Timely, specific feedback is the most important feature of simulation-based training, but providing adequate instructor supervision is challenging. Students’ ( n = 76) surgical skills were assessed after training using either the traditional (T) method of large-group teaching by multiple instructors or the alternative method of one instructor assigned (A) to a defined group of students. Instructors rotated to a different group of students for each laboratory session. The instructor-to-student ratio and environment remained identical. No differences were found in raw assessment scores or the number of students requiring remediation, suggesting that students learned in this environment whether they received feedback from one instructor or multiple. Students had no preference between the methods, though 88% of the instructors preferred the assigned method, because they perceived an increased ability to teach and observe individual students. There was no difference in the number of students identified as at-risk of remediation between groups. When both groups were considered together, students identified as at-risk were more likely (40% vs. 10%) to require post-assessment remediation. However, only 22% of students requiring remediation had been identified as at-risk, and A-group instructors were more accurate than T-group instructors at identifying at-risk students. These results suggest that students accept either instructional method, but most instructors prefer to be assigned to a small group of students. Surgical skills were learned similarly well by students in both groups, although assigned instructors were more accurate at identifying at-risk students, which could prove beneficial if early intervention measures can be offered.
Objective: To compare a low-fidelity foam and fabric (FF) model to a high fidelity silicone (SI) model for teaching canine celiotomy closure. Study design: Prospective blinded comparison of learning outcomes. Sample population: Second-year veterinary students who had never performed surgery as a primary surgeon (n = 46) and veterinarians experienced in performing canine celiotomy (n = 10). Methods: Veterinary students performed a digitally recorded celiotomy closure on a canine cadaver before and after participation in 4 facilitated laboratory training sessions on their randomly assigned model. Recordings were scored by masked, trained educators with an 8-item task-specific rubric. Students completed surveys evaluating the models. Experienced veterinarians tested the models and provided feedback on their features. Results: Completed pretest and posttest recordings were available for 38 of 46 students. Students' performance improved regardless of the model used to practice (P = .04). The magnitude of improvement did not differ between the 2 groups (P = .10). All students (n = 46) described their models favorably. Ninety percent of veterinarians thought both models were helpful for training students and gave similar ratings on all measures except for realism, which was rated higher for the SI model's skin (median, agree) compared with the FF model (median, neutral, P = .02). Conclusion: Model-based training was effective at improving students' surgical skills. Less experienced learners achieved similar skill gains after practicing with FF or SI models. Clinical significance: The acquisition of surgical skills required to perform celiotomy closure in companion animals occurs similarly well on models made of foam and fabric or of silicone, providing flexibility in model selection.
Evaluation of veterinary students' surgical skills by using digital recordings with a validated rubric improves flexibility when designing accurate assessments.
Simulation in veterinary education offers a solution for bridging the gap between observation and performance of clinical skills. An equine neck model was created that allows repetitive practice of jugular phlebotomy, intramuscular (IM) injection, and intravenous catheterization. The aim of this study was to validate the model for jugular phlebotomy and IM injection. We surveyed experienced veterinarians on the model's realism and the comprehensiveness of its features. In a randomized experimental study, we compared the learning outcomes of first-year veterinary students trained on the model (n=48) and students trained on equine head-neck cadavers (n=45). There was no difference in post-training performance of phlebotomy on the live horse between cadaver-trained students and model-trained students when assessed by a checklist (cadaver 6.87±0.33; model 6.89±0.77; p=.99) or a global rating scale (cadaver 5.23±0.87; model 5.32±0.77; p=.78). No difference was found between post-training scores for IM injection when assessed by checklist (cadaver 6.87±0.34; model 6.89±0.31; p=.76) or global rating scale (cadaver 5.23±0.87; model 5.32±0.77; p=.75). Veterinarians (n=7) found this low-fidelity model acceptable and supported its use as a training tool for veterinary students. Students reported in a post-lab survey that they felt models were as helpful as cadavers for learning the procedures. These results support the use of the model as a component of first-year veterinary student curriculum.
A validated teaching model for canine fundoscopic examination was developed to improve Day One fundoscopy skills while at the same time reducing use of teaching dogs. This novel eye model was created from a hollow plastic ball with a cutout for the pupil, a suspended 20-diopter lens, and paint and paper simulation of relevant eye structures. This eye model was mounted on a wooden stand with canine head landmarks useful in performing fundoscopy. Veterinary educators performed fundoscopy using this model and completed a survey to establish face and content validity. Subsequently, veterinary students were randomly assigned to pre-laboratory training with or without the use of this teaching model. After completion of an ophthalmology laboratory on teaching dogs, student outcome was assessed by measuring students' ability to see a symbol inserted on the simulated retina in the model. Students also completed a survey regarding their experience with the model and the laboratory. Overall, veterinary educators agreed that this eye model was well constructed and useful in teaching good fundoscopic technique. Student performance of fundoscopy was not negatively impacted by the use of the model. This novel canine model shows promise as a teaching and assessment tool for fundoscopy.
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