Comparison of 2 canine celiotomy closure models for training novice veterinary students.

OBJECTIVE: To compare a low-fidelity foam and fabric (FF) model to a high fidelity silicone (SI) model for teaching canine celiotomy closure. STUDY DESIGN: Prospective blinded comparison of learning outcomes. SAMPLE POPULATION: Second-year veterinary students who had never performed surgery as a primary surgeon (n = 46) and veterinarians experienced in performing canine celiotomy (n = 10). METHODS: Veterinary students performed a digitally recorded celiotomy closure on a canine cadaver before and after participation in 4 facilitated laboratory training sessions on their randomly assigned model. Recordings were scored by masked, trained educators with an 8-item task-specific rubric. Students completed surveys evaluating the models. Experienced veterinarians tested the models and provided feedback on their features. RESULTS: Completed pretest and posttest recordings were available for 38 of 46 students. Students' performance improved regardless of the model used to practice (P = .04). The magnitude of improvement did not differ between the 2 groups (P = .10). All students (n = 46) described their models favorably. Ninety percent of veterinarians thought both models were helpful for training students and gave similar ratings on all measures except for realism, which was rated higher for the SI model's skin (median, agree) compared with the FF model (median, neutral, P = .02). CONCLUSION: Model-based training was effective at improving students' surgical skills. Less experienced learners achieved similar skill gains after practicing with FF or SI models. CLINICAL SIGNIFICANCE: The acquisition of surgical skills required to perform celiotomy closure in companion animals occurs similarly well on models made of foam and fabric or of silicone, providing flexibility in model selection.

Effect of Different Instructional Methods on Contamination and Personal Protective Equipment Protocol Adherence among Veterinary Students.

Proper use of personal protective equipment (PPE) is crucial to prevent disease spread. Recent studies in human medicine have shown disconcerting inconsistencies in the use of PPE in hospital wards. In this study, we compared the effect of three instructional methods for PPE use on contamination and protocol adherence among veterinary students. Students were divided into three groups according to the instructional method to which they had access (instructional video, wall chart, or both). They underwent an isolation exercise consisting of donning, patient examination (mock patient prepared with contamination marker), and doffing. Student contamination after the exercise was evaluated using UV light. Videos of student performance were reviewed for errors committed. Results showed that the number of students with contamination was higher in the group who only had access to video instruction than in the two other groups. The number of students with contamination on forearms, hands, and wrists was higher in the group who only had access to charts. Disinfecting gloves between doffing steps was the most frequently omitted step. The number of students who touched the environment with unprotected areas of their bodies was higher in the group who only had access to video instruction than in the other two groups. In conclusion, video instruction was less effective in achieving PPE protocol adherence among veterinary students than was instruction with a chart or chart-video combination. Incorporating video instruction as part of the instructions may be valuable to reinforce individual steps of donning and doffing.

A Randomized Trial Comparing Freely Moving and Zonal Instruction of Veterinary Surgical Skills Using Ovariohysterectomy Models.

Timely, specific feedback is the most important feature of simulation-based training, but providing adequate instructor supervision is challenging. Students' (n = 76) surgical skills were assessed after training using either the traditional (T) method of large-group teaching by multiple instructors or the alternative method of one instructor assigned (A) to a defined group of students. Instructors rotated to a different group of students for each laboratory session. The instructor-to-student ratio and environment remained identical. No differences were found in raw assessment scores or the number of students requiring remediation, suggesting that students learned in this environment whether they received feedback from one instructor or multiple. Students had no preference between the methods, though 88% of the instructors preferred the assigned method, because they perceived an increased ability to teach and observe individual students. There was no difference in the number of students identified as at-risk of remediation between groups. When both groups were considered together, students identified as at-risk were more likely (40% vs. 10%) to require post-assessment remediation. However, only 22% of students requiring remediation had been identified as at-risk, and A-group instructors were more accurate than T-group instructors at identifying at-risk students. These results suggest that students accept either instructional method, but most instructors prefer to be assigned to a small group of students. Surgical skills were learned similarly well by students in both groups, although assigned instructors were more accurate at identifying at-risk students, which could prove beneficial if early intervention measures can be offered.

Evaluation of a method to assess digitally recorded surgical skills of novice veterinary students.

OBJECTIVE: To evaluate a method to assess surgical skills of veterinary students that is based on digital recording of their performance during closure of a celiotomy in canine cadavers. SAMPLE POPULATION: Second year veterinary students without prior experience with live animal or simulated surgical procedure (n = 19) METHODS: Each student completed a 3-layer closure of a celiotomy on a canine cadaver. Each procedure was digitally recorded with a single small wide-angle camera mounted to the overhead surgical light. The performance was scored by 2 of 5 trained raters who were unaware of the identity of the students. Scores were based on an 8-item rubric that was created to evaluate surgical skills that are required to close a celiotomy. The reliability of scores was tested with Cronbach's α, intraclass correlation, and a generalizability study. RESULTS: The internal consistency of the grading rubric, as measured by α, was .76. Interrater reliability, as measured by intraclass correlation, was 0.64. The generalizability coefficient was 0.56. CONCLUSION: Reliability measures of 0.60 and above have been suggested as adequate to assess low-stakes skills. The task-specific grading rubric used in this study to evaluate veterinary surgical skills captured by a single wide-angle camera mounted to an overhead surgical light produced scores with acceptable internal consistency, substantial interrater reliability, and marginal generalizability. IMPACT: Evaluation of veterinary students' surgical skills by using digital recordings with a validated rubric improves flexibility when designing accurate assessments.

Development and Validation of a Model for Training Equine Phlebotomy and Intramuscular Injection Skills.

Simulation in veterinary education offers a solution for bridging the gap between observation and performance of clinical skills. An equine neck model was created that allows repetitive practice of jugular phlebotomy, intramuscular (IM) injection, and intravenous catheterization. The aim of this study was to validate the model for jugular phlebotomy and IM injection. We surveyed experienced veterinarians on the model's realism and the comprehensiveness of its features. In a randomized experimental study, we compared the learning outcomes of first-year veterinary students trained on the model (n=48) and students trained on equine head-neck cadavers (n=45). There was no difference in post-training performance of phlebotomy on the live horse between cadaver-trained students and model-trained students when assessed by a checklist (cadaver 6.87±0.33; model 6.89±0.77; p=.99) or a global rating scale (cadaver 5.23±0.87; model 5.32±0.77; p=.78). No difference was found between post-training scores for IM injection when assessed by checklist (cadaver 6.87±0.34; model 6.89±0.31; p=.76) or global rating scale (cadaver 5.23±0.87; model 5.32±0.77; p=.75). Veterinarians (n=7) found this low-fidelity model acceptable and supported its use as a training tool for veterinary students. Students reported in a post-lab survey that they felt models were as helpful as cadavers for learning the procedures. These results support the use of the model as a component of first-year veterinary student curriculum.

Validation of a Model for Teaching Canine Fundoscopy.

A validated teaching model for canine fundoscopic examination was developed to improve Day One fundoscopy skills while at the same time reducing use of teaching dogs. This novel eye model was created from a hollow plastic ball with a cutout for the pupil, a suspended 20-diopter lens, and paint and paper simulation of relevant eye structures. This eye model was mounted on a wooden stand with canine head landmarks useful in performing fundoscopy. Veterinary educators performed fundoscopy using this model and completed a survey to establish face and content validity. Subsequently, veterinary students were randomly assigned to pre-laboratory training with or without the use of this teaching model. After completion of an ophthalmology laboratory on teaching dogs, student outcome was assessed by measuring students' ability to see a symbol inserted on the simulated retina in the model. Students also completed a survey regarding their experience with the model and the laboratory. Overall, veterinary educators agreed that this eye model was well constructed and useful in teaching good fundoscopic technique. Student performance of fundoscopy was not negatively impacted by the use of the model. This novel canine model shows promise as a teaching and assessment tool for fundoscopy.

Construct validation of a small-animal thoracocentesis simulator.

Training students to perform emergency procedures is a critical but challenging component of veterinary education. Thoracocentesis is traditionally taught in the classroom, with students progressing to "see one, do one, teach one" during the clinical phase of their education. This method of teaching does not permit students to gain proficiency before performing thoracocentesis on a live animal in a high-stakes, high-stress environment and is dependent on the availability of animals requiring the procedure. A veterinary thoracocentesis simulator has been created to allow students an opportunity for repetitive practice in a low-stakes environment. This study evaluated the face, content, and construct validity of the thoracocentesis simulator. Face and content validation were confirmed by survey results, and construct validity was assessed through comparison of student and veterinarian performance on the simulator. Students' median checklist and global rating scores were significantly lower than those of the veterinarians, and students took significantly longer to perform the procedure, indicating that the simulator was able to differentiate the relative expertise of the user and establishing construct validity. This study supported the use of the thoracocentesis simulator for educators to demonstrate proper technique, for students to practice the steps needed to perform the procedure and experience an approximation of the tactile aspects of the task, and for formative assessment before performing the procedure on client-owned animals.

Development of a training model for small animal thoracocentesis and chest tube thoracostomy.

Training veterinary students to perform emergency procedures, such as thoracocentesis and chest tube thoracostomy, poses challenges in terms of providing adequate hands-on experience without compromising animal welfare. A small animal thoracocentesis and chest tube thoracostomy model has been developed, that allows repetitive practice in a safe, standardised environment. The model has been incorporated into a clinical skills laboratory, where students work through computerised case studies in small groups, performing thoracocentesis or chest tube thoracostomy where indicated during the case. Student feedback indicated a high degree of satisfaction with the model and the laboratory experience, high perceived value of the case studies in improving learning, and increased confidence to perform the procedures under supervision. This model can replace the use of live animals while students are practising these procedures, improving their technique, and learning the appropriate safeguards used to prevent injuries such as pulmonary trauma.

Outcome of a one-week intensive training workshop for veterinary diagnostic laboratory workers in Liberia.

There is a huge unmet need for veterinary diagnostic laboratory services in developing nations such as Liberia. One way of bridging the service gap is for visiting experts to provide veterinary laboratory training to technicians in a central location in a short-course format. An intensive 1-week training workshop was organized for 18 student and faculty participants from the College of Agriculture and Integrated Development Studies (CAIDS) at Cuttington University in rural central Liberia. The training was designed and delivered by the non-governmental organization Veterinarians Without Borders US and funded through a Farmer-to-Farmer grant provided by the United States Agency for International Development. Although at the start of training none of the students had any veterinary laboratory experience, by the end of the course over 80% of the students were able to discuss appropriate care and use of a microscope and name at least three important components of laboratory record keeping; over 60% were able to describe how to make and stain a blood smear and how to perform a passive fecal flotation; and over 30% were able to describe what a packed cell volume is and how it is measured and name at least three criteria for classifying bacteria. The intensive training workshop greatly improved the knowledge of trainees about veterinary diagnostic laboratory techniques. The training provided initial skills to students and faculty who are awaiting the arrival of additional grant-funded laboratory equipment to continue their training.