Hurdles of Cataract Surgery: Veterinary Ophthalmology Resident's Perspective (Part B).

The purpose of this study was to describe veterinary ophthalmology residents' perceived preparedness for performing cataract surgery who are currently enrolled in, or recently graduated from, veterinary academic or private practice institutions. A descriptive survey was distributed online to 127 residents at academic and private practice training programs in the United States. The survey included items about educational resources available for residents and techniques commonly taught during cataract surgery. Residents were asked to describe their perceived preparedness in performing various surgical steps or techniques, difficulty of each surgical step, and the available educational resources. Thirty-five (27.5%) residents completed the survey and were included in this study. Residents who had access to wet labs gained surgical competency in creating a clear corneal incision, capsulorhexis, and wound closure. They reported sculpting with the phacoemulsification handpiece, quadrant or cortical removal, and capsulorhexis as most difficult and were not as prepared or a little prepared in performing capsulorhexis and sculpting during active phacoemulsification. When comparing residents' perceived competency before and after their first surgical experience, there was a significant change in their ability to perform all surgical steps except hydrodissection (p < .05). Cataract surgery is one of the more advanced surgical skills obtained during residency training. Supervised wet lab time improves a resident's preparedness for executing certain surgical steps. However, further research is needed to determine whether educational resources such as structured curriculum or virtual simulation may improve residents' preparedness for executing surgical steps not easily replicated in a wet lab.

The Impact of COVID-19 on Pre-Veterinary Opportunities and Recommendations for DVM Admissions.

During the summer of 2020, a survey-based study was conducted at North Carolina State University, a land-grant university, to evaluate the impact of COVID-19 on pre-veterinary students' ability to gain experience hours for Doctor of Veterinary Medicine (DVM) admissions. Of the 286 respondents (47% of the respondent pool), 92% reported losing at least one animal, veterinary, research, extracurricular, or work opportunity due to COVID-19, and 59% were not able to find a replacement. Of the lost experiences, 74 (20.8%) were for academic credit, resulting in 131 total academic credit hours lost, while only 12 credit hours were gained via alternative experiences. Of respondents, 30% (29.7%) identified as applicants of the 2020-2021 Veterinary Medical College Application Service (VMCAS) cycle. More than half (52.6%) of the sample identified being concerned about the strength of their VMCAS experiences due to these lost opportunities. Many respondents reported considering delaying application submissions by taking a gap year (17.5%) or having had their intended graduation timeline affected (14.8%). Since the majority of veterinary colleges utilize a holistic review process, this study provides a basis for understanding the effects of COVID-19 on the duration, depth, and diversity of experiences gained by future DVM applicants. This article also provides recommendations for DVM admissions adaptations based on the outcomes of the data.

What Matters Most to Residency and Intern Selection Committees in Veterinary Medicine?

A recent survey of members of residency selection committees for the American College of Veterinary Internal Medicine and American College of Veterinary Surgeons boards found letters of recommendation to be the most important factor when reviewing a resident's application followed by class rank as the second most important factor. These statistics indicate an interesting, but possibly troubling trend. This Letter to The Editor discusses the major problems concerning these findings and what residency program committees might consider as an alternative.

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.

Cross-Sectional Assessment of the Emotional Intelligence of Fourth-Year Veterinary Students and Veterinary House Officers in a Teaching Hospital.

Emotional intelligence (EI) is the recognition and management of emotions. This skill set is important to work relationships and professional success. In this cross-sectional, observational study, we investigated EI scores of 4th-year veterinary students, interns, and residents in a teaching hospital, using a psychometric tool with professional population norms. Participants' EI scores were compared with professional norms and between the sample groups. Scores were examined on the basis of demographics and residency program type. Twenty-four 4th-year students and 43 interns and residents completed the survey. Total, composite, and subscale scores for all groups were lower than professional means. We noted no statistically significant differences in EI scores between training levels, but evaluation of effect sizes showed a medium negative effect of higher training levels on Self-Perception Composite, Self-Regard, Emotional Expression, Interpersonal Composite, Flexibility, and Optimism and a medium positive effect of higher training levels on Impulse Control. Medium effects for residency type were found for Stress Tolerance, Flexibility, and Stress Management, with higher scores for residencies with heavy inpatient loads. Medium effects for residency type were found on Flexibility scores, with higher scores for residents in disciplines with a perceived high stress level. We found that baseline EI scores of 4th-year veterinary students, interns, and residents at a teaching hospital were similar to, but uniformly lower than, those of other professionals and did not increase with training level. These results may be used to build on strengths and address weaknesses associated with EI of students and house officers at this institution.

Effect of a mindfulness exercise on stress in veterinary students performing surgery.

OBJECTIVE: To determine students' stress while performing surgery and evaluate the ability of a mindfulness intervention to reduce this stress. STUDY DESIGN: Quasi-experimental design. SAMPLE POPULATION: Eighteen fourth-year DVM program students (n = 9 student/group). METHODS: Utilizing a quasi-experimental design, students were randomly assigned to a control or treatment group. The treatment group performed a 5-minute breathing (mindfulness) exercise immediately prior to performing surgery. Each student provided 3 samples of saliva, at time 0, at 10 minutes before surgery, and at 10 minutes after surgery. Students' salivary cortisol and α-amylase levels were compared between groups. Students' self-reported mood measures were also correlated to levels of salivary biomarkers. RESULTS: Cortisol and α-amylase levels of students in both groups greatly exceeded normative reference groups (>90th percentile) prior to surgery and diminished to average levels (50th-60th percentile) after surgery but did not differ between groups at any time point. Immediately prior to surgery when stress values were likely to peak, salivary α-amylase levels decreased approximately 30 U/L units for students in the treatment group compared with an increase of approximately 10 U/L units for students in the control group. Students in the treatment group reported being more calm (mean [M] 2.67, SD 1.03, d = 0.75) and relaxed (M 2.33, SD 1.51, d = 0.90) than students in the control group (M 3.44, SD 1.01 and M 3.44, SD 0.88, respectively). CONCLUSION: This study provides some evidence that the mindfulness intervention temporarily decreased stress levels and improved students' sense of calmness and relaxation immediately before operating on a live animal. CLINICAL IMPACT: Students who are experiencing less stress may be less likely to commit a medical error and negatively impact animal health. This study, the first of its kind in veterinary surgery, may serve as a model for related future studies.

Use of a Versatile, Inexpensive Ophthalmoscopy Teaching Model in Veterinary Medical Student Education Increases Ophthalmoscopy Proficiency.

Ophthalmoscopy is an important examination technique in the diagnosis of disease. Although it is difficult to learn, practice increases confidence and proficiency. Practicing ophthalmoscopy on live animals presents an additional level of complexity, so we sought to evaluate how students would respond to practicing ophthalmoscopy on an ocular fundus model. We constructed a simple and inexpensive model and allowed half of the students (49/100) in a first-year veterinary medicine class to practice ophthalmoscopy (direct, PanOptic, and indirect) for 20 minutes using the model. Students completed a questionnaire regarding ease of use, enjoyment, and recommendations for future use of the model immediately after the practice session. Six weeks later, we tested students' ability to correctly match a fundus to a photograph using indirect ophthalmoscopy. All students who used the model rated it as 'easy' or 'somewhat easy' to use. All students reported that they 'enjoyed' (93.9%) or 'somewhat enjoyed' (6.1%) using the model. Also, all students who used the model stated the models should continue to be used to aid student learning. Students who used the model were significantly more likely (p = .013) to correctly match a fundus photograph to the fundus being observed than students who had not used the model. These findings demonstrate that the model used in this study is well received by students and results in discernible gains in proficiency.

Medical Students Rate Black Female Peers as Less Socially Connected.

BACKGROUND: Social and cultural outcomes are critically important in medical education. A large medical school located in the United States implemented a learning community model intended to promote social and cultural growth among its medical students. The purpose of this study was to evaluate the degree to which medical students from the same peer cohort were socially connected across racial and sex groups. METHODS: Because most assessments involving social and cultural outcomes involve self-reported data of a personal nature, the possibility of social desirability bias is increased. To mitigate this threat, this study utilized a novel method for measuring medical students social connectedness by having peers in one's advisory college provide social connectedness ratings about one another. RESULTS: While surface level results did not reveal any significant differences, a closer inspection of data revealed Black females were less socially connected with medical student peers from their cohort than other peer groups. DISCUSSION: Possible explanations for this are discussed. Future research should continue to investigate the experiences of Black females in medical schools so as to better understand the needs of this important and valuable subpopulation of students.

Hydrogen peroxide plasma sterilization of a waterproof, high-definition video camera case for intraoperative imaging in veterinary surgery.

OBJECTIVE: To evaluate the safety and usability of a wearable, waterproof high-definition camera/case for acquisition of surgical images by sterile personnel. STUDY DESIGN: An in vitro study to test the efficacy of biodecontamination of camera cases. Usability for intraoperative image acquisition was assessed in clinical procedures. METHODS: Two waterproof GoPro Hero4 Silver camera cases were inoculated by immersion in media containing Staphylococcus pseudointermedius or Escherichia coli at ≥5.50E+07 colony forming units/mL. Cases were biodecontaminated by manual washing and hydrogen peroxide plasma sterilization. Cultures were obtained by swab and by immersion in enrichment broth before and after each contamination/decontamination cycle (n = 4). The cameras were then applied by a surgeon in clinical procedures by using either a headband or handheld mode and were assessed for usability according to 5 user characteristics. RESULTS: Cultures of all poststerilization swabs were negative. One of 8 cultures was positive in enrichment broth, consistent with a low level of contamination in 1 sample. Usability of the camera was considered poor in headband mode, with limited battery life, inability to control camera functions, and lack of zoom function affecting image quality. Handheld operation of the camera by the primary surgeon improved usability, allowing close-up still and video intraoperative image acquisition. CONCLUSION: Vaporized hydrogen peroxide sterilization of this camera case was considered effective for biodecontamination. Handheld operation improved usability for intraoperative image acquisition. CLINICAL SIGNIFICANCE: Vaporized hydrogen peroxide sterilization and thorough manual washing of a waterproof camera may provide cost effective intraoperative image acquisition for documentation purposes.

Think Subscores Are a Helpful Form of Feedback? Think Again.

Many educators believe subscores offer an easy approach for (1) discerning what students know/can do, and (2) providing more analytical feedback to students. In addition, many educators use subscores as a tool for guiding targeted remediation in specific areas of study. Unfortunately, there are several significant problems associated with subscores, and such beliefs and practices may be problematic and ill-advised. The purpose of this article is to address some of the problems relating to subscores in classroom assessment scenarios and to encourage educators to be cautious of these often deceptive and problematic measures.

Using a Modified Bookmark Procedure to Help Identify Reasonable Consequences for Academic Integrity Violations.

It is recommended that institutions develop academic conduct policies to help preserve academic integrity, enforce compliance, and aid in legal defensibility. These policies should also articulate reasonable consequences for persons found in violation. The problem, however, is that all academic misconduct offenses are not created equal, and determining reasonable consequences for these violations can be particularly challenging due to their subjective nature. Thus, the purpose of this study was to introduce a novel method for more objectively determining reasonable sanctions for several academic misconduct offenses of varying degrees of severity. We utilized a variation of the Bookmark procedure, a popular standard-setting technique used primarily by psychometricians in high-stakes testing environments, to investigate empirical survey data and develop policy recommendations. We encourage others to use this procedure, where appropriate, to identify appropriate cut scores and ranges to aid in policy development across a variety of contexts.

Strategies Used for Making Healthy Eating Choices among Veterinary Medical Students.

Healthy eating is a challenge for most college students, and students in the field of veterinary medicine are no exception. Health experts have recommended that universities emphasize the importance of healthy eating and promote healthy eating habits among students. However, before we can begin offering targeted interventions to promote healthy eating strategies and behaviors, we must first understand students' current strategies used for making healthy eating choices, self-reported eating habits, and perceptions of diet quality. Thus, the purpose of this study was to understand veterinary medical students' perceptions of current diet quality and to characterize their strategies for making healthy eating choices. Results indicate veterinary medical students employ a wide range of strategies and behaviors for healthy eating, yet few students reported eating a diet of poor quality. We conclude that while most students report eating a relatively healthy diet, variation in strategies used suggests room for improvement for many. This article discusses potential intervention strategies to promote healthy eating among veterinary students.

Veterinary Medical Students' Motivations for Exercise.

The Centers for Disease Control (CDC) declares exercise to be one of the most important activities one can do to improve health. The benefits of exercise are well documented and include both physiologic and psychological health. Given the current landscape of wellness issues in veterinary medical education, it is necessary that students engage in exercise activities to manage stress and increase overall health. Therefore, to develop targeted interventions with the greatest likelihood for success, it is first necessary to understand what motivates veterinary medical students to exercise given their unique situational and environmental factors. This study is the first to explore this issue systematically in veterinary medical education, thus it is the authors' hope that the findings from this research will help identify exercise-related wellness interventions that could be implemented in veterinary medical schools.

Veterinary Medical Students' Motivations for Exercise.

The Centers for Disease Control (CDC) declares exercise to be one of the most important activities one can do to improve health. The benefits of exercise are well documented and include both physiologic and psychological health. Given the current landscape of wellness issues in veterinary medical education, it is necessary that students engage in exercise activities to manage stress and increase overall health. Therefore, to develop targeted interventions with the greatest likelihood for success, it is first necessary to understand what motivates veterinary medical students to exercise given their unique situational and environmental factors. This study is the first to explore this issue systematically in veterinary medical education, thus it is the authors' hope that the findings from this research will help identify exercise-related wellness interventions that could be implemented in veterinary medical schools.

Evaluating the readability levels of medical infographic materials for public consumption.

Readability is an important element of any published material. In recent years, various health organisations have utilised infographics to communicate important medical information. Established guidelines for readability suggest levels should be targeted between a 4th and 6th grade education level (United States) in order to avoid disadvantaging individuals with lower literacy skills. The purpose of this case study was to evaluate the readability levels of several published materials from the field of athletic training and demonstrate a model for evaluating readability levels in other medical and health professions.

Pharmacists' Knowledge of Veterinary Pharmacotherapy and the Impact of an Educational Intervention.

Background: To date, there is very limited data regarding pharmacists' preparedness to handle animal prescriptions. No previous studies exist examining the impact of a veterinary-pharmacy-focused educational intervention. Objective: To assess pharmacists' baseline knowledge of veterinary pharmacotherapy, as relevant to their professional responsibilities, and assess the impact of a piloted educational program. Methods: Two studies were conducted. The first study involved a statewide assessment of pharmacists' knowledge of veterinary pharmacotherapy; the second study assessed the impact of an educational intervention to improve pharmacists' veterinary pharmacotherapy knowledge base. Participants in the pilot study were assessed via pretest and posttest. Results: The statewide sample of participants (n = 602) received a mean score of 5.9 (SD = 2.6) on a 17-item questionnaire. There were no discernible differences in participants' knowledge based on the subject matter of the question (pathophysiology, dosing, counseling, compounding, legality, and toxicology). Using the same 17-item questionnaire, pilot study participants (n = 60) received a mean score of 5.2 (SD = 2.4) on the pretest and 16.6 (SD = 0.7) on the posttest. Conclusion: The findings of this study suggest that a substantial portion of pharmacists lack the knowledge needed to process and dispense the veterinary prescriptions most commonly encountered in community pharmacies. Furthermore, this study shows that implementation of an educational intervention can increase pharmacists' knowledge of core concepts necessary to safely care for animal patients.

Why Veterinary Medical Educators Should Embrace Cumulative Final Exams.

The topic of cumulative final examinations often elicits polarizing opinions from veterinary medical educators. While some faculty prefer cumulative finals, there are many who perceive these types of examinations as problematic. Specifically, faculty often cite cumulative examinations are more likely to cause students' greater stress, which may in turn result in negative student evaluations of teaching. Cumulative finals also restrict the number of items one may present to students on most recent material. While these cited disadvantages may have some merit, the advantages of cumulative examinations far exceed the disadvantages. The purpose of this article is to discuss the advantages of cumulative examinations with respect to learning evidence, grade/score validity, fairness issues, and implications for academic policy.

Prohibiting Students from Asking Questions during Exams: A Guideline for Promoting Fairness and Preserving Score Validity.

Many medical and professional programs implement policies that prohibit students from asking questions during examinations. The reasoning behind these policies remains unclear to some, as there is a lack of literature addressing this topic. The purpose of this article is to present the rationale behind such policies and to discuss why these policies may help promote fairness and preserve score validity.

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.

Black Student Participation Rates Also a Concern for Educational Program Assessments.

Lower participation rates in the African-American population are not limited to medical research. Extant research reveals African-American students also participate at lower rates than other racial groups on college and university surveys. Students in medical and health professions programs are routinely surveyed to investigate students' perspectives about the educational curriculum, social and cultural environment, quality of faculty and resources, etc. The results attained from these assessments often carry some of the greatest weight in guiding educational curricula, programs, and policy. Thus, perhaps nowhere is there greater opportunity for African-American students to effect change than educational program assessments, where results will affect not only current and future students, but may also help improve professional development opportunities to address health disparities among minority populations. Implications and recommendations for faculty, administrators, and students in medical and health training programs are discussed.