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
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