Animal Protection, Law Enforcement, and Occupational Health: Qualitative Action Research Highlights the Urgency of Relational Coordination in a Medico-Legal Borderland.

Across Canada and internationally, laws exist to protect animals and to stop them from becoming public nuisances and threats. The work of officers who enforce local bylaws protects both domestic animals and humans. Despite the importance of this work, research in this area is emergent, but growing. We conducted research with officers mandated to enforce legislation involving animals, with a focus on local bylaw enforcement in the province of Alberta, Canada, which includes the city of Calgary. Some experts regard Calgary as a "model city" for inter-agency collaboration. Based on partnerships with front-line officers, managers, and professional associations in a qualitative multiple-case study, this action-research project evolved towards advocacy for occupational health and safety. Participating officers spoke about the societal benefits of their work with pride, and they presented multiple examples to illustrate how local bylaw enforcement contributes to public safety and community wellbeing. Alarmingly, however, these officers consistently reported resource inadequacies, communication and information gaps, and a culture of normalized disrespect. These findings connect to the concept of "medico-legal borderlands," which became central to this study. As this project unfolded, we seized upon opportunities to improve the officers' working conditions, including the potential of relational coordination to promote the best practices.

Communication skills training and assessment of food animal production medicine veterinarians: A component of a voluntary Johne's disease control program.

In food animal production medicine (FAPM), the success of control programs for infectious diseases that have serious animal health and economic consequences frequently rely on the veterinarian's effective communication and producer adherence to veterinary recommendations. However, little research has been conducted on communication skills of practicing FAPM veterinarians. During this study, we developed a communication training workshop intervention to support the Atlantic Johne's Disease Initiative. Seventeen FAPM veterinarians across 10 clinics practicing within Maritime Canada participated in a pre-post intervention study design. Communication skills were evaluated utilizing 3 assessment tools; an objective structured clinical exam (OSCE), standardized client feedback, and an instrument designed for veterinary participants to assess their self-efficacy. Study results showed that before training, communication skills of participating veterinarians had limitations, including skill deficits in communication tasks strongly associated with increased adherence to veterinary recommendations. Based on the 3 assessment tools, communication skills of participating veterinarians improved with the training provided. Significant increases were detected in pre- to postintervention self-efficacy percentage scores, OSCE percentage and global scores from expert raters, and OSCE percentage and global scores from standardized client feedback. These improvements emphasize the importance of communication skills training specific to FAPM.

From more-than-human solidarity to multi-species biographical value: insights from a veterinary school about ethical dilemmas in One Health promotion.

This article features a partnership between a veterinary school and a charity that aims to enhance the wellbeing of low-income people. Through this partnership, the charity periodically hosts veterinary clinics for clients and their pets. Even as the veterinarians and veterinary students duly examine people's pets, these pop-up clinics aim to help people and their pets. Hence our analysis revolves around the ethics of 'more-than-human solidarity'. By 'more-than-human solidarity', we mean efforts to help others that either center on or that implicate non-human beings. To delve into the ethical and sociological implications of subsidised veterinary services, and to assist with program planning, we conducted several in-depth interviews with veterinarians. Most substantively, we found that the veterinary school's outreach clinics give rise to multi-species biographical value, which is prized as a pedagogical resource for veterinary students. The veterinarians whom we interviewed felt troubled by the extent to which the pop-up clinics ultimately benefited the veterinary school, but also by the shortage of subsidised veterinary services in the vicinity. Based on these interviews and our own reflections, we invite more scholarship on cultural, economic and political influences that shape the lives of human beings and non-human animals alike.

Pets, Social Participation, and Aging-in-Place: Findings from the Canadian Longitudinal Study on Aging.

ABSTRACTThe objective of this study was to assess whether pet ownership contributes to social participation and life satisfaction for older adults. We used baseline data from the Canadian Longitudinal Study on Aging (CLSA) for this purpose, and logistic regression models to estimate associations between social participation and life satisfaction for pet owners and non-owners. One third of all older adults (≥ 65 years, n = 7,474) in our sample reported pet ownership. Pet owners were less likely than non-pet owners to report life satisfaction and to participate frequently in social, recreational, or cultural activities, but pet owners were no less satisfied than were non-owners with their current levels of social participation. For pet owners experiencing barriers to social participation, pets appeared protective of life satisfaction in some circumstances. Both individual characteristics and structural factors linked to the World Health Organization's age-friendly communities framework were relevant to understanding these findings.

Invited review: Determinants of farmers' adoption of management-based strategies for infectious disease prevention and control.

The prevention and control of endemic pathogens within and between farms often depends on the adoption of best management practices. However, farmers regularly do not adopt recommended measures or do not enroll in voluntary disease control programs. This indicates that a more comprehensive understanding of the influences and extension tools that affect farmers' management decisions is necessary. Based on a review of relevant published literature, we developed recommendations to support policy-makers, industry representatives, researchers, veterinarians, and other stakeholders when motivating farmers to adopt best management practices, and to facilitate the development and implementation of voluntary prevention and control programs for livestock diseases. Farmers will make management decisions based on their unique circumstances, agricultural contexts, beliefs, and goals. Providing them with rational but universal arguments might not always be sufficient to motivate on-farm change. Implementation of recommended management practices is more likely if farmers acknowledge the existence of a problem and their responsibility to take action. The perceived feasibility and effectiveness of the recommended management strategy and sufficient technical knowledge further increase the likelihood of adequate adoption. Farmers will also weigh the expected advantages of a proposed change against the expected disadvantages, and these considerations often include internal drivers such as pride or the desire to conform with perceived standards. Extension tools and farmers' social referents (e.g., veterinarians, peers) not only provide technical information but also influence these standards. Whereas mass media have the potential to deliver information to a broad audience, more personal approaches such as participatory group learning or individual communication with farm advisors can enable the tailoring of recommendations to farmers' situations. Approaches that appeal to farmers' internal motivators or that unconsciously elicit the desired behavior will increase the success of the intervention. Collaboration among stakeholders, assisted by social scientists and communication specialists, is necessary to provide a context that facilitates on-farm change and transfers consistent messages across extension tools in the most effective way.

Does a Rater's Professional Background Influence Communication Skills Assessment?

There is increasing pressure in veterinary education to teach and assess communication skills, with the Objective Structured Clinical Examination (OSCE) being the most common assessment method. Previous research reveals that raters are a large source of variance in OSCEs. This study focused on examining the effect of raters' professional background as a source of variance when assessing students' communication skills. Twenty-three raters were categorized according to their professional background: clinical sciences (n=11), basic sciences (n=4), clinical communication (n=5), or hospital administrator/clinical skills technicians (n=3). Raters from each professional background were assigned to the same station and assessed the same students during two four-station OSCEs. Students were in year 2 of their pre-clinical program. Repeated-measures ANOVA results showed that OSCE scores awarded by the rater groups differed significantly: (F(matched_station_1) [2,91]=6.97, p=.002), (F(matched_station_2) [3,90]=13.95, p=.001), (F(matched_station_3) [3,90]=8.76, p=.001), and ((Fmatched_station_4) [2,91]=30.60, p=.001). A significant time effect between the two OSCEs was calculated for matched stations 1, 2, and 4, indicating improved student performances. Raters with a clinical communication skills background assigned scores that were significantly lower compared to the other rater groups. Analysis of written feedback provided by the clinical sciences raters showed that they were influenced by the students' clinical knowledge of the case and that they did not rely solely on the communication checklist items. This study shows that it is important to consider rater background both in recruitment and training programs for communication skills' assessment.

Assessment of first-year veterinary students' communication skills using an objective structured clinical examination: the importance of context.

Communication skills are considered to be a core clinical skill in veterinary medicine and essential for practice success, including outcomes of care for patients and clients. While veterinary schools include communication skills training in their programs, there is minimal knowledge on how best to assess communication competence throughout the undergraduate program. The purpose of this study was to further our understanding of the reliability, utility, and suitability of a communication skills Objective Structured Clinical Examination (OSCE). Specifically we wanted to (1) identify the greatest source of variability (student, rater, station, and track) within a first-year, four station OSCE using exam scores and scores from videotape review by two trained raters, and (2) determine the effect of different stations on students' communication skills performance. Reliability of the scores from both the exam data and the two expert raters was 0.50 and 0.46 respectively, with the greatest amount of variance attributable to student by station. The percentage of variance due to raters in the exam data was 16.35%, whereas the percentage of variance for the two expert raters was 0%. These results have three important implications. First, the results reinforce the need for communication educators to emphasize that use of communication skills is moderated by the context of the clinical interaction. Second, by increasing rater training the amount of error in the scores due to raters can be reduced and inter-rater reliability increases. Third, the communication assessment method (in this case the OSCE checklist) should be built purposefully, taking into consideration the context of the case.

Prevalence and nature of cost discussions during clinical appointments in companion animal practice.

OBJECTIVE: To determine prevalence and nature of cost discussions between veterinarians and pet owners during clinical appointments in companion animal practice. DESIGN: Cross-sectional descriptive study. SAMPLE POPULATION: 20 veterinarians in companion animal practice in eastern Ontario and 350 clients and their pets. PROCEDURES: 200 veterinarian-client-patient interactions were randomly selected from all videotaped interactions and analyzed with the Roter interaction analysis system. Additional proficiency codes and blocking functions were developed to capture the prevalence, nature, and context of cost discussions. RESULTS: 58 of the 200 (29%) appointments that were analyzed included a discussion of cost. During 38 of these 58 (66%) appointments, the discussion involved costs associated with the veterinarian's time or with services provided by the veterinarian. Overall, reference to a written estimate was made during only 28 of the 200 (14%) appointments. Cost discussions were most common during appointments in which a decision related to diagnostic testing or dentistry was made. Appointments were significantly longer when a cost discussion was included than when it was not. CONCLUSIONS AND CLINICAL RELEVANCE: Results of the present study suggested that discussions related to cost were relatively uncommon during clinical appointments in companion animal practice and that written estimates were infrequently used to aid these discussions. When discussions of cost did occur, veterinarians appeared to focus on explaining costs in terms of the veterinarian's time or services provided by the veterinarian, rather than on the medical information that could be obtained or the benefits to the future health or function of the pet.

A focus group study of veterinarians' and pet owners' perceptions of veterinarian-client communication in companion animal practice.

OBJECTIVE: To compare veterinarians' and pet owners' perceptions of client expectations with respect to veterinarian-client communication and to identify related barriers and challenges to communication. DESIGN: Qualitative study based on focus group interviews. PARTICIPANTS: 6 pet owner focus groups (32 owners) and 4 veterinarian focus groups (24 companion animal veterinarians). PROCEDURES: Independent focus group sessions were conducted with standardized open-ended questions and follow-up probes. Content analysis was performed on transcripts of the focus group discussions. RESULTS: Five themes related to veterinarian-client communication were identified: educating clients (ie, explaining important information, providing information up front, and providing information in various forms), providing choices (ie, providing pet owners with a range of options, being respectful of owners' decisions, and working in partnership with owners), using 2-way communication (ie, using language clients understand, listening to what clients have to say, and asking the right questions), breakdowns in communication that affected the client's experience (ie, owners feeling misinformed, that they had not been given all options, and that their concerns had not been heard), and challenges veterinarians encountered when communicating with clients (ie, monetary concerns, client misinformation, involvement of > 1 client, and time limitations). CONCLUSIONS: Results suggested that several factors are involved in providing effective veterinarian-client communication and that breakdowns in communication can have an adverse effect on the veterinarian-client relationship.

Gatekeepers of health: a qualitative assessment of child care centre staff's perspectives, practices and challenges to enteric illness prevention and management in child care centres.

BACKGROUND: Enteric outbreaks associated with child care centres (CCC) have been well documented internationally and in Canada. The current literature focuses on identifying potential risk factors for introduction and transmission of enteric disease, but does not examine why these risk factors happen, how the risk is understood and managed by the staff of CCCs, or what challenges they experience responding to enteric illness. The purpose of this study was to explore the understanding, knowledge and actions of CCC staff regarding enteric illness and outbreaks, and to identify challenges that staff encounter while managing them. METHODS: Focus groups were conducted with staff of regulated CCCs in Southern Ontario. Five focus groups were held with 40 participants. An open ended style of interviewing was used. Data were analyzed using content analysis. RESULTS: CCC staff play an important role in preventing and managing enteric illness. Staff used in-depth knowledge of the children, the centre and their personal experiences to assist in making decisions related to enteric illness. The decisions and actions may differ from guidance provided by public health officials, particularly when faced with challenges related to time, money, staffing and parents. CONCLUSION: CCC staff relied on experience and judgment in coordination with public health information to assist decision-making in the management of enteric illness and outbreaks. Advice and guidance from public health officials to CCC staff needs to be consistent yet flexible so that it may be adapted in a variety of situations and meet regulatory and public health requirements.

A focus group study of veterinarians' and pet owners' perceptions of the monetary aspects of veterinary care.

OBJECTIVE: To compare veterinarians' and pet owners' perceptions of client expectations with respect to the monetary aspects of veterinary care and identify challenges encountered by veterinarians in dealing with pet owners' expectations. DESIGN: Qualitative study based on focus group interviews. PARTICIPANTS: 6 pet owner focus groups (32 owners) and 4 veterinarian focus groups (24 companion animal veterinarians). PROCEDURES: Independent focus group sessions were conducted with standardized open-ended questions and follow-up probes. Content analysis was performed on the focus group discussions. RESULTS: Pet owners expected the care of their animal to take precedence over monetary aspects. They also expected veterinarians to initiate discussions of costs upfront but indicated that such discussions were uncommon. Veterinarians and pet owners differed in the way they related to discussions of veterinary costs. Veterinarians focused on tangibles, such as time and services. Pet owners focused on outcome as it related to their pet's health and well-being. Veterinarians reported that they sometimes felt undervalued for their efforts. A suspicion regarding the motivation behind veterinarians' recommendations surfaced among some participating pet owners. CONCLUSIONS: Results suggested that the monetary aspects of veterinary care pose barriers and challenges for veterinarians and pet owners. By exploring clients' expectations, improving communication, educating clients, and making discussions of cost more common, veterinarians may be able to alleviate some of the monetary challenges involved in veterinarian-client-patient interactions.