Communication skills training and assessment of food animal production medicine veterinarians: A component of a voluntary Johne's disease control program.

In food animal production medicine (FAPM), the success of control programs for infectious diseases that have serious animal health and economic consequences frequently rely on the veterinarian's effective communication and producer adherence to veterinary recommendations. However, little research has been conducted on communication skills of practicing FAPM veterinarians. During this study, we developed a communication training workshop intervention to support the Atlantic Johne's Disease Initiative. Seventeen FAPM veterinarians across 10 clinics practicing within Maritime Canada participated in a pre-post intervention study design. Communication skills were evaluated utilizing 3 assessment tools; an objective structured clinical exam (OSCE), standardized client feedback, and an instrument designed for veterinary participants to assess their self-efficacy. Study results showed that before training, communication skills of participating veterinarians had limitations, including skill deficits in communication tasks strongly associated with increased adherence to veterinary recommendations. Based on the 3 assessment tools, communication skills of participating veterinarians improved with the training provided. Significant increases were detected in pre- to postintervention self-efficacy percentage scores, OSCE percentage and global scores from expert raters, and OSCE percentage and global scores from standardized client feedback. These improvements emphasize the importance of communication skills training specific to FAPM.

Dairy producer satisfaction and knowledge transfer with the veterinary-administered risk assessment and management plan in a voluntary Johne's disease control program.

The Atlantic Johne's Disease Initiative (AJDI) aims to control Mycobacterium avium ssp. paratuberculosis infection by using veterinary-administered risk assessments to identify high-risk management practices and prompt changes in management behavior. Objectives for this study were to measure producer satisfaction with the veterinary-administered risk assessment and management plan (RAMP) process in a voluntary Johne's disease (JD) control program, compare RAMP-specific satisfaction results based on herd JD status, and measure knowledge transfer from certified veterinarians to producers during the RAMP. A satisfaction questionnaire was adapted to the RAMP process in the AJDI to measure producer satisfaction. The questionnaire included 9 RAMP-specific producer satisfaction items, 1 global RAMP satisfaction item, and 16 questions to assess producer knowledge and knowledge translation about JD, bovine viral diarrhea (BVD), and bovine leukosis virus (BLV) during the RAMP (BVD and BLV used for comparison purposes). A total of 133 dairy producers in the AJDI (79.6% response rate) completed the questionnaire by telephone. The RAMP-specific satisfaction was high among the AJDI producers surveyed, and these results were not found to differ based on herd JD status. The lowest satisfaction scores and the highest number of "unable to assess" responses were for the item relating to cost. Factors that contributed to RAMP-specific producer satisfaction were not identified from the demographic and herd information available in this study. The knowledge scores indicated moderate knowledge about JD and fair knowledge about BVD and BLV. Evidence of knowledge translation from the RAMP was mixed in this study. Bovine viral diarrhea knowledge scores were not found to differ based on whether or not the certified veterinarian discussed BVD during the preceding RAMP, but BLV knowledge scores were higher among dairy producers that discussed BLV during the preceding RAMP. Strengths and gaps in producer knowledge about these 3 infectious diseases were identified. By using this producer questionnaire, interventions aimed at improving the content, delivery, and satisfaction of RAMP in JD control programs, such as the AJDI, can be developed.

Investigation of the effects of a practice-level communication training program on veterinary health-care team members' communication confidence, client satisfaction, and practice financial metrics.

OBJECTIVE: To investigate effects of an intensive 2-day practice-level communication skills training program (CSTP) with a 3-month follow-up communication in practice program (CIPP) on veterinary health-care team members' communication confidence, client satisfaction, and practice financial metrics. SAMPLE: 5 US companion animal veterinary practices. PROCEDURES: Following pilot testing at 1 veterinary practice, communication skills training was performed on-site at 4 practices. The 2-day CSTP focused on veterinary communication-specific content. The CIPP included in-practice training sessions every other week to reinforce and build upon communication skills. Team members' communication skills confidence (before and after the CSTP and after the CIPP) and client satisfaction with veterinary visits (2 months before and 3 months after the CSTP) were assessed with surveys. Practice-level financial metrics were collected for 18 months. Variables of interest were compared among time points. RESULTS: Measures of team member communication skills confidence and initiation of client conversations regarding the value of goods and services were significantly greater after the CIPP than before the CSTP. Composite communication skills confidence scores 3 months after the CSTP were positively correlated with the mean practice transaction charge and percentage change in the number of heartworm tests performed in the 3 months after the CSTP, compared with results for the same 3 months in the previous year. Measurements of client satisfaction were high before and after the CSTP. There was no significant change in financial metrics in the 3 months after CSTP, compared with the same 3 months in the previous year. CONCLUSIONS AND CLINICAL RELEVANCE: This study highlighted opportunities to increase veterinary health-care team members' communication confidence and identified future considerations for communication training in veterinary workplaces.

Measurement of leadership skills development among veterinary students and veterinary professionals participating in an experiential leadership program (the Veterinary Leadership Experience).

OBJECTIVE: To evaluate outcomes associated with an experiential leadership program (the Veterinary Leadership Experience [VLE]) among participants 1 year after program completion. SAMPLE: 157 veterinary students and 61 veterinary professionals who participated in the 2015 or 2016 VLE. PROCEDURES: Participants completed various instruments to assess emotional intelligence, psychological flexibility, resilience, and client-communication skills prior to (pretest) and 1 year after (posttest) attending the VLE; pretest and posttest findings were compared for all but client-communication skills, for which only posttest responses were analyzed. An additional posttest instrument assessed the impact that the VLE had on key knowledge areas (ie, self-awareness, self-management, social awareness, relational competence, communication skills, and conflict management skills) and overall impact. RESULTS: 1 year after completing the VLE, participants reported that the program had a high impact on all key knowledge areas; the impact on social awareness and overall impact was significantly higher for veterinary students than for veterinary professionals. Veterinary professionals reported a greater increase in emotional intelligence after program completion than did veterinary students. For each assessed client-communication skill, the percentage of veterinary professionals who reported increased confidence in that skill after program completion was lower than the corresponding percentage of veterinary students. Resilience and psychological flexibility scores did not increase after program completion. CONCLUSIONS AND CLINICAL RELEVANCE: Assessment of the effectiveness and long-term outcomes of experiential leadership programs is important to understanding whether such programs are having the intended effect. Veterinary students and veterinary professionals who were assessed 1 year after completing the VLE reported improvements in leadership skills foundational to the program.

Association between excess body weight and urine protein concentration in healthy dogs.

BACKGROUND: Markedly overweight people can develop progressive proteinuria and kidney failure secondary to obesity-related glomerulopathy (ORG). Glomerular lesions in dogs with experimentally induced obesity are similar to those in people with ORG. OBJECTIVES: The aim of this study was to evaluate if urine protein and albumin excretion is greater in overweight and obese dogs than in dogs of ideal body condition. METHODS: Client-owned dogs were screened for underlying health conditions. These dogs were assigned a body condition score (BCS) using a 9-point scoring system. Dogs with a BCS of ≥ 6 were classified as being overweight/obese, and dogs with a BCS of 4 or 5 were classified as being of ideal body weight. The urine protein:creatinine ratio (UPC) and urine albumin:creatinine ratio (UAC) were then determined, and compared between 20 overweight/obese dogs and 22 ideal body weight control dogs. RESULTS: Median UPC (0.04 [range, 0.01-0.14; interquartile range, 0.07]) and UAC (0.41 [0-10.39; 3.21]) of overweight/obese dogs were not significantly different from median UPC (0.04 [0.01-0.32; 0.07]) and UAC (0.18 [0-7.04; 1.75]) in ideal body weight dogs. CONCLUSIONS: Clinicopathologic abnormalities consistent with ORG were absent from overweight/obese dogs in this study.

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.