Studies: Clinical and Diagnostic
Skills (22)
Updated: 22 Dec. 2006
Abutarbush Sameeh M., Naylor Jonathan M., Parchoma Gale, D'Eon Marcel, Petrie Lyall & Carruthers Terry. Evaluation of traditional instruction versus a self-learning computer module in teaching veterinary students how to pass a nasogastric tube in the horse. Journal of Veterinary Medical Education 2006;33(3):447-54. Correspondence: sameeh75@hotmail.com.
Objective – To evaluate the effectiveness of a self-learning computer module (SLCM) versus traditional instruction in teaching how to pass a nasogastric tube (NG) in the horse.
Design – a double-blind, monocentric study.
Sample population – 52 third-year students in the DVM program were randomly assigned to two groups: traditional instruction (N = 25) or SLCM instruction (N = 27).
Procedure – Traditional instruction consisted of an instructor and live demonstration; SCLM students were given a CD-ROM each. Both sessions lasted one hour. The students were then united in one session to practice passing the NG tube. Their performance was videotaped and evaluated by two evaluators. Students were then given a multiple-choice knowledge quiz. One week later, a second demonstration of the same procedure by the two methods was administered, and students were allowed to choose either method of instruction. A Likert-scale questionnaire about their comfort, their confidence, and the appropriateness of the teaching method was given after the second demonstration. Data were analyzed by non-parametric tests. A focus-group study was conducted to determine students’ perception of each teaching method. Nine participants in the experiment volunteered for these focus-group sessions. The sessions were audiotaped and transcribed.
Results – Students in the SLCM group performed significantly better on the test of knowledge than traditionally instructed students. The questionnaire found significant perceived benefits to computer-based instruction, including a preference for the computer-based module, better learning, and greater preparedness. In hands-on skill, time to pass the NG tube on the successful attempt was significantly shorter in the SLCM group than in the traditionally instructed group. The data from focus-group sessions suggest that while participants expressed satisfaction with both modes of instruction, the SLCM group reported somewhat higher levels of confidence in their skills prior to performing the procedure. Whereas the traditional group reported a strong preference for continued live demonstrations of the procedure, the SLCM group stated that the computer-assisted module alone provided them with effective instruction.
Conclusion – computer-assisted learning is an acceptable and effective method of training students to pass an NG tube with potential welfare, proficiency, and knowledge advantages.
Baillie, S.; Crossan, A.; Reid, S.; Brewster, S. Preliminary development and evaluation of a bovine rectal palpation simulator for training veterinary students. Cattle Practice. British Cattle Veterinary Association, Frampton-on-Severn, UK: 2003. 11: 2, 101-106. 8 ref.
A computer based teaching tool has been developed using haptic technology to train veterinary students to examine the bovine reproductive tract, simulating rectal palpation. The student receives touch feedback from a haptic device while palpating virtual objects. The teacher can visualise the student's actions on a screen and give training and guidance. The teaching protocol is divided into several levels to support the progressive development of skills. Preclinical students are trained to orientate themselves in the three dimensional anatomical environment, to develop the correct exploratory technique and to identify key structures. More experienced students can be trained to reinforce, and further develop, existing skills. The properties of the virtual scene were assessed by veterinary surgeons. Evaluation of the teaching tool was conducted with fourteen veterinary students. After being trained with the device, each student carried out rectal examinations and assessed the effect of haptic training. The evaluation results, although preliminary, support haptic training as a possible method for enhancing the teaching of bovine rectal palpation.
Baillie S. Crossan A. Brewster S. Mellor D. Reid S Validation of a bovine rectal palpation simulator for training veterinary students. Studies in Health Technology & Informatics 2005. 111:33-6.
Bovine rectal palpation is a necessary skill for a veterinary student to learn. However, lack of resources and welfare issues currently restrict the amount of training available to students in this procedure. Here we present a virtual reality based teaching tool -- the Bovine Rectal Palpation Simulator -- that has been developed as a supplement to existing training methods. When using the simulator, the student palpates virtual objects representing the bovine reproductive tract, receiving feedback from a PHANToM haptic device (inside a fibreglass model of a cow), while the teacher follows the student's actions on the monitor and gives instruction. We present a validation experiment that compares the performance of a group of traditionally trained students with a group whose training was supplemented with a simulator training session. The subsequent performance in the real task, when examining cows for the first time, was assessed with the results showing a significantly better performance for the simulator group.
Baillie S. Mellor DJ. Brewster SA. Reid SW. Integrating a bovine rectal palpation simulator into an undergraduate veterinary curriculum. Journal of Veterinary Medical Education 2005. 32(1):79-85.
There are problems associated with teaching bovine rectal palpation to undergraduate veterinary students. The students need opportunities to examine enough cows to develop the required skills, but increasing student numbers and limitations on access to cows have made this more and more difficult to achieve. A virtual reality-based teaching tool, the Bovine Rectal Palpation Simulator, has been developed as a supplement to existing training methods. The student palpates computer generated virtual models of the bovine reproductive tract while interacting with a haptic (touch feedback) device. During training sessions, the instructor follows the student's actions inside the virtual cow on the computer screen and gives instruction. A trial integration of the simulator into the fourth-year bovine reproduction course was undertaken at the University of Glasgow Veterinary School during the 2003/2004 academic year. Students were offered two training sessions, and feedback was gathered using questionnaires. In the first session, all students were taught a range of basic skills using a standardized teaching protocol. The second training session was customized to each student's learning needs and included practice in dealing with a range of on-farm scenarios. Student feedback indicated that the training had been useful for learning various aspects of bovine rectal palpation and provided information that helped in the further development of the simulator as a teaching tool.
Bowman, K. F. Adair, H. S. Goble, D. O. Roberts, M. C. Swanson, C. R. Development of an interactive video program (Lamexam) for the diagnosis of lameness in the horse. [Abstract only. Conference paper] Veterinary Surgery. 1994. 23: 5, 396-397.
Bowman, K. F. Vasu, E. S. Roberts, M. C. Adair, H. S. Goble, D. O. Evaluation of instructional videotape versus lecture for teaching principles of equine lameness examination to veterinary medical students. [Abstract only. Conference paper] Veterinary Surgery. 1994. 23: 5, 397.
Branch, C. E. Robertson, B. T. Interactive video disc simulated animal experiments: heart sounds and murmurs in the dog. [Journal article] Journal of Veterinary Medical Education. 1986. 13: 1, 19-21. 3 ref.
Bunch, S. E. Hawkins, E. C. Hudson, L. C. Abrams, C. F. Development of a device to teach abdominal palpation skills to veterinary students. [Abstract only. Conference paper] Veterinary Surgery. 1994. 23: 5, 398.
Burns JP, Reardon FE, Truog RD. Using newly deceased patients to teach resuscitation procedures. New England Journal of Medicine 1994;331(24):1652-1655.
Frey, R. Paschmionka, B. Construction
of a realistic dummy for instruction of obstetrical procedures on calves.
[German] Tierarztliche Praxis. 1997. 24: 6, 542-548. 3 ref.
Galle U & Bubna-Littitz H. Model for teaching venous puncture techniques in the dog. Possibility for reducing stress to living experimental animals in student teaching. [German] Zentralblatt fur Veterinarmedizin, A 1983;30(10):796-9.
For obtaining practice in intravenous injection or bleeding in the dog a practice model is described which has given good results. A formalin-fixed preparation of a canine extremity in which the cephalic vein is replaced by a silicon tube is simple and cheap to set up and has the advantage of simulating the living animal. Using this model, the correct technique for injection and the reduced number of venous puncture attempts in the live animal can reduce to a minimum the stress imposed on experimental dogs.
Hansen B.D. An alternative model for teaching emergency procedures. Journal of Veterinary Medical Education 2003;30(3):270-3. North Carolina State University College of Veterinary Medicine, 4700 Hillsborough Street, Raleigh, NC 27606, USA. bernie_hansen@ncsu.edu
Emergency/critical care is a new veterinary specialty that poses special challenges in veterinary education. Traditional methods of teaching emergency procedures in the teaching hospital place novices in a high-stress, high-stakes environment not conducive to learning or to optimum patient care. Our innovative emergency-procedures laboratory enables students to acquire a high degree of proficiency, in a realistic setting, with focused, controlled instruction and practice, replicable in schools with or without emergency/critical care facilities.
Hawkins EC, Hansen B & Bunch BL. Use of animation-enhanced video clips for teaching abnormal breathing patterns. Journal of Veterinary Medical Education (Special issue: Continuing veterinary education) 2003;30(1):73-7.
The ability to characterize disease of the respiratory tract accurately based on breathing, pattern is helpful for the development of differential diagnoses and an efficient diagnostic plan and critical for the stabilization of patients in respiratory distress. Veterinary students do not have sufficient clinical experience to observe personally all types of respiratory diseases and their resultant abnormal breathing patterns. We developed a teaching tool, the animated breathing pattern videotape (ABV), to fill this gap. The ABV is a collection of video clips of small animal patients with normal and abnormal breathing patterns on a conventional videotape of approximately 20 minutes duration. Each video clip is shown for 20 to 40 seconds, followed by the same clip with superimposed animation of rib and diaphragm motion, followed by the initial clip again, without overlying animation. The ABV has since been used in teaching, third-year veterinary students, interns, residents, practicing veterinarians, and veterinary technicians. Student evaluations and responses to questionnaires by interns, residents, practicing veterinarians, veterinary technicians, and peer reviewers have been uniformly positive.
Kraft SL, Hoskinson JJ, Mussman JM, Michaels WE, McLaughlin R, Gaughan EM, Roush JK. Development of interactive patient-based multimedia computer programs in veterinary orthopedic radiology. Veterinary Radiology and Ultrasound 1998 Mar-Apr;39(2):98-104.
Long RE. Using simulation to teach resuscitation: an important patient safety tool. Critical Care Nursing Clinics of North America. 2005 Mar; 17(1): 1-8. (26 ref)
Learning resuscitation scenarios using high-fidelity simulation can have a positive impact on real-life learning for health care professionals. Simulation sessions encourage knowledge acquisition and critical thinking for nursing students, experienced nurses, nurse anesthetists, physicians, and respiratory therapists. A novice to expert theoretical perspective can be accomplished without anxiety over scenario outcome. Results of educational endeavors support simulation use, but continued research is needed to substantiate learner outcome and technologic value.
Musselman, E.
E. Grimes, G. M. Teaching recognition of normal and abnormal heart sounds using
computer-assisted instruction. [Journal article] Journal of Veterinary
Medical Education. 1976. 3: 1, 9-12. 4 ref.
Phillips C, Henderson PJ, Mandel L, Kim S, Schaad D, Cooper M, Bien C, Orkand A,
Wener MH, Fine JS, Astion ML. Teaching the microscopic examination of urine
sediment to second year medical students using the Urinalysis-Tutor computer
program. Clinical Chemistry 1998 Aug;44(8 Pt 1):1692-1700. Department of
Laboratory Medicine, University of Washington, Seattle 98195, USA. Full Text:
http://www.clinchem.org/cgi/reprint/44/8/1692.pdf.
The microscopic examination of urine sediment is a common diagnostic tool taught
to medical students, medical technologists, and others. The urine microscopic
exam is difficult to teach because supervised instruction and textbook-based
teaching suffer from numerous drawbacks. Here, we describe Urinalysis-Tutor, a
computer program that uses digitized microscope images and computer-based
teaching techniques to systematically teach the urine microscopic exam. In
addition, we report the results of a 2-year study that evaluated the
effectiveness of the program in 314 second year medical students who were
required to use the program. The program contained two, 20-question exams. In
the first year of the study (1996), one of the exams was chosen as the pretest
and the other as the posttest; the pretest had to be completed before the
students viewed the contents of the program, and the posttest was taken after
finishing the tutorial. In 1997, the order of the two exams was reversed. In
1996, 159 students completed the study. The mean pretest score was 34% (SD,
14%), the mean posttest score was 71% (SD, 13%), and the improvement was
significant (P <0.001, paired t-test). In 1997, 155 students participated. The
mean pretest score was 41% (SD, 11%), the mean posttest score was 71% (SD, 13%),
and the improvement was significant (P <0.001, paired t-test). The study shows
that Urinalysis-Tutor helps medical students learn to interpret the microscopic
appearance of urine sediment and that it is feasible to implement this tutorial
in a medical school class.
Reid JDS, Vestrup JA. Use of a simulation to teach central venous access. Journal of Medical Education 1986;61:196-197.
Scalese Ross J. & Issenberg S. Barry. Effective use of simulations for the teaching and acquisition of veterinary professional and clinical skills. Journal of Veterinary Medical Education 2005;32(4):461-7.
Simulation technology will feature prominently in this exciting, yet challenging, time for veterinary medicine. The profession is evolving to keep pace with rapid changes in clinical practice, scientific discovery, and educational strategy, while ensuring that it follows the public mandate to produce competent veterinarians. Among the challenges to meeting this educational goal are limitations—due to important issues such as animal welfare—on the availability of real patients for training. Drawing chiefly on the experience in human medicine, this article explores the use of simulations in veterinary medical education to provide safe and ethical alternative opportunities for learners to practice essential clinical and professional skills.
Simpson RM & Meuten DJ. Development of a teaching laboratory aid for instruction of fine needle aspiration biopsy cytology technique. Veterinary Clinical Pathology 1992;21(2):40-4.
An aspiration biopsy cytology teaching aid was developed by placing portions of fresh organ tissue from routine submissions to the pathology laboratory into a specimen container partially filled with chilled normal saline solution. Specimens were stored immersed in saline at 4 degrees C for up to 48 h. Prior to the cytopathology teaching laboratory period, the specimen container was removed from storage and covered with a latex diaphragm. Instructors responsible for teaching cytodiagnostic techniques used this ex vivo aspiration biopsy cytology device for instruction of fine needle aspiration biopsy, specimen processing, and microscopy. In the teaching laboratory, puncture of the diaphragm and aspiration of a tissue sample with hypodermic needle and syringe was instructed to, and practiced by, numerous trainees simultaneously using clinical operative technique without the need for live animals. Trainees prepared and stained cytology smears as well as evaluated and interpreted specimens in a single, realistic exercise. It was concluded such training experience may improve ability of trainees to procure diagnostic-quality biopsy specimens for cytodiagnosis of lesions from clinical patients.
Wood, A. K. W. Dadd, M. J. Lublin, J. A computer assisted learning program for improving student learning of diagnostic ultrasound equipment. [Abstract only] Veterinary Radiology & Ultrasound. 1993. 34: 6, 456.
