The Healer's Art (HART): Veterinary Students Connecting with Self, Peers, and the Profession

A Systematic Review of Mental Health-Improving Interventions in Veterinary Students

Literature over the past 5 years has demonstrated that veterinary students globally are experiencing poor mental health. This has detrimental consequences for their emotional well-being and physical health, as well as implications for their future careers. Considering this issue, a systematic review was devised to investigate what interventions were being used, and what effect they had, in veterinary students. The review process involved a search of five databases, from which 161 records were retrieved. Following this, the screening process revealed seven articles eligible for appraisal. These studies investigated seven different interventions, six being cohort-level workshops/courses and one being a collation of several individual strategies. All seven studies reported that the interventions were effective to some degree in improving the mental health of their participants. However, the lack of repeat interventions and control groups limited the external validity of each intervention. A comparison to the research in medical students is briefly discussed. Three of the appraised articles were recommended for further investigation.

Evaluation of team effectiveness and personal empathy for associations with professional quality of life and job satisfaction in companion animal practice personnel

OBJECTIVE

To examine variables of veterinary team effectiveness and personal empathy for associations with professional quality of life (ie, compassion satisfaction, burnout, and secondary traumatic stress) and job satisfaction in companion animal practice personnel.

DESIGN

Cross-sectional survey.

SAMPLE

Data from 232 surveys completed by personnel from 10 companion animal veterinary practices in 2 regions of the United States between April 7 and December 20, 2016.

PROCEDURES

Online surveys were used to collect practice-level data (eg, practice type, setting, and staffing) and individual-level data (eg, demographics, job position, and years in the position and profession). Instruments used in developing the surveys included the Team Effectiveness Instrument, Davis Interpersonal Reactivity Index, Professional Quality of Life Scale, and a measure for job satisfaction. Data were evaluated for associations with professional quality of life and job satisfaction.

RESULTS

Individual engagement was positively associated with job satisfaction, negatively associated with secondary traumatic stress, and moderated by levels of personal distress for compassion satisfaction and burnout. Toxic team environment was positively associated with burnout and negatively associated with job satisfaction. Empathetic concern and personal distress were both positively associated with secondary traumatic stress. Empathetic concern was moderated by team engagement for compassion satisfaction.

CONCLUSIONS AND CLINCAL RELEVANCE

Results indicated that variables influencing professional quality of life and job satisfaction were multimodal and included aspects of team effectiveness and empathy; therefore, workplace strategies that enhance individual and team engagement and mitigate toxic team environments could potentially improve professional quality of life and job satisfaction in veterinary personnel.

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.

Meaningful work and well-being: a study of the positive side of veterinary work

OBJECTIVES

Mental health is a growing concern in many healthcare professions, including veterinary medicine, as research suggests that veterinarians report higher levels of distress, burnout and suicidal ideation than other healthcare occupations and the general public. A recent literature review found that about twice as many articles published on veterinary wellness refer to the negative aspects of mental health (eg, stress and depression) compared with the positive aspects of well-being. Little attention has been devoted to examining the positive aspects of veterinarians' work, and few models have been developed to explain their well-being. This paper empirically assesses a veterinary model of work-derived well-being based on the theory of eudaimonia. Eudaimonic well-being reflects having fulfilling work that contributes to the greater good. Three core clusters of job characteristics are hypothesised relevant to veterinarian well-being that include: actualising self, helping others (animals or people) and a sense of belonging (to team or profession). In addition, meaningful work is proposed as the mechanism through which situational job characteristics may exert a positive influence on well-being.

METHODS

Survey data from 376 veterinarians in clinical practice were analysed using path analysis.

DISCUSSION

Meaningful work is important in understanding the well-being of veterinarians. Job characteristics (self-actualising work, helping animals and people and a sense of belonging) contribute to a sense of meaningful work, which in turn is related to eudaimonic well-being. Excessive job demands (work overload, financial demands and physical health risks) appear less relevant in understanding meaningful work but are clearly important in having negative consequences for veterinarians' well-being.While strategies that cultivate meaningful work may be effective in nurturing veterinarians' well being, several limitations of this study should be noted. First, due to the cross-sectional data, definitive statements about the causal ordering of variables cannot be made. Second, the data were derived from a single source such that monomethod bias may be an issue. Third, the data rely on self-report measures and the responses may be influenced by social desirability or response biases. Lastly, while the sample may be representative of the veterinarians throughout a large geographic area in Canada, it may not represent the work arrangements of veterinarians in other countries.

CONCLUSIONS

The significance of these findings is that they may shift research attention from focusing on the harmful, demanding aspects of veterinary work to better understanding the deeply meaningful aspects that improve veterinarians' well-being. In addition, the results may stimulate consideration of strategies that move beyond individual-level interventions that focus on veterinarians adopting better coping strategies and becoming more resilient. This may lead to adopting organisational and occupational-level strategies that can involve promoting more positive and supportive workplace cultures and developing more professional resources for promoting wellness and meaning in the profession of veterinary medicine.

Using a Standardized Client Encounter to Practice Death Notification after the Unexpected Death of a Feline Patient Following Routine Ovariohysterectomy

Death notification is an important skill for health care providers to carry out, yet few clinicians feel adequately prepared to complete this task. To address these gaps in clinical training, some medical educators have incorporated standardized patients (SPs) into the curriculum to allow students to practice death notification in a safe, controlled environment. Veterinary educators agree that end-of-life communication skills are essential for success in clinical practice, and many rely on standardized clients (SCs) for role-play concerning euthanasia. However, anticipatory loss is distinct from unexpected death, and death notification is strikingly absent from the veterinary literature. To introduce students to death notification, Midwestern University College of Veterinary Medicine (MWU CVM) developed a communications curriculum that culminated in a scripted encounter, "Basil, the Scottish Fold." Students must explain to an SC that his kitten died following routine ovariohysterectomy. Pre- and post-event surveys completed by 19 students demonstrated valuable lessons in death notification word choice, particularly what not to say. I hope that this teaching tool may be adapted for use by other colleges of veterinary medicine to allow students to practice death notification.