The Current State of Veterinary Toxicology Education at AAVMC Member Veterinary Schools.

This study assessed the depth, breadth, and perception of toxicology education in curricula at Association of American Veterinary Medical Colleges (AAVMC) member veterinary schools. An online questionnaire was sent twice to all 54 AAVMC members and sent once to a veterinary toxicology list serve. The survey covered areas related to instructor demographics, the depth and extent of toxicology taught, and the respondent's perceptions of their student's ability to perform entrustable professional activities (EPA). Results were analyzed using descriptive statistics. Our survey resulted in a 44% response rate. All responding schools included toxicology in their curriculum, and it was a required course in 23 programs. Contact hours in stand-alone veterinary toxicology courses ranged from 14 to 45 h. Most respondents indicated that the current time allotted for toxicology was inadequate, despite indicating that most of their students could perform most EPAs autonomously. One exception related to the ability of students to analyze toxicology data. We found small variations in teaching methods and curriculum content. The results of our study can assist veterinary schools in evaluating their curricula to better prepare new graduates for the management of toxicology issues they may face in their veterinary careers.

Assessment of Safety Culture at a Veterinary Teaching Hospital in the United States.

This study assessed the fidelity of an existing questionnaire regarding attitudes toward safety culture in an academic veterinary hospital setting and gathered baseline data on these attitudes in a local population. A cross-sectional study design was used to evaluate perceptions held by veterinary teaching hospital employees. An established veterinary safety culture survey was modified and administered as a confidential online survey to faculty, house officers, and professional staff of a veterinary teaching hospital in the United States. Confirmatory and exploratory factor analysis were conducted to compare the adapted survey to the established version. Descriptive statistics were used to characterize baseline safety culture. The adapted survey exhibited factor groupings that were mostly in agreement with, but slightly different from, the original instrument. In general, survey respondents outlined positive attitudes toward the various domains of safety culture, though we identified opportunities for improvement in some areas. An adapted veterinary safety culture survey can be applied to a veterinary teaching hospital in the United States to assess baseline data surrounding the culture of safety and to identify opportunities for focused improvement efforts.

A 45-year Retrospective Content Analysis of JVME Articles.

To study changes in Journal of Veterinary Medical Education (JVME) content, this article presents the results of an analysis of a purposeful sample (n = 537) and demographic analysis of all 1,072 articles published from 2005 to 2019. The findings were compared to a prior analysis of articles from 1974 to 2004. Article length increased, as did the number of authors and institutions per article. Female first author numbers grew at a greater rate than the proportion of female faculty at AAVMC-accredited colleges. Close to 85% of articles were by authors in the US, UK, Canada and Australia, while 40 other countries contributed the remainder. The primary topics of papers published from 2005 to 2019 were student affairs (17.3%), professional skills (15.1%), courses and curricula (12.7%), specialty/disciplinary training (12.5%), and technology/information resources (11.5%). The prevalence of articles with an identified research methodology grew from 14.2% in 1974-2004, to 55.9% (n = 300) in 2005-2019. Among research articles, 54.7% reported an intervention and 70.3% included a comparison. Random assignment to experimental or control conditions occurred in 32 articles (15.2%). Qualitative inquiry expanded, with 16.3% of research articles using this methodology alone. The most cited article was a review paper discussing the human-animal bond. Descriptions of courses and curricula constituted the majority of articles over the journal's lifespan, while no pattern was discerned between major reports in veterinary education and subsequent publications on that topic. Over the last 45 years, JVME has transitioned from a newsletter to a scholarly publication, with ongoing evolution.

Effect of Delivery Format on Student Outcomes and Perceptions of a Veterinary Medicine Course: Synchronous versus Asynchronous Learning.

The COVID-19 pandemic prompted instruction at many veterinary schools to switch to an emergency remote teaching format to prevent viral transmission associated with in-person synchronous lectures. This study surveyed student perspectives and academic performance in a pre-planned online second-year veterinary toxicology course given at North Carolina State University in Spring 2020. This course relied on asynchronous narrated presentations for content delivery. This method of delivery predated the pandemic and was used throughout the course. Academic performance and patterns of access to materials in the online course was compared with the access patterns and performance of students given classroom-based synchronous teaching in Spring 2019. Assessments evaluated in this study were identical across courses. Students' academic performance was unaffected by delivery method. Lack of instructor interaction was an important perceived barrier in the asynchronous course. Asynchronous course materials were uniformly accessed across all days of the week, while supplemental materials for the face-to-face course showed a weekly pattern. Moving from letter grades to pass/fail did not change access frequency to supplemental course materials but led to decreased video usage in the asynchronous course. Results suggest that although some veterinary students perceived the switch in delivery format negatively, the method of delivery did not adversely affect performance in this preclinical course.

Evaluation of Retention of Veterinary Clinical Pathology Knowledge between Second-Year and Fourth-Year Clinical Pathology Courses.

There is a concern over long-term retention of knowledge in professional programs. The goal of this study was to evaluate the retention of veterinary clinical pathology knowledge between the fourth-semester and fourth-year clinical pathology courses. We hypothesize that students will forget a significant amount of content area knowledge between the fourth semester and fourth year in the Doctor of Veterinary Medicine (DVM) program. We further hypothesize that a review of material during the fourth-year clinical pathology rotation will help students rebuild existing knowledge and increase performance on specific test questions, between T2 (rotation pre-test) and T3 (rotation post-test). Initial mastery of course material was assessed via a 94-item multiple-choice final exam (T1) given in the semester 4 clinical pathology course. Retention of course material from semester 4 to year 4 was assessed via a 55-item multiple-choice pre-test, administered at the start of the clinical pathology rotation in year 4 while learning/mastery during the clinical rotation was assessed via a 55-item multiple-choice post-test, administered at the end of each clinical pathology rotation. In this study, evidence of knowledge retention between semester 4 and year 4 was 55.5%. There is a small increase in the measure of knowledge gain from the beginning to the end of the rotation. As an added benefit, we were able to use identified trends for retention of knowledge within specific subject areas as a mechanism to evaluate the effectiveness of our course and reallocate additional instructional time to topics with poorer retention.

Small Animal Veterinarians' Perceptions, Experiences, and Views of Common Dog Breeds, Dog Aggression, and Breed-Specific Laws in the United States.

Dog aggression directed towards humans is a common and serious behavioral and public health issue. This cross-sectional study was designed to gain insights into U.S. small animal veterinarians' views and experiences with the most common dog breeds in the U.S., dog aggression, and breed-specific legislation. An electronic survey was distributed via email to an online veterinary community, and responses were summarized and compared by means of χ2 and Cochran-Mantel-Haenszel tests. Most respondents were concerned about the risks of dog bite injuries, but the majority were not in favor of banning specific breeds of dogs in order to enhance public safety. When participants rated the perceived bite risk associated with popular dog breeds, Chow Chows were perceived as the highest risk, with pit bull types categorized as a moderate risk. Golden Retrievers were seen as the most appropriate for families with children. Public education about animal behavior was the most frequently endorsed policy intervention to increase public safety. These findings suggest that most veterinarians feel that banning an entire dog breed is not an effective way to ensure human safety. Instead, most respondents endorsed alternative initiatives, such as public education and stricter leash laws, to reduce the risk of dog bites.

Flipped Classroom Use in Veterinary Education: A Multinational Survey of Faculty Experiences.

Active teaching approaches such as the flipped classroom are linked to better quality student learning outcomes across health care disciplines, with the potential to support students' preparedness for practice. In the flipped classroom instructional approach, students engage in significant pre-class preparation to learn foundational knowledge and skills, then undertake instructional activities in the classroom that require them to integrate, apply and extend their learning to new contexts. This study reports the results of a multinational survey of flipped classroom use in veterinary education. Participants' ( n = 165) familiarity with and extent of use of the flipped classroom technique were investigated, together with the teaching strategies used and the perceived benefits and barriers to implementation. Relationships between respondent characteristics and flipped classroom use were also explored. The results indicated that 95% of participants were familiar with the flipped classroom technique, although fewer (64%) used it in their teaching. Pre-class activities included reviewing online and printed material, and engaging in preparatory learning activities such as quizzes, case analyses, reflective assignments and group activities. A variety of active learning strategies were used in class, including discussions, presentations, quizzes, group activities, problem solving and laboratory/practical exercises. Most participants perceived that the flipped classroom technique benefited student learning, with some also identifying benefits for the faculty involved. A range of student-, faculty- and institution-related barriers to implementing the flipped classroom technique were identified. These barriers need to be considered and addressed by teachers and administrators seeking to improve students' preparedness for practice by implementing flipped classrooms in veterinary education.

Veterinarians' experiences with near misses and adverse events.

OBJECTIVE To assess the prevalence of medical errors (specifically, near misses [NMs] and adverse events [AEs]) and their personal and professional impact on veterinarians. DESIGN Cross-sectional study. SAMPLE Members of the Veterinary Information Network (n = 46,481). PROCEDURES An electronic survey regarding veterinarians' experiences with NMs and AEs was distributed via email to an online veterinary community between September 24 and October 21, 2015. Responses were summarized and compared between genders by means of the χ2 test. RESULTS 606 veterinarians completed the survey (1.3% response rate). Overall, 447 (73.8%) respondents reported involvement in ≥ 1 NM (n = 389 [64.2%]) or AE (179 [29.5%]). The NMs had a short-term (≤ 1 week) adverse impact on professional life for 68.0% (261/384) of respondents and longer-term negative impact for 36.4% (140/385). The impact on respondents' personal lives was similar (63.6% [245/385] and 33.5% [129/385], respectively). For AEs, these numbers were 84.1% (148/176), 56.2% (99/177), 77.8% (137/176), and 50.6% (89/175), respectively. Both NMs and AEs were more likely to negatively impact female veterinarians than male veterinarians. CONCLUSIONS AND CLINICAL RELEVANCE These findings suggested that many veterinarians experience emotional distress after a medical error. Support should be provided to mitigate this adverse impact on the wellbeing of veterinarians and, potentially, their future patients.

Evaluation of an Immersive Farm Experience to Teach and Attract Veterinary Students to Food-Animal Medicine.

The Bovine Educational Symposium (BES) is a unique opportunity for North Carolina State University (NCSU) veterinary students to visit dairy farms, feedlots, cow-calf operations, and processing facilities, and to meet local bovine veterinarians. We hypothesized that this active learning opportunity would increase knowledge, change perceptions of animal agriculture and food-animal medicine, and provide skills that persist beyond graduation. Pre- and post-trip surveys were administered to 124 first-, second-, and third-year veterinary students attending BES over 3 years. The surveys assessed students' perceived competence with regard to 12 key areas of bovine practice, attitudes toward segments of the cattle industry, attitudes to veterinarians' role in these segments, and interest in a career in bovine practice. Content knowledge was assessed using a multiple-choice test for comparison to self-assessments. A control group of 10 fourth-year students was administered the same tests before and after a 2-week food-animal clinical rotation. A convenience sample of nine BES alumni were interviewed to assess their opinion on the educational impact of BES. BES participants exhibited significant gains in perceived competence and actual knowledge in all 12 areas, and they also had improved perceptions of animal agriculture and increased interest in food-animal careers. Benefits noted by alumni ranged from improved knowledge of basic concepts of biosecurity and population medicine to greater appreciation for professional skills, including client communication. Immersing pre-clinical veterinary students in an active learning environment can have a significant impact on their knowledge and perception of food-animal medicine, irrespective of students' ultimate career goals.

Veterinary Curricula Today: Curricular Management and Renewal at AAVMC Member Institutions.

Renewing a veterinary curriculum is challenging work and its impact is difficult to measure. Academic leaders are charged with regular review and updating of their curricula, but have few resources available to guide their efforts. Due to the paucity of published veterinary reports, most turn to colleagues at other veterinary schools for insider advice, while a few undertake the task of adapting information from the educational literature to suit the needs of the veterinary profession. In response to this paucity, we proposed a theme issue on curricular renewal and surveyed academic leaders regarding curricular challenges and major renewal efforts underway. We compiled the results of this survey (with respondents from 38 veterinary colleges) as well as publicly available information to create a digest of curricular activities at AAVMC member institutions. This introductory article summarizes the key survey findings, describes the methods used to create the curricular digest, and presents information about key aspects of selected programs. Our overarching research questions were as follows: (1) What was the extent and nature of curricular change at AAVMC-accredited veterinary colleges over the past 5 years? and (2) How are curricula and curricular changes managed at AAVMC accredited veterinary colleges? The appended curricular digests provide selected details of current DVM curricula at participating institutions. Additional articles in this issue report on institutional change efforts in more detail. It is our hope that this issue will help to pave the way for future curricular development, research, and peer-to-peer collaboration.

Evaluation of 3D Additively Manufactured Canine Brain Models for Teaching Veterinary Neuroanatomy.

Physical specimens are essential to the teaching of veterinary anatomy. While fresh and fixed cadavers have long been the medium of choice, plastinated specimens have gained widespread acceptance as adjuncts to dissection materials. Even though the plastination process increases the durability of specimens, these are still derived from animal tissues and require periodic replacement if used by students on a regular basis. This study investigated the use of three-dimensional additively manufactured (3D AM) models (colloquially referred to as 3D-printed models) of the canine brain as a replacement for plastinated or formalin-fixed brains. The models investigated were built based on a micro-MRI of a single canine brain and have numerous practical advantages, such as durability, lower cost over time, and reduction of animal use. The effectiveness of the models was assessed by comparing performance among students who were instructed using either plastinated brains or 3D AM models. This study used propensity score matching to generate similar pairs of students. Pairings were based on gender and initial anatomy performance across two consecutive classes of first-year veterinary students. Students' performance on a practical neuroanatomy exam was compared, and no significant differences were found in scores based on the type of material (3D AM models or plastinated specimens) used for instruction. Students in both groups were equally able to identify neuroanatomical structures on cadaveric material, as well as respond to questions involving application of neuroanatomy knowledge. Therefore, we postulate that 3D AM canine brain models are an acceptable alternative to plastinated specimens in teaching veterinary neuroanatomy.

Survey of attitudes toward and experiences with animal abuse encounters in a convenience sample of US veterinarians.

OBJECTIVE To survey practicing veterinarians regarding their perceptions of and experiences with cases of suspected or confirmed animal abuse and related state laws. DESIGN Cross-sectional study. POPULATION Members of the Veterinary Information Network (VIN; n = 34,144) who were in veterinary practice at the time of the survey. PROCEDURES A survey was designed and distributed online to all VIN members from January 26 to February 28, 2015. Responses were compiled, and binary logistic regression analysis was performed to identify factors that influenced decisions or perceptions regarding animal abuse encounters and related legislation. RESULTS 1,209 completed surveys were received (3.5% response rate); 1,155 (95.5%) surveys were submitted by currently practicing veterinarians. One thousand five (87.0%) practicing veterinarians reported having encountered at least 1 case of animal abuse while in practice; 561 (55.8%) of these veterinarians indicated that they had reported at least 1 case. The most common reasons selected for reporting abuse were to protect the animal, ethical beliefs, and to protect other animals in the household. The most common reasons selected for not reporting the abuse were uncertainty that the animal had been abused, belief that client education would be better, and belief that the injury or illness was accidental versus intentional. Most respondents were unaware of the current status of laws in their state regarding animal abuse reporting. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested a need for state and national veterinary and humane-law enforcement organizations to increase communication and education efforts on recognition and reporting by veterinarians of animal abuse and the related laws.

Changes in Affective and Cognitive Empathy among Veterinary Practitioners.

Clinical empathy is a multi-dimensional concept characterized by four dimensions: (1) affective-the ability to experience patients' or clients' emotions and perspectives, (2) moral-the internal motivation to empathize, (3) cognitive-the intellectual ability to identify and comprehend others' perspective and emotions, and (4) behavioral-the ability to convey understanding of those emotions and perspectives back to the patient or client. The Davis Interpersonal Reactivity Index (IRI) was used to examine the affective and cognitive facets of empathy in veterinary practitioners. The IRI consists of four subscales that measure cognitive (perspective taking and fantasy) and affective (emphatic concern and personal distress) components of empathy. Data from a cross-sectional sample of practicing veterinarians (n=434) were collected. Veterinarians' fantasy scores were lowest for those with the most clinical experience. Personal distress scores were highest among new veterinarians and lowest for those with 26 or more years in practice. High levels of personal distress in the early years of practice are concerning for the professional wellness of veterinarians. To combat this trend, the implementation of resilience-building interventions should be considered to support veterinary practitioners.

Professional Veterinary Programs' Perceptions and Experiences Pertaining to Emotional Support Animals and Service Animals, and Recommendations for Policy Development.

Given the unique nature of programs in professional veterinary medicine (PVM), the increasing numbers of students requesting accommodations for emotional support animals (ESAs) in higher education settings is of growing interest to student affairs and administrative staff in PVM settings. Since the legislation pertaining to this type of support animal differs from the laws governing disability service animals, colleges and universities now need to develop new policies and guidelines. Representatives from a sample of 28 PVM programs completed a survey about the prevalence of student requests for ESAs and service animals. PVM associate deans for academic affairs also reported their perceptions of this issue and the challenges these requests might pose within veterinary teaching laboratories and patient treatment areas. Responses indicated that approximately one third of PVM programs have received requests for ESAs (32.1%) in the last 2 years, 17.9% have had requests for psychiatric service animals, and 17.9% for other types of service animals. Despite this, most associate deans reported not having or not being aware of university or college policies pertaining to these issues. Most associate deans are interested in learning more about this topic. This paper provides general recommendations for establishing university or PVM program policies.

Educational Research Report: Changes in Students' Levels of Empathy during the Didactic Portion of a Veterinary Program.

Empathy can be defined as the ability to understand and connect with the emotional state and frame of mind of another. Establishing connections with others is a crucial skill for veterinarians who must earn the trust and compliance of their clients to provide quality care for their patients. This is a longitudinal study using the Davis Interpersonal Reactivity Index (IRI) to assess changes in veterinary students' self-reported empathy as they progressed through the didactic portion of the DVM program at Colorado State University. The IRI consists of four subscales that measure cognitive and affective components of empathy: Perspective Taking, Fantasy, Emphatic Concern, and Personal Distress. Data were collected at three time points, corresponding to the start of the first year, the fourth semester (second year), and the fifth semester (third year). Results showed an overall decline in Perspective Taking scores, with a significant decrease between first and second year. There was an overall increase in students' levels of Personal Distress as they progressed through the program. The significant difference was found between years 1 and 3. This is especially concerning because the enhanced unease in interpersonal interactions coincides with students entering clinical rotations in the third year-the very time when these traits are necessary for quality client and patient care. Veterinary educators are urged to use this information as a basis for investigating novel curricular and programmatic interventions to counteract these changes in student empathy.

Corporate influence and conflicts of interest: assessment of veterinary medical curricular changes and student perceptions.

The ethics document of the Association of American Veterinary Medical Colleges provides guiding principles for veterinary schools to develop conflict of interest policies. These policies regulate faculty and student interactions with industry, potentially reducing the influence companies have on students' perceptions and future prescribing practices. This paper examines the implementation of a conflict of interest policy and related instructional activities at one veterinary college in the US. To inform policy and curricular development, survey data were collected regarding veterinary students' attitudes toward pharmaceutical marketing, including their perceptions of their own susceptibility to bias in therapeutic decisions. Responses from this group of students later served as control data for assessing the effectiveness of educational programs in the content area. A conflict of interest policy was then implemented and presented to subsequent classes of entering students. Classroom instruction and relevant readings were provided on ethics, ethical decision making, corporate influences, and the issue of corporate influence in medical student training. Within seven days of completing a learning program on conflict of interest issues, another cohort of veterinary students (the treatment group) were administered the same survey that had been administered to the control group. When compared with the control group who received no instruction, survey results for the treatment group showed moderate shifts in opinion, with more students questioning the practice of industry-sponsored events and use of corporate funds to reduce tuition. However, many veterinary students in the treatment group still reported they would not be personally influenced by corporate gifts.

Microscope use in clinical veterinary practice and potential implications for veterinary school curricula.

Microscopy (skill of using a microscope) and the concepts of cytology (study of cells) and histology (study of tissues) are most often taught in professional veterinary medicine programs through the traditional method of glass slides and light microscopes. Several limiting factors in veterinary training programs are encouraging educators to explore innovative options for teaching microscopy skills and the concepts of cytology and histology. An anonymous online survey was administered through the Colorado Veterinary Medical Association to Colorado veterinarians working in private practice. It was designed to assess their current usage of microscopes for cytological and histological evaluation of specimens and their perceptions of microscope use in their veterinary education. The first part of the survey was answered by 183 veterinarians, with 104 indicating they had an onsite diagnostic lab. Analysis pertaining to the use of the microscope in practice and in veterinary programs was conducted on this subset. Most respondents felt the amount of time spent in the curriculum using a microscope was just right for basic microscope use and using the microscope for viewing and learning about normal and abnormal histological sections and clinical cytology. Participants felt more emphasis could be placed on clinical and diagnostic cytology. Study results suggest that practicing veterinarians frequently use microscopes for a wide variety of cytological diagnostics. However, only two respondents indicated they prepared samples for histological evaluation. Veterinary schools should consider these results against the backdrop of pressure to implement innovative teaching techniques to meet the changing needs of the profession.

Use of interactive online histopathology modules at different stages of a veterinary program.

A mixed-method educational research study was conducted to evaluate the use of a series of online histopathology modules by students at two levels in a professional veterinary medical program. The materials were hypothesized to support student learning of histopathology concepts by facilitating "dual coding" of the content, since they provide both visual and verbal information. Second- and fourth-year professional veterinary students were surveyed about their perceptions of the effectiveness, efficiency, and appeal of the online modules. A historical comparison of final grades in the second-year Pathology course was conducted to evaluate the impact of the materials on academic outcomes. Think-aloud interviews were conducted with the fourth-year students in which the researcher observed the students interacting with the materials and asked them to "tell me what you're thinking as you use the modules." Survey results show that the only area in which the two student groups quantitatively rated the materials differently was their perception of how the materials complemented their learning. In contrast, the qualitative data indicate that advanced students used and perceived the materials differently, perhaps because of their greater metacognitive skills and pre-existing knowledge. We concluded that these findings can be attributed to the manner in which students approached the materials: the fourth-year students felt the materials were less relevant because they did not directly correspond to cases they were seeing, while the second-year students appreciated their relevance to topics in the Pathology course. There was no significant difference in final exam performance for the group of students that used the supplemental online modules and the prior four years' classes, who did not have access to the materials. Overall, this study demonstrated that it is possible to create a set of materials to be used by multiple audiences, provided the needs of each group are taken into consideration during the design process.