assessment of skills through blinded review of the esophageal portion of EGD recordings. The VRET was less stressful for participants than the LDL (p = .02). All participants found that the VRET was a useful and acceptable alternative to the LDL for training of early endoscopy skills. Based on this limited study, VRET can serve as a reasonable alternative to LDL for teaching endoscopy skills to veterinarians.