The Rapid and International Expansion of Veterinary Clinical Skills Laboratories: A Survey to Establish Recent Developments.

Veterinary clinical skills laboratories are used for teaching a wide range of practical, clinical, and surgical skills on models and simulators. A survey conducted in 2015 identified the role of such facilities in veterinary education in North America and Europe. The current study aimed to capture recent changes using a similar survey with three sections to collect data about the structure of the facility, its uses in teaching and assessment, and the staffing. The survey consisted of multiple choice and free text questions, was administered online using Qualtrics and was disseminated in 2021 via clinical skills networks and Associate Deans. Responses were received from 91 veterinary colleges in 34 countries; 68 had an existing clinical skills laboratory and 23 were planning to open one within 1-2 years. Collated information from the quantitative data described the facility, teaching, assessment and staffing. Major themes emerged from the qualitative data relating to aspects of the layout, location, integration in the curriculum, contributions to student learning, and the team managing and supporting the facility. Challenges were associated with budgeting, the ongoing need for expansion and leadership of the program. In summary, veterinary clinical skills laboratories are increasingly common around the world and the contributions to student learning and animal welfare were well recognized. The information about existing and planned laboratories and the tips from those managing the facilities provides valuable guidance for anyone intending to open or expand an existing clinical skills laboratory.

Communication as teaching content of veterinary studies - a joint position paper from the DVG specialist group "communication and didactics" and the GMA veterinary medicine committee.

Veterinarians have to face many communicative challenges in their professional capacity. Successful professional communication increases satisfaction among pet owners, staff members and colleagues, and ultimately also the veterinarians' own satisfaction. On the other hand, unsuccessful communication can easily lead to rejection, distrust and dissatisfaction. However, communicative skills are not explicitly taught as part of the compulsory courses in veterinary medicine in Germany. The position paper of the GMA Veterinary Medicine Committee and the DVG work group Didactics and Communication Competence describes the importance of successful communication for working veterinarians as well as the training situation in Germany and addresses topics that are often discussed in connection with the implementation. The authors come to the conclusion that there is both a necessity and a possibility for the introduction of communicative training content and provide recommendations that are intended to support the sustainable introduction of courses and exams to develop the communicative skills of veterinary students.

Integration and potential of teaching communication skills in the study of veterinary medicine in Germany.

Goal: Presentation of the current range of courses regarding communication at the five German educational institutions for veterinary medicine. In addition to learning objectives and individual solutions, possible potential for future developments are presented. Methods: Interviews with communication educators at the five German education institutions and subsequent synopsis. Results: To date, there are no binding education guidelines regarding communication in veterinary medicine. Nevertheless, communication education has been introduced at all five education institutions, albeit depth and formats vary considerably. The learning objectives are largely consistent and based on the recommendations for day-one-skills made by the European Association of Establishments for Veterinary Education. Communication is not recognized as a fully-fledged subject in the curricula of any of the education institutions. All education institutions clearly fall short of teaching the recommended 150 lecture hours. Conclusion: To ensure communication skills in veterinary medicine graduates, binding education guidelines should be agreed upon. Communication education should be integrated into all veterinary curricula as a fully-fledged subject with longitudinally increasing depth.

Motivation and Experience Matters: What Veterinary Mentors Think About Learning Communication Skills: A Qualitative Study.

Communication skills are a core competence in veterinary medicine. These skills play a pivotal role in professional success in the animal health professions. Over the last few decades, there has been an increased focus on communication skills in veterinary curricula. Conversely, we know less about the knowledge and motivation behind the communication skills of those veterinarians in different work domains who are acting as mentors outside the university. In 2016, semi-structured interviews (n = 16) were conducted with German practitioners in workplaces ranging from companion to farm animal practice, and throughout the veterinary industry, veterinary research, and government service. We combined two qualitative methods: a thematic analysis approach and the generation of types to identify characteristics associated with the acquisition of communication skills. In the current study, three main themes were developed: "Motivation," "Experiences with the acquisition of communication skills," and "Communication skills training during formal education." Within the identified themes, we recognized three types of communicators: "self-experienced," "extrinsic-experienced," and "unexperienced." We found that acquisition of communication skills was closely linked to motivation; therefore, motivation must be considered when developing communication skills curricula for learners and educators. By extrapolating the findings of this explorative study, we determined that intrinsically motivated mentors from the field should be a main source of veterinary education to promote further development in communication training. This qualitative study also determined that most non-university veterinary mentors had only a basic knowledge of teaching and learning communication skills, leading us to recommend formal training. Interchange between practicing veterinarians and veterinary educators and curriculum coordinators can foster relevant curricular modifications.

Evaluation of the Impact of Using a Simulator for Teaching Veterinary Students Cerebrospinal Fluid Collection: A Mixed-Methods Study.

The collection of cerebrospinal fluid (CSF) plays a pivotal role in the diagnosis of central nervous system diseases. Prior training in this invasive procedure is essential to minimize the risk of harming animals. Because of this risk, stress and anxiety can influence the learning process. Simulators can be used to teach and learn invasive procedures. The aim of this mixed-methods study was to validate a CSF collection simulator and investigate students' perceptions of the simulator as an educational tool. The quantitative approach validated the simulator for face and content validity, and students provided a general evaluation of the simulator using surveys. The simulator's construct validity was measured by means of a global rating scale. Students' perceptions were investigated qualitatively using semi-structured interviews. Experts (n = 13) confirmed the simulator's face and content validity. Students (n = 16) evaluated the simulator as supportive of their learning. Results for construct validity demonstrated higher global rating scores from experts than from students. The scores for procedural performance and procedural knowledge and flow showed significant differences (p ≤ .05). Analysis of interviews with students (n = 10) revealed four main themes: emotions, learning process, evaluation of the model, and CSF collection procedure. In conclusion, this study validated the use of the CSF simulator as an educational tool that can help students overcome some of their anxiety in relation to performing an invasive procedure.

[Perspectives of non-university stakeholders on implementing a clinical skills lab in veterinary medicine]. / Perspektiven hochschulexterner Interessenvertreter zur curricularen Implementierung eines Clinical Skills Lab in der Tiermedizin.

OBJECTIVE: Simulation-based teaching is gaining increasing importance in veterinary education worldwide and is by now an integral part of all German veterinary educational institutions in the form of Skills Labs. Students and teachers of the University of Veterinary Medicine Hannover, Foundation (TiHo) showed a good acceptance for the establishment and curricular use of a Clinical Skills Lab (CSL). This study will now examine the perspectives of non-university stakeholders in order to assess the acceptance of such a facility among clinicians. In addition, experiences in implementing a CSL in veterinary teaching are taken into account by interviewing experts. MATERIAL AND METHODS: Semi-structured guided interviews were conducted with alumni of the TiHo, senior veterinarians from various German clinics and practices and leading experts from some of the largest veterinary CSLs worldwide. RESULTS: The interviews revealed a need for improvement in the clinical-practical training of veterinary students among senior veterinarians and alumni. Respondents could imagine that teaching in the CSL may play a major role in this. Overall, the participants pleaded for a mandatory implementation of simulation-based teaching in the curriculum. CONCLUSION: The study suggests that the training of clinical-practical skills of veterinary students should be continuously adapted to the requirements of the veterinary profession in a clinical environment. Non-university stakeholders seem to support the use of a CSL to improve these skills and encourage its further implementation in the curriculum.

Influence of transrectal palpation training on cortisol levels and heart rate variability in cows.

Transrectal palpation of cows is a day-one competence for veterinary students, and it is an essential skill for the diagnosis of pregnancy as well as reproductive disorders. We hypothesized that transrectal palpation induces a stress response in cows, and this stress response may vary with the training students receive before their first transrectal palpation. Therefore, 52 Holstein-Friesian cows were used at the University of Veterinary Medicine Hanover. The experimental group (n = 26) was subjected to transrectal palpations by first and second-year students. Salivary and serum cortisol levels were assessed before and after the intervention. A control group (n = 26) was only restrained and tested for changes in salivary and serum cortisol. A total of 12 cows of the experimental group were examined by two groups of students with different training on two days. The examination was performed one day by students who were theoretically prepared for transrectal palpation in cows (NO-SBT, n = 12). The other day, students who underwent a simulator-based training (SBT, n = 12) performed the examination. The cortisol concentrations, as well as heart rate (HR) and heart rate variability (HRV), were measured in the examined cows. Blood and saliva samples were collected 25 min and immediately before (0 min) and 25 min and 85 min after the end of the examination in the experimental group. Serum cortisol levels between 0 min and 25 min were increased by Δ2.6 ng/ml in the cows in the experimental group compared to Δ-0.3 ng/ml in the control group (P = 0.001). The increases in cortisol in saliva (P = 0.033) and serum (P = 0.013) after transrectal palpation were higher in the NO-SBT group Δ0.32 ng/ml saliva, Δ5.8 ng/ml serum than in the SBT group Δ0.03 ng/ml saliva, Δ2.1 ng/ml serum. For HR and HRV analysis values recorded 30 min before the transrectal palpation (-30 min) were set as the baseline concentrations the sequence recorded during the transrectal examination started at 0 min. While the mean HR did not change significantly during the transrectal palpation (80-83 bpm SBT students; 81 to 79 bpm NO-SBT students), the HRV parameter square root of the mean squared differences of successive R-R intervals (RMSSD) decreased in the NO-SBT group (P = 0.034) during transrectal palpation compared to the baseline values (17.47-5.07 ms). These findings reflect an activation of the hypothalamic-pituitary-adrenal axis as well as a reduction in vagal tone during the teaching and practice of transrectal palpation by students. Moreover, the results indicate that a transrectal palpation is less stressful for cows when the examination is performed by students that were previously prepared by simulator-based training.

Communication identity in veterinary medicine: a grounded theory approach.

It is well established that communication skills are a core competence in veterinary medicine. Most studies in the field of veterinary medicine have focused on communication as an interpersonal skill. Much less is known about communication in the context of professional identity formation. Semistructured interviews with practitioners from companion and farm animal practice, veterinary industry, veterinary research and government service were conducted in Germany in 2016. A grounded theory approach as described by Strauss and Corbin was used to identify characteristics associated with professional communication identity formation in veterinarians. According to the current study, the identity formation process occurs in three steps: existing personal communication identity, socialisation and professional communication identity. Essentials of interpersonal communication, communication interaction experiences at work, acquisition of communication skills and subjective clarification of veterinary communication ability and skills are the key factors associated with this formation process. Since communication skills are of uttermost importance for all fields of veterinary medicine, communication education, and supporting undergraduate students in the process of communication identity formation, should be an important part of the veterinary curriculum. Furthermore, integrating communication skills training in continuing education courses could foster professionalism in veterinary medicine.

[Skills lab training in veterinary medicine. Effective preparation for clinical work at the small animal clinic of the University for Veterinary Medicine Hannover, Foundation]. / Skills-Lab-Training in der Tiermedizin. Effektive Vorbereitung auf die klinische Tätigkeit am Beispiel der Kleintierklinik der Stiftung Tierärztliche Hochschule Hannover.

OBJECTIVE: During five and a half years of studying veterinary medicine, students should in addition to theoretical knowledge acquire sufficient practical skills. Considering animal welfare and ethical aspects, opportunities for hands-on learning on living animals are limited because of the high annual number of students. The first German veterinary clinical-skills lab, established in 2013 at the University for Veterinary Medicine Hannover, Foundation (TiHo), offers opportunities for all students to learn, train and repeat clinical skills on simulators and models as frequently as they would like, until they feel sufficiently confident to transfer these skills to living animals. This study describes the establishment of clinical-skills lab training within the students' practical education, using the example of the small-animal clinic of the TiHo. MATERIAL AND METHODS: Two groups of students were compared: without skills lab training (control group K) and with skills lab training (intervention group I). At the end of both the training and a subsequent 10-week clinical rotation in different sections of the clinic, an objective structured clinical examination (OSCE) was performed, testing the students' practical skills at 15 stations. An additional multiple-choice test was performed before and after the clinical rotation to evaluate the increased theoretical knowledge. RESULTS: Students of group I achieved significantly (p ≤ 0.05) better results in eight of the 15 tested skills. The multiple-choice test revealed a significant (p ≤ 0.05) gain of theoretical knowledge in both groups without any differences between the groups. Students displayed a high degree of acceptance of the skills lab training. CONCLUSION: Using simulators and models in veterinary education is an efficient teaching concept, and should be used continually and integrated in the curriculum.

A Survey of Established Veterinary Clinical Skills Laboratories from Europe and North America: Present Practices and Recent Developments.

Developing competence in clinical skills is important if graduates are to provide entry-level care, but it is dependent on having had sufficient hands-on practice. Clinical skills laboratories provide opportunities for students to learn on simulators and models in a safe environment and to supplement training with animals. Interest in facilities for developing veterinary clinical skills has increased in recent years as many veterinary colleges face challenges in training their students with traditional methods alone. For the present study, we designed a survey to gather information from established veterinary clinical skills laboratories with the aim of assisting others considering opening or expanding their own facility. Data were collated from 16 veterinary colleges in North America and Europe about the uses of their laboratory, the building and associated facilities, and the staffing, budgets, equipment, and supporting learning resources. The findings indicated that having a dedicated veterinary clinical skills laboratory is a relatively new initiative and that colleges have adopted a range of approaches to implementing and running the laboratory, teaching, and assessments. Major strengths were the motivation and positive characteristics of the staff involved, providing open access and supporting self-directed learning. However, respondents widely recognized the increasing demands placed on the facility to provide more space, equipment, and staff. There is no doubt that veterinary clinical skills laboratories are on the increase and provide opportunities to enhance student learning, complement traditional training, and benefit animal welfare.

Committee on Veterinary Medicine at the Society for Medical Education: Skills Labs in Veterinary Medicine - a brief overview.

Since 2012, skills labs have been set up to teach practical skills at veterinary training facilities in the German-speaking world. In addition to didactic considerations, ethical points of view in terms of animal protection form the basis of the increasing significance of skills labs in veterinary medicine. Not least because of the quality standards in veterinary medicine training which apply across Europe, the link between veterinary medicine training facilities is particularly significant when it comes to the setting up and development of skills labs. The Committee on Veterinary Medicine is therefore not only interested in exchange and cooperation within veterinary medicine, but also sees an opportunity for mutual gain in the link with the Society for Medical Education Committee "Practical Skills".

[Effects of different training methods for palpation per rectum of internal genital organs on learning success and self-evaluation of students]. / Untersuchungen zur Effektivität verschiedener Unterrichtsmethoden der transrektalen gynäkologischen Untersuchung beim Rind auf Lernerfolg und Selbstevaluierung von Studierenden.

Large animal veterinary practice is more and more emphasizing herd-health-management. Processes to ensure and optimize economic viability of dairy farming are becoming more important in comparison to treatment of single ill animals. Amongst others, rectal palpation skills are crucial for proper fertility management, rapid and correct diagnosis of early pregnancies, and recognition of cycle or fertility problems. The aim of this study was first to objectively analyse the effectiveness of prevailing teaching methods for rectal palpation of the reproductive tract during the students' "agricultural internship." Simultaneously, the effectiveness of the use of two teaching simulators prior to the first hands-on experience with live animals was compared with proving just theoretical instruction. The results showed that students acted with more confidence when they were trained in groups of three to five. In particular, the subjective as well as the objective training success was greater for those students, who trained with a simulator (Haptic Cow®, Breed'n Betsy®) than for those who only had theoretical training. Furthermore simulator training resulted in a more realistic student assessment of performance, as well as in a better understanding of where reproductive structures were located (cervix, uterus) in live animals. No significant difference in effect of training was found between the different simulators used here. The results of this study suggest that it is in the interest, not only of students but also of the animals, that simulator training occurs before exercises are performed on living animals.

Stressed out or subjective acquisition of competence--how do veterinary students see their curative work placement?

Veterinary studies in Germany are regulated by the Veterinary Certification Act (TAppV). The practical part of the education consists of 1,170 hours, whereby up to 850 hours can be spent on the curative work placement. A curative work placement can result in physical and psychological stress in the sense of a professional overload. It is the aim of this study to find out in what areas and to what extent competence is acquired and psychological stress exists in students during their work placement. Veterinary students (n=142) from all German education institutes participated in a voluntary online-study based on Burnout Screening Scales (BOSS) as well as a questionnaire regarding the acquisition of competence and excessive stress during the work placement (FKÜP). The distribution of values for work placement related stress show that such work placement related stress is generally slightly increased (T=60) and lies above that of occupational stresses within the normal population. Work placement related physical complaints also show a significant slight increase (T=61). A value (T=42) within the normal range was determined for the resource values. Few of the students questioned considered themselves to be excessively stressed in favour of a high subjective acquisition of competences. The largest increase regarding the acquisition of competence was noted for the areas of animal handling/restraint and application and injection techniques. In the sense of a perceived excessive demand regarding practical capabilities the areas of emergency management, surgery and medication dispensation were mentioned. With regard to the load structure and the acquisition of competence by veterinary students during their work placement, more support of the individual and a balancing of teaching/learning goals would be desirable and represents a promising approach.

Clinical skills of veterinary students - a cross-sectional study of the self-concept and exposure to skills training in Hannover, Germany.

BACKGROUND: Students of veterinary medicine should achieve basic professional competences required to practise their profession. A main focus of veterinary education is on developing clinical skills. The present study used the guidelines of the "Day-One Skills" list of European Association of Establishments for Veterinary Education (EAEVE) to create an online questionnaire for assessing the skills acquired by students at the University of Veterinary Medicine Hannover (TiHo). The theoretical and practical veterinary knowledge levels of the students and postgraduates are determined and compared. RESULTS: In two batches, 607 people responded (response batch 1, 23.78%; response batch 2, 23.83%). From 49 defined skills, 28 are actually practised during training at the university and 21 activities are known only theoretically. Furthermore, the students showed great willingness to use simulators and models in a clinical skills lab. CONCLUSIONS: The results of this survey highlight that the opening of a clinical skills lab at the University of Veterinary Medicine Hannover and its incorporation into the study programme are ideal tools to promote practical competences and foster the motivation to learn.

Setting up a veterinary medicine skills lab in Germany.

The amendments introduced to the current Veterinary Licensing Ordinance (TAppV) by the Veterinary Licensing Regulation (TAppO) have brought a high degree of skills orientation to fill the gap between academic study and preparing for a wide range of professional skills. In order to improve the veterinary skills of students while conveying fundamental methods in a structured and reproducible way, the University of Veterinary Medicine Hannover, Foundation, has set up the first central veterinary skills lab in Germany. Practical training is provided by means of a three-tier delivery approach. This involves around 40 simulators on an area of approx. 800 m(2) under the guidance of 6-8 staff members, along with supplementary resources such as posters, text instructions and YouTube videos. Since it opened in March 2013, there have been 769 visits to the skills lab and 30,734 hits on YouTube. Initial results show that the skills lab helps to maintain student motivation by teaching them practical skills at an early stage of the basic study-based acquisition of knowledge, whilst reinforcing skills acquisition per se in competence-based teaching. It enables veterinary students to prepare for their first examinations and treatments of live patients in a manner compliant with animal welfare.

Investigations into the mechanisms controlling parturition in cattle.

A pronounced increase in fetal cortisol concentrations stimulating an increase in estrogen production at the expense of progesterone precursors in the placenta, luteolysis, and progesterone withdrawal is considered as a key event during the complex signal cascade leading to the initiation of parturition in cattle. However, there are many questions concerning the exact functional and/or temporal relationships between these individual processes which finally result in the expulsion of the calf and the timely release of the placenta. Thus, parturition was induced in 270-day pregnant cows using the progesterone receptor blocker aglepristone (group AG, n=3), the prostaglandin F(2α) analog cloprostenol (group PG, n=4), and the glucocorticoid dexamethasone (group GC, n=4) to characterize the effect on maternal steroid and prostaglandin levels and to identify immediate subsequent changes in placental morphology and gene expression as compared with untreated controls sampled on day 272 (group D272, n=3) and cows during normal parturition (group NT, n=4). All calves of the treatment groups were born on days 271-272, whereas gestational length in NT cows was 280.5±1.3 days. However, none of the treatments significantly induced the prepartal remodeling of placentomes characterized by a decline in trophoblast giant cells and reduction of the caruncular epithelium. Data on placental CYP17 and COX2 expression confirm that these key enzymes are upregulated by GC, whereas placental aromatase expression was not affected by any treatment. Maternal progesterone and prostaglandin profiles suggest differential effects of the treatments on luteal function and placental or uterine prostaglandin production. The results provide new information on the initiation of parturition in cattle but raise many new questions.

Use of the progesterone (P4) receptor antagonist aglepristone to characterize the role of P4 withdrawal for parturition and placental release in cows.

In late pregnant cows, progesterone (P(4)) is mainly of luteal origin. However, the trophoblast may provide high local P(4) concentrations in the uterus. To test for the importance of a complete P(4) withdrawal for parturition-related processes and placental release, the P(4) receptor (PGR) blocker aglepristone (Ap) was administered to three cows on days 270 and 271 of pregnancy. A complete opening of the cervix was observed 46.5±7.3 h after the start of treatment. However, expulsion of the calves was impaired obviously because of insufficient myometrial activity, and placental membranes were retained for at least 10 days. Measurement of P(4) concentrations indicated that PGR blockage induced luteolysis. To investigate the role of P(4) withdrawal for the prepartal tissue remodeling of the placentomes, the caruncular epithelium was evaluated by morphometry, and the percentage of trophoblast giant cells (TGCs) relative to the total number of trophoblast cells were assessed. Caruncular epithelium in Ap-treated cows (D272+Ap) was immature (30.5±3.3%) and not different from untreated controls (elected cesarean section (CS) on day 272; D272-CS; 31.5±1.4%), whereas it was significantly reduced at normal term (D280.5±1.3; 21.0±6.1%; P=0.011). Correspondingly, the percentage of TGCs were 20.1±1.4 in D272+Ap, 22.1±4.8 in D272-CS, and 9.8±3.9 at term (P=0.001). No effect was detected on placental estrogen synthesis. The results showed that in late pregnant cows, P(4) withdrawal only induces a limited spectrum of the processes related to normal parturition and is not a crucial factor for the prepartal tissue remodeling in placentomes and the timely release of the placenta.