1 What to teach

Deciding what skills to teach

Each area has a list of skills that are considered important in that field. However, simple checklists tend to inspire “one and done” attitudes rather than creating motivation to master the skill.  Be careful with the lists and create a program that works toward performance rather than  exposure to those skills.  Because motor skills learning takes time, programs  typically need to focus on foundational skills and work to obtain mastery of those skills. Focusing means a greater likelihood of mastery and long term retention, not to mention improved performance and confidence.

Motor skills are learned differently from knowledge skills.  The ultimate goal is retention and retention is best obtained by reaching consolidation and automaticity (mastery).  Skill learning is accompanied by protein changes, synapse formation and various other changes in the brain. These changes only occur with repetitive practice. The brain is taking in new input all the time; anything that isn’t repeated or associated with some other emotion is quickly lost. While you  are driving down the highway, you see many other cars of various makes and models. However, unless the car is unusual, you would be hard pressed to name more than one or two you saw. It wasn’t reinforced or repeated and was forgotten.

Backwards design your lists. What are the common procedures used by your graduates? Which of those are useful regardless of the type of practice or job? Are any of them foundational for other skills? Are any of them difficult to obtain later? Focus on those. Skills that are commonly addressed in continued education/professional development  and/or skills that can be learned independently may be safe to leave until later. Prioritize your list to ensure the essential skills are mastered.

UMN CVM Clinical skills program

Skills at the UMN CVM are divided into 1) common skills performed similarly across species (e.g. venipuncture) and 2) skills performed commonly in certain species or performed significantly differently across species (e.g. ovariohysterectomy). The former skills are taught in our clinical skills program while the latter are taught in species specific courses.

DIAGNOSTICS THERAPEUTICS
Physical examination Provide hemostasis (ligatures, pedicle ties, other)
Body condition and muscle condition scoring Clean, flush and debride wounds (with assistance)
Animal body language Lance abscesses
Animal restraint Place iv catheter
Draw blood Set up and administer fluids
PCV/TPP Calculate doses and rates
Obtain urine – urinary catheter Patient prep for surgery
Obtain urine – cystocentesis Perform local block
Obtain urine – ultrasound guided cystocentesis Perform sterile hand scrub
Perform urine specific gravity Open glove
Perform skin scraping Gown and glove
Perform skin biopsy Make an incision
Perform chest or abdominal tap Maintain sterile technique (drape while sterile)
Perform joint tap (with assistance) Perform basic mass removal (fusiform incision, sq dissection)
Perform FAST exams (with assistance) Place drain
Perform FNA and make smear Suture skin, subcuticular layer
Perform blood glucose Bandage limb (with assistance)
Administer medications po
Administer medications topically
Administer medications sq (includes vaccines)
Administer medications im
Administer medications iv (includes euthanasia)

Veterinary Medicine skills lists- general

Ophthalmoscopy skills in primary care:a cross-sectional practitioner survey. Veterinary Record 182(15):435-436, 2018

Stakeholder expectations regarding the ability of new veterinary graduates to perform various diagnostic and surgical procedures. JAVMA 251(2):172-184, 2017

RCVS day one competencies, updated 2014

Microscope Use in Clinical Veterinary Practice and Potential Implications for Veterinary School Curricula, JVME 41(4):331-336, 2014

Clinical skills of veterinary students – a cross-sectional study of the self-concept and exposure to skills training in Hannover, Germany. BMC Veterinary Research 10:969, 2014

Frequency of use and proficiency in performance of surgical skills expected of entry-level veterinarians by general practitioners,  JAVMA 240(11):1345-1354, 2012

Survey of veterinary technical and professional skills in students and recent graduates of a veterinary college, JAVMA 219(7):924-931, 2001

Veterinary Medicine skills lists – by species

Frequency of activities and procedures performed in private equine practice and proficiency expected of new veterinary school graduates, JAVMA 232(1): 42-46, 2008

Surgery, anesthesia, and restraint skills expected of entry-level veterinarians in bovine practice, JAVMA 221(7):969-974, 2002

Individual animal medicine and animal production skills expected of entry-level veterinarians in bovine practice, JAVMA  221(7):959-968, 2002

10 most common medical conditions of dogs and cats, Nationwide pet insurance, 2016

State of pet health, Banfield

Prevalence of Disorders Recorded in Dogs Attending Primary-Care Veterinary Practices in England, PLoS ONE 9(3): e90501. doi:10.1371/journal.pone.0090501

Influence of demographic variables on the frequency of use of various procedures, skills, and areas of knowledge among veterinarians in private small animal exclusive or predominant practice and proficiency expected of new veterinary school graduates. JAVMA 226(1):38-48, 2005

Frequency of use of various procedures, skills, and areas of knowledge among veterinarians in private small animal exclusive or predominant practice and proficiency expected of new veterinary school graduates. JAVMA 224(11):1780-17817, 2004

Parasitological Procedures, Skills, and Areas of Knowledge Used by Small-Animal Practitioners in North America, JVME 41(4):323-330, 2014

Medical student skills

Core Entrustable Professional Activities for Entering Residency, AAMC 2017

Competencies for first year residents –physicians’ views from medical schools with different undergraduate curricula, BMC Medical Education 17:154, 2017

Surgical and procedural skills training at medical school – a national review.  International Journal of Surgery 12:877-882, 2014

Tomorrow’s Doctors, Appendix I. 2009

Recommendations for Preclerkship Clinical Skills Education for Undergraduate Medical Education, AAMC 2008

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