Denis Harvey

Effect of using an audience response system on learning environment, motivation and long-term retention, during case-discussions in a large group of undergraduate veterinary clinical pharmacology students.

Background: Teaching methods that provide an opportunity for individual engagement and focussed feedback are required to create an active learning environment for case-based teaching in large groups. Aims: A prospective observational controlled study was conducted to evaluate whether the use of an audience response system (ARS) would promote an active learning environment during case-based discussions in large groups, have an impact on student motivation and improve long-term retention. Methods: Group A (N = 83) participated in large group case discussions where student participation was voluntary, while for group B (N = 86) an ARS was used. Data collection methods included student and teacher surveys, student focus group interviews, independent observations and 1-year post-course testing. Results: Results indicated that the use of an ARS provided an active learning environment during case-based discussions in large groups by favouring engagement, observation and critical reflection and by increasing student and teacher motivation. Although final exam results were significantly improved in group B, long-term retention was not significantly different between groups. Conclusions: It was concluded that ARS use significantly improved the learning experience associated with case-based discussions in a large group of undergraduate students.

Comparison of 2-step laparoscopy-guided abomasopexy versus omentopexy via right flank laparotomy for the treatment of dairy cows with left displacement of the abomasum in on-farm settings.

OBJECTIVE To compare characteristics and results of 2-step laparoscopy-guided abomasopexy versus omentopexy via laparotomy in the right paralumbar fossa for the treatment of dairy cows with a left displaced abomasum (LDA). DESIGN Prospective clinical trial. 253 dairy cows with an LDA. PROCEDURES All cows that were treated with omentopexy (n = 101) or 2-step laparoscopy-guided abomasopexy (152) from July 2005 through December 2006 were included. Presurgical, perisurgical, and postsurgical information was recorded by attending veterinarians. Producers were interviewed by telephone 7 and 60 days after surgery regarding the response of cows to surgery. Characteristics of and responses to the 2 surgical techniques were compared. RESULTS At 7 days after surgery, the 2 groups of cows were not significantly different with respect to appetite, comfort, and milk yield; at 60 days after surgery, groups were similar with respect to milk yield, cull rates, and risk of relapse of LDA. Antimicrobial treatment in response to postsurgical pyrexia was necessary in only 20.4% (31/152) of cows that were treated with 2-step laparoscopy-guided abomasopexy. Mean duration (preparation and surgery) of 2-step laparoscopy-guided abomasopexy was significantly less than that of omentopexy (36 vs 74 minutes, respectively). CONCLUSIONS AND CLINICAL RELEVANCE Results of 2-step laparoscopy-guided abomasopexy and omentopexy via laparotomy in the right paralumbar fossa were not significantly different. Compared with omentopexy, laparoscopy-guided abomasopexy was performed more quickly and required postsurgical administration of antimicrobials less frequently. Although these factors may be of economic consequence to veterinarians and producers, other aspects must also be considered when choosing between techniques.

Current State of Distance Continuing Medical Education in North America

Background: Every continuing medical education (CME) provider is confronted one day or another with deciding whether to develop distance education programs that may enhance access to CME for health professionals. To make a judicious decision, one needs to understand the features of distance education and the experiences of other providers. Methods: Since there was a lack of information in the literature regarding the actual state of distance CME in North America, a Web‐based survey aimed at CME providers was conducted including a description of the providers, the users, the activities offered, the technologies employed, and the administration of the systems. Results: The results from this study indicate that the majority (68%) of CME providers had not developed distance education programs at the time of the survey; 30% of the providers, mainly from private companies, were offering nondegree distance education programs, and 2% of the university providers were offering degree programs. The technologies mainly used to develop distance education programs were printed material (69%), videoconferencing (58%), and, to a lesser degree, videotape. The revenue sources to develop degree programs were government funding, tuition, and fees. Other sources such as commercial support and sales were used for nondegree programs. Implications: This study revealed that there was considerable interest in distance education, especially from the organizations not offering this type of program. Since distance CME features are now better known, this is a step toward the advancement and development of more and better distance education programs.

Minimally Invasive Field Abomasopexy Techniques for Correction and Fixation of Left Displacement of the Abomasum in Dairy Cows

To reduce the potential drawbacks associated with laparotomy techniques for correction and fixation of left displaced abomasums (LDA), minimally invasive techniques have been developed. This chapter reviews the toggle pin suture (TPS) and the laparoscopic abomasopexy procedures used in the field for correction and fixation of the abomasum for correction of left-displacement of the abomasum in dairy cows. The importance of case selection cannot be overestimated. By combining laparoscopy with the principle of the TPS procedure, the lack of visual control associated with the TPS procedure is eliminated, while the advantage of the speed of completion and minimal invasiveness provided by both procedures are maintained. Successful LDA treatment includes not only early detection and treatment of the LDA, but also the prevention of secondary ketosis and aggressive treatment of concurrent disease.

Comparison of Two Surgical Site Protocols for Cattle in a Field Setting

Objective To compare 2 preoperative surgical site protocols for standing laparotomy in cattle in a field setting. Study Design Cohort study. Animals Dairy cows (n = 73) undergoing a clean standing laparotomy (no visceral perforation during surgery). Methods Cows were randomly assigned to 1 of 2 preoperative skin-preparations protocols with chlorhexidine used as an antiseptic. A standard protocol (3 minutes [min] cleansing scrub, tap water rinse, 3 minutes surgical scrub with a sterile one-use chlorhexidine scrub and alternate passage of alcohol and 2% chlorhexidine solution (7 minutes; n = 32) was compared with a 3 minutes abbreviated preoperative protocol, consisting of two 90 seconds period of cleansing scrub and 3 passages of 0.5% chlorhexidine gluconate in 70% in isopropyl alcohol solution (4 minutes; n = 32). Pre- and postoperative skin bacterial counts and clinical assessment of wounds 10–15 days after surgery, as well as standardized interview with the producers focused on wound infection 30 days after the surgery were used to compare both protocols. Results There was no difference between protocols for absolute colony forming units (CFU) and percentage CFU reduction perioperatively as well as for surgical wound clinical score 10–15 days after the surgery. The infection rate at 30 days was 10.5% (6/57) but no significant difference was observed between protocols 10% (3/30) versus 11.5% (3/27). Conclusions An abbreviated preoperative protocol using nonsterile reusable material can be as effective as a standard protocol using sterile one-use brush in reducing skin microflora and preventing surgical wound infection.OBJECTIVE To compare 2 preoperative surgical site protocols for standing laparotomy in cattle in a field setting. STUDY DESIGN Cohort study. ANIMALS Dairy cows (n = 73) undergoing a clean standing laparotomy (no visceral perforation during surgery). METHODS Cows were randomly assigned to 1 of 2 preoperative skin-preparations protocols with chlorhexidine used as an antiseptic. A standard protocol (3 minutes [min] cleansing scrub, tap water rinse, 3 minutes surgical scrub with a sterile one-use chlorhexidine scrub and alternate passage of alcohol and 2% chlorhexidine solution (7 minutes; n = 32) was compared with a 3 minutes abbreviated preoperative protocol, consisting of two 90 seconds period of cleansing scrub and 3 passages of 0.5% chlorhexidine gluconate in 70% in isopropyl alcohol solution (4 minutes; n = 32). Pre- and postoperative skin bacterial counts and clinical assessment of wounds 10-15 days after surgery, as well as standardized interview with the producers focused on wound infection 30 days after the surgery were used to compare both protocols. RESULTS There was no difference between protocols for absolute colony forming units (CFU) and percentage CFU reduction perioperatively as well as for surgical wound clinical score 10-15 days after the surgery. The infection rate at 30 days was 10.5% (6/57) but no significant difference was observed between protocols 10% (3/30) versus 11.5% (3/27). CONCLUSIONS An abbreviated preoperative protocol using nonsterile reusable material can be as effective as a standard protocol using sterile one-use brush in reducing skin microflora and preventing surgical wound infection.