Clinical supervisors' and students' perspectives on preparedness for veterinary workplace clinical training: An international study.

BACKGROUND: The alignment of student and workplace supervisors' perspectives on student preparedness for veterinary workplace clinical training (WCT) is unknown, yet misalignment could negatively impact workplace learning. The aim of this study was to quantify the relative importance of WCT preparedness characteristics according to students and supervisors and to identify differences. METHODS: A survey was completed by 657 veterinary students and 244 clinical supervisors from 25 veterinary schools, from which rankings of the preparedness characteristics were derived. Significant rank differences were assessed using confidence intervals and permutation tests. RESULTS: 'Honesty, integrity and dependability' was the most important characteristic according to both groups. The three characteristics with the largest rank differences were: students' awareness of their own and others' mental wellbeing and the importance of self-care; being willing to try new practical skills with support (students ranked both of these higher); and having a clinical reasoning framework for common problems (supervisors ranked higher). LIMITATIONS: Using pooled data from many schools means that the results are not necessarily representative of the perspectives at any one institution. CONCLUSION: There are both similarities and differences in the perspectives of students and supervisors regarding which characteristics are more important for WCT. This provides insights that can be used by educators, curriculum developers and admissions tutors to improve student preparedness for workplace learning.

Rating and ranking preparedness characteristics important for veterinary workplace clinical training: a novel application of pairwise comparisons and the Elo algorithm.

Quantitatively eliciting perspectives about a large number of similar entities (such as a list of competences) is a challenge for researchers in health professions education (HPE). Traditional survey methods may include using Likert items. However, a Likert item approach that generates absolute ratings of the entities may suffer from the "ceiling effect," as ratings cluster at one end of the scale. This impacts on researchers' ability to detect differences in ratings between the entities themselves and between respondent groups. This paper describes the use of pairwise comparison (this or that?) questions and a novel application of the Elo algorithm to generate relative ratings and rankings of a large number of entities, on a unidimensional scale. A study assessing the relative importance of 91 student "preparedness characteristics" for veterinary workplace clinical training (WCT) is presented as an example of this method in action. The Elo algorithm uses pairwise comparison responses to generate an importance rating for each preparedness characteristic on a scale from zero to one. This is continuous data with measurement variability which, by definition, spans an entire spectrum and is not susceptible to the ceiling effect. The output should allow for the detection of differences in perspectives between groups of survey respondents (such as students and workplace supervisors) which Likert ratings may be insensitive to. Additional advantages of the pairwise comparisons are their low susceptibility to systematic bias and measurement error, they can be quicker and arguably more engaging to complete than Likert items, and they should carry a low cognitive load for respondents. Methods for evaluating the validity and reliability of this survey design are also described. This paper presents a method that holds great potential for a diverse range of applications in HPE research. In the pursuit quantifying perspectives on survey items which are measured on a relative basis and a unidimensional scale (e.g., importance, priority, probability), this method is likely to be a valuable option.

Farm animal careers and perception of 'fit' in undergraduate veterinary students: A mixed methods study.

BACKGROUND: Recruitment and retention of farm veterinarians have been the focus of recent research. Previous work suggests that a feeling of 'fit' is important for students to consider a farm career. The aim of this study was to identify whether students feel that they 'fit' in farm practice and reasons for their answer. METHODS: An online survey was distributed to students at all British and Irish veterinary schools. A mixed methods approach was considered, with thematic analysis on free text answers and regression analysis on demographic variables. RESULTS: Thematic analysis identified six themes: career opportunities, nature of farm veterinary work, relationships and interactions, individual experiences, expectations and perceptions, and no perceived barriers. Females, marginalised ethnic groups and those from an urban/suburban background were all identified as having significantly (p < 0.05) less agreement with the statement 'I feel able to pursue a career in farm practice'. LIMITATIONS: Survey limitations include those with a clear bias being likely to respond. However, alignment of the qualitative and quantitative results increased confidence in the findings of this mixed methods approach. CONCLUSION: This study confirms that biases that exist within wider society do have an influence on veterinary undergraduates' intentions to pursue a farm animal career. This is vital to consider both at a university level and when considering students' experiences on placements. Urgent action is required to improve inclusivity in the farm animal veterinary sector.

Gender discrimination of veterinary students and its impact on career aspiration: A mixed methods approach.

Introduction: As the veterinary profession has become feminised, gender discrimination and its effects have been documented in practicing veterinary surgeons. However, research on gender discrimination experienced by veterinary students and its effects on recruitment and retention remains limited. This study aimed to increase understanding of veterinary students' experiences of gender discrimination and its impact on their career aspirations. Methods: A questionnaire including statements with Likert-style response options and free-text questions was distributed to students studying veterinary medicine and science at a UK veterinary school in September 2020 (28% response rate). Two focus groups were carried out following the questionnaire to gain a deeper insight into student experiences. Results: Gender discrimination in a veterinary setting had been experienced by 34% of respondents, the majority (77%) on animal husbandry placements. Female students were more likely to report that their experiences of gender discrimination affected their career aspirations. Seven themes were identified from both the questionnaire and focus group data: stereotyping of certain fields, gender inequality on placements, the lesbian, gay, bisexual, transgender, queer and intersex, plus (LGBTQI+) community, encouraging reporting behaviours, barriers to reporting, education and the placement allocation. Conclusions: This study highlighted that gender discrimination was prevalent during animal husbandry placements, although reporting was infrequent and perceived negatively by students. Recommendations on how veterinary schools and the wider veterinary profession can support veterinary students are made as an outcome of this work.

How can we create a sustainable future for farm animal veterinary practice?

Recruitment and retention is a big problem for the farm vet sector, but it could be overcome by implementing small improvements at all stages of the farm vet pipeline, argues John Remnant.

Accuracy of heart girth tapes in the estimation of weights of pre-weaned calves.

BACKGROUND: Heart girth tapes (HGTs) are often used as an alternative to weight scales for calves. This study investigated the accuracy of HGT in estimating bodyweight and daily liveweight gain (DWLG) of pre-weaned calves, and the impact of inter-observer variation. METHOD: In Study 1, 119 calves were weighed using HGT and electronic scales on multiple occasions. Mixed-effects models for both bodyweight and DLWG were used to determine the accuracy of HGT compared to the electronic scales. Simulation data were used to further analyse the accuracy of DLWG estimation including for factors such as the effect of group size on group DLWG estimates.In Study 2, 10 observers weighed 20 pre-weaned calves, using HGT and electronic scales. Mixed-effect model was used to investigate the impact of different observers on the accuracy of HGT on measuring bodyweights. RESULTS: Mixed-effects model results suggest HGT provides a relatively accurate estimation of weight (MAE: 2.66 kg) and relatively inaccurate estimation of DLWG (MAE 0.10 kg/d). Simulated data identified associations between time between weight dates and error in DLWG estimation, with MAE of individual DLWG estimation decreasing from 0.43 kg/d when 14 days apart to 0.08 kg/d when 70 days apart. Increased calf numbers reduced error rates of group DLWG estimation, with <0.05 kg/d error achieved in >90% of simulations when 12 calves were weighed 70 days apart. CONCLUSIONS: HGTs are relatively accurate at estimating individual bodyweights but are unreliable methods for measuring DLWG in individual calves, particularly weighed within a short-time period. Estimates at group level however are relatively accurate, providing there is a suitable period of time between weigh dates and an appropriate number of calves per group.

Attitudes of UK veterinary students towards careers in the production animal sector: A mixed methods approach.

BACKGROUND: Within the production animal sector, it has long been forecast that demand for veterinary services could outstrip supply. This study aims to identify factors influencing veterinary undergraduates' attitudes towards a career in farm animal veterinary practice and how those factors may be influenced by their experiences during their time as an undergraduate. METHODS: An online survey was distributed to all vet schools in the UK and Ireland. Thematic analysis and descriptive data analysis were performed on the 1146 responses received. RESULTS: Seven themes were identified: relationships, preferences and interest, fit, direct experience, fear, ethics and values and lifestyle. When considering first job choice, extra mural studies (EMS) and personal interest (60% and 75% of respondents respectively) were very influential. Factors that appeal or put off respondents from a career in farm animal varied dependent on anticipated first job (p < 0.001), but working hours and out of hours were consistently identified as barriers. CONCLUSION: The results highlight the importance of EMS being more transparent about the profession and using the opportunity to discuss undergraduate concerns regarding farm animal practice.

Association of lameness and mastitis with return-to-service oestrus detection in the dairy cow.

Oestrus detection is an important part of maintaining efficient reproductive performance in dairy herds. Both lameness and mastitis are common diseases of dairy cows that may impact oestrus detection. A set of data from 28 herds identified as having good recording of clinical mastitis and lameness incidents was used for the study. Logistic regression was used to identify associations between disease episodes within 100 days of insemination and changes in the probability of reinsemination at either 18-24 or 19-26 days after an unsuccessful insemination. Population attributable risk was calculated to understand the impact these diseases may have at a herd level. Lameness 0-28 days after the first insemination of the interval decreased the odds of a reinsemination at an appropriate time by approximately 20 per cent. Clinical mastitis 1-28 days prior to the first insemination of the interval increased the odds of reinsemination at the expected time by approximately 20 per cent. The associations were similar for either interservice interval outcome. Population attributable risk suggested that the effect of these diseases on the probability of reinsemination at the expected time at a population level would likely be extremely small.

The future of cattle veterinary practice: insights from a qualitative study.

The British livestock sector is constantly changing due to environmental and economic pressures, consequentially causing a shift in demand on farm veterinary services. The aim of this study was to explore the future of cattle veterinary practice, using a qualitative approach. Telephone interviews were organised with key opinion leaders within the cattle farm and veterinary sectors to discuss their opinions on the future of the profession. The interviews were recorded and transcribed, and thematic analysis was used to interpret the data. The analysis of these interviews resulted in the development of six key themes that emerged as being important in the future of cattle veterinary practice; veterinary business structure, veterinary practice income, collaboration, the changing role of the cattle vet, the vet-farmer relationship and the new generation of cattle vets. The study identified that the role of the cattle veterinary practitioner in the UK is changing with an increasing focus on data handling, people management and training and advisory skills. It is important that these findings are accounted for in the development of undergraduate and postgraduate veterinary training.

Anatomy and Pathology of the Texel Sheep Larynx.

Laryngeal chondritis, or "Texel throat", is a disease affecting the upper respiratory tract of sheep with breeds like the Texel appearing to be predisposed. Previous work suggests the conformation of these breeds of sheep may be predisposing these animals to laryngeal disease. This study evaluated the anatomy of the Texel sheep larynx and describes incidental pathology. Forty-three larynges from rams of the Texel and Bluefaced Leicester breeds of sheep were measured and photographed. A larynx from each breed was submitted for computed tomography (CT) and magnetic resonance imaging (MRI). Measurements, photography, CT, and MRI demonstrated a difference in the anatomy of the larynx between breeds and a higher proportion of Texel sheep had laryngeal lesions. This study supports the hypothesis that the anatomy of the Texel sheep could be pre-disposing the breed to laryngeal chondritis.

Risk of iatrogenic damage to the sciatic nerve in dairy cattle.

Sciatic nerve damage in cattle could lead to pain, paralysis and lameness, creating welfare and productivity issues. Damage following intramuscular injection is highlighted in some clinical texts although there is no indication of prevalence. This cross-sectional study investigated the anatomical size and position of the sciatic nerve in four dairy cattle type cadavers. To evaluate the risk of iatrogenic damage, 54 participants placed needles in the dorsal gluteal region of two cadavers each, as per their routine intramuscular injection method. The distance from needle tip to the sciatic nerve was estimated for each. Sixty-nine per cent of injections were placed within 5 cm of the sciatic nerve. Direct nerve puncture occurred in the cadaver in poorest body condition. A short questionnaire revealed that 70 per cent of the participants regularly used the dorsal gluteal region for intramuscular injection and 50 per cent commonly used a volume of ≥20 mL at a single site. It is concluded that the sciatic nerve is at considerable risk of iatrogenic damage. The neck should be promoted as the optimum site for intramuscular injection and improved guidelines are required if the gluteal region is to remain in common use. A lateral site, between the tuber coxae and tuber ischium, is recommended.

Quantitative analysis of antimicrobial use on British dairy farms.

Antimicrobial resistance has been reported to represent a growing threat to both human and animal health, and concerns have been raised around levels of antimicrobial usage (AMU) within the livestock industry. To provide a benchmark for dairy cattle AMU and identify factors associated with high AMU, data from a convenience sample of 358 dairy farms were analysed using both mass-based and dose-based metrics following standard methodologies proposed by the European Surveillance of Veterinary Antimicrobial Consumption project. Metrics calculated were mass (mg) of antimicrobial active ingredient per population correction unit (mg/PCU), defined daily doses (DDDvet) and defined course doses (DCDvet). AMU on dairy farms ranged from 0.36 to 97.79 mg/PCU, with a median and mean of 15.97 and 20.62 mg/PCU, respectively. Dose-based analysis ranged from 0.05 to 20.29 DDDvet, with a median and mean of 4.03 and 4.60 DDDvet, respectively. Multivariable analysis highlighted that usage of antibiotics via oral and footbath routes increased the odds of a farm being in the top quartile (>27.9 mg/PCU) of antimicrobial users. While dairy cattle farm AMU appeared to be lower than UK livestock average, there were a selection of outlying farms with extremely high AMU, with the top 25 per cent of farms contributing greater than 50 per cent of AMU by mass. Identification of these high use farms may enable targeted AMU reduction strategies and facilitate a significant reduction in overall dairy cattle AMU.

Quantitative analysis of antibiotic usage in British sheep flocks.

The aim of this study was to examine the variation in antibiotic usage between 207 commercial sheep flocks using their veterinary practice prescribing records. Mean and median prescribed mass per population corrected unit (mg/PCU) was 11.38 and 5.95, respectively and closely correlated with animal defined daily dose (ADDD) 1.47 (mean), 0.74 (median) (R2=0.84, P<0.001). This is low in comparison with the suggested target (an average across all the UK livestock sectors) of 50 mg/PCU. In total, 80 per cent of all antibiotic usage occurred in the 39 per cent of flocks where per animal usage was greater than 9.0 mg/PCU. Parenteral antibiotics, principally oxytetracycline, represented 82 per cent of the total prescribed mass, 65.5 per cent of antibiotics (mg/PCU) were prescribed for the treatment of lameness. Oral antibiotics were prescribed to 49 per cent of flocks, 64 per cent of predicted lamb crop/farm. Lowland flocks were prescribed significantly more antibiotics than hill flocks. Variance partitioning apportioned 79 per cent of variation in total antibiotic usage (mg/PCU) to the farm level and 21 per cent to the veterinary practice indicating that veterinary practices have a substantial impact on overall antimicrobial usage. Reducing antibiotic usage in the sheep sector should be possible with better understanding of the drivers of high usage in individual flocks and of veterinary prescribing practices.

Clinician attitudes to pain and use of analgesia in cattle: where are we 10 years on?

Pain in cattle can arise though disease or injury or may result from veterinary or husbandry procedures. Controlling pain is important to safeguard animal welfare. Previous studies indicated that the use of analgesics in cattle has lagged behind use in companion animals. Over the last decade, more analgesic products have become available for use in cattle and there have been increased efforts to communicate the importance and benefits of analgesia. A questionnaire (based on that used in a similar study published in 2006) was sent to UK cattle practitioners asking them to score pain severity for several conditions of cattle and asking about their attitudes towards and use of analgesic medicines. A total of 242 surveys were returned. Male clinicians and those graduating before 1990 scored pain severity significantly lower and were significantly less likely to use NSAIDs. Generally, use of NSAIDs was more common for conditions assigned higher pain scores. However, uptake of NSAID use was much lower for a number of routine procedures in calves than would be expected from the pain scores they were assigned. A need remains to increase use of analgesic products, especially NSAIDs in calves, in line with best practice recommendations.