Clinical supervisors' and students' perspectives on preparedness for veterinary workplace clinical training: An international study.

BACKGROUND: The alignment of student and workplace supervisors' perspectives on student preparedness for veterinary workplace clinical training (WCT) is unknown, yet misalignment could negatively impact workplace learning. The aim of this study was to quantify the relative importance of WCT preparedness characteristics according to students and supervisors and to identify differences. METHODS: A survey was completed by 657 veterinary students and 244 clinical supervisors from 25 veterinary schools, from which rankings of the preparedness characteristics were derived. Significant rank differences were assessed using confidence intervals and permutation tests. RESULTS: 'Honesty, integrity and dependability' was the most important characteristic according to both groups. The three characteristics with the largest rank differences were: students' awareness of their own and others' mental wellbeing and the importance of self-care; being willing to try new practical skills with support (students ranked both of these higher); and having a clinical reasoning framework for common problems (supervisors ranked higher). LIMITATIONS: Using pooled data from many schools means that the results are not necessarily representative of the perspectives at any one institution. CONCLUSION: There are both similarities and differences in the perspectives of students and supervisors regarding which characteristics are more important for WCT. This provides insights that can be used by educators, curriculum developers and admissions tutors to improve student preparedness for workplace learning.

Rating and ranking preparedness characteristics important for veterinary workplace clinical training: a novel application of pairwise comparisons and the Elo algorithm.

Quantitatively eliciting perspectives about a large number of similar entities (such as a list of competences) is a challenge for researchers in health professions education (HPE). Traditional survey methods may include using Likert items. However, a Likert item approach that generates absolute ratings of the entities may suffer from the "ceiling effect," as ratings cluster at one end of the scale. This impacts on researchers' ability to detect differences in ratings between the entities themselves and between respondent groups. This paper describes the use of pairwise comparison (this or that?) questions and a novel application of the Elo algorithm to generate relative ratings and rankings of a large number of entities, on a unidimensional scale. A study assessing the relative importance of 91 student "preparedness characteristics" for veterinary workplace clinical training (WCT) is presented as an example of this method in action. The Elo algorithm uses pairwise comparison responses to generate an importance rating for each preparedness characteristic on a scale from zero to one. This is continuous data with measurement variability which, by definition, spans an entire spectrum and is not susceptible to the ceiling effect. The output should allow for the detection of differences in perspectives between groups of survey respondents (such as students and workplace supervisors) which Likert ratings may be insensitive to. Additional advantages of the pairwise comparisons are their low susceptibility to systematic bias and measurement error, they can be quicker and arguably more engaging to complete than Likert items, and they should carry a low cognitive load for respondents. Methods for evaluating the validity and reliability of this survey design are also described. This paper presents a method that holds great potential for a diverse range of applications in HPE research. In the pursuit quantifying perspectives on survey items which are measured on a relative basis and a unidimensional scale (e.g., importance, priority, probability), this method is likely to be a valuable option.

Stakeholder perspectives on veterinary student preparedness for workplace clinical training - a qualitative study.

BACKGROUND: The success of workplace clinical training (WCT) is important given that veterinary students are licensed to work independently upon graduation. Considering this, it is perhaps surprising that there is limited published work describing what it means to be prepared for this educational experience, particularly given that the transition to WCT can be stressful for students. This paper reports the results of a qualitative study aiming to generate a rich understanding of veterinary student preparedness for WCT using emic, or insider, perspectives of key stakeholders. METHODS: From a constructivist standpoint, homogenous online group interviews were held with final year veterinary students, recent student alumni, clinical supervisors, faculty, and academic educationalists to discuss what it means to be prepared for WCT. The data was analysed using a template analysis approach. RESULTS: A three-tier taxonomy to describe preparedness for WCT was constructed from the data. At the topmost level, there were seven themes to illuminate different aspects of preparedness: students should be prepared 1) for the transition to learning and working in a clinical and professional environment, 2) for self-directed and experiential learning whilst working, 3) with a growth mindset, 4) with intrinsic motivation and enthusiasm for learning and working, 5) for communication, consultation and clinical reasoning, 6) with the knowledge for work, and 7) with the practical competence and confidence for work. CONCLUSIONS: This study provides a deeper understanding of the tools we can provide, and the attributes we can nurture in, senior veterinary students to facilitate their learning and working during WCT. This improved understanding is a necessary precursor to refining pedagogical support and curriculum design within veterinary schools.

Using Learning Theories to Develop a Veterinary Student Preparedness Toolkit for Workplace Clinical Training.

Learning theories are abstract descriptions which help us make sense of educational practice. Multiple theories can inform our understanding of a single concept, in this case: veterinary workplace clinical training (WCT), which occurs just prior to students' graduation as competent veterinary surgeons. The competency movement has strongly influenced reforms in veterinary education and is considered important. In reflection of this, the term "preparedness" is operationalised here as a measure of the likelihood that the veterinary student is going to be a competent learner and participant during WCT. Preparedness itself is therefore important because it directly impacts performance. Workplace clinical training is explored through the lenses of cognitivist, social constructivist and socio-culturalist learning theories and used to inform student preparedness characteristics ("tools") in terms of their behaviours, personal attributes, knowledge and skills, and awarenesses to optimise learning and participation. These form a new conceptual framework-the "Preparedness Toolkit."

Professional stereotypes among specialties and fields of work within the veterinary community.

BACKGROUND: Medical specialties hold varying degrees of prestige, stemming from the existence of stereotypes among them. These have been shown to lead to prejudice against specific specialists, which not only influences career choices but also affects the perception of equality among specialties. METHOD: The aim of the research was to determine the presence of stereotypes in the UK veterinary community. Using an online questionnaire, participants were asked to provide an adjective that best characterises 15 specialties, in addition to their perceptions on prestige and gender association. Word cloud analysis coupled with sentiment analysis in Python using the language processing software Natural Language Toolkit (NLTK) was used to assess sentiments with respect to the adjectives. RESULTS: There were 665 questionnaire respondents, and there was evidence of their construction of specialty-specific stereotypes. Some specialties were perceived more negatively than others, including equine general practitioners, surgeons, pathologists, dermatologists and public health veterinarians/epidemiologists. Gender bias was identified within this study, most prominently within production animal and behavioural medicine veterinarians. The most prestigious specialties were neurology, surgery and cardiology. CONCLUSION: Specialty-specific stereotypes exist within the veterinary community. Acknowledging their existence is a first step to recognising the influence they have on career choices.

Veterinary Education during Covid-19 and Beyond-Challenges and Mitigating Approaches.

The public health implications of the Covid-19 pandemic have caused unprecedented and unexpected challenges for veterinary schools worldwide. They are grappling with a wide range of issues to ensure that students can be trained and assessed appropriately, despite the international, national, and local restrictions placed on them. Moving the delivery of knowledge content largely online will have had a positive and/or negative impact on veterinary student learning gain which is yet to be clarified. Workplace learning is particularly problematic in the current climate, which is concerning for graduates who need to develop, and then demonstrate, practical core competences. Means to optimise the learning outcomes in a hybrid model of curriculum delivery are suggested. Specific approaches could include the use of video, group discussion, simulation and role play, peer to peer and interprofessional education.

Gross post-mortem and histological features in 27 horses with confirmed lumbosacral region pain and five control horses: A descriptive cadaveric study.

BACKGROUND: There is a lack of understanding of the pathological and/or physiological nature of lumbosacral region pain. OBJECTIVES: To describe the gross variations of the osseous and soft tissues of the lumbosacral region and report the histological findings of sections of nerve tissue in affected and control horses. STUDY DESIGN: Descriptive post-mortem case series. METHODS: All horses had undergone full clinical and gait assessment, including ridden exercise. Horses with a substantial response to infiltration of local anaesthetic solution around the sacroiliac joint regions were included in the affected group (n = 27). Horses for which the source(s) of pain was confirmed by diagnostic anaesthesia to be distant to the lumbosacral region were included in the control group (n = 5). The pelvic regions were isolated and the soft tissues were assessed grossly. Sections of the lumbosacral plexus and cranial gluteal, sciatic and obturator nerves were examined histologically. The osseous specimens were evaluated for anatomical variants and abnormalities. Data were analysed using descriptive statistics. RESULTS: Gross discolouration of the sciatic or obturator nerves was observed in 7 (26%) affected and no control horses. Grade 3/3 histological abnormality scores were assigned in 22% of nerve sections from affected horses compared with 3% from control horses. Several osseous variants (bifid sacral spinous processes, straight-shaped sacroiliac joint surface, short arrow-shaped sacral alae, left-right asymmetry of sacral alae, sacral curvature, absence of the fourth to fifth and ankylosis of the fifth to sixth lumbar articular process joints, left-right asymmetry of caudocranial position of the fourth to fifth and lumbar-sacral articular process joints) and abnormalities (sacroiliac enthesopathy, extra ventral sacroiliac joint surface, lumbosacral symphyseal periarticular modelling, lumbosacral intertransverse joint pitting lesions) were more frequently observed in affected horses. MAIN LIMITATIONS: Both control and affected horses may have had preclinical abnormalities. CONCLUSIONS: Lumbosacral region pain may reflect the presence of a number of pathological changes. Neural pain may play an important role in some horses.