Formal instruction and continuing education engagement as factors improving small animal general practitioners discussing nutrition with clients.

OBJECTIVE: Evaluate whether general practitioners' formal small animal (canine and feline) nutrition instruction in veterinary school and the amount and type of continuing education engagement affect perceived self-reported confidence and frequency in discussing nutrition with clients. SAMPLE: 403 small animal veterinarians who responded to an online survey distributed through the American Animal Hospital Association. PROCEDURES: Veterinarians were surveyed regarding perceived amount of formal instruction received in veterinary school, interest, time committed to self-education, and confidence in both self and staff knowledge in small animal nutrition. RESULTS: Of those veterinarians who responded to the survey, 57.1% (201/352) reported they received "none" or "very little" formal instruction in small animal nutrition, while 151 of 352 answered "some" or "a significant amount." Veterinarians with more formal instruction and veterinarians who reported spending more time in self-education had increased confidence in their own nutritional knowledge (P < .01) and that of their staff (P < .01). CLINICAL RELEVANCE: Veterinarians with self-reported significant formal instruction and veterinarians with higher continuing education engagement were more confident in their knowledge and their staff's knowledge regarding therapeutic and nontherapeutic small animal nutrition. Therefore, it is important for the profession to address veterinary nutrition education gaps in order to increase the veterinary healthcare team's engagement in nutritional discussions with their clients for both healthy and sick pets.

Oil-based compounding flavors more accepted by feline patients.

OBJECTIVE: To evaluate the voluntary acceptance of 10 commercially available compounding flavors in cats. ANIMALS: 46 healthy cats between 1 and 12 years of age. PROCEDURES: Each cat underwent a 14-day study period consisting of a 4-day acclimation period followed by a 10-day trial period in which each cat was randomly offered 10 different compounding flavors. Owners completed a presurvey along with a daily observation logbook. Kits, including residual amounts of flavors, were returned and weighed to determine residual weight and calculate the amount ingested. RESULTS: Overall, cats did not voluntarily accept most of the compounding flavors; 58.8% (124/211) and 84.5% (267/311) of offered samples of oil-based and water-based compounding flavors, respectively, were rejected or minimally accepted. Cats were significantly (P < .001) more likely to accept oil-based flavors, compared to water-based flavors. The sweet water-based flavors were least accepted, compared to water-based control and water-based savory flavors (P = .040 and P < .001, respectively). Owner-perceived acceptance was moderately correlated with residual flavor weights (Kendall tau [τ] = -0.466; P < .001). Owners were not able to accurately predict which flavors their cats would accept. CLINICAL RELEVANCE: Cats should be offered oil-based compounding flavorings when available, whereas water-based sweet flavorings should be avoided. Owner perception of acceptance is a valid metric to assess flavor acceptance, which can be used in future studies evaluating flavor acceptance. Owners may not accurately predict their cats' flavor preferences, limiting their ability to guide optimal flavor selection.

Small animal general practitioners discuss nutrition infrequently despite assertion of indication, citing barriers.

OBJECTIVE: To determine what perceived factors prevent small animal general practitioners from discussing pet nutrition with clients during healthy and sick pet appointments. SAMPLE: 403 veterinarians in small animal general practice. PROCEDURES: An online survey was used to gather veterinarians' opinions on perceived barriers, knowledge levels, and confidence regarding pet nutrition discussions. RESULTS: Reported barriers to discussing nutrition during healthy pet appointments included client resistance to changing brand (149/359), time constraints (146/359), misinformation online (138/359), and difficulty keeping up with products (132/359). Reported barriers to discussing nutrition during sick pet appointments included client cost concerns (101/349), pet not accepting new food (99/349), and time constraints (83/349). Veterinarians reported discussing nutrition less during healthy pet appointments, compared to sick pet appointments, and were significantly less confident with their knowledge regarding nontherapeutic food, compared to therapeutic food. Veterinarians also reported that they perceived conversations about therapeutic foods to be more positive than conversations about nontherapeutic foods, and veterinarians with more years in practice more commonly reported that there was nothing that would dissuade them from discussing nutrition. Veterinarians who reported barriers to discussing nutrition described a need for resources and reliable information for health-care teams and clients. CLINICAL RELEVANCE: Results demonstrated a substantial gap between veterinarians' assertion that nutrition conversations are indicated and the frequency with which they discuss nutrition during appointments. Veterinarians reported that they felt their nutrition conversations were frequently positive; therefore, it is important to overcome barriers to engage with clients about pet nutrition.

Effect of personal, food manufacturer, and pet health statements made by a veterinarian during a pet wellness appointment on a dog or cat owner's decision to consider changing their pet's diet.

OBJECTIVE: To investigate the effect of statements made by veterinarians during a pet wellness appointment on a pet owner's decision to consider changing their pet's diet. SAMPLE: Pet owners who presented their dogs and cats for wellness examinations from December 2018 to February 2019 to a veterinary medical teaching hospital or an affiliated low-cost community clinic. PROCEDURES: Pet owners completed part 1 of the survey, which included questions on various pet characteristics (eg, signalment and current diet) and pet owner's degree of satisfaction with their pet's diet, after a veterinary medical student obtained the pet's medical history and examined the pet. At the conclusion of the wellness appointment, owners completed part 2, which included pet owner demographics (eg, gender and highest educational level) and statements regarding personal, food manufacturer, and pet health that could be made by a veterinarian regarding a pet's diet to which owners were asked to react. RESULTS: 84 dog and 36 cat owners completed the survey. Statements based on pet health and personal (veterinarian) preferences were the most and least effective, respectively, on owners to consider changing their pet's diet. Pet owner gender and pet species did not alter the findings. Most (93%) pet owners were at least somewhat willing to change their pet's diet on the basis of a veterinarian's recommendation. CONCLUSIONS AND CLINICAL RELEVANCE: When a pet's diet is discussed in the context of a pet's health, a primary care veterinarian consulting with a pet owner during a wellness appointment may be most persuasive to the owner for changing their pet's diet.

How to Approach Cultural Humility Debriefing within Clinical Veterinary Environments.

Cultural humility debriefing provides learners with the opportunity to consider how they engage with clients and patients while keeping their own identities and biases in mind. In this article, we invite a deeper understanding of the cultural humility debrief by reviewing its history and uses, describing the state of mind and communication skills required for successful facilitation, and providing a step-by-step process as a framework for veterinary educators to implement effective cultural humility debriefing in practice. This teaching technique is rooted in established communication tools-specifically, permission seeking, open-ended questions, reflective listening, and empathy. Drawing on experience from an inter-professional clinic that serves people who live at or below the national poverty level, this article offers insights to veterinary educators so they can use the cultural humility debrief. By utilizing the outlined debriefing strategies in a clinical setting, it is possible to augment any existing veterinary curriculum and strengthen education around cultural topics.

Use of an Interactive Online Teaching Module Improved Students' Ability to Write a Clinically Appropriate SOAP Note.

The veterinary problem-based medical records lesson (Subjective-Objective-Assessment-Plan [SOAP] notes) at the University of Wisconsin, previously taught in lecture format, provides students little time for reflection. Moreover, evaluation of student-written SOAPs from subsequent courses demonstrates poor knowledge retention and application of the SOAP note structure. This article hypothesized that a virtual, interactive, case-based module would improve student SOAP-writing skills. A second-year student cohort (n = 79) was taught SOAP skills in lecture format (LECTURE-2); 2 years later, another second-year student cohort (n = 73) used the virtual module (MODULE-2). All students wrote SOAPs, which were evaluated using a standardized rubric and the cohorts' scores were compared. SOAPs were then compared between a third-year student cohort who received lecture-based SOAP instruction the year before (LECTURE-3, n = 55) and a third-year student cohort who received the virtual module (MODULE-3, n = 44). SOAP scores were significantly higher in the MODULE-2 group (Mdn = 6.5, range = 1.5-9.0) than in the LECTURE-2 group (Mdn = 5.0, range = 2.0-9.0, p = .006). Similarly, the MODULE-3 students scored higher on the differential diagnosis SOAP component than the LECTURE-3 students (Mdn = 1, range = 0-2, vs. Mdn = 0.5, range = 0-2, p = .041). Student feedback on the online module was positive. An online teaching module improved students' short- and long-term ability to write clinically appropriate SOAP notes. The findings suggest the module encouraged student engagement and reflection, leading to long-term retention and skill application.

Teaching Cultural Humility and Implicit Bias to Veterinary Medical Students: A Review and Recommendation for Best Practices.

Cultural humility, with its concomitant understanding of the importance of the influences of diversity and inclusion, improves health outcomes in the human medical field. Recent changes to the American Veterinary Medical Association Council on Education requirements in veterinary medicine include teaching the impact of implicit bias on the delivery of veterinary medical services. Because overt enhancement of self-awareness is not fodder for traditional veterinary medical education delivery systems, in this article we review existing literature on the impact of recognition of implicit bias on health care and offer insights on ways to help veterinary students learn this skill, drawing on evidence from an inter-professional intervention called WisCARES (Wisconsin Companion Animal Resources, Education, and Social Services).