COMMUNICATIONS IN SMALL ANIMAL PRACTICE
BACKGROUND:
Institutions accredited by the American Veterinary Medical Association Council on Education (AVMA COE) must provide students with a minimum of 30 weeks of hands-on training during the clinical year. Restrictions from the state and university greatly decreased our opportunity to provide hands-on opportunities for students beginning their clinical year of training in early May 2020. The majority of students were enrolled in virtual training opportunities from May through August, with planning for increasing hands-on activities in the fall if permitted. To meet the minimum of 30 weeks of hands-on training and graduate this class on time in spring of 2021, the College worked with the campus public health officer and with faculty to create a small number of hands-on opportunities that would keep students, staff, and faculty safe while providing educational opportunities. Communications is a valuable clinical skill that can be practiced without direct in-person contact or oversight. A communications rotation was developed to provide students with some hands-on training within the virtual space.
COURSE SET UP:
Please see the syllabus for complete information. During the 2-week rotation, students practiced history-taking, presentation of common spiels, case management conversations with clients, difficult client and team-member communications, and persuasive presentations. A Canvas site was available with materials to help students prepare before each class session. These materials included course notes from prior training opportunities in the curriculum, topics lists for common spiels, case presentations and a travel sheet to ensure attention to client financial constraints, and video tapes of difficult conversations. Technologies available were Zoom for interactive class meetings; Canvas for course materials and submission of assignments; a proprietary app to remind students of patient-specific concerns based on the patient’s age, breed, sex, and intact status; video tapes of difficult client conversations created by members of the community; and video creation tools including FlipGrid and Kaltura. Students practiced communications live via Zoom, received immediate feedback from their peers and the instructor, reflected on the experience, and were given an opportunity to practice specific skills again. History-taking and case discussions were completed with one student acting as the DVM and another student or the instructor acting as the client. For case discussions, the student who was randomly chosen to be the client was informed using the “chat” function in Zoom so they could prepare; the student chosen to be the DVM was not, so they had to come at it without preparation in the moment, mimicking real life. Spiels were completed with a given student acting as the DVM and talking to the group as a whole. The set of 8 spiels on a given day was repeated so each student did two of them and got to practice after having heard someone else do a spiel first. Some of the difficult client videos and all of the persuasive talks were provided by the students acting as the DVM to lay people (adult children of the instructor who live in the home from which the instructor was working). Students also practiced creation of client education materials, either as written pieces or as videos.
STUDENT FEEDBACK:
Students rated all of the course activities as useful for their learning, with spiels, case discussions, difficult conversations, and persuasive talks rated uniformly as very useful. Zoom, Canvas, and the community-created difficult conversation videos also were rated as very useful for student learning. Among things students like best about the rotation were: (1) great opportunities to give and receive feedback; (2) the chance to prepare before some presentations and have to “fly by the seat of your pants” for others, like real life; (3) the chance to practice a variety of different kinds of conversations; (4) learning from the instructor and peers how they might handle various situations; (5) the value of reflection, repeat practice, and then reflecting again; and (6) community involvement in the creation of the difficult conversation videos and opportunity to present information to a lay person. Suggestions for improvement included: (1) more opportunities to practice talking to a lay person instead of role-playing with each other; (2) setting time limits to help students learn to be more succinct in their presentations; and (3) practicing very challenging skills, such as getting yourself out of an escalating conversation and calming down that client. Suggestions also were made about having students review and provide feedback on each other’s video assignments.
This course will be offered again several times later this summer and this feedback will be incorporated. Other changes that will be made include adding “providing and receiving feedback” as a course learning objective, focusing the case presentations the first time on explaining plans for diagnostic testing and the second time on explaining plans for treatment, finding more opportunities for the students to present information to lay people instead of to classmates or their instructor, and addressing audio issues that arose when the instructor used the “share screen” function in Zoom.
MATERIALS PROVIDED FOR REVIEW:
· Syllabus
· List of history-taking scenarios
· List of cases for case discussions / travel sheet
· List of persuasive talks topics
· General list of difficult conversation topics
· Example of difficult conversations video / instructions for those making videos / difficult conversation scripts