Models and simulators provide opportunities for veterinary students to develop their skills before using them on live animals.
How would you like to be the patient when a medical or nursing student learns to draw blood for the very first time? Any volunteers?
Even more so than in human medicine, veterinary medicine encompasses a wide range of clinical skills, from placing an endotracheal tube down an airway in order to administer anesthesia, to scrubbing and draping a patient for surgery, or castrating and dehorning cattle. Luckily, at today’s veterinary schools, models and simulators provide opportunities for veterinary students to develop their skills before using them on live animals.
Dr. Lorrie Hale Mitchell, a veterinarian and clinical instructor at the University of Illinois College of Veterinary Medicine in Urbana, explains that a model is something that mimics real conditions and enables students to learn and practice skills and processes that they can then apply to live patients and real settings.
“Advantages of using models are that they eliminate the risk of animal harm and minimize student stress while students learn new skills. The models are continuously available so students can practice until they become competent. They can then perform procedures on live patients more safely and with more confidence” explains Dr. Hale Mitchell.
The college’s Clinical Skills Learning Center was established in 2009 as an integral part of the Illinois veterinary curriculum introduced that year. Students throughout the curriculum can access the center. However, it is used predominantly during students’ first two years of study, when clinical skills are introduced and developed – before students engage in patient care at the college’s Veterinary Teaching Hospital.
A life-sized fiberglass cow–a former entry in Chicago’s 1999 “Cows on Parade” public art exhibition–gives students a chance to practice haltering a large animal. An anatomically correct llama mannequin allows students to appreciate the unusual location of the jugular vein in that species and practice drawing blood. The skills center also has a life-sized horse mannequin used for bandaging practice and to learn the proper way to take x-rays on a large animal.
Dr. Hale Mitchell and her colleague Connie Arnold have crafted several of their own models when none were commercially available. These include a castration model consisting of a saw horse, tube sock, and ladder balls, and a dehorning model composed of the cardboard tube from toilet paper, wooden dowels, and foam packing that simulates the density and texture of a horn.
A heavy fabric called duck cloth is stretched over frames and mounted on the wall to simulate the abdominal wall of a cow so students can practice making and suturing incisions. Abdominal surgery in cows is often performed with the cow standing, with a regional nerve block for pain control instead of general anesthesia. Layers of fabric mimic the layers of skin and tissue and simulate the degree of difficulty in passing a needle and suture material through a cow’s thick skin (think tough leather).
Stuffed animals come in handy. Plush dogs with a smooth abdominal area are used to teach students how to disinfect the skin in preparation for surgery. Other stuffed animals are used to practice draping a patient for surgery.
But don’t be fooled by some of the “stuffed toys” in the Clinical Skills Learning Center. There are lifelike dog, cat, and cow mannequins equipped to mimic heart or respiratory sounds, pregnancy conditions, and a host of other problems; these mannequins cost thousands of dollars apiece.
Veterinary students also have hands-on access to real veterinary equipment in the skills center, including an anesthesia machine, fluid pumps, instruments used during routine surgical procedures, microscopes, an ultrasound machine, and a rigid as well as a flexible endoscope, which allow a doctor to see inside the body.
At Illinois, students undergo comprehensive skills assessments in the second and third years of the four-year curriculum. The models in the skills center are used during these examinations to test students’ ability to perform invasive procedures, such as placing a catheter or drawing blood, while live animals are used to test students’ ability to perform physical examinations.
“Training videos are also available so students can review procedures on their own time,” says Dr. Hale Mitchell. “For example, if a student wants to review how to spay a dog before performing the surgery, the video depicts the procedure step by step. Videos are great resources, since they can be watched repeatedly. In this case, the animal in the video was a shelter dog being spayed by a clinician before being adopted. No animals were harmed, and many animals will benefit.”
The Illinois approach to early clinical training is proving effective for developing confident clinicians.
According to Dr. Hale Mitchell, “When our veterinary students perform surgery for the first time, they are more confident with catheter placement, intubation, and suturing than were students taught before the introduction of the Clinical Skills Learning Center. The new curriculum and the ability to practice using models creates that confidence.”
For more information about animal models used at the University of Illinois College of Veterinary Medicine visit vetmed.illinois.edu/asa/cslc/.
By Sarah Netherton