Basic science knowledge underlies clinical science knowledge and clinical problem solving: evidence from veterinary medicine.

Medical sciences education emphasizes basic science learning as a prerequisite to clinical learning. Studies exploring relationships between achievement in the basic sciences and subsequent achievement in the clinical sciences generally suggest a significant positive relationship. Basic science knowledge and clinical experience are theorized to combine to form encapsulated knowledge- a dynamic mix of information that is useful for solving clinical problems. This study explores the relationship between basic science knowledge (BSK), clinical science knowledge (CSK), and clinical problem-solving ability, as measured within the context of four veterinary colleges using both college-specific measures and professionally validated, standardized measures of basic and clinical science knowledge and problem-solving ability. Significant correlations existed among all variables. Structural equation modeling and confirmatory factor analysis were used to produce models showing that newly acquired BSK directly and significantly predicted BSK retained over time and newly acquired CSK, as well as indirectly predicted clinical problem-solving ability (mediated by newly acquired CSK and BSK retained over time). These findings likely suggest a gradual development of schema (encapsulated knowledge) and not an isolated development of biomedical versus clinical knowledge over time. A broader implication of these results is that explicitly teaching basic science knowledge positively and durably affects subsequent clinical knowledge and problem-solving ability independent of instructional strategy or curricular approach. Furthermore, for veterinary colleges specifically, student performance as measured by both course-level and standardized tests are likely to prove useful for predicting subsequent academic achievement in classroom and clinical settings, licensing examination performance, and/or for identifying students likely in need of remediation in clinical knowledge.

Guidelines for resident training in veterinary clinical pathology. IV: Laboratory quality management-Teaching domains, competencies, and suggested learning outcomes.

BACKGROUND: The 2019 ASVCP Education Committee Forum for Discussion, presented at the annual ASVCP/ACVP meeting, identified a need to develop recommendations for teaching laboratory quality management principles in veterinary clinical pathology residency training programs. OBJECTIVES: To present a competency-based framework for teaching laboratory quality management principles in veterinary clinical pathology residency training programs, including entrustable professional activities (EPAs), domains of competence, individual competencies, and learning outcomes. METHODS: A joint subcommittee of the ASVCP Quality Assurance and Laboratory Standards (QALS) and Education Committees executed this project. A draft guideline version was reviewed by the ASVCP membership and shared with selected ACVP committees in early 2022, and a final version was voted upon by the full QALS and Education Committees in late 2022. RESULTS: Eleven domains of competence with relevant individual competencies were identified. In addition, suggested learning outcomes and resource lists were developed. Domains and individual competencies were mapped to six EPAs. CONCLUSIONS: This guideline presents a framework for teaching principles of laboratory quality management in veterinary clinical pathology residency training programs and was designed to be comprehensive yet practical. Guidance on pedagogical terms and possible routes of implementation are included. Recommendations herein aim to improve and support resident training but may require gradual implementation, as programs phase in necessary expertise and resources. Future directions include the development of learning milestones and assessments and consideration of how recommendations intersect with the American College of Veterinary Pathologists training program accreditation and certifying examination.

Effectiveness of a Student-Developed Instructional Video in Learning the Anatomy of the Equine Distal Limb.

The anatomy of the equine distal limb (EDL) is both complex and important to veterinary clinical practice. First-year veterinary students (VM1s) often struggle to adequately understand it. Two third-year veterinary students collaborated with instructors to create an instructional video to facilitate first-year students' comprehension of EDL anatomy. The video was offered to all VM1s. Learning outcomes were assessed via practical exams. Exam scores on EDL structures were compared between students who did (video) and students who did not (no video) watch the video. Students' laboratory experiences and confidence were evaluated with a post-exam survey. The third-year students documented their experiences while producing the video. Eighty percent of VM1s viewed the video; 91% rated the video as very valuable. The video improved student confidence during the practical exam by 9%, and 89% of surveyed students indicated the video positively impacted their exam grade. One item score was significantly improved in the video group (p < .001), as was the score of the five questions combined (p < .001). As expected, overall practical exam scores were not statistically different. Student collaborators indicated that participation reinforced their knowledge while enhancing their professional development. Student collaboration was a beneficial strategy for instructional support development that positively impacted student affect and also generated opportunities for the involved students' professional growth.

"Obligated to Keep Things Under Control": Sociocultural Barriers to Seeking Mental Health Services Among Veterinary Medical Students.

Research reveals veterinary medical students and professionals are at increased risk for mental health problems such as depression, anxiety, and suicidality, yet many individuals in distress do not seek professional mental health services. Although some barriers to accessing services have been identified, other factors, including how professional culture influences service underutilization, are poorly understood. In this study, we used a mixed-methods approach to investigate 573 veterinary students' perceptions of barriers to seeking mental health services and potential mechanisms to lessen them. We identified four barrier themes: stigma, veterinary medical culture and identities, services, and personal factors. Participants' suggestions for reducing barriers to seeking help related to three themes: culture, services, and programmatic factors. We compared perceptions of barriers based on the severity of participants' self-reported symptoms of depression and anxiety and found that participants with severe depression, compared with participants with mild depression, were more likely to perceive barriers related to veterinary medical culture. The results of this study provide a deeper understanding of veterinary students' barriers to seeking mental health services and, in particular, how these barriers, as both individual and sociocultural phenomena, are often interrelated and mutually reinforcing.

Mental Health Stigma and Veterinary Medical Students' Attitudes Toward Seeking Professional Psychological Help.

Veterinary medical students may be at increased risk for a variety of mental health problems. However, research with student samples suggests that students in distress may not seek professional help, even when mental health services are available. The purpose of this study was to explore veterinary students' willingness to seek mental health services for several common presenting concerns, as well as their perceptions of their peers' willingness to seek help for the same concerns. We also sought to explore the roles of public stigma, self-stigma, and attitudes toward seeking professional psychological help in explaining students' willingness to seek services using a serial mediation analysis. Study participants were 573 veterinary medical students currently enrolled in accredited programs in the United States. Participants reported being most willing to seek mental health services for issues regarding substance abuse, traumatic experiences, and anxiety. They also tended to perceive other students were less willing to seek mental health services for most presenting issues than they actually were. As expected, self-stigma and attitudes toward seeking professional psychological help serially mediated the relationship between public stigma and willingness to seek mental health services. Public stigma was positively related to self-stigma, self-stigma was negatively related to attitudes toward seeking professional psychological help, and attitudes toward seeking help were positively related to willingness to seek mental health services. Implications for outreach, research, and education are discussed.

Mental Health Experiences and Service Use Among Veterinary Medical Students.

The mental health and wellness of veterinary students is an important contemporary focus of scholarship. Yet, to date, little empirical work has investigated mental health experiences and rates of mental health service use in large samples of veterinary students from multiple institutions. The purpose of this study is to explore the prevalence of mental health concerns among veterinary medical students, as well as rates of mental health service utilization, using validated measures and a large sample. Study participants were 573 veterinary medical students currently enrolled in accredited veterinary medical programs in the United States. Approximately one third of participants reported levels of depression or anxiety above the clinical cut-off, and a strong positive correlation was found between the two. Depression and anxiety were also associated with prior engagement in non-suicidal self-injury (NSSI), suicidal ideation, and prior suicide attempts. Nearly 80% of participants who scored above the clinical cut-off for depression or anxiety reported seeking some form of mental health services currently or in the past, and a majority reported having positive experiences with services. Results also indicated a higher than typical rate of NSSI among veterinary medical students. Implications for outreach, research, and education are discussed.

DPP4 inhibition attenuates filtration barrier injury and oxidant stress in the zucker obese rat.

OBJECTIVE: Obesity-related glomerulopathy is characterized initially by glomerular hyperfiltration with hypertrophy and then development of proteinuria. Putative mechanisms include endothelial dysfunction and filtration barrier injury due to oxidant stress and immune activation. There has been recent interest in targeting dipeptidyl peptidase 4 (DPP4) enzyme due to increasing role in non-enzymatic cellular processes. METHODS: The Zucker obese (ZO) rat (aged 8 weeks) fed a normal chow or diet containing the DPP4 inhibitor linagliptin for 8 weeks (83 mg/kg rat chow) was utilized. RESULTS: Compared to lean controls, there were increases in plasma DPP4 activity along with proteinuria in ZO rats. ZO rats further displayed increases in glomerular size and podocyte foot process effacement. These findings occurred in parallel with decreased endothelial stromal-derived factor-1α (SDF-1α), increased oxidant markers, and tyrosine phosphorylation of nephrin and serine phosphorylation of the mammalian target of rapamycin (mTOR). DPP4 inhibition improved proteinuria along with filtration barrier remodeling, circulating and kidney tissue DPP4 activity, increased active glucagon like peptide-1 (GLP-1) as well as SDF-1α, and improved oxidant markers and the podocyte-specific protein nephrin. CONCLUSIONS: These data support a role for DPP4 in glomerular filtration function and targeting DPP4 with inhibition improves oxidant stress-related glomerulopathy and associated proteinuria.