Self-care practices and depression, anxiety, and stress scores in veterinary students during a semester.

Objective: To measure associations between self-care activities and depression, anxiety, and stress of preclinical veterinary students during a semester. Procedure: Preclinical veterinary students at the University of Calgary Faculty of Veterinary Medicine were recruited voluntarily. Depression, anxiety, and stress scores (DASS-21) were measured, and a self-care questionnaire was administered at the beginning and end of the semester. Results: Depression, anxiety, and stress scores did not change during the fall semester (P = 1.000). At the beginning of the semester, students who spent 15 to 30 min (P = 0.042) or 30 to 60 min (P = 0.013) outside daily had lower anxiety scores compared to those who spent < 15 min outside daily; students who spent > 2 h daily on social media had higher stress scores than students who spent < 60 min (P = 0.024); and students who slept for 6 to 8 h daily had lower stress scores than students who slept < 6 h (P = 0.015). At the end of the semester, students who "often" felt that self-care techniques managed their stress had lower depression (P = 0.003) and anxiety (P = 0.011) scores than those who "rarely" did; students who spent 30 to 60 min outside daily had lower depression scores than those who spent < 15 min (P = 0.031); students who spent 15 to 30 min (P = 0.002) or 30 to 60 min (P = 0.009) outside daily had lower stress scores than those who spent < 15 min; and students who exercised 30 to 60 min daily had lower stress scores than those who exercised < 15 min (P = 0.047). Conclusion: Self-care activities that were associated with lower depression, anxiety, or stress scores at the beginning or end of the semester included spending at least 15 min daily outside or exercising; spending < 30 min on social media daily; and sleeping 6 to 8 h daily. These practices warrant further investigation. Clinical relevance: Encouraging certain self-care practices among preclinical veterinary students has the potential to enhance their mental health and should be considered part of a veterinary school curriculum.

Pratiques d'autosoins et scores de dépression, d'anxiété et de stress chez les étudiants vétérinaires au cours d'un semestre. Objectif: Mesurer les associations entre les activités d'autosoins et la dépression, l'anxiété et le stress des étudiants vétérinaires au cours d'un semestre. Procédure: Les étudiants vétérinaires de la faculté de médecine vétérinaire de l'University of Calgary ont été recrutés sur une base volontaire. Des scores de dépression, d'anxiété et de stress (DASS-21) ont été mesurés et un questionnaire d'autosoins a été administré au début et à la fin du semestre. Résultats: Les scores de dépression, d'anxiété et de stress n'ont pas changé au cours du semestre d'automne (P = 1,000). Au début du semestre, les étudiants qui passaient 15 à 30 min (P = 0,042) ou 30 à 60 min (P = 0,013) à l'extérieur par jour présentaient des scores d'anxiété inférieurs à ceux qui passaient < 15 min à l'extérieur par jour; les étudiants qui passaient > 2 h par jour sur les réseaux sociaux avaient des scores de stress plus élevés que les étudiants qui passaient < 60 min (P = 0,024); et les étudiants qui dormaient de 6 à 8 h par jour avaient des scores de stress inférieurs à ceux qui dormaient < 6 h (P = 0,015). À la fin du semestre, les étudiants qui estimaient « souvent ¼ que les techniques d'autosoins géraient leur stress avaient des scores de dépression (P = 0,003) et d'anxiété (P = 0,011) inférieurs à ceux qui l'étaient « rarement ¼; les étudiants qui passaient 30 à 60 min à l'extérieur quotidiennement avaient des scores de dépression inférieurs à ceux qui passaient moins de 15 min (P = 0,031); les étudiants qui passaient 15 à 30 min (P = 0,002) ou 30 à 60 min (P = 0,009) à l'extérieur quotidiennement avaient des scores de stress inférieurs à ceux qui passaient < 15 min; et les étudiants qui faisaient de l'exercice de 30 à 60 min par jour avaient des scores de stress inférieurs à ceux qui faisaient de l'exercice < 15 min (P = 0,047). Conclusion: Les activités d'autosoins associées à des scores de dépression, d'anxiété ou de stress plus faibles au début ou à la fin du semestre comprenaient le fait de passer au moins 15 minutes par jour à l'extérieur ou de faire de l'exercice; passer < 30 minutes sur les réseaux sociaux quotidiennement; et dormir 6 à 8 h par jour. Ces pratiques méritent une enquête plus approfondie. Pertinence clinique: Encourager certaines pratiques d'autosoins chez les étudiants vétérinaires a le potentiel d'améliorer leur santé mentale et devrait être considéré comme faisant partie du programme d'études d'une école vétérinaire.(Traduit par Dr Serge Messier).

Phronesis in Veterinary Medicine: Navigating the Complexity of Practice with Wisdom.

With the knowledge explosion currently occurring in veterinary medicine, it is difficult to impart to our learners all the actions that can be done, let alone teach them how to determine what should be done. Ethics curricula can provide an essential part of this answer but leave it incomplete. This can result in the disengagement of veterinary learners from the situational understanding that leads to the most appropriate actions. Phronesis is a practical understanding with sound judgment and ethical orientation. It has recently become a talking point in medicine as a framework of support for health professionals that brings together the goals of ethical care with clinical judgment. We can work to incorporate it more effectively into our curricula by evaluating how phronesis is already used in veterinary medicine. This will give learners the opportunity to practice phronetic judgment and support practical wisdom in clinical settings.

Expert Veterinarians Should Be Trained Expertly: Fostering the Development of Adaptive Expertise in Veterinary Students through Faculty Development for Veterinary Educators.

The field of health professions education is rapidly evolving, and with it the field of veterinary education. This discussion piece amalgamates literature across health professions education to provide a picture of what a veterinary clinician-educator is, why there is a need for veterinary clinician-educators when developing learners with adaptive expertise, and how faculty development can support the growth of clinicians into clinician-educators. It is intended to outline the best practices for fostering the development of adaptive expertise in veterinary students through faculty development for veterinary educators.

How medical school alters empathy: Student love and break up letters to empathy for patients.

INTRODUCTION: Medical education is committed to promoting empathic communication. Despite this, much research indicates that empathy actually decreases as students progress through medical school. In qualitative terms, relatively little is known about this changing student relationship with the concept of empathy for patients and how teaching affects it. This study explores that knowledge gap. METHODS: Adopting a constructivist paradigm, we utilised a research approach new to medical education: Love and Breakup Letter Methodology. A purposive sample of 20 medical students were asked to write love and break up letters to 'empathy for patients'. The letters were prompts for the focus group discussions that followed. Forty letters and three focus group discussions were thematically analysed. RESULTS: The three major themes were: art and artifice; empathic burden; and empathy as a virtue. Students were uncomfortable with the common practice of faking empathic statements, a problem exacerbated by the need to 'tick the empathy box' during examinations. Students evolved their own empathic style, progressing from rote empathic statements towards phrases which suited their individual communication practice. They also learned non-verbal empathy from positive clinician role-modelling. Students reported considerable empathic burden. Significant barriers to empathy were reported within the hidden curriculum, including negative role-modelling that socialises students into having less compassion for difficult patients. Students strongly associated empathy with virtue. CONCLUSIONS: Medical education should address the problem of inauthentic empathy, including faking empathic s in assessments. Educators should remember the value of non-verbal compassionate communication. The problems of empathic burden, negative role modelling and of finding empathy difficult for challenging patients may account for some of the empathy decline reported in quantitative research. Framing empathy as a virtue may help students utilise empathy more readily when faced with patients they perceive as challenging and may promote a more authentic empathic practice.

Optimal Suture Bite Size for Closure of Feline Linea Alba-A Cadaveric Study.

Objective: This study aimed to determine the most appropriate suture bite and stitch interval (SBSI) size for closing feline linea alba. Study design: Randomized ex vivo mechanical testing. Sample population: Ventral abdominal walls from 35 male feline cadavers were harvested and separated into 125 segments. Methods: Segments were incised along midline then sutured back together using 3-0 polydioxanone using one of the following SBSI: 3, 5, 7.5, or 10 mm whereby the distance represents the distance both between the suture bites, and from the bite to incision line. The location of segments as well as the weight of the cadaver were recorded. A single linear distraction mechanical breaking test was performed. Statistical analyses (logistic and linear regression) were performed to determine which factors were associated with visual and mechanical failure, as well as load at failure or maximum displacement. Results: SBSI was significantly associated with load at failure or maximum displacement (p < 0.001). In particular, 5 mm SBSI had the highest load at failure amongst all the bite sizes (LSmeans = 27.55N, 95% Confidence Interval (CI): 23.65-31.44); this was significantly higher than 7.5 mm (LSmeans = 19.15N, 95% CI: 15.26-23.05, p = 0.016) and 10 mm (LSmeans = 16.55N, 95%CI:12.39-20.70, p = 0.0012) but not significantly higher than 3 mm (LSmeans = 23.78N, 95% CI: 19.69-27.86, p = 0.2). Increased SBSI increased the odds of visual failure (p < 0.001) whereas increased weight of the cadaver reduced the odds of visual failure (OR = 0.52, 95%CI: 0.30-0.88, p = 0.016). Conclusion: The 5 mm SBSI had the highest load at failure and was not significantly different from the 3 mm SBSI when apposing feline linea alba using 3-0 polydioxanone. Clinical significance: Using 5 mm SBSI is the preferred bite size compared to 7.5 or 10 mm SBSI when apposing feline linea alba with 3-0 polydioxanone.

Asymmetric lumbosacral transitional vertebra and subsequent disc protrusion in a cocker spaniel.

A 10-year-old cocker spaniel bitch presented with severe lumbosacral pain and acute onset left pelvic limb lameness. A diagnosis of asymmetric lumbosacral transitional vertebra with disc protrusion at L6-L7 was made by computed tomography. The cauda equina and left L6 nerve root were surgically decompressed with a dorsal laminectomy and lateral foraminotomy, which led to rapid resolution of the clinical signs.

Age-related decline in the microstructural integrity of white matter in children with early- and continuously-treated PKU: a DTI study of the corpus callosum.

Structural, volumetric, and microstructural abnormalities have been reported in the white matter of the brain in individuals with phenylketonuria (PKU). Very little research, however, has been conducted to investigate the development of white matter in children with PKU, and the developmental trajectory of their white matter microstructure is unknown. In the current study, diffusion tensor imaging (DTI) was used to examine the development of the microstructural integrity of white matter across six regions of the corpus callosum in 34 children (7-18 years of age) with early- and continuously-treated PKU. Comparison was made with 61 demographically-matched healthy control children. Two DTI variables were examined: mean diffusivity (MD) and relative anisotropy (RA). RA was comparable to that of controls across all six regions of the corpus callosum. In contrast, MD was restricted for children with PKU in anterior (i.e., genu, rostral body, anterior midbody) but not posterior (posterior midbody, isthmus, splenium) regions of the corpus callosum. In addition, MD restriction became more pronounced with increasing age in children with PKU in the two most anterior regions of the corpus callosum (i.e., genu, rostral body). These findings point to an age-related decrement in the microstructural integrity of the anterior white matter of the corpus callosum in children with PKU.