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.

Comparison of a Silicon Skin Pad and a Tea Towel as Models for Learning a Simple Interrupted Suture

There has been rapid growth in the range of models available for teaching veterinary clinical skills. To promote further uptake, particularly in lower-income settings and for students to practice at home, factors to consider include cost, availability of materials and ease of construction of the model. Two models were developed to teach suturing: a silicon skin pad, and a tea towel (with a check pattern) folded and stapled to represent an incision. The models were reviewed by seven veterinarians, all of whom considered both suitable for teaching, with silicon rated as more realistic. The learning outcome of each model was compared after students trained to perform a simple interrupted suture. Thirty-two second-year veterinary students with no prior suturing experience were randomly assigned to three training groups: silicon skin pad or tea towel (both self-directed with an instruction booklet), or watching a video. Following training, all students undertook an Objective Structured Clinical Examination (OSCE), placing a simple interrupted suture in piglet cadaver skin. The OSCE pass rates of the three groups were silicon skin pad, 10/11; tea towel, 9/10; and video, 1/11. There was no significant difference between the model groups, but the model groups were significantly different from the video group (p < .017). In conclusion, the tea towel was as effective as the silicon skin pad, but it was cheaper, simpler to make, and the materials were more readily available. In addition, both models were used effectively with an instruction booklet illustrating the value of self-directed learning to complement taught classes.

Assessment of time to completion, number of errors, and knot-holding capacity of square knots and Aberdeen knots tied by veterinary students and student perceptions of knot security and knot-tying difficulty

OBJECTIVE

To assess the time to completion, number of errors, and knot-holding capacity (KHC) for starting and ending square knots (SSKs and ESKs) of a continuous pattern and Aberdeen knots tied by veterinary students and to investigate student perceptions of knot security and knot-tying difficulty for the 3 knot types.

SAMPLE

16 second-year veterinary students.

PROCEDURES

Students created 3 (4-throw) SSKs, 3 (5-throw) ESKs, and 3 (3 + 1 configuration) Aberdeen knots with 2-0 polydioxanone on a custom test apparatus. Time to complete each knot, the number of errors in each knot, and student ratings of knot-tying difficulty and confidence in knot security were recorded. Each knot was tested to failure on a uniaxial tensiometer to determine KHC and mode of failure. Variables of interest were compared by repeated-measures ANOVA or the Friedman test with post hoc pairwise comparisons.

RESULTS

Mean knot completion time for Aberdeen knots was significantly less than mean completion time for SSKs or ESKs. Mean KHC was significantly lower for ESKs than for SSKs; KHC for Aberdeen knots was not compared with these values because of methodological differences. Median error rate was higher for ESKs than for other knot types. Mean difficulty rating for Aberdeen knots was lower than that for ESKs. Most tested knots failed by breakage at the knot.

CONCLUSIONS AND CLINICAL RELEVANCE

Aberdeen knots appeared to be easy for veterinary students to learn and were completed more rapidly and with fewer errors than ESKs. Including this type of knot in surgical skills curriculum for novices may be beneficial.

Development and Evolution of the Clinical Skills Learning Center as an Integral Component of the Illinois Veterinary Professional Curriculum

The University of Illinois College of Veterinary Medicine opened a clinical skills laboratory in August 2009, making it one of the earliest North American veterinary schools to do so. The Clinical Skills Learning Center has been an integral component of the Illinois veterinary professional curriculum since its inception. However, its role in the curriculum has changed over time, which has had an impact on its size, scope, and staffing. In this article, we describe the development and growth of the Clinical Skills Learning Center, with an emphasis on its evolving curricular role and the lessons we have learned over nine years.

Retention of basic suturing skills with brief or extended practice in veterinary students

OBJECTIVE

To evaluate the effect of practice duration on accuracy, retention, and confidence when learning how to tie basic surgical knots.

STUDY DESIGN

Prospective study.

SAMPLE POPULATION

Fifteen first-year veterinary students.

METHODS

Students were randomly assigned to a 2-week practice (TWP) or an 8-week practice (EWP) to learn how to tie surgeon's, strangle, and miller's knots. Students' knot-tying accuracy and confidence were evaluated immediately after training, at an intermediate time point (2-6 weeks postpractice), and at 12 weeks postpractice.

RESULTS

Students who had been trained during an extended period tied the strangle knot correctly more often at all assessments (P = .025). The ability of students trained for 2 weeks to tie the strangle knot correctly decreased over time (P = .028). These students lost some confidence (P = .03) and repositioned suture more frequently (P = .03) while constructing the strangle knot at the final time point compared with students trained for 8 weeks. Students who completed TWP felt more confident at placing surgeon's knots than friction knots at the final assessment period (P = .0164 miller's knot, P = .0056 strangle knot), whereas confidence did not differ between knot types for students who completed EWP. All students felt less confident with their knot-tying skills at 12 weeks postpractice.

CONCLUSION

Training for 8 weeks rather than for 2 weeks resulted in superior knot tying skills. Students' confidence decreased 12 weeks after training.

CLINICAL SIGNIFICANCE

Prolonged distributed practice is recommended to train students for more complex tasks such as placement of a strangle knot.

Challenges & Issues: Evidence-Based Clinical Skills Teaching and Learning: What Do We Really Know?

The recent programmatic focus on skills development in veterinary medicine means that many programs are devoting increased time to formal clinical skills teaching. This expansion makes it essential that we use the time as effectively as possible. This review examines current practices and veterinary training principles using the broader field of evidence-based motor skills learning as a lens. In many areas, current practices may be hindering learning. Proposed practices include using videos and discussions for pre-laboratory training, focusing on a single complex skill at a time, using more near-peer instructors rather than faculty, including assessments in each teaching or practice session, and encouraging supervised distributed practice by incorporating practice sessions into the formal curriculum. Ensuring mastery of a few core skills rather than exposure to many may be the new goal. Further research is urgently needed on block versus spiral curricula, optimum instructor-to-student ratios, learning and practice schedules, hours required for proficiency, and the benefits of exercise on motor skills learning.

Evaluation of a First-Year Veterinary Surgical Skills Laboratory: A Retrospective Review

A retrospective review of the first-year surgical skills competency-based assessment was performed at the Western College of Veterinary Medicine (WCVM) using 6 years of data from 475 students. The cumulative pass rate was 88.2% on first attempt and 99.2% upon remediation. Student gender did not influence overall pass/fail rates, with a failure rate of 11.1% for female students and 10.5% for male students (p = 0.88). Significantly decreased pass rates were associated with identification of the Mayo scissors (p = 0.03), explanation of using Allis tissue forceps (p = 0.002), and performance of a Lembert suture pattern (p < 0.01). An increased pass rate was observed for the cruciate pattern (p < 0.01). No differences were found in pass/fail rates for hand ties (p = 0.80) or instrument ties (p = 0.60). The most common errors occurred with half hitch ties: hand ties (53%) and instrument ties (38%). The most common errors were also recognized for instrument handling (31%) and needle management (20%) during the suture pattern section. The veterinary medical education community may benefit from the evidence-based findings of this research, in terms of understanding student performance across competencies, identifying areas requiring additional mentoring, and determining appropriate competencies for first-year veterinary students.

Evaluation of peer teaching and deliberate practice to teach veterinary surgery

OBJECTIVE

To assess the impact of peer teaching and deliberate practice on surgical skills acquisition and retention in first- and second-year veterinary students.

STUDY DESIGN

Randomized, prospective, comparative study.

SAMPLE POPULATION

Eighteen first-year and 25 second-year students from 1 college of veterinary medicine who had previously demonstrated proficiency in basic surgical skills.

METHODS

Forty-three participants were divided into 3 groups: the test group (group A, n = 15), who participated in a structured peer-assisted learning program using deliberate practice; the time-practice control group (group B, n = 15), who participated in an unstructured peer-supported environment; and the assessment-only control group (group C, n = 13), who participated in the assessments. Participants performed a subcutaneous mass removal on a cadaver model and were assessed via a global rating system. Three assessment points were evaluated: pretraining, immediate posttraining, and retention.

RESULTS

The number of participants who achieved acceptable or excellent grand total scores in group A increased after training. Among all participants, 22% in group A, 35% in group B, and 38% in group C did not achieve an acceptable total score at the retention assessment.

CONCLUSION

The study population improved in skill level and retention through the use of standardized video and peer instruction with attention to effective learning strategies, particularly deliberate practice.

CLINICAL SIGNIFICANCE

Use and enhancement of the format introduced in this study could augment veterinary surgical education.

Teaching Veterinary Anesthesia: A Survey-Based Evaluation of Two High-Fidelity Models and Live-Animal Experience for Undergraduate Veterinary Students

In veterinary medical education, reduction, replacement, and refinement (the three Rs) must be considered. Three clinical skills in anesthesia were identified as challenging to students: endotracheal intubation, intravenous catheterization, and drug dose calculations. The aims of this project were to evaluate students' perception of their level of confidence in performing these three clinical skills in veterinary anesthesia, to document the extent of students' previous experience in performing these three tasks, and to describe students' emotional states during this training. Veterinary students completed a series of four surveys over the period of their pre-clinical training to evaluate the usefulness of high-fidelity models for skill acquisition in endotracheal intubation and intravenous catheterization. In addition, practice and ongoing assessment in drug dose calculations were performed. The curriculum during this period of training progressed from lectures and non-animal training, to anesthesia of pigs undergoing surgery from which they did not recover, and finally to anesthesia of dogs and cats in a neutering clinic. The level of confidence for each of the three clinical skills increased over the study period. For each skill, the number of students with no confidence decreased to zero and the proportion of students with higher levels of confidence increased. The high-fidelity models for endotracheal intubation and intravenous catheterization used to complement the live-animal teaching were considered a useful adjunct to the teaching of clinical skills in veterinary anesthesia. With practice, students became more confident performing drug dose calculations.