Background
Following a Food and Agriculture Organisation (FAO) workshop to establish national veterinary accreditation standards in Bangladesh, there was considerable interest in learning about new approaches to clinical skills teaching. A travel grant was awarded by Universities Federation for Animal Welfare (UFAW) to Bristol Clinical Skills Lab to work with Chittagong Veterinary and Animal Sciences University (CVASU) in Bangladesh to run a 2-day workshop.
Summary of work
Thirty-five delegates attended, representing eight veterinary schools including one from Sri Lanka. Practical activities included making simple suturing models and trying out models made from materials that could be sourced locally including injection techniques, suturing, intubation and surgical procedures e.g. bitch spay. Other activities included ‘designing your school’s skills lab’ and learning about evidence-based approaches to clinical skills. Delegates were also shown round the new clinical skills lab at CVASU, the first in Bangladesh, set up with help from the Bristol team. Feedback was gathered using a survey and indicated delegates found the workshop activities useful and felt more confident to implement new approaches. They particularly enjoyed the hands-on nature of the workshop and considered the activity planning their own lab was useful, but identified potential challenges included costs, space and time (staff and in the curriculum). A follow-up survey will be distributed six months after the workshop.
Take home message
Delegates appreciated the practicals and being able to try out simple, easy to make models. They were realistic about the challenges but were keen to implement change and organise future workshops.
A travel grant from Universities Federation for Animal Welfare (UFAW)
Background: Flank cat spays are commonly performed in UK veterinary practices. Students often perform spays while on charity placements where the midline approach is more common as the animal history is often unknown. Feedback from recent graduates has highlighted the potential value of having a model to teach the flank approach in preparation for practice.
Summary of work: A flank cat spay model was developed in an iterative process. The body consisted of a plastic drainage pipe with an 6cm2 hole cut in the left flank. The bony landmarks used to determine the location of skin incision were made from resin. The body wall consisted of cohesive bandage, wadding for the subcutaneous fat and felt for the muscle layers. The sublumbar fat was made from foam and mesenteric fat from toy filling. The reproductive tract was made of twine ribbon, elastic and wool. Clinicians evaluated (spayed) the model and several modifications were made e.g. bony landmarks were enlarged, cohesive bandage replaced Tubigrip (the original material used for the skin). Technician input focused on the model’s feasibility for a large student cohort i.e. resetting and/or remaking parts. Design changes included having a tubular abdominal wall that could be rotated to present a new incision site and modifying the positions of the internal ‘fittings’ to facilitate the reset process.
Take home message: Invaluable feedback was provided by both clinicians and technical staff during the development process resulting in a reasonably realistic model that should be feasible to use in teaching.
Teaching clinical skills to veterinary students through simulation laboratories is commonplace, though not ubiquitous in schools worldwide. Simulation equipment can be expensive, reducing access for schools with low resources.
The Inter-State School of Veterinary Science and Medicine of Dakar, Senegal (EISMV) recently created a simulation laboratory (LABOSIM) with internal and alumni funding, plus collaboration with North Carolina State University College of Veterinary Medicine (NC State), USA. EISMV has increased their focus on clinical training in recent years. A clinical skills laboratory was desired to make clinical activity more attractive, in addition to the traditional remit of live animal use reduction, clinical skills acquisition and lowering student stress. Senegal selected NC State’s SimLab as a model and adapted this program to fit the institutional goals of EISMV.
Faculty at EISMV met with NC State staff before devising an implementation plan including identifying: local teaching objectives, enthusiastic staff, and funding. NC State supplied some low-fidelity materials at minimal cost. A variety of clinical skills tasks were introduced over two semesters, with over 170 students participating. These comprised a mixture of ideas taken from NC State’s SimLab and resources specifically designed by EISMV for their curriculum. Both institutions have benefited, with NC State implementing novel ideas from LABOSIM into their clinical skills program. Continued collaboration in teaching resources is planned.
Sharing ideas and resources between veterinary schools with different curriculum missions, contexts and resources, can help improve clinical skills teaching at both institutions at a relatively low cost.
Alumni funding donation of approximately 130 GBP (100,000 CFA/172.86 US$)
The IKEA GOSIG dog toy, or other similar plush toy animals, are commonly used bases for the creation of clinical simulation models across the globe.
Rectal examination and expression of anal glands is a very common procedure for first opinion clinicians, but is not a skill which can be offered for repeated practice with live animals without compromising animal health and welfare. In addition students report a lack of confidence and nervousness when performing the procedure for the first time in live patients.
We present here the materials and methodology used to create a high-fidelity simulation model for expression of anal gland/s. The creation of this model uses simple techniques and cost-effective easily obtainable consumables which are routinely found within either a veterinary science teaching environment or are household items.
Ultimately this model not only permits the palpation of a turgid anal gland but also high- or low-pressure expression fluid from the gland in response to appropriate handling and manipulations.
The creation and subsequent use of this model as part of clinical skills centre activities or teaching may improve and develop student confidence and competence when examining and treating real-life patients.
Funded by School of Veterinary Medicine and Science, University of Nottingham
The IKEA GOSIG dog toy, or other similar plush toy animals, are commonly used bases for the creation of clinical simulation models across the globe.
Rectal examination of the canine prostate is a common procedure for first opinion clinicians, and identification of normal anatomy and abnormalities can be key indicators in clinical reasoning. This skill cannot be offered for repeated practice with live animals without compromising animal health and welfare. In addition, students report a lack of confidence and nervousness when performing the procedure for the first time in live patients.
We present here the materials and methodology used to create a high-fidelity simulation model for rectal examination and palpation of the prostate. The creation of this model uses simple techniques and cost-effective, easily obtainable, consumables which are routinely found within either a veterinary science teaching environment or are household items.
Ultimately this model not only permits the palpation of a pelvis and normal prostate gland but can also be modified to include abnormal prostate anatomy, or combined with an anal gland simulation model.
The creation and subsequent use of this model as part of clinical skills centre activities or teaching may improve and develop student confidence and competence when examining and treating real-life patients.
Funded by School of Veterinary Medicine and Science, University of Nottingham
Background: Ultrasound simulator models, known as phantoms, are important educational tools to assist students early in the academic course to understand the principles of sonography assessment in small animals. In this poster, we demonstrate the development of realistic, inexpensive and easy to produce ultrasound phantoms used to simulate the sonographic aspect of different canine organs.
Summary of work: Two organs were created: a bitch uterus in early pregnancy stage and one kidney. The uterus consisted of 16mm pen rose drains filled with ultrasound gel and contained five foetuses, three in one horn and two in the other horn. Those were made of vinyl gloves fingertips with a small piece of blue tack inside and filled with water. Both horns were tightened together in one end and immersed in a gelatine filled plastic container covered with cling film. The kidneys consisted of a mixture of water, agar and graphite powder poured into a play dough mould shaped as a half bean 6 cm long. A piece of blue tack was placed close to the hilum area whilst the agar was still setting to mimic the renal pelvis. Once the agar set, both halves of the kidneys were put together using cling film and then placed in a gelatine filled plastic container covered with cling film for sonography assessment. These models are part of a project to build a complete dog abdomen to introduce the AFAST technique for students.
Take home message: Homemade affordable phantoms can be used as an educational tool to introduce basic ultrasound techniques.
Background: Performing safe anaesthesia is an essential day one skill for veterinary students. However, there are many components to anaesthesia and it can be challenging for students to integrate them prior to exposure to the clinic-based environment.
Summary of work: Last year we piloted a voluntary 2-hour anaesthesia session which we developed for a core session for third-year vet students. Reduced time was a challenge and so it was decided that the scenarios would include a pre-determined pre-medication protocol as this process was very time demanding and is addressed in other areas of the curriculum. Students created a step by step plan for performing safe anaesthesia using laminated cards with key descriptors on e.g. ‘select appropriate breathing system’. The students were provided with all the practical equipment they would need such as breathing systems, syringes and mock drugs, as well as manikins for drug administration and intubation so they could work through the scenario in a simulated environment. Students provided feedback using a ‘post-it’ feedback wall and the response was overwhelmingly positive with students citing that it was an enjoyable session that helped them to consolidate their lecture material and clarify the chronicity of anaesthesia. A desire for more scenario-based clinical skills session was also expressed as well as more pre-session information.
Take home message: It is possible to run a high fidelity anaesthesia induction simulation in one hour’s core teaching.
Background: Jugular venepuncture requires dexterity and practical skills and is a commonly performed procedure in veterinary practice. Students need to practice the skill before being allowed to practice on live dogs. Most available models are neck and head only and do not allow students to practice the positioning of the whole animal which is a vital part of the procedure.
Summary of work: Latex rubber tubing, representing the vein, was overlaid onto thick foam tubing and covered with a thin piece of silicone “skin”. Velcro cable ties were used to attach the “skin” to the foam tubing and keep the “vein” in place. Two “jugular veins” were made per dog model and placed either side of the neck, where the model was clipped. Fluid bags, filled with red colouring and water, were then attached to the latex rubber tubing with giving sets to represent blood. The dog was also fitted with wooden dowels in its forelimbs and sand bags to allow it to sit in the correct position.
A pilot study found that the fur punctured and a plan for covering with silicone was made to ensure the model is robust. It is also planned that a “trachea” made from corrugated tubing be inserted into the model to make it more realistic.
Take home message: Low cost, easily made models allow students to practice skills in a safe and low risk environment. The whole dog model more closely simulates the way the skill will be performed on a live patient.
Background: Administering a tablet to a cat is a commonly performed task in clinical practice but it does take skill to perform efficiently and safely. Proper handling and restraint is required to administer oral tablets to cats and the use of live cats for handling in early years veterinary education is limited. Most cats find tablet administration stressful, so allowing veterinary students to practice would compromise welfare. No commercially available cat tableting models could be found for students to practice.
Summary of work: A stuffed cat model was fitted with a realistic plastic skull, both were inexpensive and commercially available. Clinicians evaluated the model and noted that the action of the jaw was realistic. A silicone tongue was stitched onto Allevyn dressing, secured to the base of the skull to create a realistic mouth and allow students to aim the tablet correctly, to the back of the tongue. Anaesthetic circuit tubing from an Ayres T-Piece, was attached to the base of the skull and connected to a tablet pot to allow tablets and capsules to be contained and retrieved. The skull was secured in the model head, with access to the tubing and tablet pot available via snap fasteners, down the dorsum of the cat. Students were able to practice administering tablets and capsules manually and using pill administrators.
Take home message: Practice of simple tasks on models, such as cat tableting, can assist in giving students dexterity and confidence in performing the skills on live animals.
Recent research and surveys among veterinarians show an increasing need for integration of soft/life skills training in veterinary education. Skill acquisition and development are essential for the performance and modernization of the profession in order to provide new forms of flexibility and security for veterinary professionals.
The SOFTVETS project aims to create a competence model, and produce an ideal version of a soft skills curriculum applicable in veterinary higher education throughout Europe. Development, implementation, evaluation and dissemination are carried out focusing on three competence areas: communication, digital competences, entrepreneurship. Intellectual outcomes will be developed in collaboration with students’ and accreditation associations (IVSA and EAEVE).
After literature research and creation of a first draft, an alternating sequence of individual review by experts and online discussions was conducted. Experts from 5 European countries participated in the reviewing process (experts: communication N= 11, digital competences N= 5, entrepreneurship N=5). Within each of the three competence areas two online experts’ discussions were held. An initial set of recommendations as SOFTVETS competence model was developed using the IQM-HE-Handbook. For now, 10 communication competences, 11 digital competences, and 14 entrepreneurship competences were identified and defined addressing cognitive and practical aspects in 4 levels (Foundation, Intermediate, Advanced, Expert).
Within next project phases a curriculum, including teaching, learning and assessment methods, will be developed and implemented at three veterinary faculties for evaluation.
The SOFTVETS project creates a framework for introducing a soft/life skills training programme into the curriculum of undergraduate veterinary education in Europe.
The project is co-funded by the Erasmus+ Programme of the European Union
Currently there are no validated synthetic models available for teaching incisional biopsies skills. Our goal was to develop a simple, cost-effective incisional mass biopsy model, which can be shared with other institutions for teaching purposes. These models illustrate the concept in three dimensions while giving students the opportunity to touch, manipulate and practice performing diagnostic sample collection procedures in a calm, low pressure environment. In addition, the construction and validation of this model will reduce the use of both live animals and cadavers while providing a similar learning experience for each student. The model consists of four silicone layers with embedded silicone masses. Layers include muscle, fascia, subcutaneous and skin. The type of silicone used was varied to mimic the density and texture of the tissue layer it represented. To validate this model, experienced veterinarians with varying advanced surgical training performed incisional biopsies using the model and answered survey questions addressing the face and content validity of the model. Following this, inexperienced phase 2 veterinary students completed incisional biopsies using the model, and then answered survey questions regarding their perception and learning experience with the model. Veterinary educators agreed that the model had excellent content and face validity. Students also agreed that the model improved their understanding of a variety of procedures and that they felt confident in their ability to perform these techniques following use of the model. This incisional biopsy model shows potential to be used for teaching these techniques in the future.
University of Guelph Undergraduate Research Assistantship program