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Death notification is an important skill for health care providers to carry out, yet few clinicians feel adequately prepared to complete this task. To address these gaps in clinical training, some medical educators have incorporated standardized patients (SPs) into the curriculum to allow students to practice death notification in a safe, controlle...
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Citations
... Introducing new content and a new approach to teaching is challenging when curriculum has already been established. 13,64,70 New colleges that offer inaugural programs, such as the University of Arizona College of Veterinary Medicine (AzCVM), have unique opportunities to create curricula from scratch, in which communication can be an intentional, integral thread throughout. Additional curricular emphasis on diversity and inclusion (D&I) themes at AzCVM and elsewhere has broadened the desire to deliver coursework that simulates diversity not only in case load experienced in clinical practice but also in clientele. ...
... Educators have instead reported on curricular design and assessment as it pertains to SCs, specifically their impact on student development and their validity. 29,64,69,70,[84][85][86][87][88] A search for standardized clients and simulated clients in the Journal of Veterinary Medical Education yielded 24 and 48 results, respectively, specific to teaching and assessment that ranged in topic from nutrition competence to bad news delivery. Only 1 of these 24 studies made use of SCs to practice communication skills to navigate consultations with a specific group of clients that is often marginalized: service dog handlers. ...
... Students have reported a range of emotions, including anxiety, fear, and grief as they experiment with word choice and the impact that those words have on others. 70 Many students have expressed that cases feel real. 70,84 However, although the medical aspects of case management and the emotional responses to cases simulate real life, are these learning events demographically realistic? ...
The push for competency-based veterinary medical education by accrediting bodies has led to the inclusion of non-technical skills within curricula. Communication, self-awareness, and cultural humility are considered essential for post-graduate success. To facilitate skills development, veterinary educators have incorporated a variety of modalities including lecture, group discussions, virtual and peer-assisted learning, role play, video review of consultations, and simulated clients (SCs). The overarching goal is developing students into self-reflective practitioners through exposure to clinical scenarios that enhance and embody diversity. Decision making about case management is subject to stereotypes, bias, and assumptions. Racial and ethnic disparities reported in health care can adversely impact patient outcomes. This study was conducted to evaluate communication training and diversity among SC pools within veterinary colleges. A questionnaire was electronically disseminated to assistant/associate deans and/or directors of curriculum/education at 54 American Veterinary Medical Association Council on Education-accredited or provisionally accredited colleges of veterinary medicine. Twenty-one institutions are represented within the data set. Participating institutions summarized their communication curricula: 18 (85.71%) used SCs. Over 55% of these did not track SC demographic data or social identities; among institutions that did track, SCs were primarily monolingual English-speaking (77%), non-disabled (94.2%), white (90.4%), non-Hispanic/Latinx (98.6%) women (57%) over age 56 (64%). Sixteen institutions agreed with the statement "I do not feel that our SC pool is adequately diverse." Respondents shared that lack of time and capacity for recruitment were barriers to diversifying SC pools and proposed strategies to improve outreach.
... 35 Although the veterinary medical field agrees that communication is an essential part of effective clinical practices, the considerations of bilingual and multilingual context tend to be neglected in literature. 30,[36][37][38][39][40] This is even more scarce in the context of a multicultural speech community such as Hong Kong. By addressing this gap in the research on veterinary communication conducted in the Asian context, compounded by language and language barriers, the aim of this study is to explore the perspectives of veterinary medical students and veterinary practitioners regarding veterinary communication in a bilingual environment and the impact of communication across different cultures. ...
Background:
Using veterinary medicine as the clinical context, this case study elicited perspectives of practitioners and students in Hong Kong about the impact of their communication skills on clinical practice.
Methods:
A cross-sectional mixed-method design was adopted. Fifty students from the Bachelor of Veterinary Medicine programme were surveyed about their perspectives on expected communication needs as future practitioners and their perceptions of communication skills to be acquired in their programme. Semi-structured interviews were conducted with five veterinary medical practitioners to ask how they themselves feel about communicating in bilingual situations.
Results:
The students highlighted that English is the predominant instructional language in their training, although there are evident discrepancies between the curriculum and the clinical setting given the three predominant languages used in Hong Kong. The veterinary medical practitioners also highlighted strategies for clear communication, and the significance of interpersonal skills as effective communication is essential for learners in training to ensure client satisfaction and optimal clinical outcomes.
Conclusion:
This study can offer insights to educators on ways to bridge veterinary training and the clinical setting in bilingual contexts where communication problems result from language differences used for instruction and in clinical settings. Taking cultural context into consideration, multimodal teaching and learning materials can be developed to accommodate students' needs for both academic and professional purposes.
... Role-play is a popular teaching technique across the helping-profession disciplines. This includes human medical practice (Englar, 2019;Himmelbauer et al., ...
... The extent of positive feedback for the virtual client experiences was surprising considering several shortcomings. For instance, the experiences trialled in this study were very short (i.e., only 2 minutes each) which is much shorter than traditional role-play experiences described in the literature that typically range from around 10-30 minutes in length (Englar, 2019;Gibbs, 2019;Logie et al., 2013;Low, 1996;Melluish et al., 2007;Osborne et al., 2016;Paramasivan & Khoo, 2020;Pecukonis et al., 2016). In future development we plan on increasing the length of ...
Background
Providing students with virtual role-play experiences has the potential to bring counseling role-plays into large undergraduate courses.
Objective
The purpose of this study was to trial a virtual reality role-play experience where students played the role of a student counsellor.
Method
Seventy-three undergraduate psychology students played the role of a student counsellor interacting with a virtual client in two role-plays, one via desktop and one via head mounted display (HMD). Students provided feedback on their experience.
Results
70% of the students found the experiences very interesting, engaging and immersive, with 82% preferring the HMD mode of presentation. The virtual characters were believable as distressed clients with 96% of students perceiving greater negative than positive emotion expressed by the characters. Most of the students (64%) mood improved from the beginning of the experience to the end, however 14% experienced a decline in mood. The students agreed (95%) that the experiences would be a valuable experience to a psychology course.
Conclusion
Our results provide evidence that the virtual role-play experiences are well-liked by students.
Teaching Implications
The approach presented in this paper represents a practical method to provide virtual role-play experiences to both on-campus and online undergraduate students.
The American Veterinary Medical Association Council on Education mandates in standard 11 that all accredited colleges of veterinary medicine must develop and deliver formal processes by which students are observed and assessed in nine competencies. The eighth competency combines clinical communication and sensitivity toward soliciting and understanding individual narratives across a diverse clientele to facilitate health care delivery. Several frameworks have been designed to structure health care consultations for teaching and coaching purposes. The Calgary-Cambridge guide (CCG) provides an evidence-based approach to outlining the flow of consultations, incorporating foundational communication skills and elements of relationship-centered care into a series of sequential tasks. Although the CCG was intended for use as a flexible tool kit, it lacks visible connections between concrete experiences (e.g., the consultation) and reflective observation (e.g., the feedback). This teaching tip describes the development of a novel anatomical representation of the consultation that integrates process elements of the CCG with other core curricular concepts. By combining knowledge, technical skills, critical thinking, reflection, cultural humility, and self-awareness into a skeletal consultation model, linkages are established between communication and intergroup dialogue skills, diversity and inclusion (D&I). This model has been further adapted as feline, caprine, porcine, equine, avian, and reptilian versions for in-class use as strategic visual aids that highlight key areas of focus for Professional Skills class sessions. Future developments by the authors will explore how to link species-specific consultation models to assessment rubrics to reinforce the connection between content (what) and process (how).
Background:
Complementary and alternative veterinary medicine (CAVM) seems to be gaining acceptance by pet owners. Client-veterinarian communication about CAVM is important to explore client perceptions and facilitate open exchange of ideas between owners and veterinarians.
Methods:
This study includes an online, cross-sectional survey of dog owners to evaluate CAVM use and client-veterinarian communication about CAVM. Based on the extended theory of planned behaviour, factors influencing the intention to use CAVM were evaluated.
Results:
Past CAVM use was reported by 45.3% clients based on 1000 valid surveys. The attitude towards CAVM was generally positive. Perceived knowledge about CAVM positively predicted perceived behavioural control and attitude towards CAVM. Both were the strongest predictors of future CAVM use. Around 45.7% of clients had already talked to their veterinarian about CAVM. This conversation was mainly initiated by the owner (66.3%). Owners expected the veterinarian to have knowledge about CAVM (91.5%) and offer referral (71.5%).
Limitations:
The limitation is difficulty in classifying and defining CAVM modalities.
Conclusions:
Owners' perceived behavioural control and attitude towards CAVM predict CAVM use. Failure to engage in a conversation about CAVM hampers clients to partner with veterinarians to discuss the treatment approach and maximise patient outcome. The veterinarian plays an essential role in providing objective accurate information about CAVM.
OBJECTIVE
To assess the impact of a communication program on a cohort of veterinary students’ knowledge and performance of communication skills.
SAMPLE
Class cohort of veterinary students at Colorado State University.
PROCEDURES
Year 3 students’ knowledge of communication skills was evaluated using quizzes, administered before and after the fall 2016 and spring 2017 Clinical Communication Skills-I and II junior practicum. In year 4, student performance of 22 Calgary-Cambridge Guide communication skills was assessed by coding video-recordings of student-client interactions collected during their second and fourth weeks of the Community Practice rotation in the summer and fall of 2017 and spring of 2018. The impact of training, association with demographic factors, and correlation between knowledge and performance of communication skills were investigated.
RESULTS
In year 3, 136 students completed both fall and spring quizzes; in year 4, 65 week-2 and 29 week-4 appointments were video-recorded during Community Practice rotation. Students’ knowledge assessed via quizzes containing skill spotting and skill demonstrating questions increased significantly after the fall and spring junior practicums; however, knowledge of communication skills was not associated with performance during year 4 Community Practice rotations. Communication skills most frequently demonstrated by students during the fourth year Community Practice rotation were open-ended questions, closed-ended questions, empathy toward the client and patient, providing “chunks” of information, and signposting. Students received high quality scores for non-verbal behaviors and logical clinical interview structure.
CLINICAL RELEVANCE
Results suggest that experiential learning techniques, including a flipped classroom approach, role-play, and communication laboratories contributed to increased student knowledge of communication skills.
