Development, implementation, and evaluation of a novel multidisciplinary one health course for university undergraduates.

Today's collaborations across fields of health and wellness are insufficient to meet societies' challenges in combating disease and maintaining the ecosystem and public health. In this article, we present a One Health curriculum model designed to encourage undergraduate students of varying disciplines to value the connectedness of animals, humans, and the environment and to think innovatively about solutions to priority global health issues. We present the design and implementation of a course that brought together multiple faculty from different fields of study, including the dental, medical, nutrition, and veterinary schools, in a curriculum designed for undergraduates primarily from Arts & Sciences fields. The curriculum was collaboratively designed around four key One Health categories: 1) Infectious zoonotic diseases and global health, 2) Naturally occurring shared disease in companion animals that can serve as models for human disease, 3) Human-animal interactions, and 4) Impact of environmental health on human and animal health. We show this course successfully deepened students' understandings of One Health, its role in addressing high priority health issues and the overall benefits of a One Health approach to tackling societal problems. We also report a positive experience by the faculty working in collaboration to implement the curriculum model and the overall enthusiasm of students for the course, all of whom would recommend it to their peers. We conclude by proposing the potential of the curriculum model underlying this course to fill the need for One Health Curricula in programs preparing future health professionals.

Fifty Years of Evolving Partnerships in Veterinary Medical Education.

The Association of American Veterinary Medical College's (AAVMC's) role in the progression of academic veterinary medical education has been about building successful partnerships in the US and internationally. Membership in the association has evolved over the past 50 years, as have traditions of collaboration that strengthen veterinary medical education and the association. The AAVMC has become a source of information and a place for debate on educational trends, innovative pedagogy, and the value of a diverse learning environment. The AAVMC's relationship with the American Veterinary Medical Association Council on Education (AVMA COE), the accreditor of veterinary medical education recognized by the United Sates Department of Education (DOE), is highlighted here because of the key role that AAVMC members have played in the evolution of veterinary accreditation. The AAVMC has also been a partner in the expansion of veterinary medical education to include global health and One Health and in the engagement of international partners around shared educational opportunities and challenges. Recently, the association has reinforced its desire to be a truly international organization rather than an American organization with international members. To that end, strategic AAVMC initiatives aim to expand and connect the global community of veterinary educators to the benefit of students and the profession around the world. Tables in this article are intended to provide historical context, chronology, and an accessible way to view highlights.

Assessing clinical competency: reports from discussion groups.

This report describes proposed new models for assessment of eight of the nine clinical competencies the American Veterinary Medical Association Council on Education requires for accreditation. The models were developed by discussion groups at the Association of American Veterinary Medical Colleges' Clinical Competency Symposium. Clinical competencies and proposed models (in parentheses) are described. Competency 1: comprehensive patient diagnosis (neurologic examination on a dog, clinical reasoning skills); Competency 2: comprehensive treatment planning (concept mapping, computerized case studies); Competency 3: anesthesia, pain management (student portfolio); Competency 4: surgery skills (objective structured clinical examination, cased-based examination, "super dog" model); Competency 5: medicine skills (clinical reasoning and case management, skills checklist); Competency 6: emergency and intensive care case management (computerized case study or scenario); Competency 7: health promotion, disease prevention/biosecurity (360 degrees evaluation, case-based computer simulation); Competency 8: client communications and ethical conduct (Web-based evaluation forms, client survey, communicating with stakeholders, telephone conversation, written scenario-based cases). The report also describes faculty recognition for participating in clinical competency assessments.

Assessment of clinical reasoning skills in veterinary students prior to and after the clinical year of training.

OBJECTIVE: To examine the effect of various clinical tracks within the veterinary medical clinical curriculum at Texas A&M University on clinical diagnostic proficiency as determined by pre- and post-training assessment. We expected that the clinical track chosen by the student would impact their measured outcome with bias toward higher scores in their chosen field. DESIGN: Prospective cohort study. STUDY POPULATION: 32 students from the College of Veterinary Medicine and Biomedical Sciences at Texas A&M University. PROCEDURES: By use of standardized, written case scenarios, clinical reasoning was assessed twice: once prior to the clinical (fourth) year of the curriculum and again at completion of the clinical year. Students demonstrated their abilities to collect and organize appropriate clinical data (history, physical examination, and laboratory findings), determine clinical diagnoses, and formulate and implement acceptable treatment modalities. Data from clinical assessments were compared for a given cohort and correlated with other measures (eg, grades, standardized test scores, and species-specific curricular track). RESULTS: Differences were detected in clinical diagnostic proficiency among students in different clinical tracks and for different species groups in the case scenarios. Tracking by species group in the clinical veterinary curriculum appeared to affect development of clinical reasoning and resulted in differential proficiency among cases for differing species groups. CONCLUSIONS AND CLINICAL RELEVANCE: Differences in clinical experiences between small animal tracks and all other track opportunities (large animal, mixed animal, and alternative) influenced the development of clinical proficiency in fourth-year veterinary students during their clinical training period.

Balancing veterinary students' and house officers' learning experiences in veterinary teaching hospitals.

Veterinary students at two large veterinary referral teaching hospitals were surveyed on their perceptions of competition with interns and residents for learning experiences during clinical instruction. Their responses led to an additional survey of a cohort of clinical educators on how this competition might be managed, what impedes effective management, and how progress toward an improved clinical learning environment might be measured. This article describes the results of the survey and discusses the nature of the competition and factors affecting the competitive learning environment. The results of this study should be expanded to include a larger cohort of veterinary students and an assessment of house officers' and faculty members' perceptions.

Vertically integrated educational collaboration between a college of veterinary medicine and a non-profit animal shelter.

The College of Veterinary Medicine and Biomedical Sciences (CVMBS) at Texas A&M University (TAMU) has developed a multifaceted program in partnership with the Brazos Animal Shelter to provide teaching opportunities with shelter animals during all four years of the professional curriculum. In the first three semesters of the professional program, students working in small groups spend two hours per semester at the shelter performing physical examinations, administering vaccinations and anthelmintics, completing heartworm or FeLV/FIV testing, and performing simple medical treatments. In an expanded fourth-year program, groups of six students spend 16 contact hours at the shelter during two-week rotations, completing similar tasks. Through this program, each student practices animal-handling skills and routine procedures on an average of 150 to 200 dogs and cats. In addition, during third- and fourth-year surgery courses, student teams spay or neuter an average of 12 to 18 dogs or cats each week. More than 800 animals are spayed/neutered annually through this program, and each student directly participates in 12 to 15 spay/neuter survival surgeries. The program represents a creative approach to veterinary training that conscientiously uses animal resources in a positive fashion. We believe that this is a successful partnership between a state-supported veterinary college and a non-profit shelter that benefits both agencies. We encourage other veterinary colleges to explore similar partnership opportunities to provide optimal training for professional students while using animal resources efficiently.

Evidence-based decision making in small animal therapeutics.

With a growing number of evidence-based resources being developed for use in veterinary medicine, the time is right for academicians, practitioners, and students to embrace the positive elements of evidence-based veterinary medicine. Clinical pharmacologists, more than most, have all the skills required to use an evidence-based approach effectively for the benefit of patients and the advancement of the profession.

Information technology in veterinary pharmacology instruction.

Veterinary clinical pharmacology encompasses all interactions between drugs and animals and applies basic and clinical knowledge to improve rational drug use and patient outcomes. Veterinary pharmacology instructors set educational goals and objectives that, when mastered by students, lead to improved animal health. The special needs of pharmacology instruction include establishing a functional interface between basic and clinical knowledge, managing a large quantity of information, and mastering quantitative skills essential to successful drug administration and analysis of drug action. In the present study, a survey was conducted to determine the extent to which veterinary pharmacology instructors utilize information technology (IT) in their teaching. Several IT categories were investigated, including Web-based instructional aids, stand-alone pharmacology software, interactive videoconferencing, databases, personal digital assistants (PDAs), and e-book applications. Currently IT plays a largely ancillary role in pharmacology instruction. IT use is being expanded primarily through the efforts of two veterinary professional pharmacology groups, the American College of Veterinary Clinical Pharmacology (ACVCP) and the American Academy of Veterinary Pharmacology and Therapeutics (AAVPT). The long-term outcome of improved IT use in pharmacology instruction should be to support the larger educational mission of active learning and problem solving. Creation of high-quality IT resources that promote this goal has the potential to improve veterinary pharmacology instruction within and across institutions.

Rb localization and phosphorylation kinetics correlate with the cellular phenotype of cultured breast adenocarcinoma cells.

Retinoblastoma protein (Rb) expression has been correlated with state of differentiation, proliferation rate, and metastatic potential in breast adenocarcinomas and established cell lines. These observations, based on immunoreactivity of total Rb rather than hypophosphorylated protein, do not address the relationship between functional Rb and indicators of an aggressive transformed cellular phenotype. We hypothesized that the distribution of functional Rb and the kinetics of Rb phosphorylation would differ between cell lines representing immortalized mammary epithelium (MCF10A), differentiated nonmetastatic mammary adenocarcinoma (MCF-7), and poorly differentiated, highly metastatic mammary adenocarcinoma (MDA-MB-231) and that these differences would be informative of the cellular phenotype. Direct immunofluorescence microscopy was used to compare qualitatively the subcellular localization of total and hypophosphorylated Rb protein in synchronized and asynchronous cells. This technique was also used to quantitatively assess the amounts of hypophosphorylated Rb throughout the cell cycle in these representative cell lines. Total Rb stained more prominently than hypophosphorylated Rb in the nucleus of all asynchronous cells. Rb phosphorylation was more rapid in MCF-7 cells than in MCF10A cells, whereas Rb dephosphorylation appeared deregulated in MDA-MB-231 cells. We conclude that assessment of hypophosphorylated Rb may be more useful than assessment of total Rb for the evaluation of transformed breast adenocarcinoma phenotypes.

Retinoblastoma function is a better indicator of cellular phenotype in cultured breast adenocarcinoma cells than retinoblastoma expression.

Loss of or lowered retinoblastoma (Rb) expression has been included as a prognostic indicator in breast cancer. Low or no Rb expression is seen most commonly in high-grade breast adenocarcinomas, suggesting that a relationship may exist between loss of Rb and a less differentiated state, high proliferation rate, and high metastatic potential. In this study, we compared Rb function in two established breast adenocarcinoma cell lines, MCF-7 and MDA-MB-231, and in an established immortalized mammary epithelial cell line, MCF10A. Cells were synchronized in G0/G1 and were released for several durations, at which time total Rb protein, mRNA, and Rb/E2F/DNA complex formation were evaluated. Rb protein was significantly higher in the tumor cells than in MCF10A cells. However, Rb function was high for a longer duration in MCF10A cells as compared with MCF-7 and MDA-MB-231 cells. Our data support the general conclusion that Rb function, but not necessarily Rb protein, is lower in highly malignant breast adenocarcinoma cells as compared with lower grade tumor cells. These results emphasize the relevance of assessing Rb function over Rb protein. This is particularly important if Rb is to be used as a prognostic indicator for breast adenocarcinoma.

Doxycycline induces expression of P glycoprotein in MCF-7 breast carcinoma cells.

P-glycoprotein (P-gp) overexpression by tumor cells imparts resistance to multiple antineoplastic chemotherapeutic agents (multiple drug resistance). Treatment of tumor cells with chemotherapeutic agents such as anthracyclines, epipodophyllotoxins, and Vinca alkaloids results in induction of P-gp expression. This study was performed to determine if clinically relevant antimicrobial drugs (i.e., drugs that are used to treat bacterial infections in cancer patients) other than antineoplastic agents can induce expression of P-gp in MCF-7 breast carcinoma cells. Expression of P-gp and MDR1 mRNA was determined in samples from MCF-7 cells that were treated in culture with doxorubicin (positive control) and the antimicrobial drugs doxycycline, piperacillin, and cefoperazone. The functional status of P-gp was assessed using laser cytometry to determine intracellular doxorubicin concentrations. The MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) assay was used to determine if the cytotoxicity of experimental drugs was related to their ability to induce P-gp expression. MCF-7 cells treated with doxycycline (MCF-7/doxy) were stimulated to overexpress P-gp, whereas cells treated with piperacillin and cefoperazone did not overexpress P-gp. MCF-7/doxy cells were compared to a positive-control subline, MCF-7/Adr, previously selected for doxorubicin resistance, and to MCF-7 cells treated with doxorubicin (MCF-7/doxo). All three sublines overexpressed P-gp and MDR1 mRNA and accumulated less intracellular doxorubicin than did control MCF-7 cells. P-gp expression was induced only by experimental drugs that were cytotoxic (doxorubicin and doxycycline). Doxycycline, a drug that has been used for treatment of bacterial infections in cancer patients, can induce functional P-gp expression in cancer cells, resulting in multidrug resistance.