Batteries not included: teaching clinical skills in veterinary education

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On the Royal (Dick) School of Veterinary Studies’ Bachelor of Veterinary Medicine and Surgery undergraduate programme, clinical skills are an essential component. 

“When we talk about undergraduate veterinary education,” says Caroline Mosley, Lecturer in Clinical Skills, “we’re talking about a very comprehensive programme of study that takes students from their first day of university through to being a fully qualified, practising vet at graduation. In the five years they are with us, they will gain an incredible amount of knowledge and skill across a very wide range of areas. In the Clinical Skills portion of the degree, what we aim to do is provide them with the hands-on skills they will need to be able to practise as a vet, applied and rehearsed in such a way that they become second nature.” 

These hands-on clinical skills vary from animal handling to surgical procedures, and students begin to explore them from day one in a safe, welfare-focused environment. “One of the first classes our students have is animal handling, using temperament-tested dogs that belong to staff. We do this right at the start of the programme so that students can develop a foundational confidence that will support them as they progress through the curriculum,” says Caroline.  

Advanced and unusual models 

For more complex techniques, live animals are not used. Caroline explains: “We put animal welfare first in all of our teaching. We would never put an animal through an unnecessary, distressing or painful procedure. Our teaching animals love the attention they get in the handling classes, when students are feeling for a pulse or looking at teeth, but we would never use a live animal for students to practise invasive veterinary techniques on.” 

To replace live animal subjects, the Clinical Skills team have a remarkable range of models that enable students to ‘learn by doing’ in a safe and cruelty-free environment. “We have mannequins and models for everything you can imagine,” says Caroline. “From equine colic simulators to limbs to practise injections on or dogs to catheterise – you name it, we’ve bought it or built it. Our Digital Education Unit even helped create a model that allowed us to measure blood pressure, which was ingenious.” 

Rehearsing skills 

Some of the skills vets need to develop are ostensibly small things that have a huge impact. “In addition to bandaging, suturing, using ophthalmoscopes, some of the really simple things that students learn with us will transform their practice. For example, developing the muscle memory to be able to hold a syringe in place and draw down on the plunger simultaneously, one-handed. You cannot insert a syringe into an animal and then let go of it – it must be done in a single action. It takes a lot of practise to perfect, but it’s a skill every vet needs.” 

In 2019, the School opened the Jill Bradley Self-Directed Learning Space, directly next to the Clinical Skills Lab. This allows students to practise their clinical skills outside of class. “Students working towards practical exams can put in as much time as they feel necessary to prepare themselves. The Clinical Skills Lab is used by all year groups, so it’s in constant use. The creation of the Self-Directed Learning Space changed the way our students can rehearse their skills and become as confident as they can be.” 

Clinical exams during the pandemic 

In their penultimate year, students will take their Objective Structure Clinical Exams (OSCEs). These cover Prescribing, Medicine, Surgery, Anaesthesia, Emergency and Critical Care, Farm Animal, Equine, Diagnostic Imaging and Clinical Pathology. The results of OSCE exams count for 10% of their final grade across the whole programme.  

In 2020, the exams had to be postponed due to lockdown, and taken later in the year. They also had to be adapted to ensure the safety of staff and students. Normally, OSCEs involve nine stations, each with an examiner who observes students carrying out a practical task. Due to restrictions on space and time, the exam was redesigned to allow for one skill to be assessed online and the remaining eight were filmed and then analysed by lecturers from remote locations. This enabled the skills to be fairly and safely examined and students to be able to fulfil their requirements for accreditation.  

“Ultimately, we are teaching students how to practise veterinary medicine, and that involves a fantastic amount of practical knowhow. By embedding clinical skills throughout the curriculum and making sure they have the confidence to handle animals and equipment, as well as undertake procedures, we’re giving them the ability to walk into their first job prepared for practice.” 

Find out more about the BVM&S programme: https://www.ed.ac.uk/vet/studying/undergraduate