ABSTRACT
The Calgary-Cambridge Guide is a widely recognised framework for teaching communication skills to healthcare professionals that has become a cornerstone of communication training programs in medicine and other healthcare fields. In the context of veterinary medicine, its integration into communication training programs has become an asset improving communication, education, interaction, and quality of service, enhancing the veterinary-client-patient relationship (VCPR). In veterinary medicine, however, a more challenging consultation dynamic involves the veterinarian, the owner, and the animal. The addition of a veterinary assistant that acts as an interpreter or translator is common in Hong Kong where the native language (Cantonese) coexists with English when consultations are led by non-native language speakers. This addition converts this commonly dyadic model into a triadic communication model. The addition of an assistant interpreter influences the way consultations are conducted, how information is conveyed, and how interpersonal cues and empathy are delivered. In this report we depict challenges applying the Calgary-Cambridge Guide in multicultural and multilingual veterinary medical centres in Hong Kong and highlight the role of veterinary supporting staff in these scenarios, specifically veterinary assistant interpreters.
ABSTRACT
BACKGROUND: A novel live porcine model replicated the endoscopic surgical field of a carotid arterial injury of the human skull base. Hemostatic techniques were applied to jugular venous and carotid arterial injuries, including muscle patches, hemoclips, and aneurysm clips. Doppler imaging distal to the injury assessed flow through the repaired vessel. MATERIALS AND METHODS: External jugular veins, and internal carotid arteries isolated from seven live anesthetized 100 kg pigs, were placed into a sinus model otorhino neuro trainer for visualization via an endoscopic nasal approach. Vessels were systematically injured and repaired, and Doppler measurements were made to assess flow through the vessels before injury and following repair. RESULTS AND CONCLUSIONS: Blood pressures were maintained within physiological ranges, despite blood losses of up to 4.5 l. Venous injuries were repaired using Floseal, hemoclips, and aneurysm clips, while arterial injuries were repaired with muscle patches and aneurysm clips. Blood flow remained in all vessels after repair. This porcine model was effective for demonstration of arterial and venous injuries during endoscopic skull base surgery. Crushed muscle patch was effective for arterial injuries of 3 mm, and the aneurysm clips for injuries of 5 mm. Jugular venous injuries of 3 mm were repaired using Floseal, 5 mm using hemoclips, and 6 mm using aneurysm clips. Doppler imaging was a noninvasive means of demonstrating ongoing flow through injured and repaired vessels. The model represents a valuable training tool with the potential to train endoscopic skull base teams the skills required to manage an internal carotid artery injury.