Veterinary Curriculum Leaders: Motivators, Barriers, and Attributes.

Curriculum leaders (individuals with responsibility for an institution's veterinary curriculum) play a vital role in driving local curriculum priorities, development, and accreditation. This study aimed to describe the career paths of curriculum leaders, and identify what motivates them, the barriers they face, and the knowledge, skills, and attributes they perceive as essential for the role. Self-determination theory was used to identify tensions experienced within the role. An international online survey targeted at those identifying as curriculum leaders was completed by 45 participants. 91% of participants held a doctoral level qualification and/or clinical Boards; 82% had additional training in leadership; 38% had additional formal training in education. Motivators included a desire to make a difference, personal satisfaction with teaching and working with students, and social influences. Participants experienced barriers relating to self-development and achievement of their curriculum goals; participants described essential knowledge (of the profession, educational theory, and wider higher education context) and skills (leading teams, change management, and communication). Attributes considered important related both to self (open-minded, patient, resilient, able to see the big picture as well as detail) and relationships with others (approachable, listener, respectful and respected, supportive, credible). Tensions arose in participants' need for autonomy (experiencing barriers to achieving their goals), in their social relatedness (achieving curriculum goals while working with colleagues with conflicting priorities), and in perceptions of necessary competence (a need, but lack of opportunity, for advanced training in educational theory). The findings may help institutions more effectively support and train current and future curriculum leaders.

Professional Identity of Pakistani Veterinary Students: Conceptualization and Negotiation.

Most work on the professional identity of veterinary and medical professionals has been conceptualized in the USA and Europe. It reports professional identity formation to be highly individualized, triggered by experiences of identity distress, and identity negotiation strategies to be generally focused around personal reflection. However, within Asia, important sociocultural differences exist that might influence professional identity and its development. Societal values may take precedence over individual ones, and some cultures consider the veterinary profession as stigmatized. With this background, we seek to understand professional identity and its construction in Pakistani veterinary students. We selected five students through purposive sampling and invited them for narrative interviews. Social identity theory and Maslow's theory of hierarchy of needs predominantly contributed to the theoretical framework, which together with principles of social phenomenology and narrative analysis informed qualitative analysis of the transcribed interviews using an in-depth approach. We found that students' professional identity was predominantly socially constructed, though their sense of their identity was not very well developed. Role models, social stigma, professional socialization in clinical settings, gender, and to some extent, cultural interpretations of religious messages seemed to mediate professional identity development. Students responded differently to their understanding of professional stigma, making sense of stigma through strategies such as denial or internalization. Since Pakistani veterinary students experience social and personal values differently compared to those from predominantly individualistic cultures, identity formation through reflecting on personal values may be less effective than strategies that emphasize social learning and beliefs.

"It's okay to not know " a qualitative exploration of faculty approaches to working with uncertainty.

BACKGROUND: Whilst it is recognised that a capacity to manage uncertainty is an essential aspect of working as a healthcare professional, there is little clear guidance on how to facilitate student learning in this domain. A lack of faculty development opportunities also suggests that health professions' educators may feel ill-equipped to assist students in developing effective approaches to uncertainty. The purpose of this study was to explore a faculty development intervention designed to help educators unpack students' experiences of uncertainty, and identify attributes which may help students to manage uncertain situations. METHODS: This qualitative study was informed by a constructivist methodological approach, where participants were encouraged to share meaning around the nature of uncertainty in health professions' education. Two 90-min faculty development sessions were held. These sessions invited participants to apply Han et al.'s taxonomy of uncertainty to role-played scenarios of student uncertainty within a focus group setting. Focus group data were collected, and examined using a two-stage, hybrid approach of deductive and inductive thematic analysis. RESULTS: Han et al.'s taxonomy helped participants to identify multiple sources and issues of uncertainty in the role played scenarios, thus unveiling the extent of uncertainties encountered by health professions' learners. Data analysis revealed four themes overall: "Sources of uncertainty", "Issues of uncertainty", "Uncertainty attributes", and "Learning environment." Participants also contributed to a list of attributes which they considered helpful to undergraduate health professions' students in managing uncertain situations. These included an awareness of the nature of uncertainty within healthcare practice, an ability to recognise uncertainty, and adopting attitudes of adaptability, positivity, and resilience. CONCLUSIONS: This study highlights the successful use of Han et al.'s taxonomy of uncertainty within a faculty development setting. Our findings suggest that the taxonomy is a practical and versatile tool that health professions' educators can use in shared reflections and conversations around uncertainty with students or colleagues.

Disease prevention efforts on Welsh cattle farms are influenced by farm demographics.

BACKGROUND: This research seeks to understand how the transition to a new generation of younger, more diverse farmers affects disease prevention efforts on UK farms. METHODS: We apply multivariate regression analysis to analyse survey responses from 112 Welsh cattle farm operators. RESULTS: Our results indicate that young farm operators (less than 40 years of age) receive less frequent visits from veterinarians. Further, farm operators who identify as female are less likely to screen and vaccinate against a range of diseases. Finally, both young farmers and female farm operators are less likely to achieve disease-free certification for various economically meaningful livestock diseases. CONCLUSION: One possible explanation for these outcomes is that female farm operators and young farmers may feel excluded from long-standing social networks in the farm animal health sector.

Student Experience and Ethnic Diversity: The Experiences of Underrepresented Minority Students at a Veterinary University in the United Kingdom.

Despite a lack of diversity, studies on the experience of ethnically diverse (ED) students have not focused on veterinary education. This study used focus groups to explore the experience of ED veterinary students, their challenges, and their sources of support in this setting. Focus groups were held using two formats: a traditional, in-person approach, and online, via a social media group. Recruitment was by invitation and focus group allocation according to participant preference. Conversations were transcribed or downloaded, anonymized, and analyzed using a two-part narrative analysis, the aim of which was to understand the experiences of ED veterinary students at an in-depth level. Students experienced identity conflicts at multiple levels (self, others, profession), which appeared to relate to their ethnicity. Conflict between self and others resulted in a feeling of otherness arising from a White student majority, both within the university and on external placements, and professional identity conflicts arose between students' personal cultural values and their values as a veterinarian. Internal conflicts arose when students felt a wish to integrate but also perceived a need to segregate with similar others to obtain support and a sense of belonging to a group. These challenges have potential implications for mental well-being and career opportunities. For veterinary medicine to adapt to changing client demographics in an increasingly globalized world, a deeper understanding of the ED student experience may offer advantages in areas such as recruitment and profession retention, which will eventually support greater diversity within the professional population.

How Do Veterinary Students Engage When Using Creative Methods to Critically Reflect on Experience? A Qualitative Analysis of Assessed Reflective Work.

Critical reflection-the exploration and questioning of one's experience, beliefs, assumptions, and actions-supports resilience, empathy, the management of uncertainty, and professional identity formation. Yet for many students and educators, the techniques to engage in critical reflection are elusive. Creative methods that foster engagement with emotional and uncertain aspects of experience reportedly help some students to reflect at a more critical level than when they use reflective writing, and this study explores more deeply the experiences of such students, who used creative methods to critically reflect on challenging or troubling past events. A narrative methodology was utilized, in which researchers collaboratively co-constructed an understanding of students' experiences of reflection to identify the activities and steps they used. Creative methods did not inherently lead to critical reflection, but when this was achieved, the creative approaches seemed to facilitate a staging of reflection, which incorporated five sequential stages: preplanning creative depiction, experimenting with different ideas, deliberately completing the reflective piece, reflecting on creative work, and reflecting again on learning and development. This cyclic, repeated revisit to experience, as students engaged in each stage of their work, appeared to facilitate both a deep connection with the emotional elements of experience and a more distanced analysis. This ultimately led to a deepening of understanding of events, including the construction of students' own beliefs and empathy with others' views.

How do veterinary students engage when reflecting on their development towards being veterinary surgeons?

BACKGROUND: Reflection has been widely acknowledged to contribute to professional development, the ability to manage tension and enhanced resilience. However, many practitioners struggle to reflect productively due to a lack of clarity of what constitutes effective reflection. METHODS: To help develop reflective competence among future professionals, 30 veterinary students' reflective assignments were analysed by thematic text analysis. Theoretical frameworks were based on published criteria for critical and core reflection. RESULTS: Reflection was described through resources (the tools used), practices (the ways of using these tools) and outcomes (what was achieved). This helped to distinguish simple skills based reflection from higher-level core reflection. Simple skills-based reflection was associated with an identity of expert learner: students perceive that their task is to identify a knowledge deficit that can be easily rectified through new learning. Core reflection was associated with students articulating an identity of adaptable professionals: rather than veterinary challenges being resolved simply through application of a body of knowledge, wider complexities of professional practice are recognised, including a need to resolve tension between their own and other stakeholders' priorities, values and beliefs. CONCLUSION: Scaffolding an iterative, cyclical reflection process may support outcomes oriented towards resilience and the management of tension.

Best Practice in Supporting Professional Identity Formation: Use of a Professional Reasoning Framework.

Professional identity and professionalism education are increasingly important to veterinary education, but many of the concepts remain intangible to veterinary students, and engagement is a persistent challenge. While whole-curriculum integration is recommended for a successful professional studies program, this is complicated by clinical faculty's discomfort with the content. Where professional studies education is centered around professional identity formation, a key element of this is the multi-perspective nature of veterinary work, with the veterinarian negotiating the needs of multiple stakeholders in animal care. Constructing teaching around a framework of professional reasoning, which incorporates the negotiation of different stakeholder needs, ethical decision making, communication, teamwork, and outcome monitoring, offers the potential to make professional identity a concept more visible to students in veterinary work, and guides students in the contextualization of taught material. A framework is presented for veterinary professional reasoning that signposts wider curriculum content and helps illustrate where material such as veterinary business studies, animal welfare, the human-animal bond, and professional responsibility, as well as attributes such as empathy and compassion, all integrate in the decisions and actions of the veterinary professional. The aims of this framework are to support students' engagement in professional studies teaching and help them use workplace learning experiences to construct an appropriate professional identity for competence and resilience in the clinic. For faculty involved in curriculum design and clinical teaching, the framework provides a tool to support the integration of professional identity concepts across the extended curriculum.

'I wish I was someone else': complexities in identity formation and professional wellbeing in veterinary surgeons.

BACKGROUND: There is widespread concern surrounding veterinarians' mental health. Upon entering the profession, early career veterinary surgeons encounter colleagues with diverse and conflicting identities, manifesting in their differential prioritisation of definitive clinical treatment, interpersonal interactions or the commercial success of the practice. In other professions, poor wellbeing arises from confusion between these conflicting identity discourses, as new professionals attempt to identify role models aligned with their own identity beliefs. New veterinarians' wellbeing may thus depend on their negotiation of different identities, as they construct their own sets of professional values and determine the type of veterinarian they wish to become. METHODS: Identity formation was explored narratively using veterinarians' social media stories. RESULTS: Poor professional wellbeing appeared to arise from identity confusion: failure to consistently commit to either the dominant diagnosis-focused discourse valued by academic role models, or a relational discourse, emphasising working through contextual challenges such as varying client needs. Workplace stress appeared to magnify the dominance of academic priorities in self-identity understanding, worsening identity confusion. Also concerning was the positioning of the client 'as enemy', obstructive to veterinarians' identity goals. Social dialogue, intended to provide support during veterinarian-client conflict, potentially reinforced rejection of the client from the veterinary professional identity, strengthening a context-inappropriate, non-relational identity. This worsened identity confusion between the prized 'diagnostic identity' and the locally valued relational identity and was detrimental to wellbeing. CONCLUSIONS: Interventions are required, within veterinary education and postgraduate continuing professional development, that encourage reflection on identity and reinforce the value of relational identity attributes.

The influences of curriculum area and student background on mindset to learning in the veterinary curriculum: a pilot study.

A student's mindset influences their achievement and response to challenge, with a 'fixed mindset' encouraging disengagement from challenging tasks and avoidance of learning and feedback opportunities. These behaviours resemble those reported for professional and non-clinical curriculum areas, which are important for employability and resilience in veterinary practice. Students with a 'growth mindset' to learning are more persistent when faced with challenges and actively seek more demanding tasks. They also demonstrate higher levels of psychological well-being. The objectives of this study were to explore whether variation in veterinary students' mindset to learning exists across different curriculum areas, and to identify whether students' backgrounds influence their learning mindset. The mindsets of veterinary students at a UK veterinary school were measured using an adapted version of the Implicit Theories of Intelligence Scale. The survey was constructed to compare mindset in clinical reasoning, professional reasoning (incorporating ethics and critical thinking), communication skills and reflection. More students demonstrated a growth mindset to communication skills (59%), reflection (84%) and clinical reasoning (83%) than to professional reasoning (34%). There were more students with a fixed mindset to professional reasoning (10%) than in other areas (0-5%). Students' background (international or non-traditional university access) did not appear to influence mindset to learning. Disengagement from professional studies curricula may be a consequence of students lacking a growth mindset in professional reasoning. Curriculum interventions that encourage engagement and the development of a growth mindset to learning non-clinical competences may be beneficial.

The Veterinary Identity: A Time and Context Model.

The nature of professionalism teaching is a current issue in veterinary education, with an individual's identity as a professional having implications for one's values and behaviors, as well as for his or her career satisfaction and psychological well-being. An appropriately formed professional identity imparts competence in making complex decisions-those that involve multiple perspectives and are complicated by contextual challenges. It enables an individual to act in a way that aligns with his or her professional values and priorities, and imparts resilience to situations in which one's actions are dissonant to these personal beliefs. There are challenges in professionalism teaching that relate to student engagement and faculty confidence in this area. However, these cannot be addressed without first defining the veterinary professional identity-in effect, the aim of professionalism teaching. In this article, existing identity models from the wider literature have been analyzed through a veterinary lens. This analysis was then used to construct a model of veterinary professional identity that incorporates the self (personal morals and values), social development (learning from the workplace environment), and professional behaviors. Individuals who form what we have termed self-environment-behavior connections are proposed to be able to use workplace learning opportunities to inform their identity development, such that environmental complexity does not obstruct the link between values and behaviors. Those who fail to connect with the environment in this way may perceive that environmental influences (e.g., the client, financial limitations) are obstructive to enacting their desired identity, and they may struggle with decision making in complex scenarios.

Identity, environment and mental wellbeing in the veterinary profession.

Mental health and career dissatisfaction are of increasing concern to the veterinary profession. The influence of identity on the psychological wellbeing of veterinarians has not been widely explored. Twelve recent veterinary graduates were enrolled in a private social media discussion group, and their identities investigated through narrative inquiry: a methodology which enables identity priorities to be extrapolated from stories of experience. Two distinct variants of the veterinary identity were identified: an academic, 'diagnosis-focused' identity, which prioritised definitive diagnosis and best-evidence treatment; and a broader 'challenge-focused' identity, where priorities additionally included engaging with the client, challenging environment or veterinary business. Contextual challenges (such as a client with limited finances or difficult interpersonal interactions) were seen as a source of frustration for those with a diagnosis-focused identity, as they obstructed the realisation of identity goals. Overcoming these challenges provided satisfaction to those with a challenge-focused identity. The employment environment of the graduates (general veterinary practice) provided more opportunities for those with a challenge-focused identity to realise identity goals, and more markers of emotional wellbeing were apparent in their stories. Markers of poor emotional health were evident in the stories of those with a diagnosis-focused identity.

Developing a Professional Studies Curriculum to Support Veterinary Professional Identity Formation.

Professional studies teaching in medical and veterinary education is undergoing a period of change. Traditional approaches, aiming to teach students professional values and behaviors, are being enhanced by curricula designed to support students' professional identity formation. This development offers the potential for improving student engagement and graduates' mental well-being. The veterinary professional identity associated with emotional resilience and success in practice incorporates complexity in professional decision making and the importance of context on behaviors and actions. The veterinarian must make decisions that balance the sometimes conflicting needs of patient, clients, veterinarian, and practice; their subsequent actions are influenced by environmental challenges such as financial limitations, or stress and fatigue caused by a heavy workload. This article aims to describe how curricula can be designed to support the development of such an identity in students. We will review relevant literature from medical education and the veterinary profession to describe current best practices for supporting professional identity formation, and then present the application of these principles using the curriculum at the Royal Veterinary College (RVC) as a case study. Design of a "best practice" curriculum includes sequential development of complex thinking rather than notions of a single best solution to a problem. It requires managing a hidden curriculum that tends to reinforce a professional identity conceived solely on clinical diagnosis and treatment. It includes exposure to veterinary professionals with different sets of professional priorities, and those who work in different environments. It also includes the contextualization of taught content through reflection on workplace-learning opportunities.

Improving Student Engagement in Veterinary Business Studies.

Improving Student Engagement in Veterinary Business StudiesIn a densely packed veterinary curriculum, students may find it particularly challenging to engage in the less overtly clinical subjects, yet pressure from industry and an increasingly competitive employment market necessitate improved veterinary student education in business and management skills. We describe a curriculum intervention (formative reflective assignment) that optimizes workplace learning opportunities and aims to provide better student scaffolding for their in-context business learning. Students were asked to analyze a business practice they experienced during a period of extra-mural studies (external work placement). Following return to the college, they were then instructed to discuss their findings in their study group, and produce a group reflection on their learning. To better understand student engagement in this area, we analyzed individual and group components of the assignment. Thematic analysis revealed evidence of various depths of student engagement, and provided indications of the behaviors they used when engaging at different levels. Interactive and social practices (discussing business strategies with veterinary employees and student peers) appeared to facilitate student engagement, assist the perception of relevance of these skills, and encourage integration with other curriculum elements such as communication skills and clinical problem solving.

Developing teaching to improve the wellbeing of future vets.

Some people are under the impression that developing the educational experience of students at the Royal Veterinary College doesn't make you a 'real vet'. Here, Elizabeth Armitage-Chan explains how her role helps future vets gain in confidence and competence.

The Challenges and Issues of Undergraduate Student Retention and Attainment in UK Veterinary Medical Education.

Student retention and attainment has recently been identified as a key area for development in veterinary medical education enquiry. Woodfield's research on retention and attainment across the UK disciplines has yielded some unique information about the challenges and issues of students who study veterinary medicine and related subjects. The present literature review aims to expand on Woodfield's findings and explain important issues about retention and attainment across veterinary medicine. Overall, the subject of retention and attainment in undergraduate veterinary medical education needs a great deal more empirical attention, such as data on the retention and attainment of mature and widening access students, and the effects of students being placed at remote locations during their studies. Our findings also cover some unsurprising issues: the dominance of women in a profession that is principally lead by men, the underrepresentation of black and minority ethnic (BME) students in veterinary medicine, and the effects of content overload in the veterinary medical curriculum. Based on data gathered by Woodfield and our investigation of the scholarly and gray literatures, we offer an overview of gaps in current knowledge and recommendations for further research.

Assessing Professionalism: A Theoretical Framework for Defining Clinical Rotation Assessment Criteria.

Although widely accepted as an important graduate competence, professionalism is a challenging outcome to define and assess. Clinical rotations provide an excellent opportunity to develop student professionalism through the use of experiential learning and effective feedback, but without appropriate theoretical frameworks, clinical teachers may find it difficult to identify appropriate learning outcomes. The adage "I know it when I see it" is unhelpful in providing feedback and guidance for student improvement, and criteria that are more specifically defined would help students direct their own development. This study sought first to identify how clinical faculty in one institution currently assess professionalism, using retrospective analysis of material obtained in undergraduate teaching and faculty development sessions. Subsequently, a faculty workshop was held in which a round-table type discussion sought to develop these ideas and identify how professionalism assessment could be improved. The output of this session was a theoretical framework for teaching and assessing professionalism, providing example assessment criteria and ideas for clinical teaching. This includes categories such as client and colleague interaction, respect and trust, recognition of limitations, and understanding of different professional identities. Each category includes detailed descriptions of the knowledge, skills, and behaviors expected of students in these areas. The criteria were determined by engaging faculty in the development of the framework, and therefore they should represent a focused development of criteria already used to assess professionalism, and not a novel and unfamiliar set of assessment guidelines. The faculty-led nature of this framework is expected to facilitate implementation in clinical teaching.

Teaching Professionalism: Using Role-Play Simulations to Generate Professionalism Learning Outcomes.

For a constructively aligned curriculum in veterinary professionalism, there is a need for well-designed higher order learning outcomes to support students' professional identity formation. A lack of uniformly accepted definitions of veterinary professionalism necessitates the defining and refining of current concepts of professionalism to inform teaching and assessment. A potential method for achieving such learning outcomes is to generate these from simulated professionalism teaching scenarios. A workshop was designed in which veterinary educators used role play to resolve a professional dilemma. Following discussion of the appropriate management approach, participants were asked to reflect on the learning outcomes that were required to resolve the scenario and that students would achieve by going through the same classroom-based process. Workshop participants identified several professionalism learning outcomes that are not currently defined in the literature: realizing that there is not a single correct answer to a professional dilemma, making a decision despite this uncertainty, communicating differences of opinion, and understanding the effect of differences in professional identity. Although the process described runs counter to traditional curricular design, it may offer a valuable contribution to the discourse surrounding professionalism learning outcomes. Furthermore, it has generated higher level learning outcomes than have been obtained through other methods.

Intra-operative hyperthermia in a cat with a fatal outcome.

HISTORY: A four year old male neutered Domestic Short Hair cat presented for general anaesthesia for hind limb orthopaedic surgery. The cat had been anaesthetized four days previously with propofol and isoflurane and made an uneventful recovery. PHYSICAL EXAMINATION AND MANAGEMENT: On pre-anaesthetic examination the cat had a temperature of 38.9 °C and was otherwise healthy. After a premedication of acepromazine and pethidine, anaesthesia was induced with thiopental and maintained with isoflurane in oxygen 50% and nitrous oxide 50%. Increases in heart rate, respiratory rate, end tidal carbon dioxide tension and temperature were observed, occurring sequentially, from 110 to 175 minutes after anaesthetic induction. Despite ceasing all warming measures and attempting to cool the patient, body temperature continued to rapidly rise, reaching 42.5 °C and limb rigidity was observed. Isoflurane administration was stopped and esmolol was administered. Cardiac arrest occurred. Cardio-pulmonary cerebral resuscitation was commenced and a lateral thoracotomy was performed to allow cardiac compressions and internal defibrillation. Atropine, adrenaline, glucose and dopamine were administered and cold saline was instilled into the thoracic cavity. FOLLOW-UP: Resuscitation was unsuccessful and the cat died. CONCLUSIONS: A presumptive diagnosis of malignant hyperthermia was made. Malignant hyperthermia should be considered, even if prior exposure to volatile inhalational anaesthesia was uneventful, and prompt and aggressive therapy instituted.