Acknowledgment v
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice) and Teresa Graham Brett, JD
Dedication vii
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice) and Teresa Graham Brett, JD
About the Authors xxv
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice) and Teresa Graham Brett, JD
Preface xxvii
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice) and Teresa Graham Brett, JD
About the Companion Website xxxii
[PRINTED BOOK]
PART 1 BUILDING A CASE FOR COMMUNICATION SKILLS TRAINING IN VETERINARY CURRICULA
1 Tracking the Perceived Need for Clinical Communication Training in Veterinary Medicine Over Time: Bridging the Gaps Between Education and Practice 3
1.1 The Case for Communication in Human Healthcare Curricula, 3
1.2 Pushback Against the Introduction of Communication Training to Veterinary Medical Education, 4
1.3 Turning the Tide: The Pew Report, 4
1.4 Acknowledging and Addressing Income Stagnation: The Brakke Study, 5
1.5 The State of the Veterinary Profession's Economic Health: The KPMG Study, 5
1.6 The Establishment of the National Commission on Veterinary Economic Issues, 6
1.7 Actions Taken by Other Stakeholders, 6
1.8 Additional Evidence for Communication Training in Veterinary Education, 9
1.9 The Roadmap for Veterinary Education, 10
1.10 The Push for Outcomes Assessment Gets Stronger, 10
1.11 Concerns About New Graduates' Lack of Confidence Persist: Reactions and Actions Taken, 10
1.12 Multiple Accrediting Bodies Accept the Evidence and Require Communication Training, 11
1.13 What's Next in Veterinary Medical Education?, 14
2 Understanding Self Before Understanding Others: Developing Awareness of Personal and Professional Identities 19
2.1 Relationship-centered Care in Veterinary Medicine, 20
2.2 Frames of Reference, 21
2.3 Identity as a Whole, 24
2.4 The Role of Professional Identity Formation in Understanding Self, 24
2.5 Integrating Personal, Social, and Professional Identities to Build Capacity for Culturally Responsive Care, 26
3 Interacting With Others in Healthcare: Mitigating Bias and Acknowledging the Effects of Expectations, Perceptions, and Assumptions on Framing Care and Forward Planning 32
3.1 Interpersonal Communication, Dialogic Communication, and Intergroup Interactions in Healthcare, 32
3.2 Adaptive Unconscious and Implicit/Explicit Learning, 42
3.3 Implicit Assumptions, Categorization, and Bias in Healthcare, 45
3.4 Malleability of Implicit Bias, 46
3.5 Moving From Reaction to Response, 50
3.6 Intent and Impact Are Not Always the Same, 51
3.7 Intent and Impact in Healthcare Settings, 53
3.8 A Brief Examination of Feedback, 54
3.9 Post-simulation Feedback and the Potential for Discrepancies Between the Learner's Experience and the Simulated Client's, 54
4 Viewing Communication Through Another's Lens: Which Communication Skills Do Canine and Feline Caregivers Prioritize? 62
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)
4.1 The Evolving Human¢"Animal Bond, 62
4.2 Four Foundational Communication Skills: RENO, 64
4.3 Expanding the Communication Toolbox: TONERR, 72
4.4 Towards a Deeper Understanding of Dog-owner and Cat-owner Communication Preferences, 75
4.5 Cost of Care-related Communication Preferences, 79
4.6 Communication Preferences of Cat and Dog Breeders, 81
4.7 Concluding Thoughts, 84
5 Viewing Communication Through Another's Lens: Which Communication Skills Do Equine Caregivers Prioritize? 93
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)
5.1 Establishing Elements That Are Foundational to Success in Equine Practice from the Client's Perspective, 93
5.2 Building Upon the Foundation of Successful Veterinarian¢"Client Relationships, 94
5.3 Additional Considerations on Partnership and the Need for Veterinarians to Assess Clients' Knowledge, 96
5.4 Expectations Surrounding Decision-making and Financing Care, 97
5.5 Concluding Thoughts, 98
6 Viewing Communication Through Another's Lens: Considerations for Communicating With Bovine Producers 101
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)
6.1 The Shift in Role from Reactive Expert-in-charge to Proactive Guide-on-the-side, 101
6.2 Lessons from Motivational Interviewing, 103
6.3 Diving Deeper into Motivation: What Drives the Dairy Farmer?, 107
6.4 Beyond Motivation: Considering Differences in Learning Styles, 109
6.5 The ¢Hard-to-reach Farmer¢, 111
6.6 Other Stakeholders and Associated Challenges, 113
6.7 Motivations and Barriers from the Veterinarian's Perspective, 114
6.8 Applications: Communication About Biosecurity, 115
6.9 Applications: Communication About Antibiotic Use, 116
6.10 Applications: Communication About Lameness, 117
6.11 Applications: Communication About Calf-rearing, 117
6.12 Concluding Thoughts, 118
7 Viewing Communication Through Another's Lens: Considerations for Communicating With Exotic Animal Caregivers 124
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)
7.1 Communicating With Caregivers of Amphibians, 129
7.2 Communicating With Caregivers of Reptiles, 132
7.3 Communicating With Caregivers of Avian Species, 146
7.4 Communicating With Caregivers of Exotic Companion Mammals (ECMs), 153
7.5 Concluding Thoughts, 161
8 Communication Models: Integrating Theory Into Practice 166
8.1 The Development of Consultation Models, 168
8.2 The Calgary¢"Cambridge Model, 171
8.3 The Revised Calgary¢"Cambridge Model for Veterinary Patients, 174
8.4 Limitations of Consultation Models, 175
8.5 Englar¢"Brett Adaptations of the Calgary¢"Cambridge Consultation Model, 177
9 Incorporating Communication Into Curricula: Learning Through Engaging 182
9.1 The Emergence of Skills Training in Healthcare Programs, 182
9.2 Where Does Communication Fit?, 184
9.3 Redefining Learners, 185
9.4 Optimizing Our Approach to Learning, 187
9.5 Curricular Integration of Communication Training, 190
9.6 Concluding Thoughts, 193
10 Structuring Simulated Client Encounters 198
10.1 Prior to Simulation: The Realm of Authentic Interactions, 198
10.2 The Shift Toward Simulation, 202
10.3 Simulation Decision-making: What Is Required to Invest in Simulations for Communication Training?, 203
10.4 Simulation Decision-making: Who Is Required for Communication Simulations?, 208
10.5 Simulation Decision-making: How Are Communication Simulations Structured?, 216
10.6 Additional Considerations with Respect to Assessment, 222
10.7 Other Simulation Options, 223
11 Scripting Simulated Client Encounters 226
11.1 Planning for Simulation, 226
11.2 How Real Is Real?, 228
11.3 Defining a Scenario, 230
11.4 Selecting a Scriptwriting Team, 233
11.5 Developing Overarching Goals of the Simulation, 234
11.6 Formulating Learning Objectives, 237
11.7 Establishing Case Logistics, 239
11.8 Detailing the Client: Character Development, 239
11.9 Detailing the Patient(s): Character Development, 244
11.10 Establishing the Rules of the Simulation (From the Perspective of the SC), 248
11.11 Establishing the Opening Statement, 249
11.12 Providing Special Instructions or Prompts, 249
11.13 Providing Rubrics for SC Written Feedback, 252
11.14 What Learners Are Given in Advance of the Encounter?, 253
11.15 SC Training, 253
11.16 Piloting and Revising, 254
11.17 Concluding Thoughts, 254
12 Preparing the Learner for Simulated Client Encounters: Investing in Preparatory Work 257
12.1 Toward a Shared Definition of Preparatory Work, 259
12.2 Differing Perspectives on Prework: The Educator's Point of View, 261
12.3 Differing Perspectives on Prework: The Learner's Point of View, 263
12.4 Prework for Simulations at the University of Arizona College of Veterinary Medicine, 264
12.5 Same-day on-site Briefing for Simulations at the University of Arizona College of Veterinary Medicine, 269
12.6 Concluding Thoughts on Preparatory Work for Simulations, 273
13 Becoming a Reflective Practitioner: Building Value into Post-encounter Reflections 276
13.1 Toward a Working Definition of What It Means to Be Reflective, 278
13.2 Reflective Practitioners Must First Become Reflective Learners, 283
13.3 Reflective Practice Is a Learned Skill: Making Meaning of Learning, 286
13.4 Models of Reflective Practice, 290
13.5 Strategies for Incorporating Reflective Practice into Curricula, 303
13.6 Our Process for Incorporating Reflective Practice into Our Simulation Program Within Professional Skills Coursework at the University of Arizona College of Veterinary Medicine, 311
13.7 Concluding Thoughts, 319
14 The Path Forward: Making the Simulation Experience More Inclusive 325
15 Technological Advances in Communications Training: The Emergence of Veterinary DialogueTrainer as a Leading Interactive Teaching Tool 328
Quintie Stoel (MSc), Saskia Nab (DVM) and Jolanda Jansen (PhD, MSc)
15.1 The Relevance of Simulation-based Training (SBT), 328
15.2 The Next Level of Simulation-based Training (SBT): The Veterinary DialogueTrainer (VDT), 328
15.3 What Does a VDT Role-play Look Like?, 329
15.4 Veterinary DialogueTrainer Dashboard and Data Collection, 330
15.5 How Is Each VDT Virtual Role-play Customized?, 331
15.6 Current Users of the Veterinary DialogueTrainer, 333
15.7 Embedding VDT Simulations into a Comprehensive E-learning, 333
15.8 Current Topics and Species Coverage in VDT Role-plays, 334
15.9 Evidence for the VDT as an Innovative Tool to Improve the Efficacy of Communication Skills Training, 335
15.10 The Endless Possibilities of Veterinary DialogueTrainer, 335
15.11 Ready to Try a VDT Demo? Developed in Partnership with the University of Arizona College of Veterinary Medicine: Intra-team Conflict, 336
15.12 Customizing the Veterinary DialogueTrainer to Meet Your Needs: Contact the Team Today!, 336
Appendix A What the Current Literature Tells Us About Simulation-based Education (SBE) in Veterinary Curricula 338
Appendix B The Englar¢"Brett Communication Consultation Models 443
Index 453
[COMPANION WEBSITE]
PART 2 Case Vignettes for Role-play and In-class Discussion
16 Clinical Case Vignettes: Canine/Feline 16-1
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)
17 Clinical Case Vignettes: Equine 17-1
Sarah Eaton, DVM, DACT, CVA, DABVP-Equine
18 Clinical Case Vignettes: Small Ruminant 18-1
Skyler Bentley and Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)
19 Clinical Case Vignettes: Bovine 19-1
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)
Jennifer Koziol, DVM, MS, DACT
Appendix C Integrative Assignments C-1
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)
Teresa Graham Brett, JD
Appendix D Overview of Simulations at the University of Arizona College of Veterinary Medicine (UA-CVM) D-1
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)
Teresa Graham Brett, JD
Appendix E Door Charts: What Information Learners Are Given Before They Enter the Simulated Exam Room E-1
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)
Teresa Graham Brett, JD
Appendix F Pre-encounter Assignments (PreWork): What the Learner Completes Prior to Engaging in the Simulation F-1
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)
Teresa Graham Brett, JD
Appendix G Post-encounter Reflection Assignments: What the Learner Completes After Engaging in the Simulation G-1
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)
Teresa Graham Brett, JD
Appendix H Scripts for Simulations H-1
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)
Teresa Graham Brett, JD
Appendix I Rubrics for Written Feedback I-1
Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)
Teresa Graham Brett, JD
