Communicating without words: Measuring nonverbal communication between veterinarians and farmers during routine herd health consultations

Uptake of advice and the ability to facilitate change on-farm are key elements for successful veterinary practice. However, having the necessary clinical skills and knowledge is not enough to achieve this: effective communication skills are essential for veterinarians to realize their advisory role by exploring and understanding the farmer's worldview. Research of verbal aspects of veterinarian communication supports the use of a relationship-centered communication style; we next need to study how veterinarian-farmer nonverbal communication (NVC) can influence interactions and their outcomes, which has been examined in medical and companion animal practice. In this study, we considered which aspects of NVC should be measured, and how, to provide an essential first step toward understanding the significance of NVC for veterinarians working in dairy practice, which should be of interest to researchers, veterinary educators, and practitioners. Eleven video recordings of routine consultations in the UK were analyzed for farmer and veterinarian NVC. The NVC attributes with established links to positive patient and client outcomes from medical and social science studies were chosen, and a methodology developed for their measurement, by adapting measures typically used in NVC research. Each consultation was segmented into intervals defined by the main activity and location on farm: introduction, fertility examination, discussion, and closing. This approach allowed us to analyze the content more consistently, establish which aspects of NVC featured within each interval, and whether the activity and location influenced the observed NVC. We measured 12 NVC attributes, including body orientation, interpersonal distance, head position, and body lean, which have been shown to influence empathy, rapport, and trust: key components of relationship-centered communication. Future research should seek to establish the significance of NVC in effective communication between veterinarian and farmer, building on our findings that show it is possible to measure nonverbal attributes. Veterinarians may benefit from becoming skilled nonverbal communicators and have more effective conversations during routine consultations, motivating farmers to make changes and improve herd health.

Measuring satisfaction in the small animal consultation and its relationship to consult length

BACKGROUND

Measuring satisfaction is a useful metric of success of any interaction, but very few validated instruments exist for measuring the satisfaction of the veterinary surgeon (vet) and the client in veterinary consultations. Additionally, there has been no research examining the impact of consultation length on satisfaction. The aim of this observational study was to investigate the use of a single-question graphic scale to assess vet and client satisfaction and the impact of consultation length on satisfaction.

METHODS

Information on consultation timing was collected for 65 health problem consultations across six practices. These measurements were compared with postconsultation measurements of client and vet satisfaction.

RESULTS

A comparison between the long-form and single-question satisfaction instruments demonstrated significant correlation for both vet and client tools (ρ=0.609, P<0.005 and ρ=0.483, P<0.005, respectively). The average client satisfaction with the consultation was high; however, vet satisfaction levels were significantly lower (U=1073, P<0.005). Increased consult length was associated with increased vet satisfaction (ρ=0.332, P=0.007) but not increased client satisfaction.

CONCLUSION

These results demonstrate that the graphic scale is an appropriate proxy for the pre-existing long-form questionnaires available for both vets and clients. Further research is required to examine the disparity identified between vet and client satisfaction.

Critically Appraised Topics (CATs) in Veterinary Medicine: Applying Evidence in Clinical Practice

Critically appraised topics (CATs) are evidence syntheses that provide veterinary professionals with information to rapidly address clinical questions and support the practice of evidence-based veterinary medicine (EBVM). They also have an important role to play in both undergraduate and post-registration education of veterinary professionals, in research and knowledge gap identification, literature scoping, preparing research grants and informing policy. CATs are not without limitations, the primary one relating to the rapid approach used which may lead to selection bias or restrict information identified or retrieved. Furthermore, the narrow focus of CATs may limit applicability of the evidence findings beyond a specific clinical scenario, and infrequently updated CATs may become redundant. Despite these limitations, CATs are fundamental to EBVM in the veterinary profession. Using the example of a dog with osteoarthritis, the five steps involved in creating and applying a CAT to clinical practice are outlined, with an emphasis on clinical relevance and practicalities. Finally, potential future developments for CATs and their role in EBVM, and the education of veterinary professionals are discussed. This review is focused on critically appraised topics (CATs) as a form of evidence synthesis in veterinary medicine. It aims to be a primary guide for veterinarians, from students to clinicians, and for veterinary nurses and technicians (hereafter collectively called veterinary professionals). Additionally, this review provides further information for those with some experience of CATs who would like to better understand the historic context and process, including further detail on more advanced concepts. This more detailed information will appear in pop-out boxes with a double-lined surround to distinguish it from the information core to producing and interpreting CATs, and from the boxes with a single line surround which contain additional resources relevant to the different parts of the review.

Appointment scheduling and cost in first opinion small animal practice

Approximately half of first opinion, small animal consultations exceed their allocated time and there's a growing call in the UK for longer consults. The aim of this study was to investigate and describe allocated appointment length in first opinion, small animal practice in the UK. Almost half (49.8%) of consults were scheduled for 15 min, with a further 39.4% scheduled for 10 min. Nearly all participants (97.1%) reported flexibility when booking appointments, scheduling longer appointments for conditions predicted to require more time. However, the majority (68.1%) reported no additional cost charged to the client for a longer consult. Furthermore, 54.7% of the survey respondents offered nurse appointments free of charge. A restructured approach to consult scheduling for both Veterinary Surgeon and Registered Veterinary Nurse (RVN) consultations could help to improve workforce wellbeing, utilise the vast knowledge and skill sets of RVNs and improve financial metrics.

Relationship between Tibial conformation, cage size and advancement achieved in TTA procedure

Background

Previous studies have suggested that there is a theoretical discrepancy between the cage size and the resultant tibial tuberosity advancement, with the cage size consistently providing less tibial tuberosity advancement than predicted. The purpose of this study was to test and quantify this in clinical cases. The hypothesis was that the advancement of the tibial tuberosity as measured by the widening of the proximal tibia at the tibial tuberosity level after a standard TTA, will be less than the cage sized used, with no particular cage size providing a relative smaller or higher under-advancement, and that the conformation of the proximal tibia will have an influence on the amount of advancement achieved.

Results

One hundred sixty-four dogs met the inclusion criteria. The mean percentage under-advancement was 15.5%. All dogs had an advancement less than the stated cage size inserted. An association between the proximal tibial tuberosity angle (increased in cases with low patellar tendon insertion), and percentage under-advancement was found, with an increase of 0.45% under-advancement for every 1 degree increase in angle a (p = 0.003). There was also evidence of a difference between the mean percentage under-advancement in breeds (p = 0.001) with the Labrador having the biggest under-advancement. Cage size (p = 0.83) and preoperative tibial plateau angle (p = 0.27) did not affect under-advancement.

Conclusions

The conformation of the tibial tuberosity and therefore the relative cage positioning have an impact on mean percentage under-advancement of the tibial tuberosity after standard TTA. In all evaluated cases, the advancement of the tibial tuberosity was less than intended by the cage size selected.