Authentic Conversations about Self-Care with Fourth-Year Veterinary Medical Students.

Expanding literature on well-being within veterinary medicine has been instrumental in recognizing the prevalence of psychological distress among students and practitioners and promoting awareness and advocacy for well-being within teaching institutions, professional associations, and the workplace. However, greater focus on distress has also been critiqued for overemphasizing illness and reactive interventions, and a call has been made for more balanced conversations about veterinary well-being, with focus on strengths and proactive interventions. This Best Practices article highlights a proactive, strengths-focused intervention, aimed at increasing fourth-year students' awareness of self-care while in training and in their transition to the profession. Authentic conversations about self-care is a required part of clinical training at Kansas State University College of Veterinary Medicine. All students attend a private meeting with a behavioral scientist, engaging in an authentic conversation about their experience of stress and coping strategies. Current practices in providing stress management interventions are restricted to pre-clinical training. Authentic conversations about self-care are presented here as an alternative to current practices, which the authors argue are not adequately addressing students' needs during clinical training and the transition to the profession. Potential implications of providing self-care interventions during the clinical year of training include greater student engagement, increasing awareness, and self-efficacy as students make efforts to maintain well-being both in training and in the professional realm.

Collaborative Development of a Shared Framework for Competency-Based Veterinary Education.

Competency-based medical education is an educational innovation implemented in health professions worldwide as a means to ensure graduates meet patient and societal needs. The focus on student-centered education and programmatic outcomes offers a series of benefits to learners, institutions and society. However, efforts to establish a shared, comprehensive competency-based framework in veterinary education have lagged. This article reports on the development and outcome of a competency-based veterinary education (CBVE) framework created through multi-institutional collaboration with international input from veterinary educators and veterinary educational leaders. The CBVE Framework is designed to reflect the competencies expected of new graduates from member institutions of the Association of American Veterinary Medical Colleges (AAVMC). The CBVE Framework consists of nine domains of competence and 32 competencies, each supplemented with illustrative sub-competencies to guide veterinary schools in implementing competency-based education in their local context. The nine domains of competence are: clinical reasoning and decision-making; individual animal care and management; animal population care and management; public health; communication; collaboration; professionalism and professional identity; financial and practice management; and scholarship. Developed through diverse input to facilitate broad adoption, the CBVE Framework provides the foundation for competency-based curricula and outcomes assessment in veterinary education internationally. We believe that other groups seeking to design a collective product for broad adoption might find useful the methods used to develop the CBVE Framework, including establishing expertise diversity within a small-to-medium size working group, soliciting progressive input and feedback from stakeholders, and engaging in consensus building and critical reflection throughout the development process.

Collaborative Development of Core Entrustable Professional Activities for Veterinary Education.

Entrustable professional activities (EPAs) have been proposed as a practical framework for the implementation of competency-based education. As veterinary education moves toward a competency-based approach, core EPAs provide a context for assessment of workplace activities. This article reports on the development of eight core clinical EPAs for veterinary education created through multi-institutional collaboration, with international input from veterinary educators and veterinary educational leaders. These core EPAs are intended as minimal expectations for clinical activities that should be assessed for every graduate of Association of American Veterinary Medical Colleges member institutions. Adoption of the core EPAs and the associated Competency-Based Veterinary Education (CBVE) framework by veterinary schools is intended to promote Day One graduate competence and thereby enhance patient care and client service.

Development of core entrustable professional activities linked to a competency-based veterinary education framework.

Purpose: Despite the adoption of competency-based education in some veterinary schools over the past 15 years, only recently has a concerted effort been directed toward this in veterinary education internationally.Methods: In 2015, educational leaders from the Association of American Veterinary Medical Colleges (AAVMC) member schools came together with a strong call to action to create shared tools for clinical competency assessment.Results: This resulted in the formation of the AAVMC Competency-Based Veterinary Education (CBVE) Working Group, which then embarked on the creation of a shared competency framework and the development of eight core entrustable professional activities (EPAs) linked to this framework.Conclusions: This paper will report on the development of these EPAs and their integration with the concurrently-developed CBVE Framework.

A Decade of Counseling Services in One College of Veterinary Medicine: Veterinary Medical Students' Psychological Distress and Help-Seeking Trends.

Much has been discussed about the high prevalence of psychological distress among veterinary medical students. Studies investigating general samples of veterinary medical students indicate that, on average, depression and anxiety symptoms are present at higher rates than in comparison samples. However, little is known about veterinary medical students who seek counseling. This study intends to expand the literature on veterinary student well-being, as the first to examine a sample of veterinary medical students seeking counseling services. It offers an overview of student distress and help-seeking trends from a decade of counseling services provided in one College of Veterinary Medicine (CVM) in the US. The sample includes data from 279 participants. Results indicate a steady increase in students seeking counseling over the last decade. First-year students sought services at higher rates but second-year students experienced the greatest distress when compared to other cohorts. Students seeking counseling services experienced levels of overall distress, symptoms of anxiety and depression, and social role concerns that were, on average, above cut-off scores. Physical health was significantly associated with student distress, suggesting opportunities for intervention.

The impact of item-writing flaws and item complexity on examination item difficulty and discrimination value.

BACKGROUND: Failure to adhere to standard item-writing guidelines may render examination questions easier or more difficult than intended. Item complexity describes the cognitive skill level required to obtain a correct answer. Higher cognitive examination items promote critical thinking and are recommended to prepare students for clinical training. This study evaluated faculty-authored examinations to determine the impact of item-writing flaws and item complexity on the difficulty and discrimination value of examination items used to assess third year veterinary students. METHODS: The impact of item-writing flaws and item complexity (cognitive level I-V) on examination item difficulty and discrimination value was evaluated on 1925 examination items prepared by clinical faculty for third year veterinary students. RESULTS: The mean (± SE) percent correct (83.3 % ± 17.5) was consistent with target values in professional education, and the mean discrimination index (0.18 ± 0.17) was slightly lower than recommended (0.20). More than one item-writing flaw was identified in 37.3 % of questions. The most common item-writing flaws were awkward stem structure, implausible distractors, longest response is correct, and responses are series of true-false statements. Higher cognitive skills (complexity level III-IV) were required to correctly answer 38.4 % of examination items. As item complexity increased, item difficulty and discrimination values increased. The probability of writing discriminating, difficult examination items decreased when implausible distractors and all of the above were used, and increased if the distractors were comprised of a series of true/false statements. Items with four distractors were not more difficult or discriminating than items with three distractors. CONCLUSION: Preparation of examination questions targeting higher cognitive levels will increase the likelihood of constructing discriminating items. Use of implausible distractors to complete a five-option multiple choice question does not strengthen the discrimination value.

Engaging Students: Using Video Clips of Authentic Client Interactions in Pre-Clinical Veterinary Medical Education.

The present study evaluated third-year veterinary medical students' perceptions of a communication lab protocol. The protocol used clips of fourth-year veterinary medical students working with authentic clients. These clips supplemented course material. Clips showed examples of proficient communication as well as times of struggle for fourth-year students. Third-year students were asked to critique interactions during class. One hundred and eight third-year students provided feedback about the communication lab. While initial interest in communication proved low, interest in communication training at the end of the course increased substantially. The majority of students cited watching videos clips of authentic client interactions as being an important teaching tool.

Level of and motivation for extracurricular activity are associated with academic performance in the veterinary curriculum.

The objectives of this project were to determine the number of school-sanctioned extracurricular opportunities available to veterinary students and characterize the policies of school administrations toward extracurricular involvement and academic standing. Further, we sought to describe the level of extracurricular involvement of veterinary students, determine the association between extracurricular activity involvement and academic performance, and determine the motivation for extracurricular involvement of veterinary students. Survey data were obtained from 18 associate deans of colleges of veterinary medicine regarding the number of extracurricular student organizations within their school and administrative recommendations regarding student involvement. Another survey was administered and responded to by 665 veterinary students enrolled in curricular years 1-3 at Kansas State University and Texas A&M University regarding their extracurricular involvement. Associate deans of 11 schools responded that they make formal or informal recommendations to students about extracurricular activities, workload, and academic priority (61.1%). In a multivariate model, students who participated two times per week or more had a significantly higher overall grade point average (GPA) than students participating once per week (p<.0500). Students for whom the primary reason for participation was networking or social enhancement had a significantly lower overall GPA than students for whom the primary reason was gaining new knowledge and skills (p<.0500). These results indicate that student extracurricular involvement is a consideration for administrators when counseling students in academic difficulty. Moderate levels of extracurricular involvement can contribute to the academic success of students, but students should temper their level of involvement based upon their own motivations.

Promoting well-being among veterinary medical students: protocol and preliminary findings.

The veterinary medical profession has been the focus of increased concern as students and professionals have been found to be at risk of poor mental health outcomes. Two interventions were proposed as an attempt to improve student well-being individually and within romantic relationships. Preliminary results indicated that students who participated in the interventions experienced significant improvements in decreasing symptoms of depression and stress and relative improvements in relationship satisfaction with their partner. These noteworthy findings provide encouragement for the development of new interventions and future research focused on enhancing veterinary medical students' well-being.

Exploring the use of tablet PCs in veterinary medical education: opportunity or obstacle?

A tablet PC is a laptop computer with a touch screen and a digital pen or stylus that can be used for handwritten notes and drawings. The use of tablet PCs has been investigated in many disciplines such as engineering, mathematics, science, and education. The purpose of this article is to explore student and faculty attitudes toward and experiences with tablet PCs 6 years after the implementation of a tablet PC program in the College of Veterinary Medicine (CVM) at Kansas State University (K-State). This study reports that the use of tablet PCs has enhanced students' learning experiences through learner-interface interaction, learner-content interaction, learner-instructor interaction, and learner-learner interaction. This study also identifies digital distraction as the major negative experience with tablet PCs during class time. The tablet PC program provides CVM faculty the potential to pursue technology integration strategies that support expected learning outcomes and provides students the potential to develop self-monitoring and self-discipline skills that support learning with digital technologies.

Correlation of pre-veterinary admissions criteria, intra-professional curriculum measures, AVMA-COE professional competency scores, and the NAVLE.

Data consisting of preadmission criteria scores, annual and final cumulative grade point averages (GPAs), grades from individual professional courses, American Veterinary Medical Association Council on Education (AVMA-COE) Competency scores, annual class rank, and North American Veterinary Licensing Exam (NAVLE) scores were collected on all graduating DVM students at Kansas State University in 2009 and 2010. Associations among the collected data were compared by Pearson correlation. Pre-veterinary admissions criteria infrequently correlated with annual GPAs of Years 1-3, rarely correlated with the AVMA-COE Competencies, and never correlated with the annual GPA of Year 4. Low positive correlations occurred between the NAVLE and the Verbal Graduate Record Examination (GRE) (r=.214), Total GRE (r=.171), and the mean GPA of pre-professional science courses (SGPA) (r=.236). Annual GPAs strongly correlated with didactic course scores. Annual GPAs and final class rank strongly correlated (mean r=-.849), and both strongly correlated with the NAVLE score (NAVLE: GPAs mean r=.628, NAVLE: final class rank r=-.714). Annual GPAs at the end of Years 1-4 weakly correlated or did not correlate with the AVMA-COE Competencies. The AVMA-COE Competencies weakly correlated with scores earned in didactic courses of Years 1-3. AVMA-COE Competencies were internally consistent (mean r=.796) but only moderately correlated with performance on the NAVLE (mean r=.319). Low correlations between admissions criteria and outcomes indicate a need to reevaluate admission criteria as predictors of school success. If the NAVLE remains the primary discriminator for veterinary licensure (and the gateway to professional activity), then the AVMA-COE Competencies should be refined to better improve and reflect the NAVLE, or the NAVLE examination should change to reflect AVMA-COE Competencies.

Using authentic client interactions in communication skills training: predictors of proficiency.

Communication training has become a focus of concern in recent years in veterinary medicine. Existing literature to date indicates that Colleges of Veterinary Medicine (CVMs) have implemented various communication training protocols. The present study focused on the evaluation of a communication training protocol implemented in 2007 at Kansas State University (KSU) in a sample of veterinary medical students (N=415) across five cohorts. The protocol includes video review of authentic client interactions, feedback from authentic clients, and small-group communication training. Findings indicate that targeted communication skills improved through video-review feedback and small-group communication training. Communication scores were particularly affected by students' attention to improving communication deficiencies during a second student-client video. Baseline scores from the first student-client video in four specific areas (using nonverbal communication, setting expectations, building rapport, and being able to clarify) were predictive of overall performance during the second evaluation. Based on the results of the present study, using videos of authentic client interactions is recommended as a valuable communication training teaching tool.

Veterinary medical student well-being: depression, stress, and personal relationships.

Existing research consistently connects higher relationship satisfaction with improved psychological and physical functioning. Investigations focusing on relational satisfaction within veterinary medicine have been sparse. This study evaluated 240 veterinary medical students at Kansas State University. Results indicate that students within higher-functioning relationships are more likely to report fewer depressive symptoms, lower stress associated with balancing their school and home lives, less relationship conflict, better physical health, and improved ability to cope with academic expectations, while at the same time experiencing more stress from being behind in studies. Based on these findings, Colleges of Veterinary Medicine (CVMs) are encouraged to institute policies and programs which foster relationship-building for students.

From theory to practice: integrating instructional technology into veterinary medical education.

Technology has changed the landscape of teaching and learning. The integration of instructional technology into teaching for meaningful learning is an issue for all educators to consider. In this article, we introduce educational theories including constructivism, information-processing theory, and dual-coding theory, along with the seven principles of good practice in undergraduate education. We also discuss five practical instructional strategies and the relationship of these strategies to the educational theories. From theory to practice, the purpose of the article is to share our application of educational theory and practice to work toward more innovative teaching in veterinary medical education.

Investigation into the impact of audience response devices on short- and long-term content retention.

Audience Response Systems (ARSs) may enhance short-term knowledge retention. Long-term knowledge retention is more difficult to demonstrate. According to previous studies, ARS questions requiring application of knowledge or peer interaction are more effective in maintaining student attention. The purpose of this study was to determine if peer discussion or individual-knowledge questions enhance short- and/or long-term knowledge retention. Third-year veterinary students responded to ARS questions posed in individual knowledge (n=3 questions) and peer discussion (n=3 questions) format from six different instructors. To test short-term memory, the same questions were delivered during the course examination (within 21 days). To test long-term retention, these questions were posed during a retention exercise (four months later). On the course examination, students had a higher (p<.01) probability (±SE) of correctly answering ARS individual-knowledge questions (93.8 ± 1.8%) compared to novel (previously unseen, non-ARS control) course examination questions (87.5 ± 3.1%), but the probability of correctly answering examination questions previously posed using ARS peer discussion format (89.5 ± 3.0%) did not differ from individual knowledge or novel examination questions. The positive impact of ARS-knowledge questions was not maintained through the retention exercise. Neither individual knowledge (70.5 ± 6.4%) nor peer-discussion questions (67.5 ± 6.9%) performed better on the retention exercise than the questions that appeared only on the course examination (68.6 ± 6.1%). Curricular strategies that emphasize content review may be more powerful than strategies that strengthen initial learning for long-term content retention.

Babesia equi-induced anemia in a Quarter Horse and subsequent regulatory response.

CASE DESCRIPTION: A 7-year-old Quarter Horse gelding used for unsanctioned racing was examined because of fever and anorexia. CLINICAL FINDINGS: Physical examination revealed fever, tachycardia, and tachypnea. Results of a CBC indicated anemia and mild thrombocytopenia. Results of microscopic examination of a blood smear indicated piroplasms in erythrocytes, consistent with Babesia spp. Regulatory authorities were contacted, and results of serologic testing at the National Veterinary Services Laboratories confirmed acute Babesia equi infection. TREATMENT AND OUTCOME: Equids on the home premises of the index horse were placed under quarantine. Those equids were tested for piroplasmosis, and 6 of 63 horses had positive results for B equi. Another horse that had previously been housed on the index premises also had positive results for B equi. Competent tick vectors for piroplasmosis organisms were not identified. All 8 horses with piroplasmosis were Quarter Horses that participated in unsanctioned racing and were trained by the same person. Two of the horses were illegally removed from the index premises; these 2 horses and the other horse with piroplasmosis that was previously housed on the index premises could not be found. The other 5 horses with piroplasmosis were euthanized. Investigators concluded that transmission of B equi among horses was most likely iatrogenic. CLINICAL RELEVANCE: The United States has been considered piroplasmosis free. However, veterinarians should consider piroplasmosis in horses with signalments and clinical signs similar to those of the index horse of this report. Regulatory authorities should be contacted regarding horses in which piroplasmosis is suspected.

Predictors of anxiety and depression in veterinary medicine students: a four-year cohort examination.

Mental health needs of veterinary medical students have become the focus of concern in recent years. Literature to date is scarce, but indicates a large number of veterinary medical students experience clinical levels of anxiety and depression. The present study focused on the prevalence of anxiety and depression in a sample of veterinary medical students (N=142) across four-year cohorts. Findings indicate elevated scores of anxiety and depression across the four-year cohorts. Students in their second and third years had the highest anxiety and depression scores. Perceived physical health, unclear expectations, difficulty fitting in, heavy workload, and homesickness were most relevant in explaining anxiety and depression symptom prevalence. Implications for practice and future research are addressed based on these findings.