Final-year student and employer views of essential personal, interpersonal and professional attributes for new veterinary science graduates

Clinical supervisors' and students' perspectives on preparedness for veterinary workplace clinical training: An international study

BACKGROUND

The alignment of student and workplace supervisors' perspectives on student preparedness for veterinary workplace clinical training (WCT) is unknown, yet misalignment could negatively impact workplace learning. The aim of this study was to quantify the relative importance of WCT preparedness characteristics according to students and supervisors and to identify differences.

METHODS

A survey was completed by 657 veterinary students and 244 clinical supervisors from 25 veterinary schools, from which rankings of the preparedness characteristics were derived. Significant rank differences were assessed using confidence intervals and permutation tests.

RESULTS

'Honesty, integrity and dependability' was the most important characteristic according to both groups. The three characteristics with the largest rank differences were: students' awareness of their own and others' mental wellbeing and the importance of self-care; being willing to try new practical skills with support (students ranked both of these higher); and having a clinical reasoning framework for common problems (supervisors ranked higher).

LIMITATIONS

Using pooled data from many schools means that the results are not necessarily representative of the perspectives at any one institution.

CONCLUSION

There are both similarities and differences in the perspectives of students and supervisors regarding which characteristics are more important for WCT. This provides insights that can be used by educators, curriculum developers and admissions tutors to improve student preparedness for workplace learning.

Examining the Motivational Climate and Student Effort in Professional Competency Courses: Suggestions for Improvement

The attainment of professional competencies leads to essential skills for successful and employable veterinarians. However, the inclusion of professional competencies in veterinary curricula is often underdeveloped, and it is sometimes less appreciated by students than the science/technical skill curricula. The aim of this study was to better understand students' motivation within professional competency courses (PC courses) by (a) comparing students' motivational perceptions in PC courses to those in science/technical skill courses (ST courses), (b) determining the extent to which students' motivational perceptions predict their course effort, and (c) identifying teaching strategies that could be used to improve PC courses. Participants included students from eight courses enrolled in their first or second year of a veterinary college at a large land-grant university in the United States. A partially mixed concurrent dominant status research design was used to collect quantitative and qualitative data. Students completed closed- and open-ended survey items regarding their effort and the motivational climate in their courses. Compared to ST courses, students put forth less effort in PC courses; rated PC courses lower on empowerment, usefulness, and interest; and had higher success expectancies in PC courses. Although students' perceptions of empowerment, usefulness, interest, and caring were significantly correlated with their effort, interest was the most significant predictor of effort in both PC and ST courses. Based on students' responses to the open-ended questions, specific motivational strategies are recommended to increase students' effort in PC courses, such as intentionally implementing strategies to increase students' interest and perceptions of usefulness and empowerment.

A Qualitative Study of How On-Campus Faculty and Off-Campus Preceptors Evaluate Veterinary Students' Professionalism

Professionalism is defined and described in a variety of ways that differ considerably in details and quantity. While professionalism has become increasingly important, educators' opinions regarding the types of professionalism vary. The objective of this qualitative study was to evaluate faculty and preceptors' perspectives regarding veterinary medical students' professionalism during their clinical rotations. A thematic content analysis was performed to classify 2,014 comments. Five main themes emerged: (a) work ethic and attitude; (b) effective interactions with clients and delivering patient care; (c) effective interactions with health care professionals; (d) punctuality, task completion, and organization; and (e) commitment to improving competency in self and others. The importance of professionalism was stressed by both groups of faculty and preceptors through written comments; however, the magnitude of each theme differed. The results indicate that without understanding professionalism elements, the lack of conceptual clarity and consensus related to expected behaviors and attitudes would make it challenging to assess professionalism appropriately. The themes identified can be used to begin a discussion about expected behavior among faculty, preceptors, and students, therefore prompting a reasonable assessment of professionalism, as well as avoiding unprofessional behavior.

Professional Skills Teaching within Veterinary Education and Possible Future Directions

Once ignored for their potential to take up precious time within the veterinary curriculum at the expense of hard science and technical competencies, professional skills such as ethical conduct, professional conduct, and communication skills are now considered essential in the creation of successful and employable graduates. Despite the requirement to include professional skills in veterinary curricula, limited communication among colleges and inconsistent documentation of curricular developments have led to a wide range of teaching and assessment methods with no consistent standards existing among colleges. Integration of professional competency teaching into the general curriculum is lauded widely, but barriers such as faculty buy-in have kept many colleges from moving toward a standard in which professional competencies are integrated into the general curriculum. The aim of this article is to provide veterinary educators and curriculum designers with an understanding of the rationale for including professional skills teaching within the curriculum while also presenting currently used, as well as recommended, strategies for effective instruction of professional skills.

Stakeholder perspectives on veterinary student preparedness for workplace clinical training – a qualitative study

Background

The success of workplace clinical training (WCT) is important given that veterinary students are licensed to work independently upon graduation. Considering this, it is perhaps surprising that there is limited published work describing what it means to be prepared for this educational experience, particularly given that the transition to WCT can be stressful for students. This paper reports the results of a qualitative study aiming to generate a rich understanding of veterinary student preparedness for WCT using emic, or insider, perspectives of key stakeholders.

Methods

From a constructivist standpoint, homogenous online group interviews were held with final year veterinary students, recent student alumni, clinical supervisors, faculty, and academic educationalists to discuss what it means to be prepared for WCT. The data was analysed using a template analysis approach.

Results

A three-tier taxonomy to describe preparedness for WCT was constructed from the data. At the topmost level, there were seven themes to illuminate different aspects of preparedness: students should be prepared 1) for the transition to learning and working in a clinical and professional environment, 2) for self-directed and experiential learning whilst working, 3) with a growth mindset, 4) with intrinsic motivation and enthusiasm for learning and working, 5) for communication, consultation and clinical reasoning, 6) with the knowledge for work, and 7) with the practical competence and confidence for work.

Conclusions

This study provides a deeper understanding of the tools we can provide, and the attributes we can nurture in, senior veterinary students to facilitate their learning and working during WCT. This improved understanding is a necessary precursor to refining pedagogical support and curriculum design within veterinary schools.

Using a Card Sort Technique to Determine the Perceptions of First-Year Veterinary Students on Veterinary Professionalism Attributes Important to Future Success in Clinical Practice

First-year veterinary students' perceptions on the veterinary professionalism attributes important to future success in clinical practice were explored using a card sort technique. The key findings were that self-oriented attributes (overall mean: 3.20; 42% responses were essential) and people-oriented attributes (overall mean: 3.13; 39% essential) were rated more highly than task-oriented attributes (overall mean: 2.98; 31% essential) (1-4 scale: 1 = irrelevant, 4 = essential). Within these overall ratings, the establishment/maintenance of effective client relationships (people-oriented attribute; mean: 3.84) and the ability to be composed under pressure and recover quickly (self-oriented attribute; mean: 3.82) received the highest scores. The highest task-oriented score was the ability to work to a high standard and achieve results (mean: 3.57). There was no difference between ethnicities or between men and women, but respondents < 20 years of age gave higher scores to people-oriented attributes than did older respondents (≥ 20 years). The use of the card sort technique has not been widely reported in veterinary educational literature, and so this study represents a novel approach to garnering opinions from newly enrolled veterinary students-a group of stakeholders whose views on this subject are seldom sought. The results show that first-year veterinary students have well-developed opinions on the key attributes of veterinary professionalism and indicate that the early development of students' opinions needs to be taken into consideration in the design of professionalism curricula within veterinary programs.

A career development program: Building resilience in veterinary undergraduates

Retaining workers in high stress occupations and preparing undergraduates to enter these occupations continues to intensify along with mental health and wellbeing challenges. The veterinary profession is particularly vulnerable to poor psychological health which contributes negatively to the retention of veterinarians in the profession. Employing the positive psychology theoretical model rationale, and the andragogy philosophies and approaches, a veterinary career development (VCD) program was scaffolded across a five year Bachelor of Veterinary Science (BVSc) degree. Thematic analysis of participants’ feedback with a focus on what they think, feel and do provided valuable insights into participants’ developing skill-strength and tacit knowledge, and their resilience-building. The authors believe this is the first report on the creation and outcomes of a veterinary career development program that fosters the building of resilience through the attainment of tacit knowledge and practical skills required for successful employment and wellbeing.

Fostering the Development of Professionalism in Veterinary Students: Challenges and Implications for Veterinary Professionalism Curricula

The importance of professional skills teaching and assessment within veterinary education has recently been highlighted in the veterinary education literature. This academic discourse follows the acknowledgement by both veterinary employers and graduates themselves that new graduates often lack the professional skills and attitudes needed for success in clinical veterinary practice. Traditionally, veterinary curricula have focused solely on teaching content knowledge and clinical skills; however, veterinary education curricula clearly must also contain dedicated instruction in veterinary professionalism. This must include instruction in communication skills, emotional intelligence, cultural awareness, teamwork abilities, dispute resolution strategies and the awareness that multiple approaches may be required to resolve challenges. It has become unrealistic to expect students to rely on observation and role modelling to foster the development of professionalism. There is a need to incorporate explicit learning activities that reinforce the knowledge, attitudes, values, and behaviours that characterise veterinary professionalism. While role modelling remains a key aspect of the veterinary professionalism learning that takes place through the informal/hidden curriculum, many students have often had more experiences with negative role models than with positive ones. This can lead to the development of a tolerance or normalisation of negative behaviours and a decline in students’ perceptions of professionalism. This article aims to continue recent conversations on professional skills teaching within veterinary education, define what is meant by veterinary professionalism and consider the plethora of terminology used when trying to establish a definition, highlight those attributes of veterinary professionalism deemed important by veterinary stakeholders for career success and employability, and explore the challenges of incorporating the teaching and assessment of professional traits into veterinary education.

Employability as a Guiding Outcome in Veterinary Education: Findings of the VetSet2Go Project

This paper presents a mini-review of employability as a guiding outcome in veterinary education-its conceptualisation, utility, core elements and dimensions, and pedagogical approaches-through a summary of the findings of a major international project with the same aims (the VetSet2Go project). Guided by a conception of the successful veterinary professional as one capable of navigating and sustainably balancing the (sometimes competing) needs and expectations of multiple stakeholders, the project integrated multiple sources of evidence to derive an employability framework representing the dimensions and capabilities most important to veterinary professional success. This framework provides a useful complement to those based in narrower views of competency and professionalism. One notable difference is its added emphasis on broad success outcomes of satisfaction and sustainability as well as task-oriented efficacy, thus inserting "the self" as a major stakeholder and bringing attention to resilience and sustainable well-being. The framework contains 18 key capabilities consistently identified as important to employability in the veterinary context, aligned to five broad, overlapping domains: veterinary capabilities (task-oriented work performance), effective relationships (approaches to others), professional commitment (approaches to work and the broader professional "mission"), psychological resources (approaches to self), plus a central process of reflective self-awareness and identity formation. A summary of evidence supporting these is presented, as well as recommendations for situating, developing, and accessing these as learning outcomes within veterinary curricula. Though developed within the specific context of veterinarian transition-to-practise, this framework would be readily adaptable to other professions, particularly in other health disciplines.

Using the critical incident technique to determine veterinary professional competencies important for enhancing the veterinarian-client interaction

BACKGROUND

While previous research has examined components of professionalism that veterinary employers and clients expect in veterinarians, little attention has been paid to practising clinical veterinarians' opinions on important professional competencies that help to enhance the veterinarian-client relationship. This study used a phenomenological approach and critical incident technique to gather the narratives of practising veterinarians in New Zealand about positive and negative veterinarian-client interactions. The intention was to identify the underlying principles of professionalism that resulted in the positive/negative outcomes of those interactions.

METHODS

Twenty-two practising veterinarians were interviewed, and each respondent was asked to recollect and narrate a significant positive and a significant negative critical incident in their career that involved a veterinarian-client interaction within a clinical setting. The professional competencies that the veterinarian believed contributed to a successful or an unsuccessful outcome were elucidated using thematic analysis.

RESULTS

Thematic analysis of the critical incident narratives revealed four major themes under the overarching theme of 'building a relationship between the veterinarian and the client': 'accountability and integrity', 'effective communication skills', 'personal wellbeing' and 'quality of care'.

CONCLUSION

The description of the important professional competencies that helped to enhance the veterinarian-client relationship provides a reference for the practising profession to help improve the likelihood of veterinarians enjoying satisfied and successful careers.

International multi-stakeholder consensus for the capabilities most important to employability in the veterinary profession

BACKGROUND

Employability has been defined within the veterinary context as a set of personal and professional capabilities that enable a veterinarian to gain employment, contribute meaningfully to the profession, and develop a career pathway that achieves satisfaction and success. This study explicitly addressed the construct of veterinary employability by exploring the perceptions of multiple stakeholders (recent graduates, employee veterinarians, veterinarian and non-veterinarian employers, para-veterinary staff, academics and policy makers).

METHODS

A four-part online survey was distributed internationally via various agencies. Free-text responses, ratings of capabilities and rankings of categories were analysed.

RESULTS

The congruence of stakeholder responses was notable, regardless of age and geographical location, with minor differences noted in academics' and para-veterinary staff responses, and gender. The most important capabilities were honesty, ethical behaviour, communicating effectively and collaboratively with clients, knowing when to ask for help, and the willingness to learn. The categories of communication and teamwork ranked highest.

CONCLUSION

This study adds granularity to the existing evidence for the importance of communication and teamwork. The relationship between the veterinarian (self) and their work, enabled by engagement, meaning and purpose, and respect for their profession was a key finding, and illustrative of how to achieve personal satisfaction and well-being within the profession.

Arizona Veterinarians' Perceptions and Consensus Regarding Skills, Knowledge, and Attributes of Day One Veterinary Graduates

The purpose of this study was to assess Arizona veterinarians' perceptions and consensus regarding the importance of items in the domains of clinical skills, knowledge, and attributes of Day One graduates of veterinary school and to determine demographic predictors for items on which consensus was low. In this survey-based prospective study, respondents were asked to rate the importance of 44 items on a 5-point Likert scale ranging from 1 (not at all important) to 5 (extremely important). Responses were visualized as divergent stacked bar charts and evaluated via summary quantitative and qualitative analyses. Several items had a median score of 5. For clinical skills, items were the ability to formulate a preventive health care plan, the ability to interpret test results, and basic safe handling and restraint of animals; for knowledge, knowledge of pain management and anesthesia; and for attributes, teamwork, problem-solving skills, and client communication skills. The majority of items (80%) had a strong or very strong consensus measure, 18% had a moderate consensus measure, and 2% had a weak consensus measure. Six items (14%) varied by at least one demographic category. We found demographic differences between large and small animal practices in the clinical skill of ability to perform a necropsy, knowledge of large animal theriogenology, and knowledge of canine theriogenology. In conclusion, we found differences in the importance of items and agreement among practitioners, suggesting that critical evaluation of the mapped curriculum, particularly with regard to core curriculum compared with electives and clinical tracks, may benefit students and future employers.

Impact of dealing with bereaved clients on the psychological wellbeing of veterinarians

BACKGROUND

Research has identified that members of the veterinary profession are at high risk of occupational stress, burnout, poor psychological wellbeing and an elevated rate of suicide. Although scholarly interest in veterinarians has increased in recent years, relatively few studies have specifically examined the emotional work in veterinary interactions and what effect dealing with companion animal owners' grief has on the wellbeing of veterinarians. The purpose of this study was to determine if dealing with bereaved clients affected the psychological wellbeing of veterinarians. The concept of compassion fatigue was explored, including whether veterinarians believed that their training had equipped them for communicating with grieving clients.

METHODS

Veterinary surgeons registered in South Australia in 2015 were invited to complete an online survey, with 105 participants responding.

RESULTS

Many participants, particularly female and younger veterinarians, were experiencing mild to severe psychological distress and nearly half of the sample was experiencing high to very high levels of compassion fatigue. No participants reported seeking psychological or other professional mental health support and the majority had not referred a grieving client to a psychologist or other mental health professional. A significant proportion of veterinarians felt their own mental health was affected by dealing with clients grieving the loss of a companion animal.

DISCUSSION

The findings are discussed in terms of increasing the wellbeing of veterinarians through improved curriculum training and workplace health promotion, particularly considering the high suicide rate reported for the profession.

Peer Feedback on Collaborative Learning Activities in Veterinary Education

Collaborative learning activities are an increasingly prominent feature of veterinary curricula that have been redesigned to achieve competency-based graduate learning outcomes. This evolution challenges the traditional individualistic approach to veterinary education and necessitates revisions to assessment and feedback practices to ensure constructive alignment. Peer feedback has been widely reported in the medical education literature as a teaching intervention in collaborative learning settings, with learning gains reported for students who receive and provide peer feedback. In this setting, peer feedback has been demonstrated to provide valuable formative feedback on professional behaviors and skills. However, there are very few such reports in the veterinary education literature to date. Barriers to the introduction of this approach can include teacher and student perceptions, and concerns around validity and reliability. This review aimed to provide an overview of current evidence regarding peer feedback on collaborative learning activities in higher education, and to explore opportunities and challenges for the introduction of peer feedback in the context of veterinary education. We contend that early and repeated provision of formative peer feedback can provide an opportunity to scaffold the development of crucial core competencies within veterinary education, including the self-regulated learning skills required to work in collaborative teams, and interpret and act on feedback.

What Are Employers Looking for in New Veterinary Graduates? A Content Analysis of UK Veterinary Job Advertisements

As veterinary educators, we have a responsibility to ensure that our graduates are prepared for working life. Veterinary practices, like any other businesses, rely on good employees, and the implications of a poor match between newly employed veterinarian and employing practice could be extremely costly in terms of personal well-being and enjoyment of work as well as the time, financial, and goodwill costs of high staff turnover for the practice. Contemporary veterinary curricula encompass a range of teaching to complement the clinical content; including communication, teamwork, problem solving, and business skills, to support good practice and increase the employability of new graduates. Previous studies have examined the qualities required of early career veterinarians as viewed by educators, recent graduates, pet owners, and practitioners; however, nobody has previously constructed a picture of the employment market for new veterinary graduates by exploring the nature of its recruitment advertising. Three months of UK veterinary job advertisements were examined. Content analysis yielded 10 distinct characteristics desired by employers of early career veterinarians. The most common by far was "enthusiasm," followed by an interest in a particular area of practice, being an "all-rounder" (i.e., having a broad range of skills), demonstrating good communication skills, teamwork, client care, and independence, as well as being caring, ambitious, and having high clinical standards. While several of these qualities are expected and are specifically taught in veterinary school, the dominance of "enthusiasm" as a specifically desired trait raises interesting questions about the characteristics of veterinary students who we are supporting, encouraging, or maybe even suppressing, during veterinary training.

Beyond Competence: Why We Should Talk About Employability in Veterinary Education

The purpose of this article is to explore employability as a complement to competency in defining the overarching objectives of veterinary education. Although the working usage of the term competency has evolved and stretched in recent years, and contemporary competence frameworks have expanded to better reflect the range of capabilities required of a veterinary professional, the potential remains for the dominance of competency-led discourse to obscure the aim of producing not only competent but also successful and satisfied veterinarians. Expanding the educational mission to include employability may provide this broader focus, by stretching the end point, scope, and scale of veterinary education into the crucial transition-to-practice period, and beyond. In this article we review available evidence from multiple stakeholder perspectives and argue that employability expands the focus beyond servicing the needs of the public to better integrate and balance the needs of all the stakeholders in veterinary education, including the graduates themselves. By refocusing the goal of veterinary education to include the richer end point of success, turning the attention to employability could enhance current attribute frameworks and result in veterinarians who not only better meet the needs of those they serve but are also better prepared to experience fulfilling and satisfying careers. Finally, we suggest one educational approach may be to conceptualize competency, professionalism, and employability as overlapping dimensions of the successful veterinary professional.

Expectations of Graduate Communication Skills in Professional Veterinary Practice

Good communication skills are an important entry-level attribute of graduates of professional degrees. The inclusion of communication training within the curriculum can be problematic, particularly in programs with a high content load, such as veterinary science. This study examined the differences between the perceptions of students and qualified veterinarians with regards to the entry-level communication skills required of new graduates in clinical practice. Surveys were distributed to students in each of the four year levels of the veterinary science degree at the University of Melbourne and to recent graduates and experienced veterinarians registered in Victoria, Australia. Respondents were asked to rank the relative importance of six different skill sets: knowledge base; medical and technical skills; surgical skills; verbal communication and interpersonal skills; written communication skills; and critical thinking and problem solving. They were then asked to rate the importance of specific communication skills for new graduate veterinarians. Veterinarians and students ranked verbal communication and interpersonal skills as the most important skill set for an entry-level veterinarian. Veterinarians considered many new graduates to be deficient in these skills. Students often felt they lacked confidence in this area. This has important implications for veterinary educators in terms of managing the expectations of students and improving the delivery of communication skills courses within the veterinary curriculum.

Which professional (non-technical) competencies are most important to the success of graduate veterinarians? A Best Evidence Medical Education (BEME) systematic review: BEME Guide No. 38

BACKGROUND

Despite the growing prominence of professional (non-technical) competencies in veterinary education, the evidence to support their importance to veterinary graduates is unclear.

AIM

To summarize current evidence within the veterinary literature for the importance of professional competencies to graduate success.

METHODS

A systematic search of electronic databases was conducted (CAB Abstracts, Web of Science, PubMed, PsycINFO, ERIC, Australian and British Education Index, Dissertations & Theses) from 1988 to 2015 and limited to the veterinary discipline (veterinar* term required). Evidence was sought from consensus-based competence frameworks, surveys of stakeholder perceptions, and empirical evidence linked to relevant outcomes (e.g. employability, client satisfaction or compliance). Data extraction was completed by two independent reviewers and included a quality assessment of each source.

RESULTS

Fifty-two sources were included in the review, providing evidence from expert frameworks (10 sources), stakeholder perceptions (30 sources, including one from the previous category), and empirical research (13 sources). Communication skills were the only competency to be well-supported by all three categories of evidence. Other competencies supported by multiple sources of empirical evidence include empathy, relationship-centered care, self-efficacy, and business skills. Other competencies perceived to be relatively more important included awareness of limitations, professional values, critical thinking, collaboration, and resilience.

CONCLUSIONS

This review has highlighted the comparatively weak body of evidence supporting the importance of professional competencies for veterinary graduate success, with the exception of communication skills. However we stress this is more indicative of the scarcity of high-quality veterinary-based education research in the field, than of the true priority of these competencies.

Final-year veterinary students' perceptions of their communication competencies and a communication skills training program delivered in a primary care setting and based on Kolb's Experiential Learning Theory

Veterinary graduates require effective communication skills training to successfully transition from university into practice. Although the literature has supported the need for veterinary student communication skills training programs, there is minimal research using learning theory to design programs and explore students' perceptions of such programs. This study investigated veterinary students' perceptions of (1) their communication skills and (2) the usefulness of a communication skills training program designed with Kolb's Experiential Learning Theory (ELT) as a framework and implemented in a primary care setting. Twenty-nine final-year veterinary students from the Ontario Veterinary College attended a 3-week communication skills training rotation. Pre- and post-training surveys explored their communication objectives, confidence in their communication skills, and the usefulness of specific communication training strategies. The results indicated that both before and after training, students were most confident in building rapport, displaying empathy, recognizing how bonded a client is with his or her pet, and listening. They were least confident in managing clients who were angry or not happy with the charges and who monopolized the appointment. Emotionally laden topics, such as breaking bad news and managing euthanasia discussions, were also identified as challenging and in need of improvement. Interactive small-group discussions and review of video-recorded authentic client appointments were most valuable for their learning and informed students' self-awareness of their non-verbal communication. These findings support the use of Kolb's ELT as a theoretical framework and of video review and reflection to guide veterinary students' learning of communication skills in a primary care setting.