Discussion of cost continues to be uncommon in companion animal veterinary practice.

OBJECTIVE: To determine the prevalence and nature of cost conversations occurring during veterinarian-client-patient interactions within companion animal practice. SAMPLES: 60 randomly selected, practicing veterinarians working in 55 practices across southern Ontario, Canada, and 909 of their clients, sampled by convenience. PROCEDURES: A cross-sectional descriptive study including 917 video-recorded appointments. Associations between veterinarian, client, or appointment-level factors and occurrence of a cost conversation were evaluated using multi-level logistic regression. RESULTS: 215 of 917 (23.4%) videos included a discussion of cost between the veterinarian and client. Cost conversations involving veterinarians primarily focused on conveying the price in relation to the time or service being offered (74.0% [159/215]), whereas the benefit to the future health and wellness of the patient was conveyed in 14.4% (31/215) of veterinarians' cost conversations. Costs were most frequently discussed by veterinarians in relation to diagnostic testing (44.2% [96/215]). The odds of a cost discussion occurring were greater during problem appointments versus wellness (P = .011) or recheck (P = .029) appointments, for feline versus canine patients (P = .037), as appointment duration increased (P < .001), and as a client's number of visits in the past year decreased (P = .049). CLINICAL RELEVANCE: Discussing cost of care in veterinary practice continues to be relatively uncommon. Opportunities exist for veterinary professionals to frame their communication of the cost of veterinary care in relation to the benefits offered to the future health and wellbeing of the veterinary patient.

Replacing a Veterinary Physiology Endocrinology Lecture with a Blended Learning Approach Using an Everyday Analogy.

Understanding scientific concepts and processes is critical for veterinary education. This article outlines the impact of blended learning and the use of an analogy on student understanding of the hypothalamic-pituitary-target gland axis over a three-year period. The first-year veterinary physiology course at our institution was modified to incorporate a blended learning approach. An analogy centered around a fast-food restaurant was introduced via an animated video to explain key concepts using an online module. Students completed the module on their own time and class time was optional for asking questions or obtaining clarification as needed. Learning was assessed using the same set of multiple-choice exam questions (MCQs). As hypothesized, students using the online module performed equally well (significantly better for those in the lower quartile) on three summative MCQs to those who received the same information delivered by traditional lecture. Student feedback identified positive aspects regarding blended learning using the analogy, including dynamic visuals, ability to work at their own time and pace, and ease of repeating information. Students cited lack of discipline and poor time management as obstacles to completing the module. Changing the anatomy and physiology of the hypothalamus and pituitary gland from static images and text to an animated video significantly improved student's preference for the blended learning approach. Blended learning and the analogy was preferred by 47% of students over the traditional lecture format (21% preferred traditional lecture and 32% were indifferent) and it was more effective in helping students master this important physiological concept.

The Creation of a Massive, Multi-team Organized (MMO) Course.

Instructors and administrators recognize that our world demands graduates who are not only prepared to meet today's challenges but are also equipped to tackle novel problems of the future. This article describes the creation of an interdisciplinary, team-taught course designed using features of collaborative learning and problem-based learning with a focus on the impact of teaching with a large number of faculty. The course was well-received by students with positive feedback about integration of previous curricular content and a low-pressure learning environment. However, the course was not without its challenges. Participation from over half of the program's teaching faculty required a considerable investment of time and resulted in weekly inconsistencies throughout the semester. This article highlights successes, challenges, and recommendations for others seeking to design a course with a similar number of faculty. This course style is referred to as a "massive, multi-team organized (MMO) course."

The Use of a Modified Script Concordance Test in Clinical Rounds to Foster and Assess Clinical Reasoning Skills.

The development of clinical reasoning skills is a high priority during clinical service, but an unpredictable case load and limited time for formal instruction makes it challenging for faculty to foster and assess students' individual clinical reasoning skills. We developed an assessment for learning activity that helps students build their clinical reasoning skills based on a modified version of the script concordance test (SCT). To modify the standard SCT, we simplified it by limiting students to a 3-point Likert scale instead of a 5-point scale and added a free-text box for students to provide justification for their answer. Students completed the modified SCT during clinical rounds to prompt a group discussion with the instructor. Student feedback was positive, and the instructor gained valuable insight into the students' thought process. A modified SCT can be adopted as part of a multimodal approach to teaching on the clinic floor. The purpose of this article is to describe our modifications to the standard SCT and findings from implementation in a clinical rounds setting as a method of formative assessment for learning and developing clinical reasoning skills.

The Creation of a Collaborative, Case-Based Learning Experience in a Large-Enrollment Classroom.

Numerous educational studies have shown that passive learning methods are frequently associated with disappointing learning outcomes, yet many faculty instructors continue to rely on passive didactic lectures. This article describes the creation of an active learning teaching approach-referred to as the collaborative, case-based classroom-that combines three pedagogical strategies: peer-assisted learning, case-based learning, and just-in-time teaching. Data from student surveys of a third-year cardiology elective showed a preference for this teaching approach compared with a case-based lecture. Six major themes emerged from survey analysis: engagement/interactivity, instructional benefit, clinical reasoning, clinical relevance, peer-assisted learning, and timely feedback. Although detailed here in the context of a cardiology elective, the collaborative, case-based classroom is a teaching approach that could be modified to fit a variety of other teaching environments.

Pilot Study of Small Animal Rotating Intern Telephone Communication Training Using Simulated Referring Veterinarians.

Proficiency in client communications is now widely accepted as a significant requirement of veterinary student education, with numerous training systems in use and documentation of outcomes required for academic accreditation. Little information is available concerning communication training for veterinary house officers (interns and residents), despite the large number of new graduates who enter such programs seeking further training and mentorship. The majority of student communication training focuses on face-to-face interactions with clients and development of core communication skills. By contrast, veterinary house officers in specialty hospitals frequently communicate about cases with practitioner colleagues by telephone, to assess emergent and urgent referrals and follow up on shared cases. Successful telephone communication with these colleagues is a valuable skill to cultivate in novice interns. In this pilot study, self-reported veterinary intern confidence with communication skills improved after a telephone-based simulated referring veterinarian (RDVM) communications training experience. The use of simulated RDVMs, and telephone-based training, shows promise for incorporation into future training experiences of veterinarians at this level.

Developing Cultural Competence through the Introduction of Medical Spanish into the Veterinary Curriculum.

The AAVMC has prioritized diversity as one of its core values. Its DiVersity Matters initiative is helping veterinary medicine prepare for the changing demographics of the United States. One example of the changing demographics is the growing Hispanic population. In 2013, the Texas A&M University College of Veterinary Medicine & Biomedical Sciences responded to the needs of this growing sector by introducing medical Spanish into the core curriculum for Doctor of Veterinary Medicine (DVM) students. The medical Spanish course takes place over 5 weeks during the second year of the curriculum, and is composed of lectures and group learning. While this may seem like a very compressed time frame for language learning, our goal is to provide students with basic medical vocabulary and a limited number of useful phrases. In this paper, we outline the implementation of a medical Spanish course in our curriculum, including our pedagogical approaches to the curricular design of the course, and an explanation of how we executed these approaches. We also discuss the successes and challenges that we have encountered, as well as our future plans for the course. We hope that the successes and challenges that we have encountered can serve as a model for others who plan to introduce a foreign language into their curriculum as a component of cultural competency.