India F. Lane

Candida spp. Urinary Tract Infections in 13 Dogs and Seven Cats: Predisposing Factors, Treatment, and Outcome

Records from 20 animals (13 dogs, seven cats) with Candida spp. urinary tract infections were reviewed. Six Candida spp. were isolated; Candida albicans was the most common isolate. Concurrent diseases or nonantifungal drugs administered within 1 month of isolation included antibiotics (n=16), corticosteroids (n=6), diabetes mellitus (n=4), nonurogenital neoplasia (n=3), and noncandidal urogenital disease (n=14). All animals had sources of local or systemic immune compromise that likely predisposed to infection. Of five animals with resolution of infection, three did not receive specific antifungal treatment. The authors conclude that correction of predisposing conditions is likely critical for management of Candida spp. urinary tract infection.

Diagnosis and management of urinary retention.

Failure to empty the urinary bladder completely can be attributed to failure of detrusor contractile function, inappropriate outlet resistance, or both. For each of these mechanisms, anatomic, neurogenic, and end-organ (myogenic or idiopathic) abnormalities are possible. The approach to urinary retention involves systematic consideration of neurogenic, obstructive, and functional causes and requires understanding of the neurophysiology and pharmacology of micturation.

Professional competencies in health sciences education: from multiple intelligences to the clinic floor

Nontechnical competencies identified as essential to the health professional’s success include ethical behavior, interpersonal, self-management, leadership, business, and thinking competencies. The literature regarding such diverse topics, and the literature regarding “professional success” is extensive and wide-ranging, crossing educational, psychological, business, medical and vocational fields of study. This review is designed to introduce ways of viewing nontechnical competence from the psychology of human capacity to current perspectives, initiatives and needs in practice. After an introduction to the tensions inherent in educating individuals for both biomedical competency and “bedside” or “cageside” manner, the paper presents a brief overview of the major lines of inquiry into intelligence theory and how theories of multiple intelligences can build a foundation for conceptualizing professional and life skills. The discussion then moves from broad concepts of intelligence to more specific workplace skill sets, with an emphasis on professional medical education. This section introduces the research on noncognitive variables in various disciplines, the growing emphasis on competency based education, and the SKA movement in veterinary education. The next section presents the evidence that nontechnical, noncognitive or humanistic skills influence achievement in academic settings, medical education and clinical performance, as well as the challenges faced when educational priorities must be made.

Faculty perspectives regarding the importance and place of nontechnical competencies in veterinary medical education at five North American colleges of veterinary medicine

OBJECTIVE To explore perceptions of faculty educators regarding the importance of nontechnical competencies in veterinary graduates and the placement of nontechnical competency development in veterinary education. DESIGN Survey. SAMPLE POPULATION All faculty members at 5 North American veterinary medical institutions. PROCEDURES Participants rated the importance of 14 nontechnical competencies and indicated in which phase or phases of veterinary education such competencies should be developed (ie, curriculum placement). Differences in mean ratings were statistically evaluated, as were associations between ratings or curriculum placement and respondent institution, gender, experience, and discipline. RESULTS Mean ratings of importance were above neutral for all competencies and were highest for ethical, critical thinking, and interpersonal and intrapersonal competencies; development of these competencies was favored in preveterinary and veterinary training. Ratings were lower for management and business competencies; development of these and other competencies was placed primarily in the clinical phase of the veterinary curriculum. Basic science, nonveterinarian, and junior faculty appeared to more strongly appreciate the importance of nontechnical skills, whereas large animal and midcareer faculty reported a more reserved degree of support. Female faculty were more likely to place nontechnical competency development throughout the educational process. CONCLUSIONS AND CLINICAL RELEVANCE Participants agreed nontechnical competencies are important for veterinary graduates; however, faculty perceptions differed from previously published findings regarding the relative importance of business and management skills. Those involved in faculty hiring, faculty development, and curricular planning should also be aware of disciplinary and career stage differences affecting faculty perspectives.

99mTc-DTPA diuretic renal scintigraphy in cats with nephroureterolithiasis

The purpose of this study was to evaluate results of diuretic renal scintigraphy in 32 feline kidneys with nephroureterolithiasis and variable degrees of renal pelvis/ureteral dilation. Six kidneys showed a non-obstructive scintigraphic pattern, with a downward slope of time-activity curves (TAC) and a median excretion half-time of radiopharmaceutical (T½) of 6.09 (5.08–8.43) min. Eight kidneys showed an obstructive pattern, with a continuous rise of TAC and median T½ of −7.91 (−43.13–0.00) min. In one kidney with presumptive partial obstruction scintigraphic results were equivocal. Seventeen kidneys, most of which had an individual kidney glomerular filtration rate below 0.5 ml/min/kg, had non-diagnostic studies. Diuretic renal scintigraphy may be a useful adjunct modality in the diagnosis of ureteral obstruction in some cats if renal function is maintained. However, the large number of non-diagnostic studies in animals with decreased renal function represents a clear limitation of the technique.

Perceptions of Veterinary Faculty Members Regarding Their Responsibility and Preparation to Teach Non-technical Competencies

The development of non-technical competencies has become an important component of veterinary education. In this study, we determined faculty perspectives regarding their perceived involvement and ability in the cultivation of these competencies. A survey was administered to faculty members at five institutions. Respondents were asked whether the competency should be taught in their own courses and how prepared they felt to teach and evaluate the competency. Responses were analyzed by participant institution, gender, terminal degree and year, discipline, rank, and teaching experience. More than 90% of faculty respondents reported a personal responsibility to teach or cultivate critical thinking skills, communication skills, self-development skills, and ethical skills, with more than 85% also agreeing to a role in skills such as interpersonal skills, creativity, and self-management. The lowest percentages were seen for crisis and incident management (64%) and business skills (56%). Perceived preparedness to teach and evaluate these competencies paralleled the preceding findings, especially for the four consensus competencies and self-management. Faculty preparedness was lowest for business skills. Junior faculty were somewhat less likely than others to perceive a responsibility to teach non-technical competencies; however, instructors were more prepared to teach and evaluate business skills than were other faculty. Institutional trends were evident in faculty preparation. Although male faculty and non-DVM faculty tended to report a higher degree of preparedness, few differences reached statistical significance. Faculty perceptions of their responsibility to teach non-technical competencies vary by competency and parallel their perceived preparedness to teach and evaluate them.

Qualitative urinalyses in puppies 0 to 24 weeks of age.

Suggestions for interpreting qualitative urinalyses from puppies have been based on limited results obtained in the laboratory setting. Proteinuria, glucosuria, and decreased concentration of urine have been considered normal in puppies <8 weeks of age due to immature renal function. In this study, the authors reviewed 149 voided urine samples from 118 different, apparently healthy, random-source puppies. The primary finding was that mean urine specific gravity (USG) was significantly lower in 0- to 3-week-old puppies when compared to puppies 4 to 24 weeks old. Mean USG in all other age groups was >1.030. There was no difference in the frequency of positive protein or occult blood dipstick results among age groups, and there were no positive glucose, ketone, bilirubin, or urobilinogen reactions in any samples analyzed. Urine sediment results are reported for 41 samples. Epithelial cells and white blood cells were the most common sediment findings in these 41 voided samples, observed in 34 (83%) and 18 (44%) samples, respectively. Crystals were observed in 15 (37%) samples, whereas casts, bacteria, and red blood cells were observed less commonly.

Making the Most of Five Minutes: The Clinical Teaching Moment

Clinical educators face the challenge of simultaneously caring for patients and teaching learners, often with an unpredictable caseload and learners of varied abilities. They also often have little control over the organization of their time. Effective clinical teaching must encourage student participation, problem solving, integration of basic and clinical knowledge, and deliberate practice. Close supervision and timely feedback are also essential. Just as one develops an effective lecture through training and practice, clinical teaching effectiveness may also be improved by using specific skills to teach in small increments. The purpose of this paper is to identify potential teachable moments and to describe efficient instructional methods to use in the clinical setting under time constraints. These techniques include asking better questions, performing focused observations, thinking aloud, and modeling reflection. Different frameworks for teaching encounters during case presentations can be selected according to learner ability and available time. These methods include modeling and deconstructing the concrete experience; guiding the thinking and reflecting process; and providing the setting and opportunity for active practice. Use of these educational strategies encourages the learner to acquire knowledge, clinical reasoning, and technical skills, and also values, attitudes, and professional judgment.

Teaching Tip: Making the Most of Hospital Rounds

Effective clinical teaching rounds are facilitated by adequate and specific orientation, a positive climate, interpersonal rapport, and dynamic discussions. Using fewer and better-quality questions also promotes effective learning and saves valuable time, while providing multiple opportunities for student engagement and for assessing student performance. This paper provides a brief review of these key points and offers tips and examples for clinicians or other team members leading conference room rounds sessions in veterinary settings.

Linking Veterinary and Human Public Health Education: Collaborations at the University of Tennessee

The increasing demand for veterinarians in public health has created an environment for innovative educational approaches, providing opportunities for veterinary students to gain additional education in public health. At the University of Tennessee, this environment has enabled a collaboration between the College of Veterinary Medicine and the College of Education, Health, and Human Sciences to establish a veterinary concentration in an existing Master of Public Health degree program. The veterinary public-health concentration was approved in 2004. In addition, other courses and initiatives have been developed at the College of Veterinary Medicine, creating stronger collaborations with academic units and public-health professionals.