Adaptation of a hands-on veterinary surgical training course from a traditionally taught laboratory to a remotely taught laboratory during a global pandemic.

OBJECTIVE: The goal of this study was to evaluate and report details of a remotely taught surgical laboratory. STUDY DESIGN: Observational. SAMPLE POPULATION: Second-year veterinary students (n = 143) enrolled in a surgical laboratory; 9 weeks were taught traditionally, and 6 weeks were taught remotely. METHODS: Because of the global pandemic, remote laboratories were developed and delivered. Students performed surgical procedures in model organs remotely while being observed by and receiving feedback from instructors on an internet-based video platform. Methods for remote surgical teaching were explored, and successes and challenges were detailed. Surveys were administered to the students and faculty to gather perspectives on their experience and subsequent confidence. RESULTS: Surveys were completed by 81 of 143 (57%) students and seven of seven (100%) instructors. The mean overall student satisfaction score (1 not at all satisfied, 10 very satisfied) for in-person instruction was 8.2, and the mean score for remote instruction was 6.2 (P < .001). Overall, the instructors had a mean satisfaction score of 8 for in-person laboratories and a mean satisfaction score of 6 for remotely taught laboratories. Most students had a perception of greater one-on-one instructor attention in remote laboratories. Students reported similar confidence levels for three surgical procedures. CONCLUSION: The described remote teaching method resulted in the perception of greater instructor attention given to students. Student and instructor satisfaction was lower with remote teaching than with in-person teaching. IMPACT: The described method of remote teaching may be applied to teaching surgical students in settings when face-to-face instruction cannot be achieved and may be developed further to create an experience equivalent to face-to-face instruction.

Adopting Learning Analytics in a First-Year Veterinarian Professional Program: What We Could Know in Advance about Student Learning Progress.

Over the past decade, the field of education has seen stark changes in the way that data are collected and leveraged to support high-stakes decision-making. Utilizing big data as a meaningful lens to inform teaching and learning can increase academic success. Data-driven research has been conducted to understand student learning performance, such as predicting at-risk students at an early stage and recommending tailored interventions to support services. However, few studies in veterinary education have adopted Learning Analytics. This article examines the adoption of Learning Analytics by using the retrospective data from the first-year professional Doctor of Veterinary Medicine program. The article gives detailed examples of predicting six courses from week 0 (i.e., before the classes started) to week 14 in the semester of Spring 2018. The weekly models for each course showed the change of prediction results as well as the comparison between the prediction results and students' actual performance. From the prediction models, at-risk students were successfully identified at the early stage, which would help inform instructors to pay more attention to them at this point.

Adopting Learning Analytics in a First-Year Veterinarian Professional Program: What We Could Know in Advance about Student Learning Progress.

Over the past decade, the field of education has seen stark changes in the way that data are collected and leveraged to support high-stakes decision-making. Utilizing big data as a meaningful lens to inform teaching and learning can increase academic success. Data-driven research has been conducted to understand student learning performance, such as predicting at-risk students at an early stage and recommending tailored interventions to support services. However, few studies in veterinary education have adopted Learning Analytics. This article examines the adoption of Learning Analytics by using the retrospective data from the first-year professional Doctor of Veterinary Medicine program. The article gives detailed examples of predicting six courses from week 0 (i.e., before the classes started) to week 14 in the semester of Spring 2018. The weekly models for each course showed the change of prediction results as well as the comparison between the prediction results, and students' actual performance. From the prediction models, at-risk students were successfully identified at the early stage, which would help inform instructors to pay more attention to them at this point.

Impact of Expert Commentary and Student Reflection on Veterinary Clinical Decision-Making Skills in an Innovative Electronic-Learning Case-Based Platform.

One challenge in veterinary education is bridging the divide between the nature of classroom examples (well-defined problem solving) and real world situations (ill-defined problem solving). Solving the latter often relies on experiential knowledge, which is difficult to impart to inexperienced students. A multidisciplinary team including veterinary specialists and learning scientists developed an interactive, e-learning case-based module in which students made critical decisions at five specific points (Decision Points [DPs]). After committing to each decision (Original Answers), students reflected on the thought processes of experts making similar decisions, and were allowed to revise their decisions (Revised Answers); both sets of answers were scored. In Phase I, performance of students trained using the module (E-Learning Group) and by lecture (Traditional Group) was compared on the course final examination. There was no difference in performance between the groups, suggesting that the e-learning module was as effective as traditional lecture for content delivery. In Phase II, differences between Original Answers and Revised Answers were evaluated for a larger group of students, all of whom used the module as the sole method of instruction. There was a significant improvement in scores between Original and Revised Answers for four out of five DPs (DP1, p =.004; DP2, p =.04; DP4, p <.001; DP5, p <.001). The authors conclude that the ability to rehearse clinical decision making through this tool, without direct individual feedback from an instructor, may facilitate students' transition from problem solving in a well-structured classroom setting to an ill-structured clinical setting.

Survey of Intraoperative Bacterial Contamination in Dogs Undergoing Elective Orthopedic Surgery.

OBJECTIVE: To investigate the frequency, source, and risk factors of intraoperative (IO) surgeon and patient bacterial contamination during clean orthopedic surgeries, and to investigate the relationship between IO contamination and surgical site infection (SSI) in dogs. STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Client-owned dogs undergoing stifle surgery (n = 100). METHODS: IO cultures were taken in each case from surgical foot wrap, peri-incisional skin, surgical gloves, and the surgical team's hands. The environment (operating room [OR] lights, computers, scrub sink faucet, anesthesia gurney, and radiology table) was sampled every 5 months. Bacteria were identified and the contamination of each case was categorized. All gloves from the surgical team were collected and tested for perforations using a water infusion test. Cases were followed for at least 8 weeks to determine the presence or absence of SSI. Perioperative variables were evaluated for association with IO contamination and SSI. RESULTS: Bacterial isolates were yielded from 81% of procedures from 1 or more sources; 58% had positive hand cultures, 46% had positive glove cultures, 23% had positive patient skin cultures, and 12% had positive foot wrap cultures. Staphylococcus spp. was the most commonly recovered bacteria. There was no apparent association between IO contamination and SSI. The highest level of environmental contamination was associated with the scrub sink faucet, followed by the radiology table, anesthesia gurney, and OR computers. The IO glove perforation rate was 18%. CONCLUSION: Clean orthopedic procedures commonly had clinically insignificant bacterial contamination. In our study, bacteria responsible for SSI did not appear to colonize the patient in the OR.

Intercostal approach for right adrenalectomy in dogs.

OBJECTIVE: To describe an intercostal (IC) approach to the right adrenal (RA) gland in dogs. STUDY DESIGN: Cadaveric study and case series. ANIMALS: Dogs with right adrenal (RA) tumors (n = 11) and normal canine cadavers (6). METHODS: Cadavers had an IC (n = 3) or paracostal (3) approach to the RA. The relative spatial position of the RA to the incision was evaluated. Medical records (June 2007-December 2012) of dogs that had an IC approach to the RA were reviewed. Perioperative data were recorded and described. RESULTS: In cadavers, the RA was closer to the cranial aspect of the surgical incision after an IC approach compared with a paracostal approach. The IC approach for right adrenalectomy was successfully performed in 11 dogs (6 adrenocortical carcinomas, 4 pheochromocytomas, and 1 osteosarcoma) with a mean anesthesia duration of 242 minutes and mean surgical of 144 minutes. Dogs had vascular invasion into the phrenicoabdominal vein (n = 11) and caudal vena cava (6). There were no significant intra- or postoperative complications. One dog was euthanatized intraoperatively. Median survival time for all dogs was 786 days. CONCLUSIONS: The IC approach for right adrenalectomy offers superior exposure of the RA compared with a paracostal approach.

Influence of different cell storage/culture conditions on spontaneous proliferation and level of tyrosine kinase receptor inhibition in two feline injection-site sarcoma cell lines.

Optimizing cell culture conditions is important when studying cell proliferation and viability, particularly in response to cytotoxic compounds. Altered cell storage conditions can adversely impact proliferation and viability in mortal cell lines. However, little is known regarding the effects on immortal feline cell lines. In the present study, two feline injection-site sarcoma (ISS) cell lines were evaluated under standard culture conditions and three alternative storage/culture conditions for spontaneous proliferation rate and sensitivity to masitinib, a highly selective tyrosine kinase inhibitor with activity against primary and metastatic ISS cell lines. Cell viability was assessed by 7-aminoactinomycin D and cytology. Spontaneous proliferation did not significantly differ across the FBS concentrations (10% vs. 1%) for one cell line, however, with the other cell line spontaneous proliferation was significantly decreased in the 1% FBS 1-step technique, and the cold step technique at both 1% and 10% FBS. When normalized to untreated control cells, the IC50 values for masitinib were comparable across all culture techniques. Furthermore, apoptosis appeared to be the primary mechanism of this proliferation inhibition. Our preliminary findings suggest that select feline sarcoma cell lines cultured in 10% FBS yield comparable cytotoxicity data even when subjected to varying storage/culture conditions.

Canine vaginal leiomyoma diagnosed by CT vaginourethrography.

A 13 yr old female spayed Labrador retriever presented for vulvar bleeding. Abdominal radiographs revealed a soft tissue mass in the ventral pelvic canal. A computed tomography (CT) exam and a CT vaginourethrogram localized the mass to the vagina, helped further characterize the mass, and aided in surgical planning. A total vaginectomy was performed and the histologic diagnosis was leiomyoma. Vaginal tumors make up 1.9-3% of all tumors. Seventy-three percent of vaginal tumors are benign, and 83% of those are leiomyomas. Leiomyomas often have a good long-term prognosis with surgical resection. The diagnostic investigation of this case report utilized a multimodal imaging approach to determine the extent and respectability of the vaginal mass. To the best of the authors' knowledge, this is the first report describing a CT vaginourethrogram.

Efficacy of serosal patching in dogs with septic peritonitis.

The objective of this study was to evaluate the correlation of serosal patching in dogs with existing septic peritonitis with continued postoperative septic peritonitis and death. Records were collected from dogs that underwent intestinal surgery from 1998 to 2007 at four veterinary teaching hospitals and one private referral clinic. Dogs were included if they were diagnosed with septic peritonitis and had subsequent surgery of either the small intestine or cecum. Eighty-two surgeries were evaluated. Eighteen dogs (22%) received a serosal patch during surgery. Of those, three dogs (16.7%) had septic peritonitis postoperatively. Sixty-four dogs (78%) did not receive a serosal patch, and 19 of those dogs (29.7%) had postoperative septic peritonitis (P = 0.27). Of the 18 cases with serosal patching, 6 (33.3%) died prior to discharge. Of the 63 cases that did not receive a patch and had information regarding survival, 14 (22.2%) died prior to discharge (P = 0.34). Use of a serosal patch did not protect dogs from either postoperative septic peritonitis or failure to survive.

Postoperative complications associated with caudectomy in brachycephalic dogs with ingrown tails.

Surgical correction of an ingrown tail is indicated to relieve clinical signs of intertriginous dermatitis. The objective of this retrospective study was to identify the type and frequency of complications following caudectomy in dogs with ingrown tails. Medical records of dogs with ingrown tails treated with caudectomy from 2000 to 2010 at the University of Georgia Veterinary Teaching Hospital were reviewed. Data collected included signalment, preoperative infection status, surgical procedures performed, prophylactic antibiotic use, complications noted both during hospitalization and at suture removal, treatments instituted, and owner satisfaction. Seventeen dogs were identified for inclusion. At presentation, 4 of the 17 dogs (23.5%) were receiving antibiotics. Infection was present in 7 of the 17 dogs (41%), and 6 of the 7 cases resolved immediately postoperatively. All dogs received perioperative antimicrobial therapy, and 13 of the 17 dogs (76%) received antibiotics after surgery for an average of 13.5 days ± 5.2 days. Complications occurred in 2 of the 17 cases (12%) immediately after surgery, including decreased rectal sensation with adequate anal tone, failure to posture to defecate, and postoperative draining tracts. Complications were reported in 2 of 15 dogs (13%) at suture removal, including delayed wound healing and wound inflammation, persistent tail chasing behavior, and temporary changes in defecation habits. Caudectomy provided resolution of clinical signs with no long-term complications.

Efficacy of incisional gastropexy for prevention of GDV in dogs.

Incisional gastropexy (IG) is routinely performed as either a prophylactic procedure to prevent occurrence of gastric dilatation-volvulus (GDV) or at the time of surgical correction of GDV to prevent recurrence. Despite its common use, the long-term efficacy of the IG procedure has not been reported. The hypothesis of this study was that IG performed either during surgical treatment of GDV or as a prophylactic measure would effectively prevent GDV. Medical records of 61 dogs undergoing IG following either gastric derotation for treatment of GDV or as a prophylactic procedure were evaluated retrospectively. Median follow-up time for all dogs was 717 days (range, 49-2,511 days). Of the 61 dogs, 27 had prophylactic IG performed. The remaining 34 dogs presented for GDV and had an IG performed during surgical treatment of GDV. No dog experienced GDV after IG. Recurrence of gastric dilatation (GD) alone was noted in 3 of 34 patients (8.8%) undergoing IG during surgery for GDV and in 3 of 27 patients (11.1%) treated prophylactically with IG. This study confirmed the efficacy of IG for the long-term prevention of GDV in dogs.

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.

Domestic violence shelter partnerships and veterinary student attitudes at North American veterinary schools and colleges.

Animal abuse and domestic violence are linked issues, and pet ownership is reported to play a crucial role in the choice to leave an abusive situation. Although veterinarians witness the effects of abuse and violence over the course of their careers, they have limited training regarding these issues. One mechanism for educating veterinary students while providing a service for victims of domestic violence is the creation of partnerships between domestic violence shelters and veterinary schools. These extracurricular programs can provide both care for pets belonging to victims of domestic violence and an educational platform for student participants. The goals of this study were to determine the prevalence and characteristics of domestic violence shelter partnerships (DVSPs) at North American veterinary teaching hospitals and to determine whether the presence of a DVSP was associated with increased awareness among veterinary students regarding animal abuse and domestic violence. Nine of 33 veterinary schools surveyed described a DVSP program. Students at schools with DVSPs associated with their veterinary teaching hospitals were significantly more likely to indicate that their awareness of the link between animal abuse and domestic violence had increased during veterinary school. Most veterinary students reported that they felt poorly prepared to handle domestic violence and animal abuse issues in the workplace. This study indicates that extracurricular DVSPs are a viable means of educating veterinary students regarding domestic violence and animal abuse. A need for improved education on these topics in veterinary schools across North America is identified.

The unintended detrimental effects of pursuing a professional vocation: The case of veterinarians.

Pursuing one's life calling can be personally fulfilling and professionally rewarding, but it also requires sacrifice. We provide evidence of a strong vocational drive using veterinary students as a case study and find that they willingly contribute higher monetary donations for helping animals relative to students in other fields. We also find a significant reduction in the cognitive performance of veterinarian students when exposed to an animal-in-need manipulation. The performance of non-veterinary students in the cognitive task is unaffected by the manipulation. Our results highlight the need for programs to address the economic, financial, and mental health well-being of students and professionals to promote sustainable vocational career commitment. "You owe it to all of us to get on with what you're good at." W.H. Auden.

Identification of risk factors for septic peritonitis and failure to survive following gastrointestinal surgery in dogs.

OBJECTIVE: To identify risk factors for failure to survive and development of septic peritonitis following full-thickness gastrointestinal incision in dogs. Design-Retrospective cohort study. ANIMALS: Dogs that underwent gastrointestinal surgery from 1998 through 2007 at the University of Georgia Veterinary Teaching Hospital. Procedures-Medical records of dogs undergoing a full-thickness gastrointestinal incision were reviewed, and information regarding dog history, clinicopathologic findings, surgery characteristics, and outcome was collected. RESULTS: Records for 197 dogs (225 surgeries) were evaluated. In 35 (16%) surgeries, the dogs died prior to hospital discharge. After 28 (12%) surgeries, dogs developed septic peritonitis. For 45 (20%) surgeries, dogs had preoperative septic peritonitis; of those, approximately a third resulted in continued septic peritonitis (17/45; 38%) or death (15/45; 33%). Of the 180 surgeries performed in dogs lacking preoperative septic peritonitis, 11 (6%) resulted in development of septic peritonitis and 20 (11 %) resulted in death. When all surgeries were considered, common risk factors for development of septic peritonitis included preoperative septic peritonitis, low preoperative serum albumin and plasma protein concentrations, and intraoperative hypotension. Presence of a foreign body was a protective factor. CONCLUSIONS AND CLINICAL RELEVANCE: Multiple factors were associated with failure to survive and development of septic peritonitis after gastrointestinal surgery in dogs. Aggressive perioperative attempts to increase protein concentrations and intraoperative surgical strategies to decrease the chance of a poor outcome may be indicated in dogs with risk factors identified in this study.

Hypocalcemia following surgical treatment of metastatic anal sac adenocarcinoma in a dog.

A 9 yr old neutered male mixed-breed dog was presented for an anal sac apocrine gland adenocarcinoma with regional nodal metastases. At presentation, ionized calcium was 1.91 mmol/L (NOVA Stat reference range, 1.1-1.3 mmol/L). Surgical excision of the primary tumor and metastatic lymph nodes was performed. Following surgery, symptomatic hypocalcemia was noted. Repeated ionized calcium measurements confirmed hypocalcemia, and hypercalcemia of malignancy panels suggested parathyroid gland suppression as the cause. The calcium normalized with parenteral calcium administration, but calcium later became elevated with tumor recurrence and an increase in the parathormone-related peptide. Disrupted calcium homeostasis is a potential complication following the treatment of long-standing humoral hypercalcemia of malignancy.

Comparison of the carbon dioxide laser and the radiofrequency unit for feline onychectomies.

This study compared the collateral tissue damage and incisional bridging with granulation tissue via histopathological examination following feline onychectomy performed by radiofrequency (RF) and carbon dioxide (CO(2)) laser. Two cats were euthanized, and their digits were harvested for histopathological evaluation on days 1, 3, and 7 post-onychectomy. Each digit was evaluated for total lesion width, total necrosis width, and degree of edema, hemorrhage, and inflammation. This study found few significant differences in collateral tissue damage between RF and CO(2) laser, but more incisional bridging by granulation tissue was noted with RF for feline onychectomies. These results indicate that RF for feline onychectomy is a reasonable alternative to CO(2) laser in regard to collateral tissue damage and bridging of the incision by granulation tissue. In addition, RF is not accompanied by the strict safety considerations and initial expense of acquisition of a CO(2) laser.

Successful treatment of a metacarpal trophic ulcer utilizing a neurovascular island flap.

A 4-year-old, neutered male, soft coated wheaten terrier mixed-breed dog was presented for evaluation of a nonhealing ulcer of the metacarpal pad of 10 to 12 weeks' duration. A diagnosis of an ulnar nerve deficit and secondary trophic ulceration was made. The ulcer was repaired using a neurovascular island flap. Postoperatively, a fiberglass clamshell splint was used to protect the healing flap. The flap healed successfully and developed a highly keratinized epithelium much like a normal footpad.

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.