1. CLINICAL PROBLEM SOLVING A fundamental skill for PROFESSIONAL PRACTICE VETS4111: VETERINARY ANAESTHESIA So how do we teach students to think like clinicians & make clinical decisions when they have no clinical experience? TEACHING CLINICAL PROBLEM SOLVING TO VETERINARY SCIENCE STUDENTS PRIOR TO THEIR CLINICAL YEAR: AN INTEGRATED CASE – BASED APPROACH TEACHING CLINICAL PROBLEM SOLVING TO VETERINARY SCIENCE STUDENTS PRIOR TO THEIR CLINICAL YEAR: AN INTEGRATED CASE – BASED APPROACH. Dr Sanaa Zaki Lecturer in Veterinary Anaesthesia Faculty of Veterinary Science CONCLUSIONS ACKNOWLEDGMENTS The author is grateful to the Thyne Reid Innovative Teaching Unit for the technical and financial support they have contributed to the design and delivery of the new curriculum; and to the students who continue to inspire and motivate the author to strive for the achievement of quality learning outcomes. This unit of study: integrates a number of different learning opportunities, to maximise student participation and ensure learning outcomes are achieved. has a strong clinical focus. At every level, learning activities are designed to stimulate inquiry. Students are more attentive and focussed, and any knowledge they gain during one session is carried forward and used in the next. PRACTICAL CLASSES TUTORIAL CLASSES LECTURES CLINICAL LEARNING SESSIONS Small group learning Cases that students review or are involved with, are then used as a focus for discussion in lectures and tutorials. Pre clinical students working in pairs: Examine, evaluate and plan an anaesthetic regimen for a patient scheduled for anaesthesia. Assist technicians with setting up of anaesthetic machines and preparation for the day’s cases. Review case files from the previous day to look at analgesia plans, anaesthetic records, sedation protocols and comment on their effectiveness and any complications that may have risen. ANALGESIA REVIEW FORM DATE: __________________ BODY WEIGHT (kg): ____________ ANAESTHETIST: _____________ LOCATION: _____________ STUDENT: ___________________________ PROCEDURE: ___________________________ HISTORY/PROBLEMS: _______________ SUBJECTIVE FINDINGS: BEHAVIOUR RESPONSE TO TOUCH OBJECTIVE FINDINGS: HR PR Qual CRT MM Col RR Temp OTHER PAIN ASSESSMENT: (NO SIGN OF PAIN) (EXTREMELY PAINFUL) 1 2 3 4 5 PERI OPERATIVE ANALGESIA PLAN (include drug and route & frequency of administration) ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ________________________________________________ EVALUATION: _________________________________________________ ALTERNATIVE ANALGESIA PLAN (Include reasons as related to this patient) (DRUG, ROUTE, DOSE RATE, FREQUENCY) ADV DISADV ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ___________________________________ CONSIDERATIONS/ANTICIPATED COMPLICATIONS: ______________________________________________________________ ______________________________________________________________ ________________________ Worksheets such as this are completed by students during the sessions. Largegrouplearning Patient case files from the University Veterinary Centre are presented as a clinical problem, to highlight key concepts in anaesthesia. Students see the outcomes of real decisions made on real animal patients. They have the opportunity to follow up cases by viewing the hospital computerised records or even visiting the patient in hospital. Student input during these sessions centres on their involvement with cases in the Clinical Learning Sessions. Case selection is based on clinic activity and lecture content for that week. Students work in groups of 10 to discuss key focus points and come up with realistic case management plans. These are shared and compared within the larger group (40 students) before the actual outcome of the case is revealed. Tutorial 2: Morbidity & Mortality Case 1: ‘Merlin’ Celeste A 15-yo black, male neutered, DSH cat. Presenting complaint: rapidly growing mass on RHS upper lip/face The mass was previously diagnosed as a squamous cell carcinoma The owner, although eccentric, was very keen to explore all options for her cat. Practical classes expose students to the equipment and techniques used in anaesthesia. Technical skills are an essential part of the student’s professional training. Part of the problem solving process during tutorials and lectures is discussing what information, tools and skills are required to manage a particular case. The ‘tools of the trade’ are introduced and the ‘skills of the profession’ practiced in the these classes.