Clinical communication patterns of veterinary practitioners during dairy herd health and production management farm visits

How can better calf care be realized on dairy farms? A qualitative interview study of veterinarians and farmers

Improving health and welfare outcomes for replacement and surplus dairy calves is important for the sustainability of the dairy industry. Dairy farmers and veterinarians hold expertise in calf management and have valuable perspectives on how to practically motivate improvements. The objective of this study was to determine strategies that could improve the care calves receive on dairy farms from the perspective of dairy farmers and their herd veterinarians. Two veterinary clinics specializing in dairy practice in British Columbia, Canada, and 21 of their client dairy farms participated in the project. Following a meeting in which calf colostrum management was discussed between farmers and their herd veterinarian, participant interviews were conducted. Separate interviews were conducted for the farmers (n = 27 farmers from 21 farms) and their herd veterinarians (n = 7, with 1 to 5 farms that each vet worked with enrolled in the study) using tailored semi-structured question guides. Interviews (n = 42) were transcribed and coded following inductive thematic analysis methodology. The themes identified included strategies for farmers, veterinarians, and calf buyers, as well as contexts that influenced the dairy farmers' internal motivation to provide good calf care. Results indicated that farmers could optimize their calf management through fostering engagement of calf care personnel or by enlisting technology. Veterinarians could provide support to farms by being actively involved in calf monitoring, assisting in developing operating protocols, and setting goals, and especially by using farm-specific data to guide their management recommendations. Calf buyers could communicate with and provide accountability to farmers and improve their purchasing strategies to encourage farms to raise more vigorous surplus calves. Farmers' personal values, social networks, and relationships with different dairy industry stakeholders influenced their concern about the standards of their calf care practices. These findings provide guidance on how dairy farmers could achieve or be prompted to achieve improvements in their calf care practices.

Long-term effects of motivational interviewing vs. traditional counseling on dog owners' adherence to veterinary dental home care: a three-year follow-up study

Introduction

Periodontal disease is one of the most common health issues in dogs. However, disease is largely preventable by eliminating dental plaque, best achieved by daily tooth brushing. Unfortunately, owner adherence is low to the recommendation of daily tooth brushing in dogs.

Objective

This study aimed to evaluate the impact of various communication strategies, traditional advice (TA) versus motivational interviewing (MI), and compare them to a control group receiving no additional communication (CG), on dog owners' performance of dental home care and the oral health of their dogs.

Methods

The study was conducted as a longitudinal clinical intervention study spanning 3 years, and involved 75 dog owners with young dogs who were randomly assigned to one of three groups: TA, MI, or CG. Intervention groups received annual telephone consultations based on their assigned methodology. A questionnaire was administered twice to all groups, and the dental health of the dogs was assessed at the study's conclusion.

Result

Tooth brushing frequency demonstrated a significant increase in the MI group compared to the CG group (p < 0.01), albeit with a relatively low occurrence of daily brushing among owners. Dental health assessment revealed a significantly lower plaque index in the MI group compared to the CG group (p < 0.05), and a lower calculus index in the TA group compared to the CG group (p < 0.01). No statistically significant differences were observed between the MI and TA groups in terms of dental health.

Conclusion

Regular veterinary communication appears to have a positive influence on dog owner adherence to veterinary recommendations concerning dental care in dogs. Communication with veterinarians (MI and traditional advice) improved owner knowledge, attitude, and decreased frequency of not brushing. Although dental health parameters improved, the effect size was small, suggesting the complexity of adherence. Personalized calls to dog owners offer potential for dental health improvement, warranting further comparison of MI with traditional advice.

Clinician motivational interviewing skills in 'simulated' and 'real-life' consultations differ and show predictive validity for 'real life' client change talk under differing integrity thresholds

Background

Accurate and reliable assessment of clinician integrity in the delivery of empirically supported treatments is critical to effective research and training interventions. Assessment of clinician integrity can be performed through recording simulated (SI) or real-life (RL) consultations, yet research examining the equivalence of these data is in its infancy. To explore the strength of integrity assessment between SI and RL samples in Motivational Interviewing (MI) consultations, this article examines whether Motivational Interviewing Treatment Integrity (MITI) assessments differ between SI and RL consultations and reviews the predictive validity of SI and RL MI skills categorisations for RL client response language.

Methods

This study first compared MITI coding obtained in SI and RL consultations for 36 veterinary clinicians. Multilevel models of 10 MITI behaviour counts and four MITI global scores were run using MLwiN 3.02 to assess if a significant difference existed between SI and RL MITI data, with consultation within clinician within cohort (A and B) as nested random effects. Second, we investigated the effect of SI and RL MI skills groupings on rate of RL client response talk using three multivariable regression models. Two Poisson regression models, with random intercepts for farm and veterinarian and offset for number of minutes of the recordings, were estimated in the statistical software R using the package glmmTMB for the two response variables Change Talk and Sustain Talk. A logistic regression model, with the same random intercepts, with the response variable Proportion Change Talk was also estimated using the same package.

Results

Veterinary clinicians were less MI consistent in RL consultations, evidenced through significantly lower global MITI Cultivating Change Talk (p < 0.001), Partnership (p < 0.001) and Empathy (p = 0.003) measures. Despite lower objective MI skills groupings in RL consultations, ranking order of veterinary clinicians by MI skills was similar between contexts. The predictive validity of SI and RL MI skills groupings for RL client Change Talk was therefore similar, with significantly more RL client Change Talk associated with veterinarians categorised in the highest grouping ('moderate') in both SI (p = 0.01) and RL (p = 0.02) compared to untrained veterinarians in each respective context.

Conclusions

Findings suggest SI and RL data may not be interchangeable. Whilst both data offer useful insights for specific research and training purposes, differing contextual MI skills thresholds may offer a more equitable assessment of clinician RL client-facing MI integrity. Further research is needed to explore the applicability of these findings across health contexts.

Use of an online gaming tool, the Veterinary DialogueTrainer, for teaching clinical communication skills to bovine veterinary practitioners

Effective clinical communication is essential for bovine veterinary practitioners to establish and maintain positive client relationships. When applied properly in herd health consultancy, it increases client satisfaction and adherence to veterinary advice, and improves patient health and welfare. Although communication skills are often taught by providing feedback on simulated conversations, this has limitations, including time constraints, subjective assessments, and cost. The Veterinary DialogueTrainer (VDT) is an online serious game platform using 'digital role-play' with avatars, recently developed to enhance and assess learning outcomes, improve use of learned skills, and increase cost-effectiveness of communication training. The objective was to evaluate its suitability and applicability. Finnish (n = 24) and Swedish (n = 21) bovine veterinarians participated in communication training using VDT for training and assessment. Participants completed the provided scenario at least twice. After playing a bovine health communication simulation, participants received their scores and feedback on selected conversation options. VDT scores measured multiple aspects of communication on a 0-100% scale, based on motivational interviewing methodology and Calgary-Cambridge guidelines. Mean (±SD) number of attempts participants played the scenario was 4.1 (±2.6, Finland) and 3.9 (±1.3, Sweden), with highest total score reached after a mean of 3.5 (±2.1, Finland) and 3.1 (±1.1, Sweden) attempts. On the first attempt, 39 participants (87%) scored <50% of the highest possible score, whereas most (n = 34, 76%) achieved a higher score on the second attempt. Mean total score increased from 15 (±14) to 77% (±33) for Finish participants and from 40 (±22.0) to 87% (±19.4) for Swedish participants. The majority (n = 33, 73%) of participants reached a score >80% after 4.0 (±1.6, Finland) or 2.8 (±1.0, Sweden) attempts. Net Promoter Score of the training was +89 (Finland), +88 (Finland) and + 83 (Sweden) on a scale from -100 to +100, indicating that most participants were very likely to recommend the training to other veterinarians. Use of VDT increased communication skills scores but whether it will improve communication skills in practice requires further study. We concluded there is a likely benefit of using the VDT in teaching and monitoring veterinary communication competencies and preparing for offline role-plays and real-life conversations in veterinary practice.

Integrating Communication Skills, Awareness of Self and Others, and Reflective Feedback into One Inclusive Anatomical Representation of Relationship-Centered Health Care

The American Veterinary Medical Association Council on Education mandates in standard 11 that all accredited colleges of veterinary medicine must develop and deliver formal processes by which students are observed and assessed in nine competencies. The eighth competency combines clinical communication and sensitivity toward soliciting and understanding individual narratives across a diverse clientele to facilitate health care delivery. Several frameworks have been designed to structure health care consultations for teaching and coaching purposes. The Calgary-Cambridge guide (CCG) provides an evidence-based approach to outlining the flow of consultations, incorporating foundational communication skills and elements of relationship-centered care into a series of sequential tasks. Although the CCG was intended for use as a flexible tool kit, it lacks visible connections between concrete experiences (e.g., the consultation) and reflective observation (e.g., the feedback). This teaching tip describes the development of a novel anatomical representation of the consultation that integrates process elements of the CCG with other core curricular concepts. By combining knowledge, technical skills, critical thinking, reflection, cultural humility, and self-awareness into a skeletal consultation model, linkages are established between communication and intergroup dialogue skills, diversity and inclusion (D&I). This model has been further adapted as feline, caprine, porcine, equine, avian, and reptilian versions for in-class use as strategic visual aids that highlight key areas of focus for Professional Skills class sessions. Future developments by the authors will explore how to link species-specific consultation models to assessment rubrics to reinforce the connection between content (what) and process (how).

Empathy Levels among Veterinary Medicine Students in Colombia (South America)

Empathy plays an important role in veterinarians' relationships with their patients, clients, and colleagues. Because it relates to greater clinical competence and facilitates the acquisition of information for diagnosing, prescribing therapies, and identifying and treating animal pain, empathy is an essential competence to be strengthened during professional training. The objective of this study was to evaluate the empathy levels of veterinary medicine students toward people and animals and to identify associated factors. The animal empathy scale and the Davis interpersonal reactivity index were applied through an electronic survey to first-, third-, and fifth-year students (n = 559) in three veterinarian medical schools in Colombia. A principal components analysis was performed to identify composite scores of human and animal empathy levels. The empathy toward humans total score ranged from 0 to 112, and the empathy toward animals total score was between 22 and 198. The average empathy scores for students were 89.67 ± 9.02 (mean ± SD; range: 60-115) and 115.01 ± 13.41 (mean ± SD; range: 67-165), respectively. The results suggest that empathy scores toward people are acceptable. Gender, university, program type, age, year of study, and diet were significantly associated with empathy levels toward animals. It is proposed that levels of empathy toward animals be strengthened by fostering a positive learning environment, developing ethical and animal welfare competencies, and increasing empathetic contact and hands-on experience with animals during the curriculum.

Veterinary communication can influence farmer Change Talk and can be modified following brief Motivational Interviewing training

Current veterinary communication skills training often focuses on the strategies necessary to successfully transfer information and promote shared decision making rather than inspiring client motivation to engage in behaviour change(s). One evidence-based communication methodology with a specific focus on enhancing conversations about change is Motivational Interviewing (MI), which is perceived by veterinarians to be highly relevant to their profession. We examined whether veterinarians who experienced brief (4–5 hours) MI training (BMIT) were able to change their communication behaviours to be more MI consistent. Fourteen veterinarians recorded 31 veterinary herd health consultations before (n = 15) and after (n = 16) BMIT to allow pre-post intervention analysis of veterinarian and farmer verbal behaviour. Additionally, using a sequential linguistic analysis of 3885 veterinarian-farmer communication events within these consultations, the influence of veterinarians’ verbal behaviours on farmers’ response language was explored. Analysis of veterinary consultations undertaken before and after BMIT revealed that veterinarians changed their communication style to be more consistent with the MI methodology, including more use of reflection statements, a more empathic and partnership-oriented consultation style and greater emphasis on clients’ own language in favour of change goals. In response, farmers contributed more to the conversation and discussed more herd health-related changes. Sequential linguistic analysis suggested that following a veterinarian emphasising something positive about the farmer (e.g. efforts, strengths), seeking collaboration or emphasising farmer choice, farmers were subsequently more likely to express arguments in favour of change (‘Change Talk’), especially phrases indicative of commitment. This study offers the first evidence of the potential value of a BMIT experience to enhance veterinary communication skills, although conscious and disciplined use of MI principles, strategies and Spirit–an ethos of compassion, acceptance, partnership and evocation—requires longer and more complex training. Further studies examining the longevity and consistency of these verbal behaviour changes following BMIT are required.

Dairy herd health management activities in relation to training of veterinarians in motivational interviewing

Communication has been identified as one constraint for cattle veterinarians to act as proactive health consultants. Motivational Interviewing (MI), an evidence-based client-centered communication methodology, may therefore be a useful tool in veterinary herd health management (VHHM). The aim of this exploratory study was to investigate associations between training in MI and different measures of performance in VHHM. MI skills of 36 Swedish cattle veterinarians randomly assigned to two groups - MI veterinarians (n = 18) who had received six-months training in MI and control veterinarians (n = 18) who were not trained - were assessed using the MI Treatment Integrity coding system. Skills were categorized as untrained, trained_poor, trained_near moderate and trained_moderate. Veterinarians each visited two to six cattle farms for VHHM consultations and revisited the same farms three to six months later to document implementation of recommendations. A gamma model and logistic or ordered logistic regression models were used to evaluate associations between MI training and performance measured as: a) proportion of consultations resulting in written herd health plans, b) proportion of recommended measures fully or partially implemented, c) Likert scores of different estimates of client satisfaction and d) total time during 6 months allocated to VHHM visits on cattle farms. We found no evidence of any significant effects of MI training on the eight performance variables analyzed. However, a pattern of numerically higher values (better performance) in trained veterinarians with poor or moderate MI skills than in untrained veterinarians was observed in most variables. Clients were highly satisfied with veterinarians' attitude, competence and time efficiency. Farms implemented a median of 66.7% (interquartile range: 50-100) of the measures partially or fully. Veterinarians allocated little time to VHHM visits (median: 2.2; interquartile range: 0.65-4.1 h per week of full-time work within cattle). Veterinarians with moderate skills spent 2.14 times more time on VHHM visits than untrained veterinarians, but the confidence interval was wide (0.88-5.21). The pattern of numerically higher values in trained veterinarians supported findings from other studies in the same project indicating a positive effect of MI training on VHHM. Our observations suggest a considerable potential to increase veterinarians' engagement in VHHM.

Impact of Veterinary Herd Health Management on German Dairy Farms: Effect of Participation on Farm Performance

German dairy farming has intensified markedly in recent years, and the demand for Veterinary Herd Health Management (VHHM) is rising. To protect farms from epidemics, ensure food safety, and prevent developing of antibiotic resistance, VHHM has been anchored in EU law since April 2021. Via an online survey, distributed by different farmers' organizations, dairy farmers were asked about the cooperation with their veterinarian. The aim was to evaluate farm performance as a function of participation in VHHM. From 216 analyzed questionnaires, 106 respondents participated in VHHM. Results showed that farmers who make use of VHHM and consult their veterinarian in decision-making frequently have the highest 305-day milk yield (305dMY), the lowest bulk tank somatic cell counts, and the lowest age at first calving (AFC). However, these farmers tended to have higher replacement rates and a higher mortality of cows in the period up to 60 days in milk (MORT60DIM). Furthermore, respondents who defined VHHM as “evaluation of herd data, strategic planning” had the highest 305dMY compared with those who defined VHHM through one of the different options given (“pregnancy checks and support in reproduction”/“problem solving”). In the multifactorial regression model, VHHM participating farms had a 660-kg higher 305dMY and 1 month less in AFC, compared with farms not participating in VHHM. However, within the VHHM participants, no association between VHHM practices and performance parameters was found. Further research is needed, to find out if tailored advice of the VHHM approach may show effect herein.

Historical Evolution of Cattle Management and Herd Health of Dairy Farms in OECD Countries

This work aimed to review the important aspects of the dairy industry evolution at herd level, interrelating production with health management systems. Since the beginning of the industrialization of the dairy cattle sector (1950s), driven by the need to feed the rapidly growing urban areas, this industry has experienced several improvements, evolving in management and technology. These changes have been felt above all in the terms of milking, rearing, nutrition, reproductive management, and design of facilities. Shortage of labor, emphasis on increasing farm efficiency, and quality of life of the farmers were the driving factors for these changes. To achieve it, in many areas of the world, pasture production has been abandoned, moving to indoor production, which allows for greater nutritional and reproductive control of the animals. To keep pace with this paradigm in milk production, animal health management has also been improved. Prevention and biosecurity have become essential to control and prevent pathologies that cause great economic losses. As such, veterinary herd health management programs were created, allowing the management of health of the herd as a whole, through the common work of veterinarians and farmers. These programs address the farms holistically, from breeding to nutrition, from prevention to consultancy. In addition, farmers are now faced with a consumer more concerned on animal production, valuing certified products that respect animal health and welfare, as well as environmental sustainability.

Producer Perceptions Toward Prevention and Control of Lameness in Dairy Cows in Alberta Canada: A Thematic Analysis

Lameness in dairy cattle poses both an animal welfare and economic threat to dairy farms. Although the Canadian dairy industry has identified lameness as the most important health issue, lameness prevalence in the province of Alberta has not decreased over the last decade. Factors related to lameness have been reported, but the prevalence remains high. Therefore, this study was conducted to investigate dairy producers' perceptions on lameness and how these perceptions influence lameness prevalence in their cows. Qualitative interviews with open-ended questions were conducted with nine dairy producers in Alberta, Canada presenting farms with a wide variety of lameness prevalence. Thematic analysis of these interviews revealed five major themes, as well as five distinct types of producers regarding their perceptions. All nine producers mentioned similar challenges with lameness prevention and control. Identifying lameness, taking action, delays in achieving success, various approaches to prevention and control strategies, and differences between farms were the challenges encountered. However, producers' attitudes when dealing with these challenges varied. We concluded that understanding producers' perceptions is essential as no “one size fits all”, when advising them regarding how to address lameness, as guidance and support will be most successful when it is aligned with their viewpoint.

Benefits of Veterinary Herd Health Management on German Dairy Farms: Status Quo and Farmers' Perspective

Veterinary Herd Health Management plays an important role in veterinary medicine on dairy farms and has also been mandatory at the European Union level since April 21, 2021. Despite the increasing importance of VHHM, little is known about the extent of utilization of VHHM by dairy farmers and their view on this type of collaboration. Therefore, this cross-sectional study aimed to determine the status quo of the currently practiced VHHM in Germany. For this purpose, an online survey was conducted among dairy farmers in November and December 2020. From 216 analyzed questionnaires, about half (n = 106) of the surveyed dairy farmers used VHHM at different scopes. However, regardless of the group, the term “veterinary herd health management” generally was given most relative importance by the participants as a veterinary service for herd fertility improvement, rather than the actual definition of a holistic approach. In contrast to this, the actual motivation of the VHHM participants, to take part in such a program was primarily based on the desire to safeguard animal health by employing preventive measures, that is, to avoid the occurrence of diseases via improved management and to improve farm performance (and profitability). Dairy farmers who opted for VHHM tended to manage larger higher yielding herds than those who did not. Additionally, the farmers in latter farms were more likely to make joint animal health decisions with their veterinarians. Using a latent class analysis, two groups of farmers among farms that were not currently using VHHM were identified, one of which expressed great interest in using VHHM while the other did not. Since the new legal basis makes the topic even more relevant than before, dairy farmers, animals, and veterinarians might benefit from the study to exploit hidden opportunities for VHHM collaboration.

Communication skills training and assessment of food animal production medicine veterinarians: A component of a voluntary Johne's disease control program

In food animal production medicine (FAPM), the success of control programs for infectious diseases that have serious animal health and economic consequences frequently rely on the veterinarian's effective communication and producer adherence to veterinary recommendations. However, little research has been conducted on communication skills of practicing FAPM veterinarians. During this study, we developed a communication training workshop intervention to support the Atlantic Johne's Disease Initiative. Seventeen FAPM veterinarians across 10 clinics practicing within Maritime Canada participated in a pre-post intervention study design. Communication skills were evaluated utilizing 3 assessment tools; an objective structured clinical exam (OSCE), standardized client feedback, and an instrument designed for veterinary participants to assess their self-efficacy. Study results showed that before training, communication skills of participating veterinarians had limitations, including skill deficits in communication tasks strongly associated with increased adherence to veterinary recommendations. Based on the 3 assessment tools, communication skills of participating veterinarians improved with the training provided. Significant increases were detected in pre- to postintervention self-efficacy percentage scores, OSCE percentage and global scores from expert raters, and OSCE percentage and global scores from standardized client feedback. These improvements emphasize the importance of communication skills training specific to FAPM.

Small Animal Veterinarians' Communication With Dog Owners From a Motivational Interviewing Perspective

Veterinary communication skills are fundamentally important in animal practice. Despite client-centered communication being recommended as the optimal medical communication style, a paternalistic approach is still common in veterinary medical encounters with pet owners. Motivational interviewing (MI) is a client-centered, evidence-based counseling method aiming to strengthen a person's motivation and commitment to behavior changes. In this exploratory study, the aim was to investigate Swedish small animal veterinarians' use of client centered communication with dog owners regarding dental home care in dogs. This was achieved by analyzing the use of MI-techniques among veterinarians without previous training or knowledge of the method. Individual telephone calls, reflecting a veterinary clinical scenario, between small animal veterinarians (n = 8) and a trained professional actor playing a dog owner were recorded and coded according to an MI coding protocol (MITI 4.2.1). In the present study, the degree of spontaneously used MI was low. From an MI-communication perspective, with a simulated dog owner, the veterinarians predominantly relied on asking questions, giving information, and persuasive talk. The veterinarians dominated the conversations and made minimal attempts to involve the dog owner resulting in a power imbalance between veterinarian and client. As the degree of spontaneously used MI was found to be low, MI-training may be required in order to apply the method in professional counseling. The veterinarians' communication pattern suggested a paternalistic communication style, when attempting to motivate a client to brush his or her dog's teeth. We suggest that Motivational Interviewing (MI) has a potential to improve veterinary communication and adherence to medical recommendations if introduced and implemented in veterinary practice.

A proposed structural approach to improve cow-claw health on Dutch dairy farms

Despite extensive research leading to an improved understanding of the risk factors and pathogenesis of infectious and non-infectious disorders, claw health has not structurally improved in recent decades. Several studies have shown that claw disorders harm milk production, fertility and longevity of the dairy cows and job satisfaction of the farmer. This is enough reason to structurally improve claw health on dairy farms. The focus should be on a rapid curative intervention when lameness occurs and above all the prevention of claw problems. Most claw disorder diagnoses are nowadays made during regular claw trimming by the professional trimmer or the dairy farmer. Registration of the detected disorders during claw trimming is not always done consistently, so the estimated prevalence (number of cows with a claw disorder) is in most cases an underestimation of the real prevalence. The quality of these records often makes it difficult for consultants to formulate appropriate claw health advice. To be able to give good advice on claw health, insight into the prevalence of the various hoof disorders on a farm is a key condition. However, good quality advice alone is not a guarantee for an improved claw health situation on a farm. Research has shown that in addition to high quality substantiated advice, the communication style between the consultant and the dairy farmer is essential for the interpretation and motivation of the dairy farmer to implement the advice. In this paper a 7-point plan is presented as a guidance for herd advisors who want to support dairy farmers to improve claw health.

The use of the roter interaction analysis system in assessing veterinary student clinical communication skills during equine wellness examinations in rural Kentucky, USA: A pilot study

BACKGROUND

Effective clinical communication can aid veterinarians in building good client relationships, increase adherence to recommendations and, ultimately, improve patient health and welfare. However, available information on veterinary communication in the equine context is limited. The objective of this study was to describe the communication of veterinary students in the equine environment who had previous communication training. Additionally, we assessed the suitability of the Roter Interaction Analysis System (RIAS) for the analysis of audio-video recordings of equine wellness consultations.

METHODS

Twenty-seven equine wellness consultations performed by second-year Ross University School of Veterinary Medicine students were recorded in rural Kentucky, United States of America. Recordings were submitted to a professional coder who applied the RIAS to the equine context by expanding or adjusting code definitions.

RESULTS

A substantial amount of utterances (i.e. segments of speech) were allocated to core communication skills including building rapport (30%), facilitation and client activation (24%) and education and counselling (23%). There was a large variation in utterances used among consultations of the same veterinary student and students; they did not appear anxious or nervous.

CONCLUSIONS

Students made use of core communication skills, indicating that experiences from pre-clinical training could be transferred to equine practice. Furthermore, this study demonstrated that the RIAS could be considered for consecutive studies aiming to provide observational data on clinical communication in the equine context.

Motivations and Barriers for Veterinarians When Facilitating Fertility Management on UK Dairy Farms

It is economically essential, but challenging, for dairy farmers to manage bovine fertility. Vets can help farmers to improve fertility, and this is cost-effective bringing benefits for production, animal health and welfare, and the environment. However, the extent to which vets are involved in fertility varies considerably between farms, for reasons that are unclear. This study investigated the motivators and barriers that vets perceive when trying to increase their involvement with fertility management on UK dairy farms. Interviews were conducted with 20 vets and four themes identified. The first, "clinical baggage," highlighted vets' disillusionment due to past experiences of low uptake of their advice by farmers. Consequently, some vets made assumptions about farmer needs and behaviours, and exhibited ageist stereotyping. These issues, along with concerns and fatigue associated with repeatedly offering the same advice which was not acted upon, negatively influenced vets' engagement with farmers. The second theme "stuck in the comfort zone" revealed a loss of enthusiasm by some senior vets, whilst others lacked confidence to engage due to perceived gaps in their knowledge. Vets also reported farmers not perceiving their problems and lack of farm data or facilities, as barriers. The "vet-farmer relationship" theme highlighted building trust and developing strong relationships which were key drivers for vets to proactively engage and to "go the extra mile" for their clients. The final theme "money matters" explored vets' motivations to improve their clients' profitability and included the future sustainability of their own businesses. Our themes provide useful insight into the challenges vets face and provide key areas that can be targeted in future interventions to improve veterinary involvement in fertility management. For example, post-graduate training and support for vets needs to consider factors such as reflection, mentorship, stereotyping, relationships, communication, and leadership skills. This type of postgraduate support is currently limited for vets and requires investment from stakeholders if improvements in production, animal health and welfare, and the environment are to be achieved. Our findings are informative for facilitating veterinary involvement in any disease context, and are relevant for stakeholders including governments, educators, charities, farmer representatives, environmentalists, and veterinary leaders.

Changing Veterinary Attitudes towards Delivering Biosecurity Advice to Beef Farmers

Simple Summary

Biosecurity advice is an important way veterinarians can help farmers to reduce disease burdens on their farms. Many different factors are at play when delivering this advice, one being veterinary competence and their communication skills. This study looked at the private veterinary practitioners’ perceptions of their own competence to deliver biosecurity advice as part of a longitudinal biosecurity project spanning two years. Their responses were collected in the form of a telephone questionnaire. The results showed that as the project progressed the private veterinary practitioners felt more comfortable, better capable, and more consistent in giving their advice. In addition, they felt the uptake of their advice by the famers had improved throughout the study period. The mean average time spent delivering biosecurity advice increased and dropped subsequently, suggesting an initially more thorough process, and later a more efficient process. The results suggest development of the participating veterinarians following the conscious-competence learning model, showing a need to improve the knowledge and training of future generations of vets in the area of biosecurity with an increased focus on the importance of the veterinarian-farmer relationship in particular.

Abstract

Biosecurity advice is an important way veterinarians can help farmers to reduce disease burdens on their farms. Many different factors are at play when delivering this advice, one being veterinary competence and their communication skills. This study looked at the private veterinary practitioners’ perceptions of their own competence to deliver biosecurity advice as part of a longitudinal biosecurity project. Their responses were collected in the form of a telephone questionnaire. The results showed significant increases in private veterinary practitioners’ responses to comfort (p = 0.022), capability (p = 0.002), and consistency (p = 0.006) as well as an increase of uptake of advice (p = 0.015) as the project progressed. The mean time spent delivering biosecurity advice increased and dropped subsequently, suggesting an initially more thorough and later on a more efficient process. The overall perceptions of the veterinarians of the study were also assessed. The results suggest development of the participating veterinarians following the conscious-competence learning model showing a need to improve the knowledge and training of future generations of private veterinary practitioners in the area of biosecurity with, in particular, an increased focus on the importance of the veterinarian–farmer relationship.

Herd health and production management visits on Canadian dairy cattle farms: Structure, goals, and topics discussed

Regular veterinary visits to improve herd health and production management (HHPM) are important management components on many dairy cattle farms. These visits provide opportunities for constructive conversations between veterinarians and farmers and for shifting management from a reactionary approach to proactively optimizing health and welfare. However, little is known about the structure of HHPM farm visits and to what extent veterinarians provide assistance beyond purely technical services. Therefore, our aims in this cross-sectional study were to describe HHPM farm visit structure, determine which dairy-specific topics were discussed, and assess whether the focus of the visits aligned with farmers' priorities. Veterinary practitioners (n = 14) were recruited to record audio and video of regularly scheduled HHPM farm visits (n = 70) using an action camera attached to their chest or head. A questionnaire was distributed to farmers containing closed- and open-ended questions to assess their goals and perceptions related to farm management and HHPM farm visits. Descriptive statistics and negative binomial and Poisson regression models were used to study dairy-specific topics initiated by the farmer or veterinarian during various activities. A mean of 51% of the visit duration was dedicated to transrectal pregnancy and fertility diagnostics, and a considerable amount of time (30%) was spent on visit preparation, transitions between tasks, and leaving. A total of 488 discussions were initiated by either the veterinarian (55%) or the farmer (45%). Mean length of discussions was 2 min, and only 17% of the HHPM visit duration was spent discussing dairy-specific topics. Veterinarians initiated 62% of their discussions about herd issues, whereas farmer-initiated discussions revolved around herd health in 39% of the discussions. Discussion topics most frequently raised by participants included fertility, udder health, calf health and management, and transition diseases. Consistently, farmers' answers to a rank question regarding their main HHPM farm visit goals indicated that their priorities were to have transrectal pregnancy and fertility diagnostics performed and to improve herd fertility and general herd health. Answers to an open-ended question revealed that additional aims of many farmers were to receive information, have questions answered, and identify and discuss problems. A farmer's belief that HHPM farm visits were "absolutely" tailored toward his or her goals was positively associated with number of discussions during the visit and their conviction that they "always" voiced their wishes and needs to the veterinarian. Opportunities to broaden the focus of HHPM farm visits and improve communication between farmers and veterinarians should be identified and veterinarians should be trained accordingly, which would increase veterinarians' ability to add value during HHPM farm visits.

Comparison of food-animal veterinarians' and producers' perceptions of producer-centered communication following on-farm interactions

BACKGROUND

Human medicine has demonstrated that a patient-centered physician-patient relationship is more effective than the traditional physician-centered model. Objectives were to explore food-animal veterinarians' and producers' perceptions of producer-centered communication (VPPC and PPPC), during on-farm interactions and examine associated factors.

METHODS

A cross-sectional sample of food-animal veterinarians and their clients were recruited in Ontario, Canada. Immediately following on-farm veterinarian-producer interactions, the producer and veterinarian independently completed a questionnaire assessing PPC. Symmetry of paired responses between veterinarians and producers was examined. Employing listwise deletion, independent mixed linear regression models were developed to determine factors associated with PPPC and VPPC, respectively.

RESULTS

Two hundred and three paired veterinarian and producer survey responses were analysed. Significant asymmetry (p-value < 0.05) was observed, with veterinarians assessing PPC lower than producers. Based on data from 32 veterinarians and 159 producers, the only factor associated with PPPC was veterinarian burnout (PPPC decreased with burnout). Based on data from 32 veterinarians and 155 producers, factors positively associated with VPPC included veterinarian compassion satisfaction (VPPC increased with compassion satisfaction), length of interaction (VPPC increased with length of interaction) and producers identifying as female (VPPC higher with female producers).

CONCLUSION

Producer's positive PPPC is encouraging, yet veterinarians should be aware that mental health parameters may impact producers' and their own perceptions of PPC. Further examining veterinarians' delivery of PPC is important for food-animal practice.

Communication and animal observation in livestock farming - pilot study of a teaching project in veterinary education

Objective: Within the scope of a teaching project, students of veterinary medicine are to study animal and environmental observation and how to communicate with the persons responsible for animals on pig farms. They will be prepared to reflect on conversational behavior, identify difficult conversational situations and solve them in a goal-oriented way. In addition to piloting, the the aim of the study is to evaluate the teaching project by the students and the teaching staff. Methodology: Animal observation is trained using a virtual tour of a stock farm based on pictures and videos. The didactic approaches Design Thinking and the creative Walt Disney method are used in order to work on a previously prioritized problem. A typical conflict situation in pig farming is simulated in a role-play. Acquired skills are put into practice during a stock examination on the practice day, where the students communicate their observations. Evaluation is conducted using paper-based questionnaires and feedback interviews. Results: Evaluations of the students are generally positive. The desire to include communication studies in the curriculum was expressed several times. For the theoretical teaching units, a larger group of participants is needed to achieve higher interaction through diversity. The acquired knowledge is reliably applied and utilized on the practice day. Conclusion: The theoretical teaching units extensively prepare the students for the practical stock examination and teach basic skills of communication. Some adjustments to the procedure and focus should be made regarding the practical part. Generally, the conveyed information and methods are considered to be important by the students.

Survey of perceptions and attitudes of an international group of veterinarians regarding antibiotic use and resistance on dairy cattle farms

Veterinarians are the main source of information for farmers regarding the responsible use of antibiotics in farm animals and how to reduce the risk of antibiotic resistance. Consequently, understanding how veterinarians perceive their clients' and colleagues' antibiotic use and their own beliefs about the development of antibiotic resistance is essential to determining areas in which antibiotic use practices can be improved to minimize the emergence of antibiotic resistance. An international cross-sectional study was carried out using a questionnaire designed to elucidate perceptions, attitudes, and concerns of dairy veterinarians regarding antibiotic use and the emergence of antibiotic resistance in dairy farming. The questionnaire was initially administered to veterinarians attending the International Bovine Mastitis Conference in Milano, Italy, 2018, followed by veterinarian members of the National Mastitis Council, and all conference registrants. A total of 71 participants from 21 countries participated in the survey, the majority were from the United States and member countries of the European Union. Logistic regression analysis was conducted to identify predictors of veterinarians' level of concern about the development of antibiotic resistance on their clients' farms. Associations were described with odds ratios (ORs) and the associated 95 % confidence intervals (95 % CIs). Free text responses where participants shared their views on the reason for overprescribing antibiotics by veterinarians were analyzed using thematic analysis. Participants perceived that nearly half of their clients overuse or inappropriately use antibiotics, and nearly half of their colleagues overprescribe or inappropriately prescribe antibiotics. After controlling for other factors, the odds of veterinarians being concerned about antibiotic resistance on dairy farms they served decreased by a factor of 0.91 for each additional year of participants' experience working with dairy cattle (OR = 0.91, 95 % CI = 0.84-0.99). Participants concerned about antibiotic resistance on clients' dairy farms were also more likely to consider better adherence to drug labelling as important for reducing farmers' antibiotic use (OR = 6.86, 95 % CI = 1.21-38.93). Thematic analysis revealed four themes surrounding the perceived reasons for veterinarians' overprescribing of antibiotics: (i) knowledge, (ii) attitudes, (iii) barriers, and (iv) rules and regulations. The study findings will aid in the development of strategies to improve antibiotic use in dairy farming and educational initiatives looking to enhance the communication between veterinarians and farmers about judicious use of antibiotics.

Dairy veterinarians' skills in motivational interviewing are linked to client verbal behavior

Veterinarians often give advice in a persuasive form, a style that has been shown to evoke resistance to change in clients experiencing psychological ambivalence (i.e. those who see both advantages and disadvantages to changing). With this style of communication, veterinarians run the risk of counteracting their purpose to encourage clients to follow recommendations. Motivational interviewing (MI) is a client-centered communication methodology that aims to facilitate clients’ internal motivation to change. In MI, Change Talk represents clients’ own statements expressing consideration of, motivation for or commitment to behavior change and has been shown to be strongly correlated with behavior change. Sustain Talk is corresponding statements related to maintaining the status quo. The aim of this exploratory study was to evaluate the potential of MI to facilitate behavior change in veterinary herd health management (VHHM) by investigating the effect of dairy cattle veterinarians’ MI skills on client Change and Sustain Talk. We recorded VHHM consultancies on 170 Swedish cattle farms performed by 36 veterinarians, randomly distributed into 2 groups: MI veterinarians (n = 18) had received 6-month training in MI and control veterinarians (n = 18) had not received any training. Veterinarians’ MI skills were assessed using the Motivational Interviewing Treatment Integrity coding system 4.2.1 and categorized as poor_untrained, poor_trained, near moderate and moderate. Client communication was coded using the Client Language Easy Rating coding system. The effect of MI skills on Change Talk, Sustain Talk and Proportion of Change Talk(Change Talk divided by the sum of Sustain Talk plus Change Talk) was investigated using cross-classified regression models with random intercepts for veterinarian and client (farm). The models also included additional explanatory variables (e.g. type of veterinarian and client’s satisfaction with the consultation). The veterinarian’s MI skills were associated with the client’s Change Talk, but results regarding Sustain Talk or Proportion of Change Talk were inconclusive. Clients of veterinarians reaching the highest (i.e. moderate) MI skills expressed 1.5 times more Change Talk than clients of untrained veterinarians. Clients of general large animal practitioners expressed less Sustain Talk than clients of animal health veterinarians and had higher Proportion of Change Talk. Results indicate that learning to practice MI may be one means to improve adherence to veterinary recommendations and to improve efficiency in VHHM services.

High biosecurity and welfare standards in fattening pig farms are associated with reduced antimicrobial use

In order to reduce antimicrobial use in pig production, the consequences of insufficient biosecurity and welfare problems need to be known. This study aimed to investigate associations between the number of antimicrobial treatments per fattening pig, and biosecurity, indicators for animal welfare as well as the prevalence of lesions at slaughter. The data used in this study were extracted from the pig health and welfare classification system (Sikava), which gathers data on medicine usage, meat inspection, animal welfare and the condition of farm buildings from over 95% of pig production in Finland. The data were registered during years from 2011 to 2013. Upon antimicrobial prescription, information on the number of fattening pigs treated and the main reason for treatment was recorded. In addition, at least 4 times per year, pig farms registered in Sikava were visited by the farm veterinarian who assessed, among other things, biosecurity and indicators for animal welfare (air quality, condition of facilities, cleanliness, enrichment and stocking density). Finally, data from slaughterhouse inspections were collected (number of carcasses with joint infection, abscesses, lung lesions, pleurisy and liver lesions). For analysis, these datasets were aggregated at the farm level to a quarter of a year. During the studied period, the mean number of antimicrobial treatments per fattening pig per 3 months was equal to 0.09. The main reasons for antimicrobial treatments were musculoskeletal diseases, tail biting and respiratory disorders (42, 33 and 12% of diagnoses, respectively). The meat inspection scoring indicated that as much as 14.7% of all pigs had pleurisy, 5.3% liver lesions and 4.1% abscesses. A standard zero-inflated negative binomial model was used to identify factors associated with the number of antimicrobial treatments per pig. The count of antimicrobial treatments per pig increased with the size of a farm. Regardless of prevalence of lesions, farms with poor drinking equipment, insufficient enrichment and a combination of poor condition of pens and high stocking density were associated with an increased number of antimicrobial treatments for musculoskeletal diseases per pig. Problems with stocking density and enrichment were associated with the number of antimicrobial treatments for tail biting, although these results depended on prevalence of joint infections. Problems with air quality and the combination of poor cleanliness and poor condition of facilities were associated with increased number of antimicrobial treatments due to respiratory diseases. This study suggests that by improving biosecurity and welfare at pig farms, antimicrobial use can be reduced.

Communication styles of Swedish veterinarians involved in dairy herd health management: A motivational interviewing perspective

Veterinary communication has evolved in the context of traditional veterinary tasks, such as diagnosing and treating sick animals, and this may encourage a directive communication style, in which the veterinarian acts as an expert, directing the client in what to do and how to do it. This type of communication style has been shown to evoke resistance to change in clients who are experiencing psychological ambivalence, a well-known aspect of farmers' herd health decisions. Veterinary herd health management (VHHM) constitutes an increasing proportion of the work of cattle veterinarians and often focuses on behavior change. The present study aimed to characterize communication styles of Swedish dairy cattle veterinarians involved in VHHM in relation to their skills in facilitating behavior change. A secondary aim was to investigate whether these skills differed among veterinarians depending on their experience in the veterinary profession or in VHHM. Audio-recorded role-play conversations (n = 123; reflecting VHHM telephone consultations) with 42 veterinarians involved in VHHM in Swedish dairy herds and audio-recorded on-farm consultations (n = 86) with 18 of those veterinarians were coded using a system developed to evaluate motivational interviewing (MI) skills. Motivational interviewing is a communication methodology aimed at facilitating clients' internal motivation to change. The MI Treatment Integrity (MITI) code identifies frequency counts of 10 verbal behaviors, and assesses 4 global variables on a Likert scale, based on 20 min of conversation. It also suggests 6 summary measurements of MI competency based on these 14 original variables. Of the 42 veterinarians, 39 also responded to a web questionnaire about their age, continuing education, and experience in the profession, in dairy herds and in VHHM. We analyzed associations between the 6 summary MITI variables from the role-play conversations and characteristics of the 39 veterinarians using logistic and linear multivariable regression models. Veterinarians in the role-play and on-farm conversations relied predominantly on giving information, questions, and persuasion in their consultation approaches. They generally did not explore the client's expectations or wishes regarding the agenda for the consultation, or acknowledge the client's right to make decisions about actions. Veterinarians gave advice without exploring the client's need for the advice or how the information was perceived. We found a significant reduction in so-called relational scores (Empathy plus Partnership) and an increase in MI-nonadherent behaviors (Persuasion plus Confront) as years of veterinary experience increased. Results showed that there is room for improvement in the communication style of veterinarians involved in VHHM. Wider literature suggests that training veterinarians in a client-centered communication methodology such as MI may increase the demand for and success of VHHM.

Factors associated with dairy farmers' satisfaction and preparedness to adopt recommendations after veterinary herd health visits

Herd health and production consultancy are important aspects of the modern dairy veterinary practice; therefore, veterinary farm visits will likely be more successful if veterinary practitioners communicate effectively and meet farmers' expectations. Objectives were to assess dairy farmers' satisfaction with veterinary advisors and their perceived preparedness to adopt veterinary advice. Furthermore, we assessed whether farmers' satisfaction and preparedness to adopt advice were associated with specific predictor variables; that is, general (demographic) factors of veterinarians or farmers, communication tools used by veterinarians, and veterinarians' affective attributes during the farm visit. Audio-video recordings of 14 dairy veterinarians during 70 herd health and production management farm visits were analyzed using the Roter interaction analysis system. Demographic data, farmers' satisfaction, and farmers' preparedness to adopt advice were obtained by using questionnaires. Overall, farmers were satisfied with their veterinarian's communication during farm visits and 58% of farmers felt "absolutely" prepared to follow veterinary recommendations. Based on multivariable regression analysis, farmers' satisfaction was positively associated with their level of education and the amount of talk the veterinarian dedicated to counseling the farmer. However, satisfaction was negatively association with the ratio between veterinarian talk and farmer talk. In addition to various demographic variables, farmers' preparedness to adopt veterinary advice was positively associated with their satisfaction. Other predictor variables for farmers' preparedness to follow recommendations included increased veterinary counseling and frequent herd data discussions, whereas there was a negative relationship between number of farmer questions and dominance of the veterinarian during the farm visit. Identification of factors influencing farmers' satisfaction and preparedness to adopt advice will make veterinary communication more effective and could inform training of veterinarians in communication.