March 15, 2000

 

 Laboratories terminated, but lessons learned


Posted Mar. 1, 2000

Teaching laboratories in which animals are not revived, or nonsurvival laboratories, have for decades been under scrutiny at medical schools, driven by student objectors and, often, animal rights activists.

At veterinary colleges, such laboratories have come under increasing attention this past year. For the veterinary profession, criticism over the very issue of animal welfare has been unnerving.

A front-page headline in the Jan 4, 2000 Chicago Tribune announced: "Vet students oppose U of I animal killings." The report focused on the first-year physiology laboratories and noted: "Even in a world peppered with militant animal rights groups, the killing of animals at vet schools to teach physiology has remained in the shadows."

The University of Illinois College of Veterinary Medicine has apparently been one of the few remaining North American veterinary colleges with nonsurvival laboratories. The laboratories were part of its first-year core curriculum, in renal, cardiovascular, respiratory, and gastrointestinal physiology.

The physiology and sometimes the anatomy laboratories typically held in the first year have come under the most fire, less so the third-year surgery courses in many schools' curricula. Ironically, the U of I veterinary college has been a leader in pioneering alternatives in its surgery instruction program. (Surgery courses will be addressed in the April 15 issue.)

Just how many veterinary colleges still have nonsurvival teaching laboratories is not known. The Association of American Veterinary Medical Colleges is in the process of developing a survey about use of animals in veterinary medical education. The survey is undergoing scientific testing and validation.

Of some value is a questionnaire sent to the 31 North American veterinary colleges by the Association of Veterinarians for Animal Rights last September to identify invasive (but survival) procedures they perform that are unnecessary for the animal's health or do not benefit the overpopulation problem, nonsurvival surgeries being performed, sources of cadavers, and teaching alternatives offered. The survey was approved by the AAVMC after AVAR agreed to some modifications.

Twenty-one of the 31 schools responded. The results were published in the Jan 2000 edition of AVAR's Alternatives in Veterinary Medical Education newsletter, online at www.avar.org (with updated information scheduled for the April edition).

Of the 21 responding schools, 17 said they perform invasive procedures in core courses, and all but one of them offered the students an alternative. Fifteen schools perform invasive procedures in their elective courses, and eight offered an alternative.

Alternatives listed by the schools include spay/neuter programs, cadavers, skills models, externships, extra rotations, special projects, instructor prerogative, instructor/student agreement, or declining to do the procedure.

The federal Animal Welfare Act requires teachers to provide a written narrative to the Institutional Animal Care and Use Committee (at U of I, the Laboratory Animal Care Advisory Committee) as to whether alternatives exist to procedures that may cause pain or distress in animals used for teaching. Animal use must be justified, if alternatives exist. Information on alternatives to animal use abound on Web sites sponsored by the USDA Animal Welfare Information Center, AVAR, Humane Society of the United States, and other organizations.

At the U of I, discontent among students who object to nonsurvival laboratories has been simmering for some time. Dr. Gerald Pijanowski, associate dean of academic and student affairs, said, "Over the years, numbers of students have had serious objections to the use of animals in some of the programs, so it's not a new issue. Early in the fall [1999] semester, the [College of Veterinary Medicine Courses and] Curriculum Committee began development of a formal policy for the college on the use of animals in the teaching program."

Up to that time, animal usage was the instructor's prerogative, subject to approval from the university's Laboratory Animal Care Advisory Committee.

Opinions vary on whether students were being told or given enough advance notice that alternatives existed, and how useful those alternatives were. As a result, it has become a tradition over the past few years for second-year students to call a meeting where they present the spectrum of opinions on the physiology laboratories so each member of the incoming class has a basis for deciding whether to participate.

At a Nov 11 college-wide meeting, Dr. Pijanowski stated the college's position that it would be the student's responsibility to find an alternative and present it to the professor. Third-year student Annmarie Hill said that, during the meeting, she asked clinicians who were interested in helping find alternatives or knew of clinically relevant ones to contact her. Hill said no one has contacted her.

Eight students from three class years then decided to collaborate in searching for alternatives that met the learning objectives of the six physiology laboratories. Then last fall, 26 of the 100 first-year students gave notice not to order animals for their use because they would not be participating in the cardiovascular and respiratory physiology laboratories this spring.

A college-wide student survey was conducted on the benefits and drawbacks of the physiology laboratories. The margin was narrow between students who took the laboratories and did or did not consider their educational experience "worth the resources used," as was the margin between students who would or would not have opted for "an equivalent educational alternative," had it existed. Of laboratory participants, 59 students said their understanding of physiology was not at all enhanced, 140 students said somewhat, and 63 students said substantially.

On Dec 7, the eight-student group presented key faculty and administration with a packet of 200 alternatives and 28 research studies about alternatives. The students also specified their goals: to ensure that viable alternatives to live animal use were developed, that students were informed of them, that the minimal number of animals then be purchased for students taking the laboratories, and that the college acquire the animals from reputable and humane sources rather than the class B dealers that were being used.

Second-year student Linnaea Stull said that because "there was a very poor reception" of the information she and the other students had spent considerable time and expense compiling, she sent a letter to the Chicago Tribune "telling them I had an interesting story for them to cover."

Reacting to publicity in the Tribune as well as the campus newspaper, Dean Victor E. Valli over the holiday break issued a memo announcing three decisions: the curriculum committee would begin reviewing and approving all animal use protocols on file for the teaching program; the college would use only purpose-bred dogs purchased from class A dealers; and the college would suspend the first-year nonsurvival laboratories for the rest of the year.

"There is a sort of ingrained feeling that invasive procedures are necessary to demonstrate physiological functions," Dr. Valli said. "But we have to accept that if the European schools haven't done this for years, and most of our [North American] schools haven't done it for years and are accredited and graduating capable people, it simply isn't necessary."

The timing of that decision was met with disappointment both by students who had anticipated the laboratories and the students seeking alternatives, whose motives were now mistaken by many of their classmates.

Kevin Dajka, elected representative for the first-year class, said that a Jan 20 meeting of his class cleared up many misconceptions, including a perception that those seeking alternatives wanted the laboratories ended.

"It was definitely an overall agreement by our class that the labs needed to be done in a better manner. What we got out of them and what was being taught were two totally different things."

Annmarie Hill commented on the lack of supervision in the laboratories, and animals dying under anesthesia. "There's no reason we can't do nonterminal labs. I don't need to give epinephrine to see what it does. You work that much harder so you don't sacrifice the life of an animal." With clinical rotations, she noted, the learning experience is not successful until you see the animal recover and go home.

Students wishing for more hands-on opportunities their first two years feel the laboratories at least provided some animal-handling experience.

Dean Valli said that in two AVMA accreditations during his deanship the school has drawn criticism over insufficient live animal exposure the first two years of the curriculum. "The type of live animal exposure the students are looking for is not a physiological demonstration; it is contact with the live animal in a clinical setting.

"What we've now done is employ a new staff member who operates a community practice in the afternoon and evenings. The students will rotate through that practice and get very good experience in putting animals on the table, restraining them, and gaining experience with minor techniques."

On Feb 8 the college took a decisive step when it approved a formal animal usage policy. This policy grants students the option of not participating in laboratories "that conclude with the death or euthanasia of animals used solely for instructional purposes" and requires instructors to "identify a suitable alternative for obtaining the knowledge and skills acquired in the laboratory." The curriculum committee will review the use of all animals in the teaching program, with continuous oversight. Usage proposals then go forward to the university for LACAC review. According to the policy, alternatives must be available for students who object to animal use. The policy specifies the responsibilities of the instructors, students, and the college.

The subjects for the fall semester of the physiology program at U of I this academic year consisted of endocrinology, renal, and reproductive systems. The spring semester addresses cardiovascular, respiratory, and gastrointestinal systems.

Dr. David Gross, professor and head of Veterinary Biosciences, introduced four new laboratories, two involving live animals, when he began teaching the renal section of the physiology course in 1997. "This is a tried and proven method of physiological instruction, and I felt, personally, that our students were missing out on that."

"I feel a definite move now among medical schools back to those labs," Dr. Gross said. "[Without them] students are exiting these programs without the broad base of understanding physiologists and some clinicians feel is needed."

Data are not available to support or refute the premise about medical schools. The most recent survey on use of live animals in medical school curricula was done in 1994 by the Association of American Medical Colleges and covered only the undergraduate curriculum.

Dr. Gross believes that, when tied to lectures, laboratories provide "intangibles," including an intuitive feel for complex physiologic systems, animal handling experience, self-assurance, knowledge of the monitoring equipment, and "an appreciation for the wonder and complexity of the living animal." "The very best laboratory exercises occur, from a teaching standpoint, when something goes wrong, when the animal crashes, [students] give too much anesthetic, or the animal starts to wake up."

The U of I was not alone in offering nonsurvival laboratories. Dean Alex Livingston confirms that the Western College of Veterinary Medicine, University of Saskatchewan, still has nonsurvival physiology laboratories that use sheep for blood coagulation studies and dogs for cardiovascular studies. Dean Livingston said he is not aware of students requesting alternatives, because these laboratories are seen as an important component of the curriculum. The number of animal laboratories at Saskatchewan has been in decline, however.

Cost concerns forced many medical and veterinary schools to end laboratories that involved animals. Budgetary pressures and inadequate facilities and personnel accounted for such a decision at the Oregon State University College of Veterinary Medicine when it ended its nonsurvival physiology laboratories about seven years ago, according to Dr. Brad Smith, associate professor of veterinary physiology at the college.

Dr. Smith teaches the gastrointestinal, endocrine, and reproductive physiology systems. "We basically decided we could accomplish the same end points with case-based class discussions. Our students have done very well, but it would be better if it had the lab component."

But there is no consensus. Dr. Jean Hall teaches the respiratory, cardiovascular, and renal physiology laboratories at Oregon State. "I don't feel live animals are necessary in a freshman physiology course. We used to do renal physiology in live animals by giving injections to determine glomerular filtration rate by inulin and creatinine clearance tests. Now we 'dry lab' it by giving the students the values so they can assume they're measuring blood and urine samples."

For social and monetary reasons, Texas A&M University's Veterinary Physiology and Pharmacology Department has gone from using pound animals (a practice now banned by some localities in Texas) to purpose-bred animals (which can cost $500 apiece) to maintaining a chronic colony of dogs that stay for years, according to Glen Laine, PhD, professor and department head. "We've developed laboratories for professional students that are nonterminal. We eventually adopt the dogs out."

Cadavers used for veterinary anatomy laboratories are sometimes acquired as live animals. Texas A&M purchases pound dogs, for example, and Tufts University School of Veterinary Medicine purchases horses bound for slaughter. A University of Florida student expressed ethical objections to a cadaver laboratory in anatomy. The student wanted to study on an animal that had been sick, suffering, and ready to die, explained Dr. Jim Thompson, associate dean for students and instruction. Working against the clock, the administration located an animal acceptable to the student and a consenting owner.

Recent history in the area of alternative teaching methods goes back to 1989, to a student initiative at Tufts that resulted in the veterinary school offering a course in medical and surgery exercises that did not use live animals. This pilot program was considered the first of its kind among US veterinary colleges.

On Feb 8 of this year Tufts announced the veterinary school plans to end its nonsurvival dog laboratory as an elective, which would mean the school no longer has any nonsurvival laboratories and surgeries in core or elective courses.

Dr. Gary Patronek, head of Tufts' Center for Animals and Public Policy, said, "Tufts has found no distinguishable differences in the skill level between students who have or have not taken the elective surgical lab. This has been supported through postgraduate employer feedback."

With the new animal usage policy at the U of I in place, Dean Valli said, "The college curriculum committee and campus LACAC are anxiously waiting to receive protocols for survival demonstrations."

So far Dr. Gross has reviewed five alternatives for his renal section and found one that has value but only as a review instrument or supplemental learning tool. This semester and over the summer he plans to revamp his course. "There will be no live animal labs for the regular course," he said. "We hope to be able to offer an elective course that will be two whole semesters of experiments of all different kinds, some having live animals."

Terry Rathgeber, U of I associate dean for development and alumni affairs, said, "Many people think it's a matter of time before [this movement] will affect areas other than physiology."

Via the Internet, students as distant geographically from the United States as Australia are working together "almost like a support network" on the alternatives issue, according to Linnaea Stull. "This was a good wake-up call to say times have changed. The new way of teaching students doesn't necessarily have to involve animal deaths. In all likelihood, this sort of student will only increase in numbers."

Several U of I faculty said this experience has forced the students to think through animal use issues, as should the entire profession, in the societal context.

So, with the moratorium on nonsurvival physiology laboratories in effect, the discipline is being taught other ways. And while agreement may not be possible on the underlying philosophic issues, one of the enduring lessons is tolerance. Jenn Libbra, a first-year student and member of the college curriculum committee, said, "As a class, we came to an understanding that we respect each other's positions. Everyone has a chance now to learn in the best way for them, whether it's in the labs or through the alternatives worked out with their professors."