What makes a 'good group'? Exploring the characteristics and performance of undergraduate student groups.

Group work forms the foundation for much of student learning within higher education, and has many educational, social and professional benefits. This study aimed to explore the determinants of success or failure for undergraduate student teams and to define a 'good group' through considering three aspects of group success: the task, the individuals, and the team. We employed a mixed methodology, combining demographic data with qualitative observations and task and peer evaluation scores. We determined associations between group dynamic and behaviour, demographic composition, member personalities and attitudes towards one another, and task success. We also employed a cluster analysis to create a model outlining the attributes of a good small group learning team in veterinary education. This model highlights that student groups differ in measures of their effectiveness as teams, independent of their task performance. On the basis of this, we suggest that groups who achieve high marks in tasks cannot be assumed to have acquired team working skills, and therefore if these are important as a learning outcome, they must be assessed directly alongside the task output.

Intra- and interobserver agreement in the interpretation of navicular bones on radiographs and computed tomography scans.

REASONS FOR PERFORMING STUDY: Criteria for the radiographic evaluation of navicular bones in horses have been published to standardise classification of radiographic signs. However, intra- and interobserver agreement have not been established. OBJECTIVE: To determine intra- and interobserver agreement in the evaluation of radiographic and computed tomographic (CT) navicular changes. It was hypothesised that: 1) intraobserver agreement would be better than interobserver agreement; 2) agreement would be better for CT than for radiography; and 3) pathological changes would be recognised with greater certainty with CT. METHODS: Radiographs and CT scans of 60 cadaver navicular bones were evaluated by 3 observers using published criteria. A subset of 30 studies was evaluated twice by one observer. Agreement was tested using the kappa statistic. Certainty about pathological changes was evaluated by giving the observers the option to choose 'not sure'. RESULTS: Agreement varied from poor to almost perfect for radiographic evaluation and from poor to substantial for CT evaluation. For radiographic evaluation mean interobserver agreement was fair, as it was for CT evaluation. For radiographic evaluation mean intraobserver agreement was moderate as it was for CT evaluation. Pathological changes were evaluated with greater certainty on CT scans compared to radiographs; however, this was not associated with improved agreement. CONCLUSIONS: Variations in classification of navicular lesions in radiographic and CT studies were considerable between and within observers and challenge the use of such studies for diagnostic and prognostic purposes. POTENTIAL RELEVANCE: The results of this study allowed the identification of evaluation criteria with sufficient precision to be useful for navicular bone evaluation.

Approaches to defining day-one competency: a framework for learning veterinary skills.

Competency at graduation, in a variety of physical and attitudinal skills, is an essential outcome measure for courses training veterinary surgeons. The approach adopted by the Royal Veterinary College, London, to identify and define the expected skill competencies required of our veterinary undergraduates by the time of graduation is described. In addition, we demonstrate how this skill set was built into a framework that was aligned with other student learning objectives. This two-year project resulted in the publication of a day-one skills handbook, which was introduced to the college staff and students in 2007.

Accuracy of non-invasive ICP assessment can be increased by an initial individual calibration.

OBJECTIVE: In a formerly introduced mathematical model, intracranial pressure (ICP) could be non-invasively assessed using cerebral blood flow velocity (FV) and arterial blood pressure (ABP). The current study attempts to check whether the accuracy of the non-invasive ICP assessment (nICP) improves after an initial individual calibration by implanted ICP probes. METHODS: Thirteen patients with brain lesions (35-77 years, mean: 58 +/- 13 years) were studied. FV, ABP and ICP signals were recorded at days 1, 2, 4 and 7. nICP was calculated and compared to ICP. In the first recording of each patient the (invasively assessed) ICP signal was used to calibrate the nICP calculation procedure, while the follow-up recordings were used for its validation. FINDINGS: In 11 patients 22 follow-up recordings were performed. The mean deviation between ICP and the original nICP (+/- SD) was 8.3 +/- 7.9 mmHg. Using the calibrated method this deviation was reduced to 6.7 +/- 6.7 mmHg (P < 0.005). CONCLUSIONS: Initial individual calibration of nICP assessment method significantly improves the accuracy of nICP estimation on subsequent days. This hybrid method of ICP assessment may be used in intensive care units in patients with initially implanted ICP probes. After removal of the probes, ICP monitoring can be continued using the calibrated nICP assessment procedure.

Variation in conformation in a cohort of National Hunt racehorses.

REASONS FOR PERFORMING THE STUDY: Assessment of conformation is commonly used in the selection of horses for performance purposes. Little information is available on the normal range of conformational traits within the Thoroughbred population. OBJECTIVES: To describe variations in conformation in a cohort of racing Thoroughbreds in order to provide a set of baseline standards within which conformational traits can be considered normal. MATERIALS AND METHODS: Ninety-eight conformational parameters were measured in a cohort of 108 National Hunt racehorses using a digital motion analysis system. The measurements consisted of segment lengths, joint angles in 2D and 3D, inclinations, deviations and circumference measurements. The differences between left and right sides were determined to obtain a measure of asymmetry. Conformational parameters were related to each horse's country of origin, preferred race distance and race type. RESULTS: The majority of parameters followed a normal distribution with the biggest relative variation in hoof related measurements and in stifle and coxal angle. All circumference measurements and the majority of the length measurements were significantly correlated with the height of the horse at the withers. No underlying pattern of combinations of conformational parameters was identified. Twenty-five per cent of the parameters showed a significant difference between left and right-sided measurements. A significant difference in girth and intermandibular width was observed between Irish and French horses. CONCLUSIONS: Thoroughbreds differ from other breeds, not only with regard to segment lengths but also with regard to joint angles and deviations. Variation in conformational parameters was relatively small and no distinct pattern of combinations of conformational traits identified. CLINICAL RELEVANCE: The variation in conformational measurements in Thoroughbred racehorses establishes a set of baseline measurements of conformational range against which individual horses can be assessed.

The effect of conformation on orthopaedic health and performance in a cohort of National Hunt racehorses: preliminary results.

REASONS FOR PERFORMING STUDY: There is a lack of scientific data and studies on the effect of conformation on performance or on orthopaedic health. OBJECTIVES: To investigate the relationship between conformation, injury and performance in racehorses used for racing over fences. METHODS: Over 2 years, 108 National Hunt racehorses were followed and their medical and performance data recorded. Conformation was measured in 3D with a computerised motion analysis system. Linear multiple regression models were used to evaluate the effect of conformation on measures of race performance and stepwise forward logistic regression models to assess the effect on risk of injury. RESULTS: An increase in intermandibular width, flexor angle of the shoulder joint and coxal angle (the angle between the ilium and ischium) was demonstrated to have a positive effect on performance. Performance decreased with increasing girth, length of the hind digit and valgus conformation of the metacarpophalangeal joint. The risk of suffering from superficial digital flexor tendon injury increased with increasing metacarpophalangeal joint angle and with carpus valgus conformation. The risk of pelvic fracture increased with valgus conformation of the tarsus and decreased with an increasing coxal angle. CONCLUSION: Valgus deformation was demonstrated to be detrimental to performance or increased risk of injury, perhaps resulting in higher loads on musculoskeletal structures. The coxal angle was the only parameter to have an effect on both risk of injury and performance. An alignment of the muscles with the axis of the pelvis may be beneficial for force transmission and decrease the bending moment of the muscles on the bones. The statistical power of this study is limited, however it provides preliminary data necessary for the planning of a larger scale study on the effect of conformation on performance and risk of injury. CLINICAL RELEVANCE: Studies of the effects of conformation on performance and risk of injury may aid in identifying individuals likely to perform well on the racecourse and avoid risks of injury.

Reliability of conformational measurements in the horse using a three-dimensional motion analysis system.

REASONS FOR PERFORMING STUDY: The importance of a reliable method for conformation studies is generally acknowledged, but there are only limited data on the accuracy and precision of current assessment methods. OBJECTIVES: To assess (1) the accuracy and repeatability of marker placement, (2) influence of stance of the horse on conformational parameters, (3) practicality of a computerised motion analysis system and (4) to compare the computerised motion analysis system to photographic systems of assessment. METHODS: Twenty-eight reflective markers placed over anatomical landmarks were located in 3D using a computerised motion analysis system and their coordinates used to calculate segment lengths and joint angles. Four experiments, involving a cadaver study, a series of repeated measures on a single Thoroughbred and repeat measurements on 108 racehorses were performed. RESULTS: Identification of anatomical landmarks was found to introduce the biggest variation in the measurements for proximal conformation parameters with the interoperator being larger than intraoperator variation. Length measurements were least influenced by stance, with distal interphalangeal and metacarpo/metatarsophalangeal joint angles being the most variable. In some measurements, the variation between stances within a horse proved to be almost as large as between horses, rendering these parameters less useful as predictors of performance or orthopaedic health. CONCLUSIONS: A computerised motion analysis system allows 3D assessment of conformation with high accuracy and precision. It eliminates 3 major sources of error associated with photography-based methods and increases accuracy of conformational assessment by allowing repeat measurements in a relatively short period. POTENTIAL RELEVANCE: Studies on conformation should be viewed in the light of the limitations of the measurement technique used. The presented method maximises accuracy and precision and is a valuable basis for future studies investigating the effect of conformation on performance or orthopaedic health.

Evidence of bias affecting the interpretation of the results of local anaesthetic nerve blocks when assessing lameness in horses.

Eighteen observers were influenced to different extents in the grades of lameness they allocated to eight horses by whether they knew that a nerve block had been administered; on a scale from 0 to 10 the mean difference in grade allocated once the observer knew a horse had been nerve-blocked was increased by 0.4. The consistency of the assessments made by the individual observers was good, with a an average of 0.6 of a grade difference when grading the same horse on two occasions. The agreement between the assessments of four orthopaedic experts was reasonable (+/-1 grade), but significantly poorer for four non-experts and 10 final year veterinary students.

Assessing and enhancing quality through outcomes-based continuing professional development (CPD): a review of current practice.

Numerous professional bodies have questioned whether traditional input-based continuing professional development (CPD) schemes are effective at measuring genuine learning and improving practice performance and patient health. The most commonly used type of long-established CPD activities, such as conferences, lectures and symposia, have been found to have a limited effect on improving practitioner competence and performance, and no significant effect on patient health outcomes. Additionally, it is thought that the impact of many CPD activities is reduced when they are undertaken in isolation outside of a defined structure of directed learning. In contrast, CPD activities which are interactive, encourage reflection on practice, provide opportunities to practice skills, involve multiple exposures, help practitioners to identify between current performance and a standard to be achieved, and are focused on outcomes, are the most effective at improving practice and patient health outcomes.

What is the veterinary professional identity? Preliminary findings from web-based continuing professional development in veterinary professionalism.

Professionalism and professional skills are increasingly being incorporated into veterinary curricula; however, lack of clarity in defining veterinary professionalism presents a potential challenge for directing course outcomes that are of benefit to the veterinary professional. An online continuing education course in veterinary professionalism was designed to address a deficit in postgraduate support in this area; as part of this course, delegates of varying practice backgrounds participated in online discussions reflecting on the implications of professional skills for their clinical practice. The discussions surrounding the role of the veterinary professional and reflecting on strengths and weaknesses in professional skills were analysed using narrative methodology, which provided an understanding of the defining skills and attributes of the veterinary professional, from the perspectives of those involved (i.e. how vets understood their own career identity). The veterinary surgeon was understood to be an interprofessional team member, who makes clinical decisions in the face of competing stakeholder needs and works in a complex environment comprising multiple and diverse challenges (stress, high emotions, financial issues, work-life balance). It was identified that strategies for accepting fallibility, and those necessary for establishing reasonable expectations of professional behaviour and clinical ability, are poorly developed.

Continuing professional development: learning that leads to change in individual and collective clinical practice.

The lack of effectiveness of traditional models of continuing professional development is increasingly recognised. While they can lead to increased knowledge of participants, research suggests that there is a general failure to produce meaningful and sustained changes in clinician behaviours. The aim of this study was to explore the effect of the Royal College of Veterinary Surgeons' (RCVS) new individual outcomes-focused approach to delivery of continuing professional development (CPD) through the reflective accounts of participant experiences. Content analysis of 12 summaries of their learning, produced by early pioneers of the Professional Key Skills (PKS) Module of the RCVS Certificate in Advanced Veterinary Practice, revealed that the benefits of the PKS-related professional development is best understood through 'a framework of 'stakeholder' dynamics', with impact and behavioural change at the individual participant level having an effect on practice team behaviours, leading to patient, owner and business benefits. It can be concluded that, at least for these early pioneers, this new model for CPD has resulted in changes that have gone beyond knowledge accumulation to changed practitioner behaviours and recognisable patient, owner and business benefits.

Errors in veterinary practice: preliminary lessons for building better veterinary teams.

Case studies in two typical UK veterinary practices were undertaken to explore teamwork, including interprofessional working. Each study involved one week of whole team observation based on practice locations (reception, operating theatre), one week of shadowing six focus individuals (veterinary surgeons, veterinary nurses and administrators) and a final week consisting of semistructured interviews regarding teamwork. Errors emerged as a finding of the study. The definition of errors was inclusive, pertaining to inputs or omitted actions with potential adverse outcomes for patients, clients or the practice. The 40 identified instances could be grouped into clinical errors (dosing/drugs, surgical preparation, lack of follow-up), lost item errors, and most frequently, communication errors (records, procedures, missing face-to-face communication, mistakes within face-to-face communication). The qualitative nature of the study allowed the underlying cause of the errors to be explored. In addition to some individual mistakes, system faults were identified as a major cause of errors. Observed examples and interviews demonstrated several challenges to interprofessional teamworking which may cause errors, including: lack of time, part-time staff leading to frequent handovers, branch differences and individual veterinary surgeon work preferences. Lessons are drawn for building better veterinary teams and implications for Disciplinary Proceedings considered.

Veterinary team interactions, part one: the practice effect.

Veterinary practices have evolved since the era of solo practitioners working on one site. Today veterinary practices tend to include veterinary surgeons, veterinary nurses, receptionists and business managers, leading to the notion of the veterinary team and the rise of interprofessional working. In addition, practices have grown in size and frequently include several branches, creating a distributed team. Research regarding veterinary teamwork is lacking. This paper uses Social Network Analysis (SNA) to address this issue. SNA measures interactions between members of a network. The types of interactions in practice and the effects of practice size and location (branches) are considered. Information sharing and asking for advice are straightforward, lower order interactions. Problem solving and being influenced by another are complex, higher order interactions. Smaller practices have higher densities of interactions, implying a more cohesive team. However, individuals in smaller practices still do not interact with everyone and therefore actively choose with whom to interact. Practices with little staff rotation across branches experience limited interactions across locations. The results of this study have implications for practices aiming to expand their team, either in a single site or by acquiring more branches. Suggestions for ways to maintain and improve interactions are made.

Veterinary team interactions, part 2: the personal effect.

Modern veterinary practices consist of multiple professions/occupations, often spread over multiple branches. Within these teams are identifiable 'key people' who are central to information and resource flow. Key people are frequently the appointed leaders, such as practice managers, but also include emergent leaders. Veterinary surgeons are commonly involved in the flow of higher order interactions such as problem solving, while administrators are often involved in information interactions. These key people are repeatedly boundary spanners, sharing resources across physical boundaries such as branches. Their marginal status (belonging to multiple groups) also allows them to interact across professional boundaries. Lower order interactions including asking for information and advice are often interprofessional; however, higher order interactions tend to be intraprofessional. Analysis of interaction reciprocity between professions demonstrated the prevalence of a profession based hierarchy, with veterinary surgeons at the top. Being social outside of work with a colleague is also linked to work based interactions. The results of this paper demonstrate the need for practices to consider key people and support them appropriately. Further to this, they suggest that, to promote an effective team, interactions should be based on experience as much as professional status, and that social interactions should be encouraged.

Understanding hind limb lameness signs in horses using simple rigid body mechanics.

Hind limb lameness detection in horses relies on the identification of movement asymmetry which can be based on multiple pelvic landmarks. This study explains the poorly understood relationship between hind limb lameness pointers, related to the tubera coxae and sacrum, based on experimental data in context of a simple rigid body model. Vertical displacement of tubera coxae and sacrum was quantified experimentally in 107 horses with varying lameness degrees. A geometrical rigid-body model of pelvis movement during lameness was created in Matlab. Several asymmetry measures were calculated and contrasted. Results showed that model predictions for tubera coxae asymmetry during lameness matched experimental observations closely. Asymmetry for sacrum and comparative tubera coxae movement showed a strong association both empirically (R(2)≥ 0.92) and theoretically. We did not find empirical or theoretical evidence for a systematic, pronounced adaptation in the pelvic rotation pattern with increasing lameness. The model showed that the overall range of movement between tubera coxae does not allow the appreciation of asymmetry changes beyond mild lameness. When evaluating movement relative to the stride cycle we did find empirical evidence for asymmetry being slightly more visible when comparing tubera coxae amplitudes rather than sacrum amplitudes, although variation exists for mild lameness. In conclusion, the rigidity of the equine pelvis results in tightly linked movement trajectories of different pelvic landmarks. The model allows the explanation of empirical observations in the context of the underlying mechanics, helping the identification of potentially limited assessment choices when evaluating gait.

The characterisation of equine interleukin-1.

Equine interleukin-1 has been produced from peripheral blood monocytes by stimulation with E. coli lipopolysaccharide. Sephacryl S200 gel filtration revealed a molecular weight of 17-18 kD. Chromatofocusing of the 17-18 kD peak identified four active fractions. Two major peaks were detected at pH 6.7 and pH 7, with smaller peaks at pH 6.3 and pH 5.9. The pI 7 molecule is probably the equine form of IL-1 beta.

Species restrictions demonstrated by the stimulation of equine cells with recombinant human interleukin-1.

Equine thymocytes, which respond to equine monocyte supernatants, do not respond to stimulation with recombinant human interleukin-1 alpha and beta, and equine synovial fibroblasts show a limited response in the form of prostaglandin E2 production without any evidence of neutral metalloproteinase production. Human interleukin-1 beta was about three to ten times as active on equine synovial cells as human interleukin-1 alpha in terms of prostaglandin E2 production. This preliminary evidence would suggest that there are qualitative and quantitative differences in the way recombinant human interleukin-1 stimulates human cells and the way in which it stimulates equine cells.

Anti-collagen antibodies and immune complexes in equine joint diseases.

An investigation was made into the possible contribution of autoimmune mechanisms to equine arthropathies. Serum and synovial fluid (SF) immune complexes and anti-collagen Type II antibodies were measured, by ELISA, in groups of horses with naturally occurring osteoarthritis (OA), osteochondritis dissecans (OCD), bone fracture, traumatised joints, synovitis, infected joints and non-diseased (control) joints. Significantly raised anti-collagen Type II antibodies were found in osteoarthritic (P < 0.02) and traumatised joint synovial fluids (P < 0.01) compared with the control, where ten of 38 (26%) OA and five of eight (63%) traumatised joint synovial fluid samples had raised anti-collagen Type II antibodies (above mean and 2 SD of control group; P < 0.05). Significantly raised levels of C1q-binding immune complexes were found in the synovial fluids of horses with OA (P < 0.001), OCD (P < 0.02), fractured articular bone (P < 0.001), infected (P < 0.01) and traumatised joints (P < 0.001) as compared with the control horses. Raised C1q-binding activity (above mean and 2 SD of control group; P < 0.05) was shown in synovial fluids in 18 of 38 (47%) OA, four of 16 (25%) OCD, four of nine (44%) fractured bone, one of eight (14%) synovitis, two of four (50%) infected joints and seven of eight (88%) traumatised joints. No raised anti-collagen Type II antibodies or C1q-binding activity were detected in sera from any clinical group. Correlations were found, in synovial fluids, between anti-collagen Type II antibodies and C1q-binding activity in OA (P < 0.02), synovitis (P < 0.01) and infected joint (P < 0.05) groups. Within individual horses, there were no correlations between the SF and sera measurements of either anti-collagen II or C1q-binding activity. The relationship between cause and effect of these immunological findings cannot be determined; as they are common to many types of equine joint disorder it is probable that they are not an initiating factor in pathology.

Modifying drug-reinforced behavior by altering the economic conditions of the drug and a nondrug reinforcer.

Six rhesus monkeys were trained to self-administer orally delivered phencyclidine (0.25 mg/mL) and saccharin (0.03% wt/vol) under concurrent fixed-ratio 16 schedules. In Condition 1 the fixed-ratio requirement for phencyclidine was changed from 16 to 4, 8, 16, 32, 64, 128 and 16 while the fixed-ratio requirement for saccharin deliveries remained constant at 16. In Condition 2 the fixed-ratio value for saccharin was systematically altered while the fixed-ratio requirement for phencyclidine remained at 16, and in Condition 3 the fixed-ratio requirements for both phencyclidine and saccharin were altered simultaneously. Water was then substituted for saccharin, and the series of fixed-ratio manipulations was replicated. The phencyclidine concentration was reduced to 0.125 mg/mL and Conditions 1 and 3 were repeated. When the fixed-ratio requirement for phencyclidine was increased and the fixed-ratio requirement for saccharin or water remained fixed at 16, phencyclidine deliveries decreased when saccharin (vs. water) was concurrently available. The magnitude of the decrease ranged from 20% to 90% (of the concurrent water condition) as the fixed-ratio requirement for phencyclidine increased from 4 to 128. When the fixed-ratio requirement for phencyclidine remained at 16 and the fixed-ratio requirements for concurrent saccharin or water varied between 4 and 128, phencyclidine deliveries decreased by 30% to 40% due to the concurrent availability of saccharin (vs. water). This decrease occurred only at the three lowest fixed-ratio values when saccharin intake was relatively high. When the fixed-ratio requirements for both phencyclidine and concurrent saccharin or water were varied simultaneously, phencyclidine deliveries were reduced from 20% to 45% when saccharin (vs. water) was concurrently present. There was little effect of reducing the phencyclidine concentration when the data were analyzed in terms of unit price (responses per milligram). Thus, changes in the fixed-ratio requirement or drug concentration were functionally similar, and unit price of phencyclidine was the variable that was influenced by the presence of concurrent saccharin. These data indicate that drug-reinforced behavior is substantially reduced when the environment is enriched with an alternative nondrug reinforcer. The economic context in which these substances are presented is an important determinant of drug-reinforced behavior.

Isolation of equine peripheral blood mononuclear cells using Percoll.

The concentration of Percoll required for isolating equine peripheral blood mononuclear cells has been reinvestigated. A poor cell yield was obtained at the 60 per cent concentration already reported. It is recommended that workers specifically interested in high yields of mononuclear cells, for investigation of lymphocyte and monocyte functions, use a concentration of 65 per cent Percoll. However, workers wishing to isolate pure populations of equine neutrophils might consider a concentration of 70 per cent in the upper layer of Percoll used to retain the mononuclear cells.