Measuring Post-training Activities Following a Veterinary Teaching Workshop in East Africa.

A teaching workshop was delivered for faculty members of East African colleges of veterinary medicine to foster teaching development and reflection. The goal was for participants to use knowledge gained to improve teaching skills. The approach was to "train the trainer" so attendees could transfer new knowledge to colleagues at their institutions. Techniques were used to increase the likelihood that participants would apply the training. A culturally responsive survey was developed to assess training transfer 1 year later. Pilot survey results suggest that participants applied what they learned and shared with colleagues largely due to peer and supervisor support. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-021-01428-2.

Flipping the Rounds Room: Pre-Receiving Rounds to Enhance Clerkship Effectiveness.

Clinical rounds sessions and patient admissions are valued opportunities for teaching and learning in veterinary teaching hospitals. Although using the rounds format to discuss inpatient or recent patients is common, using a similar format prior to receiving cases can improve learner preparation, expand teaching and modeling opportunities, and improve service receiving efficiency. This article describes pre-receiving rounds sessions, perceived benefits and limitations, and tips for effective implementation.

Sustaining a Collegewide Teaching Academy as a Community: 10 Years of Experience With the Master Teacher Program at the University of Tennessee College of Veterinary Medicine.

On the basis of strategic initiatives and an evolving focus on educational program enhancement, faculty and staff members designed a structured program to provide leadership and resources for improving instruction and disseminating educational scholarship in a veterinary college. The University of Tennessee College of Veterinary Medicine Master Teacher Program was conceptualized in the teaching academy model as a forum for professional development and dialogue. A small leadership team worked with other faculty to develop the program proposal, including its mission, vision, values, and initial goals. Programming includes monthly meetings to discuss a range of policy, theoretical, and practical topics, as well as periodic workshops focused on current strategic initiatives or hot topics. Ten years later, the program continues to successfully connect educators and have an impact on the college and profession. Attendance has grown steadily; feedback has been positive. Participants rate the program's overall value highly, particularly its impact on their teaching, the opportunity to stay current in educational topics, and the opportunity to learn from colleagues. Discussions within the program have provided valuable input for college policy and practices. Keys to sustained success have included a historical culture emphasizing the teaching mission, alignment with college goals, consistency in leadership and programming, periodic revisions and rebranding, and attention to new faculty and staff needs. This article describes the development, growth, and perceived impact of the program and emphasizes lessons learned and actions taken to sustain its success without additional personnel and at minimal cost.

Veterinary Curricula Today: Curricular Management and Renewal at AAVMC Member Institutions.

Renewing a veterinary curriculum is challenging work and its impact is difficult to measure. Academic leaders are charged with regular review and updating of their curricula, but have few resources available to guide their efforts. Due to the paucity of published veterinary reports, most turn to colleagues at other veterinary schools for insider advice, while a few undertake the task of adapting information from the educational literature to suit the needs of the veterinary profession. In response to this paucity, we proposed a theme issue on curricular renewal and surveyed academic leaders regarding curricular challenges and major renewal efforts underway. We compiled the results of this survey (with respondents from 38 veterinary colleges) as well as publicly available information to create a digest of curricular activities at AAVMC member institutions. This introductory article summarizes the key survey findings, describes the methods used to create the curricular digest, and presents information about key aspects of selected programs. Our overarching research questions were as follows: (1) What was the extent and nature of curricular change at AAVMC-accredited veterinary colleges over the past 5 years? and (2) How are curricula and curricular changes managed at AAVMC accredited veterinary colleges? The appended curricular digests provide selected details of current DVM curricula at participating institutions. Additional articles in this issue report on institutional change efforts in more detail. It is our hope that this issue will help to pave the way for future curricular development, research, and peer-to-peer collaboration.

Making the Most of Five Minutes: The Clinical Teaching Moment.

Clinical educators face the challenge of simultaneously caring for patients and teaching learners, often with an unpredictable caseload and learners of varied abilities. They also often have little control over the organization of their time. Effective clinical teaching must encourage student participation, problem solving, integration of basic and clinical knowledge, and deliberate practice. Close supervision and timely feedback are also essential. Just as one develops an effective lecture through training and practice, clinical teaching effectiveness may also be improved by using specific skills to teach in small increments. The purpose of this paper is to identify potential teachable moments and to describe efficient instructional methods to use in the clinical setting under time constraints. These techniques include asking better questions, performing focused observations, thinking aloud, and modeling reflection. Different frameworks for teaching encounters during case presentations can be selected according to learner ability and available time. These methods include modeling and deconstructing the concrete experience; guiding the thinking and reflecting process; and providing the setting and opportunity for active practice. Use of these educational strategies encourages the learner to acquire knowledge, clinical reasoning, and technical skills, and also values, attitudes, and professional judgment.

Teaching tip: making the most of hospital rounds.

Effective clinical teaching rounds are facilitated by adequate and specific orientation, a positive climate, interpersonal rapport, and dynamic discussions. Using fewer and better-quality questions also promotes effective learning and saves valuable time, while providing multiple opportunities for student engagement and for assessing student performance. This paper provides a brief review of these key points and offers tips and examples for clinicians or other team members leading conference room rounds sessions in veterinary settings.

Perceptions of veterinary faculty members regarding their responsibility and preparation to teach non-technical competencies.

The development of non-technical competencies has become an important component of veterinary education. In this study, we determined faculty perspectives regarding their perceived involvement and ability in the cultivation of these competencies. A survey was administered to faculty members at five institutions. Respondents were asked whether the competency should be taught in their own courses and how prepared they felt to teach and evaluate the competency. Responses were analyzed by participant institution, gender, terminal degree and year, discipline, rank, and teaching experience. More than 90% of faculty respondents reported a personal responsibility to teach or cultivate critical thinking skills, communication skills, self-development skills, and ethical skills, with more than 85% also agreeing to a role in skills such as interpersonal skills, creativity, and self-management. The lowest percentages were seen for crisis and incident management (64%) and business skills (56%). Perceived preparedness to teach and evaluate these competencies paralleled the preceding findings, especially for the four consensus competencies and self-management. Faculty preparedness was lowest for business skills. Junior faculty were somewhat less likely than others to perceive a responsibility to teach non-technical competencies; however, instructors were more prepared to teach and evaluate business skills than were other faculty. Institutional trends were evident in faculty preparation. Although male faculty and non-DVM faculty tended to report a higher degree of preparedness, few differences reached statistical significance. Faculty perceptions of their responsibility to teach non-technical competencies vary by competency and parallel their perceived preparedness to teach and evaluate them.

Faculty perspectives regarding the importance and place of nontechnical competencies in veterinary medical education at five North American colleges of veterinary medicine.

OBJECTIVE: To explore perceptions of faculty educators regarding the importance of nontechnical competencies in veterinary graduates and the placement of nontechnical competency development in veterinary education. DESIGN: Survey. SAMPLE POPULATION: All faculty members at 5 North American veterinary medical institutions. PROCEDURES: Participants rated the importance of 14 nontechnical competencies and indicated in which phase or phases of veterinary education such competencies should be developed (ie, curriculum placement). Differences in mean ratings were statistically evaluated, as were associations between ratings or curriculum placement and respondent institution, gender, experience, and discipline. RESULTS: Mean ratings of importance were above neutral for all competencies and were highest for ethical, critical thinking, and interpersonal and intrapersonal competencies; development of these competencies was favored in preveterinary and veterinary training. Ratings were lower for management and business competencies; development of these and other competencies was placed primarily in the clinical phase of the veterinary curriculum. Basic science, nonveterinarian, and junior faculty appeared to more strongly appreciate the importance of nontechnical skills, whereas large animal and midcareer faculty reported a more reserved degree of support. Female faculty were more likely to place nontechnical competency development throughout the educational process. CONCLUSIONS AND CLINICAL RELEVANCE: Participants agreed nontechnical competencies are important for veterinary graduates; however, faculty perceptions differed from previously published findings regarding the relative importance of business and management skills. Those involved in faculty hiring, faculty development, and curricular planning should also be aware of disciplinary and career stage differences affecting faculty perspectives.

(99m)Tc-DTPA diuretic renal scintigraphy in cats with nephroureterolithiasis.

The purpose of this study was to evaluate results of diuretic renal scintigraphy in 32 feline kidneys with nephroureterolithiasis and variable degrees of renal pelvis/ureteral dilation. Six kidneys showed a non-obstructive scintigraphic pattern, with a downward slope of time-activity curves (TAC) and a median excretion half-time of radiopharmaceutical (T((1/2))) of 6.09 (5.08-8.43) min. Eight kidneys showed an obstructive pattern, with a continuous rise of TAC and median T((1/2)) of -7.91 (-43.13-0.00) min. In one kidney with presumptive partial obstruction scintigraphic results were equivocal. Seventeen kidneys, most of which had an individual kidney glomerular filtration rate below 0.5ml/min/kg, had non-diagnostic studies. Diuretic renal scintigraphy may be a useful adjunct modality in the diagnosis of ureteral obstruction in some cats if renal function is maintained. However, the large number of non-diagnostic studies in animals with decreased renal function represents a clear limitation of the technique.

(99m)Tc-DTPA diuretic renal scintigraphy in dogs with nephroureterolithiasis.

This study evaluated the results of diuretic renal scintigraphy in dogs with urolithiasis. Eighty-three kidneys with nephroureterolithiasis +/- renal pelvis/ureteral dilation were included in the study. Sixty-three kidneys showed a non-obstructive pattern, with a steep drop or gradual downward slope of renal time-activity curve (TAC). Excretion half-time of radiopharmaceutical (T(1/2)) was 3.99 (2.99 to 7.95) min. Three kidneys showed an obstructive pattern, with continuous rise of the TAC and median T(1/2) of -10.71 (-5.20 to -17.56) min. Fifteen kidneys had non-diagnostic studies characterized by flat TAC. Individual kidney glomerular filtration rate was <0.5 mL/min/kg body weight in most non-diagnostic studies. Diuretic renal scintigraphy appears to be a useful adjunct modality to rule out or confirm ureteral obstruction in dogs. Additional diagnostic procedures may be necessary to achieve a definitive diagnosis in cases of severely impaired renal function.

Professional competencies in health sciences education: from multiple intelligences to the clinic floor.

Nontechnical competencies identified as essential to the health professional's success include ethical behavior, interpersonal, self-management, leadership, business, and thinking competencies. The literature regarding such diverse topics, and the literature regarding "professional success" is extensive and wide-ranging, crossing educational, psychological, business, medical and vocational fields of study. This review is designed to introduce ways of viewing nontechnical competence from the psychology of human capacity to current perspectives, initiatives and needs in practice. After an introduction to the tensions inherent in educating individuals for both biomedical competency and "bedside" or "cageside" manner, the paper presents a brief overview of the major lines of inquiry into intelligence theory and how theories of multiple intelligences can build a foundation for conceptualizing professional and life skills. The discussion then moves from broad concepts of intelligence to more specific workplace skill sets, with an emphasis on professional medical education. This section introduces the research on noncognitive variables in various disciplines, the growing emphasis on competency based education, and the SKA movement in veterinary education. The next section presents the evidence that nontechnical, noncognitive or humanistic skills influence achievement in academic settings, medical education and clinical performance, as well as the challenges faced when educational priorities must be made.

Diuretic renal scintigraphy in normal cats.

The purpose of this study was to develop a protocol for diuretic renal scintigraphy (renography) in cats and describe normal findings. 99mTc-DTPA renal scintigraphy was performed twice in 10 healthy cats. Furosemide or saline were injected 4.5 min after radiopharmaceutical administration for the diuretic or control scan, respectively. A dynamic acquisition was performed for 8 min. The following parameters were evaluated: (1) global and individual glomerular filtration rate (GFR); (2) shape of the time-activity curve (TAC); (3) time of peak (TOP); (4) individual kidney excretion half-time (T1/2) of the radiopharmaceutical; (5) percentage of maximum activity measured at the end of the study. Global GFR in the control studies (2.79 +/- 0.83 ml/min/kg, mean +/- SD) did not differ significantly from the diuretic scans (2.34 +/- 0.51 ml/min/kg). The shape of most (16/ 20) TAC of diuretic renograms was similar to those of control renograms. The TOP of the diuretic renogram curves was 3.06 +/- 0.58 min, and did not differ from that of the control scans (3.01 +/- 0.61 min). T1/2 of the diuretic renograms was significantly shorter (5.15 +/- 0.83 min) than that of the control renograms (6.31 +/- 1.50 min). A significantly lower percentage of maximum activity was present at the end of the study in diuretic renograms (median: 47.25%; range: 33.60-59.60%) compared with control renograms (63.40%; 30.00-69.40%). Diuretic renal scintigraphy is a noninvasive and fast procedure to perform in cats. The applicability of this technique needs to be investigated in patients with significantly impaired renal function and obstructive uropathies.

Clinical veterinary education: insights from faculty and strategies for professional development in clinical teaching.

Missing in the recent calls for accountability and assurance of veterinary students' clinical competence are similar calls for competence in clinical teaching. Most clinician educators have no formal training in teaching theory or method. At the University of Tennessee College of Veterinary Medicine (UTCVM), we have initiated multiple strategies to enhance the quality of teaching in our curriculum and in clinical settings. An interview study of veterinary faculty was completed to investigate the strengths and weaknesses of clinical education; findings were used in part to prepare a professional development program in clinical teaching. Centered on principles of effective feedback, the program prepares participants to organize clinical rotation structure and orientation, maximize teaching moments, improve teaching and participation during formal rounds, and provide clearer summative feedback to students at the end of a rotation. The program benefits from being situated within a larger college-wide focus on teaching improvement. We expect the program's audience and scope to continue to expand.

Change in higher education: understanding and responding to individual and organizational resistance.

In many fields, the ability of educators and practitioners to cope with rapid change is essential to sustained success. In veterinary medical education, as in other scientific disciplines, meaningful change is challenging to achieve and subject to resistance from many individual and organizational norms. Individual concerns often relate to fears of instability or uncertainty, loss of current status, or effects on individual time and workload. Sources of organizational resistance may include a conservative culture, fierce protection of current practices, and prevalence of disciplinary or territorial viewpoints. In academia, especially in scientific or medical fields, individuals appear to be strongly independent and conservative in nature, and generally skeptical of educational change. In this environment, a highly participatory process, with regular communication strategies and demonstrations or evidence that supports proposed changes, can be useful in facilitating change. An understanding of the nature of complex change, as well as of the reasons underlying resistance to change, and some methods to overcome these barriers are highly valuable tools for educational leaders.

"If it's tuesday, I must be the student": lessons learned from the other side of the classroom.

After teaching veterinary students for over 10 years, the author returned to graduate school as a part-time doctoral student in educational administration and policy studies. Sitting in the student's chair brought back an acute awareness of the submissive position of the student, the daunting prospects of navigating a university system, and the challenges of managing the workload of a degree program. The experience also provided a fresh perspective on instruction, including course delivery, effective use of class time, and the potential impact of the language one uses with students. These insights on teaching and learning and on the student's viewpoint may help educators become more empathetic and effective instructors and mentors of veterinary students.

Liver aspirate from a Shar Pei dog.

A 5-year-old, neutered male, Shar Pei dog was presented with weight loss, anorexia, lethargy, stranguria, and distal limb edema. Clinicopathologic abnormalities included anemia, an inflammatory leukogram, azotemia, icterus, urinary tract infection, and hepatomegaly with a markedly hypoechoic liver. Cytologic findings in a fine-needle aspirate of the liver included large amounts of amorphous, pink, extracellular matrix between hepatocytes. The amorphous material was congophilic using Congo red stain on a hepatic cytology specimen and green birefringent areas were observed under polarized light, confirming the presence of amyloid. The dog was euthanized and a necropsy was done. Histopathologic evaluation using H&E and Congo red staining confirmed amyloid deposits within the liver, kidneys, intestinal vessels, pancreas, and mesenteric ganglia. Immunohistochemical staining of liver and kidney sections using anti-AA amyloid and anti-P component antibodies confirmed the presence of AA amyloid. In this case, we demonstrated that Congo red staining and polarized light microscopy are a useful diagnostic technique in cytologic specimens of suitable thickness for confirming the presence of amyloid.

Update: Management of calcium oxalate uroliths in dogs and cats.

Calcium oxalate has become the most common mineral occurring in canine and feline uroliths. Although calcium oxalate urolith formation may be a consequence of metabolic disease, the underlying cause is not identified in many dogs and cats. Currently, there is no successful medical dissolution protocol, and calcium oxalate uroliths must be removed physically if causing problems. Effective preventative protocols are available for dogs and cats, although they are not uniformly successful.

Lithotripsy: an update on urologic applications in small animals.

Lithotripsy methods for fragmenting uroliths continue to evolve.Increasing access to and experience with newer generation lithotriptors and continued study of laser methodology are likely to increase the application of lithotripsy methods in small animal urology. For small animals in which intervention is recommended for progressive, symptomatic, infected, or obstructive uroliths, nonsurgical extracorporeal or intracorporeal lithotripsy methods maybe considered.

Effects of a mock ultrasonographic procedure on cortisol concentrations during low-dose dexamethasone suppression testing in clinically normal adult dogs.

OBJECTIVE: To determine whether the stress of an ultrasonographic procedure would interfere with the suppressive effect of dexamethasone during a low-dose dexamethasone suppression test (LDDST) in healthy dogs. ANIMALS: 6 clinically normal adult dogs. PROCEDURE: In phase 1, an LDDST was performed 5 times at weekly intervals in each dog. Serum samples were obtained 0, 2, 4, 6, and 8 hours after dexamethasone injection. A mock 20-minute abdominal ultrasonographic examination was performed on all dogs at each time point during the LDDST on weeks 2 through 5. In phase 2, serum cortisol concentrations were measured before and immediately after a 20-minute mock abdominal ultrasonographic examination, as described for phase 1. RESULTS: We did not detect significant differences after dexamethasone injection when comparing median cortisol concentrations for weeks 2 to 5 (mock ultrasonographic procedure) with median concentration for week 1 (no mock ultrasonographic procedure). For 5 of the 6 dogs, cortisol concentrations after dexamethasone injection decreased to < 35.9 nmol/L after each mock ultrasonographic procedure and remained low for the duration of the LDDST. In phase 2, all dogs had significant increases in cortisol concentrations immediately after the mock ultrasonographic procedure. CONCLUSIONS AND CLINICAL RELEVANCE: A 20-minute mock abdominal ultrasonographic examination performed during LDDST did not alter results of the LDDST in most dogs. Cortisol concentrations measured immediately after a mock ultrasonographic examination were significantly increased. Ultrasonographic procedures should be performed a minimum of 2 hours before collection of samples that will be used to measure cortisol concentrations.

Qualitative urinalyses in puppies 0 to 24 weeks of age.

Suggestions for interpreting qualitative urinalyses from puppies have been based on limited results obtained in the laboratory setting. Proteinuria, glucosuria, and decreased concentration of urine have been considered normal in puppies <8 weeks of age due to immature renal function. In this study, the authors reviewed 149 voided urine samples from 118 different, apparently healthy, random-source puppies. The primary finding was that mean urine specific gravity (USG) was significantly lower in 0- to 3-week-old puppies when compared to puppies 4 to 24 weeks old. Mean USG in all other age groups was >1.030. There was no difference in the frequency of positive protein or occult blood dipstick results among age groups, and there were no positive glucose, ketone, bilirubin, or urobilinogen reactions in any samples analyzed. Urine sediment results are reported for 41 samples. Epithelial cells and white blood cells were the most common sediment findings in these 41 voided samples, observed in 34 (83%) and 18 (44%) samples, respectively. Crystals were observed in 15 (37%) samples, whereas casts, bacteria, and red blood cells were observed less commonly.