Survey of Integrative Veterinary Medicine Training in AVMA-Accredited Veterinary Colleges.

A survey approved by the Association of American Veterinary Medical Colleges was sent to the academic deans of all 49 accredited veterinary colleges to obtain information on educational programs offered in integrative veterinary medicine (IVM). Results were compared to a previous survey with a similar design performed 7 years earlier. Survey responses were received from 43 of 49 institutions (87.8%). Thirteen respondents (30.2%) reported offering a formal course in IVM, 33 (76.7%) offered some level of instruction in the curriculum, and 32 (74.4%) provided clinical services in IVM. The most common IVM topics covered in the curriculum were rehabilitation and acupuncture. Dedicated courses in IVM had decreased since the previous survey, although faculty trained in at least one aspect of IVM increased. Clinical services incorporating IVM were present in the majority of veterinary teaching hospitals. Further investigation is required to determine the effectiveness of current IVM training in preparing veterinary graduates to discuss or utilize IVM in practice.

Analysis of teaching methods in anaesthesia in the undergraduate curriculum of four veterinary universities.

OBJECTIVE: To design a holistic audit tool to assess the effectiveness of anaesthesia teaching strategies, and thereby to study veterinary undergraduate teaching methods in different geographical areas. STUDY DESIGN: Qualitative study using interviews of university staff and students to identify common themes and differences in teaching veterinary anaesthesia. METHODS: An audit was performed using an audit tool in four veterinary universities (École Nationale Vétérinaire d'Alfort, France; Royal Veterinary College, UK; University of Buenos Aires, Argentina; and Alma mater studiorum - Università di Bologna, Italy). First, an open-question interview of anaesthesia head of service (60-90 minutes) identified the pedagogical strategies in order to conceive a subsequent semi-directive interview formulated as a SWOT analysis (Strength/Weaknesses/Opportunity/Threats). Second, the SWOT reflection was conducted by a second staff member and focussed on: 1) general organization; 2) topics for pre-rotation teaching; 3) teaching methods for clinical rotation; and 4) assessment methods. Qualitative analysis of the interview responses was performed with semi-structured interviews. Finally, the students evaluated their teaching through a students' questionnaire generated from the output of both interviews. RESULTS: A group of nine lecturers and 106 students participated in the study at four different sites. Preclinical teaching ranged from 13 to 24 hours (median 15 hours). Clinical teaching ranged from 4 to 80 hours (median 60 hours). Overall, all faculties perceived time as a limitation and attempted to design strategies to achieve the curriculum expectations and optimize teaching using more time-efficient exercises. Large animal anaesthesia teaching was found to be a common area of weakness. Internal feedback was delivered to each university, whereas generalized results were shared globally. CONCLUSIONS: This preliminary study proved the generalizability of the protocol used. Recruiting a larger pool of universities would help to identify and promote efficient teaching strategies and innovations for training competent new graduates in an ever-expanding curriculum.

Mind-body therapies: an intervention to reduce work-related stress in veterinary academia.

Studies investigating perceived stress and mindfulness awareness support mind-body therapy (MBT) effectiveness in reducing stress and anxiety and, thus, has potential to decrease work-related stress. A pre/postexperimental design involved 30 faculty and staff working at Ross University School of Veterinary Medicine, Saint Kitts and Nevis, who experienced a two-day MBT intervention programme. An additional 16 faculty and staff not involved in MBT who went about their daily work schedules served as contemporary controls. Demographics, Perceived Stress Scale 10 (PSS-10), Mindful Attention Awareness Scale (MAAS), 16 Personality Factor (16PF) Openness to Change subscale and saliva cortisol concentrations were analysed. Control participants reported significantly perceived less stress (PSS-10: M=13; sd=1.4) than intervention participants (M=20; sd=6.6) during pretest. However, at post-test the intervention group reported a significant decrease in perceived stress (M=11; sd=6.0). MAAS pretest results indicated the intervention group displayed a lower average score (M=54; sd=15.3) than control participants (M=68; sd=2.0). Post-MAAS intervention scores showed improvements in mindfulness (M=63; sd=15.3). Correlations between the 16PF Openness to Change subscale and MAAS were r=0.03 and r=-0.17 for the intervention and control groups, respectively. Mean concentrations of saliva cortisol indicated a larger and significant decline in cortisol for the intervention group both during day 1 (P=0.0001) and day 2 (P=0.0008). In conclusion, these preliminary results provide support that MBTs in veterinary academia can improve psychological and physiological aspects of personal wellbeing.

Novel hyperthermia applicator system allows adaptive treatment planning: Preliminary clinical results in tumour-bearing animals.

Hyperthermia (HT) as an adjuvant to radiation therapy (RT) is a multimodality treatment method to enhance therapeutic efficacy in different tumours. High demands are placed on the hardware and treatment planning software to guarantee adequately planned and applied HT treatments. The aim of this prospective study was to determine the effectiveness and safety of the novel HT system in tumour-bearing dogs and cats in terms of local response and toxicity as well as to compare planned with actual achieved data during heating. A novel applicator with a flexible number of elements and integrated closed-loop temperature feedback control system, and a tool for patient-specific treatment planning were used in a combined thermoradiotherapy protocol. Good agreement between predictions from planning and clinical outcome was found in 7 of 8 cases. Effective HT treatments were planned and verified with the novel system and provided improved quality of life in all but 1 patient. This individualized treatment planning and controlled heat exposure allows adaptive, flexible and safe HT treatments in palliatively treated animal patients.

The Impact of a Brief Embedded Mindfulness-Based Program for Veterinary Students.

Veterinary medical students, like other university students, are likely to experience elevated levels of stress, anxiety, and depression over the course of their studies. Mindfulness-based interventions have previously been effective for university students in reducing stress, depression, and anxiety. In this study, a mindfulness-based intervention was embedded in a core (compulsory) unit of a veterinary science course, in part with the aim of improving student well-being. Preliminary results suggest that, despite the mindfulness intervention, overall symptoms of stress, depression, and anxiety among participants (n=64) increased between the start and end of the semester. However, further analysis showed that most of this longitudinal increase was attributable to individuals who scored above the normal range (i.e., at least mild level of symptoms) in one or more measures at the beginning of the semester. Within this subset, individuals who regularly engaged in mindfulness practice once a week or more throughout the semester reported significantly lower depression and anxiety symptoms than those who practiced less than once a week (i.e., who had long periods without practice). Results suggest that engaging regularly in mindfulness practice potentially acted as a protective factor for students already experiencing at least a mild range of symptoms of anxiety and depression at the beginning of the semester. While not all veterinary students may derive significant benefit immediately, providing access to an embedded mindfulness program early in their program may facilitate the development of adaptive coping mechanisms, which may be engaged to increase resilience across their academic and professional life.

Adjuvant therapy with carboplatin and pamidronate for canine appendicular osteosarcoma.

Amputation and chemotherapy are the mainstay of treatment for canine appendicular osteosarcoma (OSA). In vitro studies have demonstrated anti-tumour activity of pamidronate against canine OSA. The purpose of this study was to assess the safety of adding pamidronate to standard post-operative carboplatin chemotherapy in 17 dogs with appendicular OSA treated with limb amputation. Median disease-free interval (DFI) and median survival time (MST) were evaluated as secondary endpoints. Incidence of side effects and treatment outcomes were compared to 14 contemporary control patients treated with carboplatin alone. There were no identified side effects to the pamidronate treatment. The median DFI for the study group was 185 days compared to 172 days for the control group (P = 0.90). The MST of the study group was 311 days compared to 294 days for the control group (P = 0.89). Addition of pamidronate to carboplatin chemotherapy for the treatment of canine appendicular OSA is safe and does not impair efficacy of standard carboplatin treatment.

Programmatic assessment of competency-based workplace learning: when theory meets practice.

BACKGROUND: In competency-based medical education emphasis has shifted towards outcomes, capabilities, and learner-centeredness. Together with a focus on sustained evidence of professional competence this calls for new methods of teaching and assessment. Recently, medical educators advocated the use of a holistic, programmatic approach towards assessment. Besides maximum facilitation of learning it should improve the validity and reliability of measurements and documentation of competence development. We explored how, in a competency-based curriculum, current theories on programmatic assessment interacted with educational practice. METHODS: In a development study including evaluation, we investigated the implementation of a theory-based programme of assessment. Between April 2011 and May 2012 quantitative evaluation data were collected and used to guide group interviews that explored the experiences of students and clinical supervisors with the assessment programme. We coded the transcripts and emerging topics were organised into a list of lessons learned. RESULTS: The programme mainly focuses on the integration of learning and assessment by motivating and supporting students to seek and accumulate feedback. The assessment instruments were aligned to cover predefined competencies to enable aggregation of information in a structured and meaningful way. Assessments that were designed as formative learning experiences were increasingly perceived as summative by students. Peer feedback was experienced as a valuable method for formative feedback. Social interaction and external guidance seemed to be of crucial importance to scaffold self-directed learning. Aggregating data from individual assessments into a holistic portfolio judgement required expertise and extensive training and supervision of judges. CONCLUSIONS: A programme of assessment with low-stakes assessments providing simultaneously formative feedback and input for summative decisions proved not easy to implement. Careful preparation and guidance of the implementation process was crucial. Assessment for learning requires meaningful feedback with each assessment. Special attention should be paid to the quality of feedback at individual assessment moments. Comprehensive attention for faculty development and training for students is essential for the successful implementation of an assessment programme.

Promoting one health: the University of Missouri Research Center for Human/Animal Interaction.

The University of Missouri's College of Veterinary Medicine is home to the Research Center for Human-Animal Interaction. This center uniquely addresses a growing area of research that focuses on how the human-animal bond impacts health in people and animals. This article highlights the One Health basis for the center, several research projects, and future goals for the center.

Survey of colleges and schools of veterinary medicine regarding education in complementary and alternative veterinary medicine.

OBJECTIVE: To obtain information on educational programs offered in complementary and alternative veterinary medicine (CAVM) among AVMA Council on Education (COE)-accredited colleges and schools of veterinary medicine. DESIGN: Survey. SAMPLE: 41 COE-accredited colleges and schools of veterinary medicine. PROCEDURE: A questionnaire was e-mailed to academic deans at all COE-accredited colleges and schools of veterinary medicine. RESULTS: Responses were received from 34 of 41 schools: 26 in the United States, 2 in Canada, 3 in Australia and New Zealand, and 3 in Europe. Sixteen schools indicated that they offered a CAVM course. Nutritional therapy, acupuncture, and rehabilitation or physical therapy were topics most commonly included in the curriculum. One school required a course in CAVM; all other courses were elective, most of which were 1 to 2 credit hours. Courses were usually a combination of lecture and laboratory; 2 were lecture only, and 1 was laboratory only. Of the 18 schools that reported no courses in CAVM, many addressed some CAVM topics in other courses and 4 indicated plans to offer some type of CAVM course within the next 5 years. CONCLUSIONS AND CLINICAL RELEVANCE: The consensus among survey respondents was that CAVM is an important topic that should be addressed in veterinary medical education, but opinions varied as to the appropriate framework. The most common comment reflected strong opinions that inclusion of CAVM in veterinary medical curricula must be evidence-based. Respondents indicated that students should be aware of CAVM modalities because of strong public interest in CAVM and because practitioners should be able to address client questions from a position of knowledge.

O ensino da extensão rural nos cursos superiores de medicina veterinária no Brasil / The rural extension teaching in undergraduate courses of medicine veterinary in Brazil

Esta pesquisa investigou como os Cursos Superiores de Medicina Veterinária no Brasil (CSMV) estão oferecendoconhecimentos relacionados à “Extensão Rural”. Foram aplicados questionários aos 149 cursos de Medicina Veterináriaem funcionamento. Deste universo, obteve-se uma amostra de 57 entrevistados que responderam à pesquisa (38,3%).Em que pesem as mudanças curriculares após o Parecer 105/2002, a disciplina ainda é oferecida na maioria (97%)dos cursos, evidenciando o reconhecimento de sua importância na formação dos alunos de graduação. Três aspectosobservados merecem reflexão: a heterogeneidade na carga horária da disciplina, variando de 30 a 90 horas/semestre; certaheterogeneidade da inserção (semestre/período) na grade, podendo constar desde o segundo até o último período; e aampla gama de temas que constam nos programas. Sugere-se que os programas da disciplina de Extensão Rural, a seremoferecidos nos CSMV, procurem inserir três pontos que se entende serem importantes, mas nem sempre abordados: i)a “extensão rural” com seus múltiplos enfoques (serviço público para o desenvolvimento holístico das famílias rurais,assistência técnica propriamente dita, difusão de tecnologia, prática pedagógica, processo de comunicação etc.); ii)temas relacionados diretamente à atuação do médico veterinário (tais como a relação da extensão com a sanidade animale humana, a defesa agropecuária etc.); e iii) temas emergentes relacionados a áreas multidisciplinares, especialmente asustentabilidade, o meio ambiente e o bem-estar animal

This research investigates how the Undergraduate Courses of Medicine Veterinary currently provide knowledgeregarding “Rural Extension”. It was applied questionnaires to the 149 courses in activity, out of which 57 answered thesurvey (38.3%). Despite the curricular changes proposed by the government in 2002, the discipline is still offered in themajority of the schools (97%), showing the recognition of its importance in the undergraduate student education. Threecentral aspects needs attention: the heterogeneity regarding the hours of the discipline, ranging from 30 to 90 hours persemester; a relative heterogeneity where the discipline is inserted in the curriculum, ranging from the second to the lastsemester; and the wide range of issues presented in the discipline’s programs. It’s suggested that the programs should tryto include three sets of knowledge that are considered important to professionals of the future, and that appeared withlittle relevance in current programs: i) an extension with its multiple focus; ii) issues directly related to the veterinaryactuation; and iii) emerging issues related to multidisciplinary areas, specially sustainability, the human-animal relationand the animal welfare

Ionized hypocalcemia as a prognostic indicator in dogs following trauma.

OBJECTIVE: To determine the incidence of ionized hypocalcemia (iHCa) in dogs with blunt and penetrating traumatic injuries upon presentation to a hospital, and to determine the association of iHCa with mortality, duration of hospitalization, and requirement for intensive care therapies. DESIGN: Retrospective study (January 2007-December 2008). SETTING: University veterinary teaching hospital. ANIMALS: Eighty-eight dogs admitted to the ICU within 24 hours of a traumatic event and with assessment of a venous blood gas sample, including ionized calcium, at hospital admission. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Most dogs (72%) sustained injuries as a result of a motor vehicle accident. iHCa (<1.25 mmol/L [<2.50 mEq/L]) was present in 14 of 88 dogs (16%). Dogs with abdominal trauma were significantly more likely to have iHCa (P = 0.020) than dogs with other injuries. Dogs with iHCa spent significantly longer time in the hospital (P = 0.036) and ICU (P = 0.005), and were more likely to require oxygen supplementation (P = 0.048), synthetic colloids (P = 0.020), vasopressors (P = 0.0043), and blood transfusions (P < 0.0001). Six of 14 dogs (43%) with iHCa demonstrated clinical signs consistent with hypocalcemia during the course of hospitalization, and calcium gluconate was administered intravenously to one dog. Overall mortality was 16% (14/88) and dogs with iHCa were significantly less likely to survive (P < 0.001). CONCLUSIONS: The incidence of iHCa upon hospital admission in this group of dogs with blunt and penetrating trauma is similar to the incidence of iHCa in critically ill dogs. Findings further suggest that dogs with iHCa are more severely injured and subsequently require increased intensive care therapies and have a lower likelihood of survival compared to dogs with normocalcemia. Ionized calcium concentration may therefore be a useful prognostic indicator in dogs with blunt and penetrating traumatic injuries.

Inadvertent transvaginal administration of sodium phosphate enemas in 2 alpaca crias.

OBJECTIVE: To describe the clinical presentation and resultant metabolic disturbances following retroperitoneal administration of hyperphosphate enemas in alpaca crias. CASE OR SERIES SUMMARY: Two crias presented to the Colorado State University Veterinary Teaching Hospital after inadvertent transvaginal retroperitoneal hyperphosphate enema administration. The first cria developed an acute onset of neurologic signs, severe hypernatremia, and died soon after presentation. The second cria developed severe hyperphosphatemia, hypocalcemia, and acidemia. The metabolic derangements normalized within 24 hours of intensive treatment with calcium supplementation and IV crystalloid fluid diuresis. The cria was discharged after 1 week in the hospital. NEW OR UNIQUE INFORMATION PROVIDED: This report provides a description of electrolyte disturbances secondary to inadvertent transvaginal retroperitoneal administration of hyperphosphate enemas in 2 crias and attendant clinical signs of these disturbances. Management of hyperphosphatemia and hypocalcemia in 1 cria via aggressive fluid therapy with calcium supplementation led to a rapid and sustained normalization of phosphorus, calcium, and acid-base balance.

Tying art and science to reality for recruiting minorities to veterinary medicine.

The challenge of this message, which is a synopsis of my presentation at the 2009 Iverson Bell Symposium, is to look more holistically and at the how, what, when, and who of our recruitment activities in the context of the realities of managing resources, expectations, and metrics.

Current perspectives on curriculum needs in zoological medicine.

Advances have been made in expanding veterinary curricula to deliver basic key knowledge and skills necessary for provision of health care to captive and companion non-domestic or non-traditional species in the veterinary colleges of the United States and Canada. These advances were in large part facilitated by the deliberations and recommendations of the White Oak Accords. Though a five-year review of curricular opportunities at US and Canadian veterinary colleges shows that progress has been made in implementing the recommendations of the White Oak Accords, there remains room for improvement. The broadly comparative and health-maintenance basis of zoological medicine contributes critically to the potential for veterinary medicine to make important contributions to the concept of the integrated health of the planet. Emergence of key zoonotic and production-animal diseases derived from and within wildlife populations since 2000 has increased awareness worldwide of the importance of zoological medicine in protecting both production livestock and public health. These areas are addressed in elective curricula at colleges emerging as centers of excellence in zoological medicine, but it is critical that core curricula in zoological medicine at all schools be strengthened to include these important areas to prepare our DVM/VMD graduates to protect companion-animal, production-animal, and public health.

Communication skills training at the Atlantic Veterinary College, University of Prince Edward Island.

Communication skills are considered a core clinical skill in human medicine. Recognizing the importance of communication skills and addressing them in veterinary curricula, however, is just beginning. In the fall of 2003, the Atlantic Veterinary College, University of Prince Edward Island, markedly changed the way in which it approaches communication teaching. An intensive one-week elective rotation on client communication was offered in the senior year. This rotation made extensive use of experiential techniques through the use of role plays and videotaped real client interactions. A group of faculty and hospital staff members were trained as coaches to support students as they practiced their communication in various client scenarios. The skills taught were based on the Calgary-Cambridge Observation Guide, which outlines observable behaviors that contribute to effective medical communication. Student response to and feedback on the rotation have been very positive. As a result, the number of rotations given per year has been increased. Long-term plans include expanding communication skills teaching into other years of the DVM program and incorporating simulated clients into the teaching program. Challenges that lie ahead include the development of a fully integrated communication teaching program that spans the whole curriculum, addressing the ongoing need for the professional development of coaches, improving methods of student assessment, and recruiting/training a sufficient number of coaches.

Veterinary school admission interviews, part 1: literature overview.

An analysis of the admission interview used by schools in four health professions (veterinary medicine, allopathic medicine, optometry, and dentistry) portrays a largely similar approach to selection interviews: INTERVIEW USE: At least 80% of schools interview applicants. For schools that offer interviews, at least 40% of candidates are interviewed (a strong academic profile is the number one determinant of receiving an interview offer). The interview is one of the three most important selection tools used by schools. Less than 26% of schools fix the interview's weight in the selection process (fixed weights range from 31% to 35%). INTERVIEW PURPOSE AND CONTENT: The most common purposes of the interview are to (1) gather information, (2) make decisions, (3) verify information provided in other parts of the application, (4) recruit candidates, and/or (5) promote public relations. The most common characteristics and skills interviewers are interested in assessing are motivation for the profession, interpersonal skills, and communication skills. The desire to assess cognitive ability with the interview (>25% of schools) is surprising in view of the use of other selection tools (e.g., GPA). INTERVIEW FORMAT: Medical schools are more likely to offer two interviews per candidate, while optometry schools are more likely to offer one interview per candidate. Individual interviews (one interviewer, one candidate) are the predominant format among medical schools, while panel interviews (more than one interviewer, one candidate) are the most common format among optometry schools. The duration of the interview is 30 to 45 minutes. Interview questions most often address facts and knowledge, hypothetical situations, and the ability to meet program requirements. Most interviews do not meet the criteria for a structured interview, which has demonstrated greater validity and reliability than semi-structured or unstructured interviews. INTERVIEWERS: Interviewers are most likely to be health care faculty members (e.g., veterinarians at a veterinary school). Interviewers receive limited training. RECOMMENDATIONS FOR INCREASING INTERVIEW RELIABILITY AND VALIDITY: The purpose(s) of the interview must be clearly articulated so that the interview and interviewer training can be designed to achieve that purpose. Interview structure should be increased by developing a "job analysis" set of questions that is posed to all candidates and scored using behavioral anchors. Interviewers should receive more training in rater bias, listening skills, and interview structure. Panel interviews should be used to increase reliability. Interviewers should not have access to the candidate's application unless the interview is used to verify information. To increase the utility of the interview in the selection process, the weight of the interview in relation to other selection components should be determined.

Subjective criteria as the sole method of selecting veterinary candidates at a US veterinary medical school.

For the past four years, Colorado State University College of Veterinary Medicine and Biomedical Sciences' veterinary Admissions Committee has used a completely subjective process to select veterinary students. The basic premise of the subjective admissions process is to evaluate applicants holistically, with equal emphasis on cognitive and non-cognitive attributes. The system allows the Committee the flexibility to weigh factors deemed by the school and profession to be important without the necessity of creating complex mathematical models to fit the confines of a point system. The subjective system, endorsed by the school's faculty and legal counsel, is summarized in this article.