A narrative review of the impact of work hours and insufficient rest on job performance.

OBJECTIVE: This review discusses the scientific evidence regarding effects of insufficient rest on clinical performance and house officer training programs, the associations of clinical duty scheduling with insufficient rest, and the implications for risk management. STUDY DESIGN: Narrative review. METHODS: Several literature searches using broad terms such as "sleep deprivation," "veterinary," "physician," and "surgeon" were performed using PubMed and Google scholar. RESULTS: Sleep deprivation and insufficient rest have clear and deleterious effects on job performance, which in healthcare occupations impacts patient safety and practice function. The unique requirements of a career in veterinary surgery, which may include on-call shifts and overnight work, can lead to distinct sleep challenges and chronic insufficient rest with resultant serious but often poorly recognized impacts. These effects negatively impact practices, teams, surgeons, and patients. The self-assessment of fatigue and performance effect is demonstrably untrustworthy, reinforcing the need for institution-level protections. While the issues are complex and there is no one-size-fits-all approach, duty hour or workload restrictions may be an important first step in addressing these issues within veterinary surgery, as it has been in human medicine. CONCLUSION: Systematic re-examination of cultural expectations and practice logistics are needed if improvement in working hours, clinician well-being, productivity, and patient safety are to occur. CLINICAL SIGNIFICANCE (OR IMPACT): A more comprehensive understanding of the magnitude and consequence of sleep-related impairment better enables surgeons and hospital management to address systemic challenges in veterinary practice and training programs.

A survey of attributes of surgical resident applicants deemed important to American College of Veterinary Surgeons board-certified surgeons involved in resident selection and methods used to evaluate these attributes.

OBJECTIVE: To determine which attributes of residency applicants were most commonly assessed by large and small animal American College of Veterinary Surgeons diplomates and to determine which evaluation methods were perceived to assess those attributes. STUDY DESIGN: Online survey. SAMPLE POPULATION: American College of Veterinary Surgeons board-certified surgeons as of March 2019. METHODS: An online survey was sent to eligible individuals. Respondents rated the importance of 23 attributes assessed by the Veterinary Internship and Residency Matching Program (VIRMP) application as well the usefulness of interviews, conversations with people knowledgeable with the applicants, and review of the VIRMP packet for evaluating each of these attributes. Responses were compared between large and small animal practitioners and between individuals involved in residency selection (supervisors) and individuals not involved in residency selection (nonsupervisors). RESULTS: Surveys were completed by 221 individuals (14.6% response rate). Seventeen of the 23 attributes were considered important by most respondents. Grade point average (GPA) and class rank were used as screening tools by 73% and 65% of supervisors, respectively. Letters of reference (LOR) were ranked as the most important part of the VIRMP packet. Conversations with people knowledgeable with the applicant was the only method judged by most respondents to be appropriate to evaluate all 23 attributes. Responses were similar between large and small animal supervisors and nonsupervisors. CONCLUSION: Respondents considered conversations with people knowledgeable with the applicant to be the most useful methods for assessing a resident applicant, but LOR, GPA, and class rank were also important. IMPACT: Resident applicants and mentors can use this information to strengthen applications.

Critical incidence reporting systems - an option in equine anaesthesia? Results from a panel meeting.

OBJECTIVE: To provide a brief introduction into Critical Incident Reporting Systems (CIRS) as used in human medicine, and to report the discussion from a recent panel meeting discussion with 23 equine anaesthetists in preparation for a new CEPEF-4 (Confidential Enquiry into Perioperative Equine Fatalities) study. STUDY DESIGN: Moderated group discussions, and review of literature. METHODS: The first group discussion focused on the definition of 'preventable critical incidents' and/or 'near misses' in the context of equine anaesthesia. The second group discussion focused on categorizing critical incidents according to an established framework for analysing risk and safety in clinical medicine. RESULTS: While critical incidents do occur in equine anaesthesia, no critical incident reporting system including systematic collection and analysis of critical incidents is in place. CONCLUSIONS AND CLINICAL RELEVANCE: Critical incident reporting systems could be used to improve safety in equine anaesthesia - in addition to other study types such as mortality studies.

[Review of 40 years AO/ASIF. The development of the Veterinary Surgical Working Group for Osteosynthesis Questions(AO) in Veterinary Medicine (AOVET) and a systematic operative fracture treatment in animals]. / Rückblick auf 40 Jahre AOVET. Die Entwicklung der veterinärchirurgischen Arbeitsgemeinschaft für Osteosynthesefragen (AOVET) und einer systematischen operativen Frakturbehandlung beim Tier.

With respect to the founding of the AOVET in 1969, the development of the systematic osteosynthesis in large and small animals is reviewed. With the introduction of the stable OS techniques corresponding to the principles and operative techniques developed by the organization of ASIF/AO (hum), the systematic operative fracture treatment in animals expanded remarkably. The application of the "absolutely" stable compression osteosynthesis was the basis for the successful fracture treatment in large animals. The systematic osteosynthesis in small animals was realized through the generation of a multitude of stabilization techniques for the different fracture types in the various anatomical areas and for special orthopaedic interventions. This was achieved through a specifically developed implant- instrument system and corresponding operation methods. This development was supported by instruction courses, published manuals and visiting fellowships. The extensive collaboration in research and development led to an increasing understanding of the diverse bone healing processes. The AOVET enjoyed a progressing integration into the AO/ASIF (hum) organization.

The European College of Veterinary Surgeons 1991-2011: a 20-year success story.

The first meeting leading to the formation of the European College of Veterinary Surgeons (ECVS) was held August 30/31, 1990 in Lenzburg, Switzerland. Specialists in small animal and large animal surgery from practice and academicians from many European countries were invited. The constitution was developed based on that of the American College of Veterinary Surgeons (ACVS). ECVS was founded during the ACVS European Surgical Forum in Nice in 1991. The provisional Board elected at this meeting stayed active during the initial 4 years to provide stability. For the 146 Charter Members to become a Diplomate, they had to pass an examination. Therefore, the ECVS is the only Specialty College that does not have a "Grand Father Clause." In 2000 ECVS, was the first College to acquire full recognition-status by the European Board of Specialization (EBVS), which underlines the leading role the surgeons play in the development of the European veterinary specialty colleges. Like its American Sister College, ECVS maintains high standards for surgical training programs for Residents and administers rigorous certifying examinations. It is appropriate to recall the facts that lead to foundation of ECVS on its 20-year anniversary.