Academic leaders ponder effective teaching models
posted June 1, 2010
Some sacred cows of veterinary education were on the chopping block during discussions at the North American Veterinary Medical Education Consortium's April 29-May 1 meeting in Kansas City, Mo., hosted by the Association of American Veterinary Medical Colleges.
Participants were asked to deconstruct and reconstruct nine veterinary education models. Their mission was to analyze and create new and improved models, using projected future societal needs and the veterinary competencies needed to fulfill those needs as a guide. Ideas developed in the breakout groups will be shared in the near future at www.navmec.org.
Before the discussions, nearly two dozen speakers gave presentations on ideas for revamping veterinary education to inspire participants in their discussions, touching on everything from online instruction to outcomes assessment.
"The good old days of the ivory tower are gone. We need to create better models that are sustainable. We need to be more efficient. There is no easy answer," said one of the speakers, Dr. Jennifer L. Hodgson, associate dean for professional programs at the Virginia-Maryland Regional College of Veterinary Medicine.
Learning in the real (and virtual) world
Digital technology was cited by many speakers as deserving a greater presence in classrooms at veterinary schools and colleges.
Rebecca Henry, PhD, a professor at Michigan State University's College of Human Medicine, recommended that instructors blend online tools and activities with some scheduled class meeting times.
"The good old days of the ivory tower are gone. We need to create better models that are sustainable. We need to be more efficient. There is no easy answer."
—DR. JENNIFER L. HODGSON,
ASSOCIATE DEAN FOR PROFESSIONAL PROGRAMS,
VIRGINIA-MARYLAND REGIONAL COLLEGE OF VETERINARY MEDICINE
Dr. Henry said this approach allows the learning process to become more engaging and autonomous for students, and it accommodates various learning styles while increasing active learning strategies within the class.
"I can't tell you how well the model (of blended learning) is working at our institution just yet, but what we do know is through our systems assessment, the students who took these classes increased their scores, and they tell us they love it," Dr. Henry said.
Online instruction has popped up at veterinary schools and colleges largely in a haphazard manner, but some institutions are trying to create a more cohesive system so as to share courses and expertise.
Dr. Jeannette McDonald, director of the Technology for Learning Center at the University of Wisconsin-Madison School of Veterinary Medicine, spoke about one such program—the Veterinary Internet Course Exchange.
VetICE is a cooperative—open to all AAVMC member institutions—that will provide students access to quality, Internet-based learning materials and courses in a variety of animal health disciplines. The program received a two-year grant from the Department of Education this past October.
So far, veterinary schools and colleges at North Carolina State University, Iowa State University, the University of California-Davis, Tufts University, and UW-Madison have signed on. VetICE's steering committee is in the process of developing pilot test courses and asking more schools to join as well as finalizing its business plan.
Though still in its inception, VetICE eventually will develop and host multiple stand-alone, complete courses with content, activities, and assessments for any teacher who can facilitate the course.
"We want to have a Wal-Mart mentality here where we give people what they want, to get the broadest audience possible," said Dr. McDonald, who is project coordinator for VetICE.
VetICE will take courses only from AAVMC member institutions for now but may open up to nonmember courses later on. Dr. McDonald anticipates charging a $25 to $35 fee per student for each course.
The website, www.veterinaryice.org, will have more information posted in coming months.
Let's get nontechnical
A noticeable shift in emphasis from students memorizing basic science facts toward them being taught how to operate in the real world was another popular topic among speakers at the meeting.
Dr. Karen E. Felsted, CEO of the National Commission on Veterinary Economic Issues, cited in her talk the 2000 Brakke Study, which said scientific, technologic, and clinical skills are necessary but not sufficient to produce successful veterinarians. They also need to demonstrate business expertise, communication and other interpersonal skills, teamwork, cultural competence, and leadership.
"We tend to lump a bunch of this stuff under business skills. I would say 'nontechnical' or 'life skills' is a better term. These are skills you need no matter what you do in life," Dr. Felsted said.
Dr. Felsted quoted 2009 figures from the NCVEI/VetPartners Profitability Estimator that showed the average profit margin for private practices was 9.78 percent. By comparison, an 18 percent profit margin is considered superior by VetPartners, an association of management consultants.
A healthy bottom line is only one likely result of honing nontechnical skills in veterinary students. It can also help them avoid malpractice risks and ensure greater client compliance.
Kathleen A. Bonvicini, PhD, of the Institute for Healthcare Communication quoted a study by the Joint Commission on Medicine that looked at root causes for medical errors in human medicine. Sixty-six percent of these mistakes were found to stem from a lack of effective communication among members of the health care team. The same study also found that up to three-fourths of litigation in human medicine resulted from breakdowns in communication.
"Compliance is going to happen if the client trusts you, feels the care and concern is there," Dr. Bonvicini said. "If you feel you have good relationships with people you work with and clients you serve, it helps with word-of-mouth marketing and job satisfaction."
To help educate students in this area, the Institute for Healthcare Communication started the Communication Project with Bayer Animal Health. The institute created 13 modules to help veterinary students communicate with colleagues in practice and work with people from various backgrounds.
Ready from day one
Two important drivers for curricular change in veterinary education mentioned by Dr. Hodgson are accrediting agencies and outcomes assessment.
Entities such as the AVMA Council on Education, the Royal College of Veterinary Surgeons, and the European Association of Establishments for Veterinary Education have substantial input when it comes to curriculum development, albeit in a mostly indirect manner, she said.
Dr. Hodgson said a recent focus of accrediting bodies has been to hold the veterinary schools and colleges accountable for demonstrating the competence of their graduates.
Definitions of competence abound, as do views on how it can be developed and assessed. But in general terms, competence is a concept that integrates knowledge, skills, and attitudes, Dr. Hodgson said.
The Royal College of Veterinary Surgeons has taken the lead in this area by defining the essential competencies required of British veterinary practitioners in two parts: on graduation, called "day-one competencies," and after a year of further professional experience in particular areas of practice, called "year-one competencies." They can be found by visiting www.rcvs.org.uk and clicking on the links "Veterinary Surgeons" and "Education."
The RCVS has spent a number of years developing these competencies; they were created in partnership with practicing veterinarians, said Dr. Christoph K.W. Muelling, associate dean at the University of Calgary Faculty of Veterinary Medicine in Alberta, Canada.
"We recognize society is turning out individuals who are less confident, not (less) competent. The lack of confidence from new graduates is one area we have to address, and these competencies address that," Dr. Muelling said.
Putting it all together
The initiatives mentioned, while aimed at providing solutions for perceived shortcomings in the veterinary curriculum, raise a number of their own challenges—faculty buy-in and cost foremost among them.
Dr. Paul D. Pion, president and co-founder of the Veterinary Information Network, said during an open forum that if technology were always cheaper or easier, veterinary schools and colleges would be using it more frequently, but that is not always the case.
"You still need people to mentor and develop these programs. Instead, technology will enhance education—not take it over entirely or replace faculty. It will free them up to do more," he said.
Starting this fall, the University of Pennsylvania School of Veterinary Medicine is putting a greater amount of class material and tools online.
"We're still covering the same amount of material, but when (the students) access it is up to them, though obviously some time before the exam," said Dr. Thomas Van Winkle, associate dean at the school. "Also, putting material online gives us flexibility to do early clinical experience (for second-year students)."
Dr. Van Winkle said the school has been using technology to a certain degree for a decade already, but that available technology is sophisticated enough now that it can be used to an even greater extent. For example, classes will be using digital slides instead of microscope slides.
The biggest challenge in implementing these changes? Time, Dr. Van Winkle said.
"Our faculty is extremely busy, whether they're doing research or clinics or teaching. All this takes extra time, and we will have some students working this summer to help provide technical support for that," Dr. Van Winkle said.
Curricular change is possible on a macro level, too—something dental educators can attest to.
The American Dental Education Association initiated the Commission on Change and Innovation in Dental Education in 2005 to oversee and guide the association's educational change efforts.
The commission came in response to repeated calls made for curricular reform and innovation in dental education, said Richard W. Valachovic, DMD, executive director of the ADEA.
So the ADEA CCI was formed; it counts the American Dental Association, Joint Commission on National Dental Examinations, Commission on Dental Accreditation, Association of American Medical Colleges, and Academy of Comprehensive Esthetics as members.
So far, the ADEA CCI has developed a list of competencies needed by newly graduated general dentists. These were approved by the ADEA House of Delegates in April 2008. The ADEA has since worked with CODA to revise predoctoral accreditation standards for dental education programs to incorporate these competencies. Proposed revisions to the standards are currently out for public comment.
"Of all the issues I've faced as an executive director, the most controversial issue was the concept of trying to create a national curriculum. We overcame that, but as a cautionary tale, it almost derailed the work we were doing on a national level," Dr. Valachovic said. "We had to have the conversation to say … this is about building consensus, and not imposing standards.'"