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Abstract
OBJECTIVE
To adapt the 3 scales of the Autonomy Preference Index to veterinary medicine and validate the 3 new scales to measure pet owner preferences for autonomy and information when making medical decisions for their pets.
SAMPLE
10 small-animal veterinarians and 10 small-animal clients at a veterinary school–based community practice (pilot study) and 311 small-animal clients of the practice (validation study), of which 47 participated in a follow-up survey.
PROCEDURES
Wording of items in the Autonomy Preference Index was adapted, and instrument wording was finalized on the basis of feedback obtained in the pilot study to create 3 scales: the Veterinary General Decision-Making Preferences Scale (VGDMPS), Veterinary Clinical Decision-Making Preferences Scale (VCDMPS), and Veterinary Information-Seeking Preferences Scale (VISPS). The 3 scales were then validated by means of administering them to small-animal clients in a clinical setting.
RESULTS
The 3 scales had acceptable reliability and validity, but clients expressed concern over item wording in the VGDMPS during the pilot study. Overall, results showed that clients had a very high preference for information (mean ± SD VISPS score, 4.78 ± 0.36 on a scale from 1 to 5). Preferences for autonomy varied, but mean values reflected a low-to-moderate desire for autonomy in clinical decision-making (mean ± SD VCDMPS score, 2.04 ± 0.62 on a scale from 1 to 5).
CONCLUSIONS AND CLINICAL RELEVANCE
The VCDMPS was a reliable and valid instrument for measuring client preferences for autonomy in clinical decision-making. Veterinarians could potentially use this instrument to better understand pet owner preferences and tailor their communication approach accordingly.
Abstract
OBJECTIVES
To describe self-reported radiation safety practices by equine veterinary technicians in North America and identify factors associated with these practices.
SAMPLE
154 equine technicians.
PROCEDURES
An electronic questionnaire regarding radiation safety practices during the use of portable x-ray equipment was sent to 884 members of the American Association of Equine Veterinary Technicians and Assistants. Data were summarized, and various factors were evaluated for associations with reported safety practices.
RESULTS
221 of 884 (25.0%) questionnaires were completed, including 154 by equine technicians who had been involved in equine radiography as x-ray tube operators, cassette holders, or both in the previous year. Lead apron use was suboptimal, reported as “always” for 80.0% (104/130) of tube operators and 83.1% (123/148) of cassette holders. Approximately 20% of participants never wore thyroid shields, and approximately 90% never wore lead eyeglasses. Almost 50% of participants did not have lead eyeglasses available. Although > 55% of participants always held the x-ray equipment by hand, 58.4% (73/125) of tube operators and 25.0% (35/140) of cassette holders never wore gloves. Cassette holders wore lead gloves and personal radiation dose–monitoring devices significantly more frequently than did tube operators.
CONCLUSIONS AND CLINICAL RELEVANCE
Compliance of North American equine technicians with radiation safety recommendations by the National Council on Radiation Protection and Measurements was suboptimal. Improvements in radiation safety training and education, strengthening the connection between academic institutions and private practices, and greater availability and requirement of personal protective equipment use by senior clinicians and employers might aid in improving safety practices.
Abstract
OBJECTIVE
To evaluate the efficacy of ethylene oxide (EtOH) sterilization of 4 different waterproof camera cases and the ability of those sterilized cases to maintain a sterile barrier for intraoperative camera use.
SAMPLE
3 action cameras, 1 smartphone, and associated waterproof cases.
PROCEDURES
Cases were inoculated by immersion in medium containing Staphylococcus pseudintermedius, Escherichia coli, and Pseudomonas aeruginosa and then manually cleaned and subjected to EtOH sterilization. Cameras were disinfected, loaded into sterile cases, and sterilely operated for 2 hours. Samples were collected from cases after inoculation, EtOH sterilization, camera loading, and 1 and 2 hours of operation and from all cameras after 2 hours of operation. Procedures were repeated twice, followed by an additional challenge round wherein cameras were purposefully contaminated prior to loading. All samples underwent bacterial culture.
RESULTS
All cases were successfully sterilized, and loading of nonsterile cameras into sterile cases caused no contamination when cameras had been disinfected beforehand. Nonpathogenic environmental contaminants were recovered from 6 of 64 culture samples and 2 of 4 room samples. During the challenge round, only the postload sample for 1 case yielded E coli, suggesting sterile glove contamination; however, postload, 1-hour, and 2-hour samples for the GoPro case yielded E coli and S pseudintermedius, suggesting major contamination.
CONCLUSIONS AND CLINICAL RELEVANCE
Results suggested that the evaluated cases can be safely sterilized with EtOH and used for image acquisition by aseptically prepared surgeons when cameras are disinfected prior to loading. Except for the GoPro camera, camera use did not jeopardize sterile integrity.
Abstract
OBJECTIVE
To determine the perceptions of training, self-efficacy, and mentoring among veterinary clinical specialty trainees on the basis of their career interest.
SAMPLE
207 veterinarians who were either in a residency training program or had recently (within 2 years) completed one in a specialty recognized by the American Board of Veterinary Specialties.
PROCEDURES
An online survey was used to collect data about the respondents' perceived preparedness for an academic career, training emphasis, and mentoring received during training and demographic information. Results were compiled and compared by professional career interest (ie, academic medicine or private practice) and gender.
RESULTS
Included respondents represented 20% (207/1,053) of those invited. Preferred career choice was academic medicine for 48% (93/194) of respondents and private clinical practice for 52% (101/194) and did not differ by gender. Respondents perceived their likelihood of success in an academic career as high, and these perceptions did not differ by gender or preferred career choice. Mean self-efficacy scores for teaching were high among all respondents for most but not all listed teaching skills and did not differ by gender or preferred career interest. Mean self-efficacy scores were low for formulating research hypotheses and designing studies. Perceptions of training emphasis indicated strong mentoring in the areas of clinical practice and teaching with less mentoring and training emphasis in multiple areas of research and academic activity.
CONCLUSIONS AND CLINICAL RELEVANCE
Lower self-efficacy of veterinary clinical specialty trainees in aspects of academic career appeared to be related to training emphasis and mentoring. Enhancement of emphasis on the identified areas of weakness may improve the interest and success of trainees in an academic career.
Abstract
OBJECTIVE
To describe the radiation safety behaviors of veterinary specialists performing small animal fluoroscopic procedures and examine potential risk factors for these behaviors, including knowledge of radiation risk and training regarding machine operating parameters.
SAMPLE
197 veterinary specialists and residents in training.
PROCEDURES
An electronic questionnaire was distributed to members of the American Colleges of Veterinary Internal Medicine (subspecialties of cardiology and small animal internal medicine), Veterinary Radiology, and Veterinary Surgery.
RESULTS
The overall survey response rate was 6% (240/4,274 email recipients). Of the 240 respondents, 197 (82%) had operated an x-ray unit for a small animal fluoroscopic procedure in the preceding year and fully completed the questionnaire. More than 95% of respondents believed that radiation causes cancer, yet approximately 60% of respondents never wore hand or eye protection during fluoroscopic procedures, and 28% never adjusted the fluoroscopy machine operating parameters for the purpose of reducing their radiation dose. The most common reasons for not wearing eye shielding included no requirement to wear eyeglasses, poor fit, discomfort, and interference of eyeglasses with task performance. Respondents who had received training regarding machine operating parameters adjusted those parameters to reduce their radiation dose during procedures significantly more frequently than did respondents who had not received training.
CONCLUSIONS AND CLINICAL RELEVANCE
On the basis of the self-reported suboptimal radiation safety practices among veterinary fluoroscopy users, we recommend formal incorporation of radiation safety education into residency training programs. All fluoros-copy machine operators should be trained regarding the machine operating parameters that can be adjusted to reduce occupational radiation exposure.
Abstract
CASE DESCRIPTION
In February 2020, a swine farm operating in multiple states throughout the Midwest began to evaluate emergency plans to respond to potential impacts of the COVID-19 pandemic.
CLINICAL FINDINGS
From February through April, extensive mitigation strategies were implemented in anticipation of market disruption. The farm consulted the AVMA Guidelines for the Depopulation of Animals to identify preferred methods for depopulation of swine; however, none of these methods were feasible. When the first US packing plant closed in April 2020 because of human COVID-19 infection, the farm began to evaluate whether ventilation shutdown plus (VSD+) could be used for depopulation.
TREATMENT AND OUTCOME
Through proof-of-concept trials, a method for ventilation shutdown with the addition of supplemental temperature and humidity was developed. A single location with 4 barns that could be retrofitted for the process was selected, and between April and June 2020, 243,016 pigs were depopulated (59,478 nursery and 183,538 finishing pigs). Mean ± SD time to silent (the time when no sounds could be heard and no motion seen) was 55.4 ± 14.5 minutes for the nursery pigs and 65.0 ± 18.1 minutes for the finishing pigs. Only 728 (0.300%) pigs required manual euthanasia at the end of the de-population process.
CLINICAL RELEVANCE
Efficacy exceeded AVMA recommendations for the use of VSD+ (> 95% mortality rate in < 1 hour). Findings could potentially guide the use of this method for mass depopulation in the event of a foreign animal disease outbreak or severe market disruption in the future. (J Am Vet Med Assoc 2021;259:415–424)
Abstract
OBJECTIVE
To determine prevalences of low compassion satisfaction (CS), high burnout (BO), and high secondary traumatic stress (STS) scores among full-time US veterinarians and estimate effects of selected demographic, employment-related, and education-related factors on those scores.
SAMPLE
5,020 full-time veterinarians who participated in the 2016, 2017, and 2018 AVMA Census of Veterinarians surveys.
PROCEDURES
Data were obtained from census surveys regarding demographic, employment-related, and education-related factors, and scores assigned to items from a professional quality-of-life instrument designed to measure CS and compassion fatigue (ie, BO and STS) were compared between and among various demographic and employment groups.
RESULTS
Overall, 35.5% of veterinarians were classified as having low CS scores, 50.2% as having high BO scores, and 58.9% as having high STS scores. Controlling for other variables, high educational debt was associated with low CS, high BO, and high STS scores. Veterinarians who spent ≥ 75% of their time working with dogs or cats had higher BO and STS scores than did those who spent < 25% of their time. Veterinarians with more experience and higher annual incomes had higher CS scores and lower BO and STS scores. Women had higher BO and STS scores than did men, but no gender differences were observed in CS scores.
CONCLUSIONS AND CLINICAL RELEVANCE
Several variables were identified that may put veterinarians at higher risk than others for compassion fatigue and low CS. These findings may be useful in the development of resources and targeted initiatives to support and defend veterinarian well-being.
Abstract
OBJECTIVE
To determine the prevalences and relative odds of mental health problems, suicidal ideation, psychotropic medication use, problem drinking, trouble sleeping, and lack of social support among veterinarians and veterinary technicians, compared with other medical professionals, in the US Army.
SAMPLE
7,744 US Army personnel (957 officers [101 veterinarians and 856 physicians and dentists] and 6,787 enlisted personnel [334 veterinary technicians and 6,453 medics]) participating in the Millennium Cohort Study.
PROCEDURES
Eligible participants completed ≥ 1 survey while serving as an Army veterinarian, veterinary technician, physician, general dentist, or medic. Analysis methods including multivariable logistic regression adjusted for covariates and stratified by pay grade were used to investigate associations between each health-care occupation and outcomes of interest.
RESULTS
Veterinarians had higher reported prevalences of mental health problems, trouble sleeping, and lack of social support than did nontrauma physicians, trauma physicians, or dentists. On multivariable analysis, veterinarians had higher odds of mental health problems, trouble sleeping, and lack of social support, compared with physicians and dentists combined; odds for these outcomes were also higher for veterinarians, compared with various individual reference groups. Veterinary technicians had lower reported prevalence and lower odds of psychotropic medication use, compared with medics.
CONCLUSIONS AND CLINICAL RELEVANCE
Further examination of Army policies and organizational structures related to veterinarians may be warranted, along with the development of policies and interventions designed to improve mental health, sleep quality, and social support among military veterinarians.
