Lawrence N. Hill

Frequency of use and proficiency in performance of surgical skills expected of entry-level veterinarians by general practitioners

OBJECTIVE To identify a list of core surgical skills and determine the frequency of use and proficiency in performance of these skills expected of entry-level veterinarians by general practitioners. DESIGN Mail-based survey. SAMPLE 750 general practitioners randomly chosen from the AVMA membership database. PROCEDURES Survey respondents rated the proficiency and frequency of use expected of entry-level veterinarians in regard to 26 surgical skills. Demographic information (gender; graduation year; practice type, geographic location, and setting; number of veterinarians in practice; number of surgical procedures performed per week; and number of new graduates mentored in the past 5 years) of respondents was obtained. RESULTS 387 (52%) general practitioners responded to the survey. Greater than 60% of respondents expected new graduates to have high proficiency and require minimal supervision for 21 of 26 skills. Greater than 60% of respondents assigned 6 of the skills a low expected frequency of use rating. Orthopedic skills, creation of square knots by use of a 1-handed tie technique, and use of electrosurgical and laser instruments received some of the lowest ratings. CONCLUSIONS AND CLINICAL RELEVANCE Core surgical skills were identified. Results indicated a broad consensus among general practitioners independent of demographic characteristics. Results may aid veterinary colleges in identification of the surgical skills that are most important to include in surgical curricula and for which new graduates should attain proficiency according to general practitioners.

Expected Frequency of Use and Proficiency of Core Surgical Skills in Entry‐Level Veterinary Practice: 2009 ACVS Core Surgical Skills Diplomate Survey Results

Objectives ACVS Diplomates were surveyed to identify a complete list of core surgical skills, determine the expected frequency of use of these skills, and ascertain the level of skills proficiency expected of entry-level practicing veterinarians. Study Design Internet-based survey. Sample Population Randomly chosen ACVS Diplomates (n = 750). Methods Rating scale items were used to construct the main portion of the survey with 26 skills that were scored by participants based on rankings of proficiency expected of entry-level veterinarians, as well as expected frequency of use of these skills. Additional demographic questions were included to gather information regarding gender, practice type, year of veterinary school, year of ACVS membership, job description, primary surgical discipline, practice location, average number of procedures performed on a weekly basis, and number of new graduates mentored in the last 5 years. Results Of 337 Diplomates (44.9%) who responded to the survey, >60% expected entry-level graduates to have good skills with minimal supervision or complete skills for 21 of the 26 skills categories listed. More than 60% of respondents ranked 7 skills with a lower frequency score (seldom or occasionally use). Orthopedic instrument handling and fixation skills as well as electrosurgical and laser skills received some of the lowest expected proficiency and frequency rankings. No additional skills categories were identified in the open-ended survey questions. Conclusions A complete list of core surgical skills was identified. There was broad consensus between boarded surgeons irrespective of their practice type, experience, or discipline for ranked proficiency and frequency scores among the core surgical skills expected of entry-level veterinarians.OBJECTIVES ACVS Diplomates were surveyed to identify a complete list of core surgical skills, determine the expected frequency of use of these skills, and ascertain the level of skills proficiency expected of entry-level practicing veterinarians. STUDY DESIGN Internet-based survey. SAMPLE POPULATION Randomly chosen ACVS Diplomates (n = 750). METHODS Rating scale items were used to construct the main portion of the survey with 26 skills that were scored by participants based on rankings of proficiency expected of entry-level veterinarians, as well as expected frequency of use of these skills. Additional demographic questions were included to gather information regarding gender, practice type, year of veterinary school, year of ACVS membership, job description, primary surgical discipline, practice location, average number of procedures performed on a weekly basis, and number of new graduates mentored in the last 5 years. RESULTS Of 337 Diplomates (44.9%) who responded to the survey, >60% expected entry-level graduates to have good skills with minimal supervision or complete skills for 21 of the 26 skills categories listed. More than 60% of respondents ranked 7 skills with a lower frequency score (seldom or occasionally use). Orthopedic instrument handling and fixation skills as well as electrosurgical and laser skills received some of the lowest expected proficiency and frequency rankings. No additional skills categories were identified in the open-ended survey questions. CONCLUSIONS A complete list of core surgical skills was identified. There was broad consensus between boarded surgeons irrespective of their practice type, experience, or discipline for ranked proficiency and frequency scores among the core surgical skills expected of entry-level veterinarians.

Intra- and interobserver variability of board-certified veterinary radiologists and veterinary general practitioners for pulmonary nodule detection in standard and inverted display mode images of digital thoracic radiographs of dogs.

OBJECTIVE To determine intra- and interobserver variability of 2 veterinary radiologists and 2 veterinary general practitioners for detection of pulmonary nodules in standard and inverted (reversed grayscale) displays of digital thoracic radiographs of dogs. DESIGN Evaluation study. SAMPLE 114 sets of 3-view (right lateral, left lateral, and ventrodorsal or dorsoventral views) digital thoracic radiographs from 114 dogs. PROCEDURES 2 experienced board-certified veterinary radiologists and 2 experienced veterinary general practitioners individually evaluated 114 randomized sets of radiographs. Pulmonary nodules were present in radiographs of 60 of 114 dogs. Each reviewer examined all images in standard or inverted display mode and scored nodule detection on a confidence scale of 1 to 5. After ≥ 2 months, the same individuals evaluated the same images in the remaining display mode. Intraobserver agreement for each display mode was determined via a κ statistic; results between the 2 groups of reviewers were compared via receiver operator curve analysis. RESULTS There was no significant intraobserver variability in pulmonary nodule detection between the 2 display modes. Detection accuracy for board-certified radiologists was significantly greater than that of veterinary general practitioners for both display modes. Near-perfect intraobserver agreement was detected between the 2 display modes for board-certified radiologists, whereas moderate to slight intraobserver agreement was detected for the veterinary general practitioners. CONCLUSIONS AND CLINICAL RELEVANCE Detection of pulmonary nodules in digital thoracic radiographs was comparable, whether a standard or inverted mode was used for evaluations. However, the board-certified radiologists had greater detection accuracy than did veterinary general practitioners.

Fostering the Human-Animal Bond for Older Adults: Challenges and Opportunities

Older adults are at high risk for physical illness and emotional disorders, particularly those of lower socioeconomic status. Pet ownership has the potential to reduce the impact of these problems by providing companionship, reducing social isolation, and enhancing physical activity and well-being. Despite these potential benefits, older adults face challenges in adopting and owning pets, including functional limitations, financial considerations, and concerns should the pet owner fall ill or die. In this article, the authors detail the literature on pet ownership for older adults, hurdles they face in adopting pets, and steps that could be taken to address these challenges.