Reflections on AVA 2012 part 3

This is the third and final review post of the lecture sessions I attended at AVA 2012. I also plan to report on the education poster session and on my experiment with using social media as a backchannel during the conference.

Sustainable teaching of surgery to veterinary students – Dr Rick Read

Focusing on the teaching of two of the basic requirements to becoming a good surgeon – manual dexterity and surgical decision-making – and the benchmark of day 1 competency in the bitch spey, Dr Read detailed how universities have had to change the way in which develop these skills in students given constraints in funding and limited access to animals for student training e.g. developing non-animal based exercises to develop manual dexterity, use of dog substitutes, closer relationship with shelters to increase access to pound animals and use of OSCEs (objective structured clinical examinations) to assess some skills.

He believes the current concept of the ‘omnicompetent’ new graduate is outdated and unsustainable.

Having graduated in the days when access to animals was easier and surgical caseloads at universities higher, I can see how the new funding and welfare constraints have forced change in surgical training, a situation which must be even more difficult in countries such as the UK where there are even greater restrictions on use of animals. Many novel alternatives have been created and I’m sure it is an area where necessity will continue to be the mother of invention. A move away from the omnicompetent graduate would be a major paradigm shift for the profession but over the sessions I attended I came to see that it may be intrinsically linked with the future sustainability of veterinary education.

Producing graduates who will stay in rural practice – Dr Kym Abbott

Recruiting and retaining vets in rural areas is a challenge for the veterinary profession. Dr Abbott discussed the two views on why this may be – the economic view that salaries and working conditions are not attractive and the alternative view that the profession is not producing the right type of graduates. There are three major ways to fill the rural positions – pulling through good conditions, pushing through tax incentives and producing graduates who are drawn intrinsically.

The three stages of the ‘rural pipeline’ were explained – encouraging selection of rural students, opportunities to train in a rural setting and then support on entry into practice in rural areas. Two of the newer veterinary schools in Australia – Charles Sturt and James Cook universities – are located in rural areas and have more course content based on rural practice training. Charles Sturt also prioritises selection of students from rural backgrounds; I’m not sure if this is the case at JCU. Although it is early days for graduates from these newer schools it appears that these measures are having some success.

 

Assessment of veterinary education at UQ in preparing graduates for practice

Dr Julia Dowsett graduated from UQ in 2011 and, after 5 months in practice, spoke about how well she felt she had been prepared for her new career on many levels, such as factual knowledge, practical skills and approaches to clinical problems. I was especially interested in her comment that she felt that the communication skills she learnt were among the most valuable assets from her education as they are not something you can easily look up in the clinic but need to be developed over time. She also highlighted how her training had made her a very critical assessor of evidence such as that presented by drug companies to support their new products.

Julia talked about her personal challenge in third year when she struggled to admit that she had to change her style of learning to manage the volume and structure of clinical material. She came close to deferring or leaving completely and the profession should be glad she persisted as she is clearly a credit to the veterinary world. When asked what the university could have done to help her either avoid or minimise her mid-course issues she said it was mostly personal and the difficult patch had been good for her in the longer term. I had a similar revelation about learning style during my fourth year so could identify with her experience.

Julia is obviously an excellent veterinarian. She has a previous degree and work experience and was involved in the leadership program as a student. I did wonder whether all the new graduates would be as confident as she is (I know I wasn’t at the same stage) but she has clearly been served well by her education, which was certainly broader in many ways than that received by graduates in earlier times.

 

National undergraduate veterinary student survey – Dr Guyan Weerasinghe

In 2010 two undergraduates from the University of Queensland noticed that although there was information about expectations of new graduates from employers, there were no inquiries into veterinary students’ expectations and opinions of their first job. Showing fabulous initiative, they decided to conduct a study themselves, which they distributed online to 5 of the 7 veterinary schools.

When asked to rank their priorities in choosing their first job a good supportive boss was top priority, followed by being employed in their area of interest. I was surprised by this result as I would have thought these would have been reversed.

Student ideas about their income from their first job showed that the majority expected to receive $40,000 to $45,000, which is between the award wage for graduate veterinarians ($38,721) and the average starting salary based on data from the Graduate Careers Survey ($45,000). Poor remuneration has long been an issue for vets and I am personally extremely disappointed and concerned to note that the starting salary has not improved since I graduated in the mid 1990s and that the situation in similar in both the US and UK.

Guy pointed out some shortcomings in the design of the study, such as bias in the wording of some questions. Despite these flaws, it is a very worthwhile piece of research which will hopefully be improved upon and repeated in 3-5 years. Kudos to Guy and Suffien for their initiative. I was very impressed with Guy and hope to see more of his work in the future.

 

Facebook for clinics – Dr James Ramsden

Being interested in social media, I had a break from my education focus to learn about how clinics are using Facebook and what value it has. James started by reviewing the key client communication tools – email for current clients and websites for prospective clients who need information about the clinic such as phone numbers and maps. Social media is the new form of word of mouth and several in the room shared their experiences with Facebook. Ways of managing the inevitable negative comments were discussed with one story of a criticism being made by an owner who had never visited the clinic. Within a short time many clients posted their support for the vet, which largely resolved the matter and demonstrates the power of the medium.

James discussed the amount of time and type of content needed to sustain a page, including keeping up regular posting and including images of cute patients which are very popular with clients. A champion Facebook user in the audience explained his frankly brilliant although use of Facebook to build his relationships with clients and keep them informed about their animals eg posting a picture a bandage change while the owner is at work so they could see the progress for themselves.

What I took home from AVA 2012

AVA 2012 was my first foray into wider veterinary issues for several years as I have been focusing on family duties. It was also somewhat experimental as I planned to tweet and blog the event for my own focus and learning and also to provide a mini backchannel for anyone interested but not able to attend. I’ll be blogging about the experience in a couple of weeks’ time.

I was impressed with the changes and innovations which have occurred in veterinary education. Current students receive a far more rounded, engaging experience than I did, which was great to hear. I was concerned, but not surprised, by the many pressures and constraints experienced by veterinary educators and suspect there may be significant changes ahead, which may include streaming of students or an intern year to develop some of the technical skills. A concern raised by multiple speakers was that by focusing on day 1 competencies, the veterinary degree risks becoming a technical rather than a science course, not an idea I had previously considered.

On a profession-wide level, the discussion with the strongest resonance for me is the need for more veterinarians to work in the areas of agriculture and public health and for the profession as a whole to be more visible to the public and to increase its influence in the corridors of power. Although I have not reviewed Professor John Webster’s very valuable contributions to the conference in detail, I feel that if we could all emulate his passion for the well-being of animals and his willingness to stand up and defend his convictions, the profession and the world we live in would benefit greatly. Thanks to the AVA for presenting an excellent conference.

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About rebekahmcbrown

I am a veterinarian with a special interest in instructional design and developing eLearning in the veterinary and medical areas. I write teaching materials for both face-to-face and online learning as well as writing and editing articles.
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7 Responses to Reflections on AVA 2012 part 3

  1. TJ says:

    Rural Work
    In regard to the three draws for rural practice, I would question the third idea: producing graduates that are intrinsically drawn. Professor Heath’s research has shown that those who grow up on farms leave rural practice at the same rate of those who don’t (50%). Better working conditions seem to be far superior and the increased number of graduates from the new universities could potentially worsen the working conditions. Graduates are more likely to return to university and complete a degree that provides good working conditions than be forced to work under poor conditions. Positive incentives seem to be far superior.

    Veterinary Curriculum
    I would question whether more ‘communication skills’ within the degree would improve graduate quality. This would obviously be to the detriment of core science subjects (which are obviously important in making a diagnosis and treating patients). Most personality and communication skills are developed in childhood which would suggest that recruiting good communicators to the degree would be easier than training poor communicators. However testing these does pose challenges as does testing improvements in communication skills. Maybe the way the course is advertised could assist. Currently it attracts people who ‘want to work with animals’. More advertising by universities that a veterinarian requires good communication skills may assist.
    It is quite disturbing that veterinarians have to be able to critically evaluate drug company products. Human products have a far more rigorous approval process through the TGA. There is also the factor that veterinarians are selling most of the pharmaceuticals and may have biases in accepting evidence of efficacy.

    Student Survey
    It is quite apparent that students are aware of incomes but not concerned about them. However once they graduate and receive cost complaints from owners, start renting, have interprofessional salary comparisons, look at career progression, consider family care/retirement then wages become one of the biggest concerns.

    More veterinarians in public health
    For this to occur will require a shortening of the degree. Intelligent individuals can obtain these jobs with much shorter degrees and complete postgraduate qualifications before a veterinary student has even graduated.

    • JHH says:

      Actually in 2006 Heath et al wrote “There is, however, some evidence that, despite a high attrition rate, veterinary graduates who grew up on farms with animals are more likely to remain working in rural practices than their colleagues who have not had extensive experience on farms. In a longitudinal study of Queensland graduates, 83% of those from farms but 55% of other graduates started work in mixed rural practices. Ten years later a majority of both groups had left, but 28% of those from farms, and 14% of the rest, remained in practice (AVJ Vol 84, No. 6, Pg 221).

      And this was before the regionally located schools at CSU and JCU produced graduates. I can’t speak for JCU, and CSU only has had graduates working for 2 years, but all of these, who sought veterinary employment, found jobs in rural/regional Australia. Two years on and from the 30 2010 graduates, 3 have recently gone to the UK to locum (in mixed practice) and one has gone back to uni; the rest are still working in rural/regional practices. All but one of the 42 2011 graduates are living and working in rural/regional areas twelve months after graduation. It will be interesting to see what the figures are ten years on!

      There are a number of ways in which vet schools could influence the decision of graduates to stay in rural/regional Australia. One of them is by sourcing students from regional Australia, already with a range of animal related skills and knowledge of rural Australian lifestyle; and teaching them in a rural setting in a course that assists them to be ready for mixed paractice.It may then be far more likely these graduates will stay in rural/regional Australia – whether that be working as a vet in 10 years we will have to wait and see!

    • timjwhitebeng says:

      @JHH – Prof Heath shows that they leave rural practice at similar ‘rates’. More start in rural practice if they grew up in a rural area but only about 30% are left after 10 years regardless of where they grew up ie. the reasons for leaving such as poor working conditions (pay and hours) appear to have the same impact after they commence employment. The RCVS surveys also highlight the fact that students aren’t concerned about income but it becomes ones of the top 3 concerns once they are qualified and have commenced employment. It is highly likely that JCU and CSU will see similarly poor retention rates at 5 and 10 years in rural areas. Maybe even worse as the job market becomes flooded due to oversupply.

    • timjwhitebeng says:

      In 2008 AVJ, his more recent contribution Professor Heath wrote “Although approximately half of veterinary graduates start in rural areas, most leave within a few years and this applies to those who grew up on farms to almost the same extent as those from other backgrounds.”

      5 previous articles are referenced in support of this statement suggesting its importance.

  2. Thanks so much for you input Tim. With your knowledge of this area your comments are especially valuable. I particularly agree with a couple of comments –

    1. Vet science attracts people who want to work with animals, whereas the reality is that so many other skills and abilities are equally (or more) important.

    2. Graduates aren’t concerned by lack of remuneration until financial pressures begin to build. How can we make them more aware of the issues they may face?

  3. Thanks for taking the time to comment Jenny and Tim. It will be very interesting to see where the early CSU grads are in 10 years’ time. I certainly hope for the profession’s sake that they remain in rural areas.

    Re incomes: Last week I was asked by my high school to participate in a careers event for yr 9-11 students. After my talk a year 10 student approached me and said that her vet had told her she should not even consider vet science due to poor remuneration, a comment she did not understand at all. It was sad, but not that surprising to hear the comment. My response was that she should listen to the comment as there was clearly a reason for it being made but that she needed to make up her own mind.

    I have also recently had a left-field idea for trying to change the way the profession is viewed in the community and so perhaps influence applications towards those interested in food animal practice and One Health areas – make a TV series, possibly a drama but perhaps a documentary, about vets working in those areas and making a difference in people’s lives. Most people see Bondi Vet as what a vet does and don’t consider other options. Of course it would have to look appealing but changing community perceptions is always important.

    • timjwhitebeng says:

      The vet profession has been the victim of some poor decisions. Other professions such as medicine and optometry have been quite firm in stating that increasing supply is a poor method to increase rural retention. The 50% increase in graduating vets between 2008 and 2013 will likely lead to many of the best leaving the profession for others that have been more sensible in caring for their members.

      As most who choose the profession do so at age 13 I think it is important to explain why economic security is important when providing career advice: it allows for purchase of good quality equipment, many owners will not get highest standard care due to cost, it allows for staff training, it means that vets can do what is best for the patient rather than over servicing, it allows funding for holidays/family time/retirement…

      My career advice would be to study medicine as the government provides funding for training and employment and cares for the professionals. A medicine degree allows for government work or other options, has great economic security within clinical jobs and allows a high standard of care.

      My other recommendation would be to do a science degree where it is easier to get good marks which are important for obtaining a government graduate program or CSIRO etc. An honors year, Masters in Public Health or PhD can then be done. A Science degree is a quicker and probably better route to one health positions. Government veterinary employment has deteriorated from 50% fifty years ago to 10% today.

      I don’t think we necessarily need to advertise the course to those interested in food animals or one health. We have not seen issues recruiting into these positions, retention is the key issue due to poor working conditions. Reducing the number of veterinarians and somehow gaining extra funding for this work seem to be possible options along with the suggestions in April Australian Veterinary Journal page 19: Economic Sustainability.

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