Comparative Effectiveness of Training with Simulators Versus Traditional Instruction in Veterinary Education: Meta-Analysis and Systematic Review.

One of the greatest challenges in veterinary education is adequately preparing students with the clinical skills they need to be successful health care providers. Integration of simulators, devices used to represent real world phenomena under test conditions, into the veterinary curriculum can help address challenges to clinical instruction. The use of simulators in veterinary education is increasing; however, their effectiveness remains unclear. This meta-analysis seeks to synthesize the evidence for simulator training in veterinary education to provide a consensus of effect, guide the integration of simulators into the curriculum, and direct the development of future simulation-based research in veterinary medicine. A systematic search identified 416 potential manuscripts from which 60 articles were included after application of inclusion criteria. Information was extracted from 71 independent experiments. The overall weighted mean effect size for simulator training was g = 0.49 for the random-effects model. The outcome measures of knowledge, time, process, and product all produced statistically significant mean effect sizes favoring simulation (d = 0.41, 0.35, 0.70, 0.53, respectively). A moderator analysis revealed that study characteristics and instructional design features moderated the effectiveness of simulator training. Overall, the results indicate that simulator training in veterinary education can be effective for knowledge and clinical skill outcomes.

Evaluating a Multimodal Clinical Anesthesia Course Integrated Into an Existing Veterinary Curriculum.

INTRODUCTION: This study evaluated a multimodal, simulation-based course in veterinary anesthesia integrated into an existing veterinary curriculum. METHODS: A simulation-based, multimodal training course in clinical anesthesia was evaluated using outcomes from multiple levels of the Kirkpatrick Model of Training Evaluation. Cognitive and affective outcomes were evaluated before and after instruction. Head-mounted cameras were used to record clinical performance during students' first live patient anesthesia experience in the curriculum. RESULTS: Pretest-posttest analysis of cognitive and affective outcomes for course participants revealed significant increases in knowledge and self-efficacy. Course participants received higher ratings on clinical task performance and professional skills (ie, communication and collaboration) compared with a matched control group when evaluated by blinded, external raters using a standardized rubric. CONCLUSIONS: These findings indicate that implementing a multimodal anesthesia simulation-based course directly into the curriculum can enhance cognitive and affective outcomes and prepare students for subsequent anesthesia-related patient care experiences.

Development and assessment of a formal learning module to educate veterinary students in an intensive care unit about transfusion reactions.

OBJECTIVE: To develop and assess the instructional efficacy of an online learning module on transfusion reactions in small animals and to evaluate participants' satisfaction of the module. DESIGN: Randomized controlled trial. SETTING: University teaching hospital. SUBJECTS: A total of 55, fourth-year veterinary students, 27 in a treatment group that received the learning module plus standard rotation training and 28 in a control group (no module) who received only standard training INTERVENTIONS: Students received a pretest on transfusion reactions followed by administration of a transfusion reaction learning module covering recognition, treatment, prevention, case examples, and self-assessment questions for 6 common transfusion reactions. Students also received a module satisfaction survey, a post-test at 2 weeks post-module, and a retention test at 6 weeks post-module. MEASUREMENTS AND MAIN RESULTS: Previous transfusion medicine exposure did not affect pretest scores and there was no difference in pretest scores between groups. The module group scored higher on the post-test (P < 0.001) and retention test (P = 0.002) than the control group. Mean post-test scores were 74.4% and 57.7% and mean retention test scores were 80.6% and 56.5% for the module and control groups, respectively. The module group scored higher on posttest and retention questions involving reaction recognition (P < 0.001). Students were overall very satisfied with the module with an average score of 4.8 (1-5). CONCLUSIONS: A transfusion reaction instructional module can be delivered successfully to veterinary students on an ICU-based clinical rotation. Students taking the module scored significantly better on post-assessments up to 6 weeks after module administration as compared to students receiving only conventional clinical rotation training.

Development and validation of a contextualised measure of resilience in veterinary practice: the Veterinary Resilience Scale-Personal Resources (VRS-PR).

BACKGROUND: This article reports on the development and validation of a contextualised measure of personal resources for resilience in veterinary practice. METHODS: Exploratory factor analysis and structural equation modelling were used to evaluate data from two surveys of veterinary practitioners. RESULTS: Exploratory factor analysis of the first survey (n=300) revealed six items comprising the Veterinary Resilience Scale-Personal Resources (VRS-PR). These items focused on flexibility, adaptability, optimism, building strengths, enjoying challenges, and maintaining motivation and enthusiasm at work. Structural equation modelling using the second survey (n=744) confirmed the factor structure of the VRS-PR and established convergent validity with an established measure of general resilience, the Brief Resilience Scale. Examination of the mean and standard deviation of the combined survey data enabled scores on the VRS-PR to be provisionally classified into 'low', 'moderate' and 'high' (reported by approximately 13%, 72% and 15% of respondents, respectively). Respondents also reported results spanning 'low', 'moderate' and 'high' classifications for the Brief Resilience Scale (approximately 34%, 57% and 9%, respectively). CONCLUSION: The VRS-PR may be used to evaluate the extent to which respondents draw upon the personal resources captured in the scale and identify areas for improvement.

A systematic review of digital badges in health care education.

OBJECTIVES: A challenge to competency-based medical education is the verification of skill acquisition. Digital badges represent an innovative instruction strategy involving the credentialing of competencies to provide evidence for achievement. Despite increasing interest in digital badges, there has been no synthesis of the health care education literature regarding this credentialing strategy. The present authors proposed to address this gap by conducting the first systematic review of digital badges in health care education, to reveal pedagogical and research limitations, and to provide an evidence-based foundation for the design and implementation of digital badges. METHODS: A systematic search of the medical education literature from January 2008 to March 2019 was conducted using MEDLINE, Web of Science, CAB Abstracts and ScienceDirect. Included studies described digital badges in academic or professional medical education programmes in any health care profession. Included studies were appraised and quality assessment, methodological scoring, quantitative analysis and thematic extraction were conducted. RESULTS: A total of 1050 relevant records were screened for inclusion; 201 full text articles were then assessed for eligibility, which resulted in the identification of 30 independent papers for analysis. All records had been published since 2013; 77% were journal articles, and 83% involved academic health care education programmes. Scores for quality were relatively moderate. Thematic analyses revealed implications for the design and implementation of digital badges: learner characteristics may moderate student outcomes; the novelty effect can negate the value of digital badges, and educators may overcome instruction-related challenges with digital badges using design and implementation strategies such as the creation of badging ecosystems. CONCLUSIONS: The results indicate a growing momentum for the use of digital badges as an innovative instruction and credentialing strategy within higher education and provide evidence for outcomes within a learner-centred, competency-based model of medical education. There is a paucity of research to support the design and implementation of this credentialing system in health care education. The potential benefits necessitate future high-quality analyses reporting institutional, patient and workplace-based outcomes to evaluate the effectiveness and moderating conditions of digital badges.

Is a Picture Worth a Thousand Words? Evaluating the Design of Instructional Animations in Veterinary Education.

Empirical evidence demonstrates that student learning outcomes improve when animations are developed in alignment with the design principles of the cognitive theory of multimedia learning (CTML). The extent to which these principles are used in the design of veterinary instructional animations is unknown. In this study, we reviewed the veterinary education literature for articles that discussed specific veterinary medical animations as learning resources. The 30 referenced animations accessed through this search were analyzed to determine whether they used the CTML's 11 major design principles. Analysis revealed that the animations most commonly adhered to only 4 principles: coherence, redundancy, modality, and spatial contiguity. The majority of the 11 CTML principles were used in fewer than 40% of the animations. We also examined the alignment between raters' perceptions of the effectiveness and enjoyment of the animations and adherence to the design principles. Analyses revealed that the animations deemed by raters as most enjoyable and effective did not utilize more design principles than animations they viewed as least enjoyable and effective. The results of this study indicate many missed opportunities to increase learning by developing animated learning resources according to empirically based design principles. Decisions to include specific animations in instruction should be based on whether the resources include elements that have been shown to increase learning rather than subjective perceptions of effectiveness and enjoyment.

Challenging identity: development of a measure of veterinary career motivations.

BACKGROUND: While little is known about the motivations underpinning veterinary work, previous literature has suggested that the main influences on veterinary career choice are early/formative exposure to animals or veterinary role models. The aim of this study was to develop and provisionally validate a veterinary career motivations questionnaire to assess the strength of various types of career motivations in graduating and experienced veterinarians. METHODS: A cross-sectional sample of experienced veterinarians (n=305) and a smaller cohort of newly graduated veterinarians (n=53) were surveyed online using a long-form questionnaire. Exploratory factor analysis (EFA) was used to iteratively derive a final, short-form questionnaire for survey of a second cross-sectional sample of experienced veterinarians (n=751). RESULTS: EFA derived a final questionnaire with 22 items loading onto six factors (social purpose, animal orientation, vocational identity, challenge and learning, career affordances, and people orientation). While motivations based on animal orientation were predictably strong, those based on vocational identity were not universal and were weaker in younger and graduate veterinarians; both of these motivations were rated lower by male veterinarians. Motivations based on challenge and learning emerged as some of the strongest, most universal and most influential; people orientation and social purpose were also important, particularly for older veterinarians. CONCLUSION: The major motivations for pursuing a veterinary career may best be represented as an intrinsic passion for animal care and for learning through solving varied challenges. These motivations are largely intrinsically oriented and autonomously regulated, thus likely to be supportive of work satisfaction and wellbeing.

Guided Hands-On Activities Can Improve Student Learning in a Lecture-Based Qualitative Biomechanics Course.

A qualitative biomechanics (functional anatomy) course is a typical course in kinesiology curriculum. Most evidence suggests that biomechanics learning could be improved with the inclusion of laboratory experiences. However, implementing laboratories into biomechanics curriculum is difficult due to cost and time constraints. This study was conducted to evaluate whether hands-on activities in lecture improve qualitative biomechanics learning. A lecture format was compared to the same course with guided and unguided hands-on activities included during lecture. Test performance and student evaluations were compared between lecture formats to determine if hands-on experiences improve learning. The hands-on group performed better on the same test questions and they evaluated their overall course activities as beneficial to their learning. The findings suggest that guided hands-on experiences may improve learning compared to unguided activities. The hands-on experiences seem to provide an embodied cognitive learning experience, facilitating retention of learned material through three-dimensional and tactile mental representations. Findings from this research are currently shaping how biomechanics is taught to students at this university and could at other universities as well.

Magnetic resonance imaging versus computed tomography to plan hemilaminectomies in chondrodystrophic dogs with intervertebral disc extrusion.

OBJECTIVE: To determine the influence of preoperative computed tomography (CT) versus magnetic resonance (MR) on hemilaminectomies planned to treat thoracolumbar (TL) intervertebral disc (IVD) extrusions in chondrodystrophic dogs. STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Forty chondrodystrophic dogs with TL IVD extrusion and preoperative CT and MR studies. METHODS: MR and CT images were randomized and reviewed by 4 observers masked to the dog's identity and corresponding imaging studies. Observers planned the location along the spine, side, and extent (number of articular facets to be removed) based on individual reviews of CT and MR studies. Intra-observer agreement was determined between overall surgical plan, location, side, and size of the hemilaminectomy planned on CT versus MR of the same dog. RESULTS: Similar surgical plans were developed based on MR versus CT in 43.5%-66.6% of dogs, depending on the observer. Intra-observer agreement in location, side, and size of the planned hemilaminectomy based on CT versus MR ranged between 48.7%-66.6%, 87%-92%, and 51.2%-71.7% of dogs, respectively. Observers tended to plan larger laminectomy defects based on MR versus CT of the same dog. CONCLUSION: Findings from this study indicated considerable differences in hemilaminectomies planned on preoperative MR versus CT imaging. Surgical location and size varied the most; the side of planned hemilaminectomies was most consistent between imaging modalities.

State population as a predictor of radiation therapy staffing levels.

PURPOSE: Considering the cyclical nature of shortages and oversupplies of staffing levels in the labor force, an accurate prediction of future demand for personnel is of great importance. Historically, the profession of radiation therapy has been plagued with these cycles. This study establishes state population as a strong predictor of radiation therapy staffing levels. METHODS: A linear regression analysis was performed to determine the association between state population and radiation therapy staffing levels from 2002 to 2010. RESULTS: State population is a significant and substantial predictor variable for the number of actively employed and registered radiation therapists, with 89.5% to 91.4% of the variance accounted for from 2002 to 2010. CONCLUSIONS: Additional research in estimating future demand in radiation therapy is possible. By monitoring change in state population, health care professionals can proactively address cycles of shortages and oversupplies in staffing levels.

Pediatric digital radiography education for radiologic technologists: current state.

BACKGROUND: Digital radiography (DR) is one of several new products that have changed our work processes from hard copy to digital formats. The transition from analog screen-film radiography to DR requires thorough user education because of differences in image production, processing, storage and evaluation between the forms of radiography. Without adequate education, radiologic technologists could unknowingly expose children to higher radiation doses than necessary for adequate radiograph quality. OBJECTIVE: To evaluate knowledge about image quality and dose management in pediatric DR among radiologic technologists in the U.S. MATERIALS AND METHODS: This communication describes a survey of 493 radiologic technologists who are members of the American Society of Radiologic Technologists (ASRT) and who evaluated the current state of radiological technologist education in image quality and dose management in pediatric DR. The survey included 23 survey questions regarding image acquisition issues, quality assurance, radiation exposure and education in DR of infants and children. RESULTS: Radiologic technologists express many needs in areas of training and education in pediatric DR. Suggested improvements include better tools for immediate feedback about image quality and exposure, more information about appropriate technique settings for pediatric patients, more user-friendly vendor manuals and educational materials, more reliable measures of radiation exposure to patients, and more regular and frequent follow-up by equipment vendors. CONCLUSION: There is a clear and widespread need for comprehensive and practical education in digital image technology for radiologic technologists, especially those engaged in pediatric radiography. The creation of better educational materials and training programs, and the continuation of educational opportunities will require a broad commitment from equipment manufacturers and vendors, educational institutions, pediatric radiology specialty organizations, and individual imaging specialists.

Motivational interviewing skills are positively associated with nutritionist self-efficacy.

OBJECTIVE: To examine the relationships between physical and social self-concepts, motivational interviewing (MI), and nutrition assessment skills with dimensions of counseling self-efficacy. DESIGN: Cross-sectional survey. SETTING: Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics. PARTICIPANTS: Sixty-five WIC nutritionists. MAIN OUTCOME MEASURES: Counseling self-efficacy on topics related to physical activity and nutritional behaviors and in the presence of language and cultural differences. ANALYSIS: Multiple linear regression. RESULTS: Nutritionists' perception of their own MI skills was positively associated with their self-efficacy for counseling clients of a culture different than their own, when counseling about physical activity, and when counseling about nutrition behavior. Hispanic ethnicity and social self-concept were positively associated with counseling self-efficacy when culture differences were present. Physical self-concept was positively associated with self-efficacy related to physical activity topics. Nutrition assessment skill was negatively associated with self-efficacy for working with non-English-speaking clients. CONCLUSIONS AND IMPLICATIONS: Development of MI skills and strategies to improve social and physical self-concept may increase WIC nutritionists' counseling self-efficacy, particularly when counseling clients from diverse backgrounds.