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- Author or Editor: Jason B. Coe x
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Abstract
OBJECTIVE To identify actions taken by owners to socialize puppies < 20 weeks of age, to determine factors affecting attendance of structured puppy classes, and to examine associations between class attendance and owner response to various undesirable puppy behaviors.
DESIGN Cross-sectional study.
SAMPLE 296 puppy owners (each with 1 puppy).
PROCEDURES Participants completed a survey at enrollment (to gather data regarding owner demographics and puppy characteristics) and again when puppies were 20 weeks of age (to gather information on socialization practices and owner responses to misbehavior and signs of fear in their puppy). Responses were compared between owners that did (attendees) and did not (nonattendees) report attending puppy classes.
RESULTS 145 (49.0%) respondents reported attending puppy classes. Class structure differed greatly among respondents. Attendees exposed their puppies to a greater number of people and other dogs than nonattendees as well as to various noises and situations. Puppies of attendees were less likely than puppies of nonattendees to have signs of fear in response to noises such as thunder and vacuum cleaners as well as to crates. Fewer attendees reported use of punishment-based discipline techniques than did nonattendees. Almost one-third of puppies received only minimal exposure to people and dogs outside the home during the survey period.
CONCLUSIONS AND CLINICAL RELEVANCE A notable number of puppies < 20 weeks of age in this study received few early socialization opportunities, which could lead to behavior problems and subsequent relinquishment. Opportunities exist for veterinarians to serve an important role in educating puppy owners about the importance of early puppy socialization and positive reward training.
Abstract
OBJECTIVE
To describe burden transfer in a sample of veterinary workers employed by a Canadian veterinary corporation and to examine the association between different levels of burden transfer and employee burnout and perceived psychosocial work environment.
SAMPLE
475 employees of small-animal veterinary hospitals owned by a corporate practice group.
METHODS
Veterinary team members among 14 working groups responded to an online survey that included assessments of burden transfer, psychosocial environment, and burnout within the workplace. Participants were divided into groups on the basis of self-reported burden-transfer scores being low, mid, or high, and multivariate analysis of covariance was conducted to ascertain associations between level of burden transfer, psychosocial environment, and burnout.
RESULTS
On average, participants perceived difficult encounters with clients to occur with moderate frequency and reported reactions that were low-moderate in intensity. Individuals with high burden-transfer scores were identified in all working groups. Across the 3 burden-transfer groups, the key finding was that high-level burden transfer was associated with perception of greater emotional demands within the workplace, reduced support from supervisors, reduced feeling of social community in the workplace, and elevated rates of burnout among these participants.
CLINICAL RELEVANCE
Findings highlight elevated risks for a certain population of veterinary employees experiencing high levels of burden transfer and underscore the potential need for targeted interventions to support these individuals. Employees who currently react to challenging client interactions with moderate or low intensity may also benefit from these programs as a preventative measure.
Abstract
Objective—To examine veterinarian solicitation of client concerns in companion animal practice.
Design—Cross-sectional descriptive study.
Sample—20 veterinarians in companion animal practice in Eastern Ontario and 334 clients and their pets.
Procedures—Beginning segments of 334 appointments were coded for a veterinarian solicitation (open- or closed-ended question) used to elicit client concerns. Appointments including a solicitation were analyzed for completion of the client's response and its length. The association between veterinarian solicitations at the beginning and concerns arising at the closure of the interview was examined.
Results—123 (37%) of the coded appointments contained a veterinarian solicitation, of which 93 (76%) were open-ended and 30 (24%) were closed-ended solicitations. Client responses to a solicitation were interrupted in 68 of 123 (55%) appointments. Main reasons for incomplete client responses were veterinarian interruptions in the form of closed-ended questioning (39/68) and noninterrogative statements (18/68). Median length of time clients spoke before interruption was 11 seconds (range, 1 to 139 seconds; mean, 15.3 seconds; SD, 12.1 seconds). The odds of a new concern arising during the closing segment of an appointment were 4 times as great when the appointment did not contain a veterinarian solicitation at the beginning of the interview.
Conclusions and Clinical Relevance—Not soliciting client concerns at the beginning of an interview increased the odds of a concern arising during the final moments of the interaction. This required the veterinarian to choose among extending the appointment to address the concern, ignoring the concern at a possible cost to client satisfaction, or deferring the concern to another visit.
Abstract
Objective—To compare veterinarians' and pet owners' perceptions of client expectations with respect to veterinarian-client communication and to identify related barriers and challenges to communication.
Design—Qualitative study based on focus group interviews.
Participants—6 pet owner focus groups (32 owners) and 4 veterinarian focus groups (24 companion animal veterinarians).
Procedures—Independent focus group sessions were conducted with standardized open-ended questions and follow-up probes. Content analysis was performed on transcripts of the focus group discussions.
Results—Five themes related to veterinarian-client communication were identified: educating clients (ie, explaining important information, providing information up front, and providing information in various forms), providing choices (ie, providing pet owners with a range of options, being respectful of owners' decisions, and working in partnership with owners), using 2-way communication (ie, using language clients understand, listening to what clients have to say, and asking the right questions), breakdowns in communication that affected the client's experience (ie, owners feeling misinformed, that they had not been given all options, and that their concerns had not been heard), and challenges veterinarians encountered when communicating with clients (ie, monetary concerns, client misinformation, involvement of > 1 client, and time limitations).
Conclusions—Results suggested that several factors are involved in providing effective veterinarian-client communication and that breakdowns in communication can have an adverse effect on the veterinarian-client relationship.
Abstract
Objective—To determine prevalence and nature of cost discussions between veterinarians and pet owners during clinical appointments in companion animal practice.
Design—Cross-sectional descriptive study.
Sample Population—20 veterinarians in companion animal practice in eastern Ontario and 350 clients and their pets.
Procedures—200 veterinarian-client-patient interactions were randomly selected from all videotaped interactions and analyzed with the Roter interaction analysis system. Additional proficiency codes and blocking functions were developed to capture the prevalence, nature, and context of cost discussions.
Results—58 of the 200 (29%) appointments that were analyzed included a discussion of cost. During 38 of these 58 (66%) appointments, the discussion involved costs associated with the veterinarian's time or with services provided by the veterinarian. Overall, reference to a written estimate was made during only 28 of the 200 (14%) appointments. Cost discussions were most common during appointments in which a decision related to diagnostic testing or dentistry was made. Appointments were significantly longer when a cost discussion was included than when it was not.
Conclusions and Clinical Relevance—Results of the present study suggested that discussions related to cost were relatively uncommon during clinical appointments in companion animal practice and that written estimates were infrequently used to aid these discussions. When discussions of cost did occur, veterinarians appeared to focus on explaining costs in terms of the veterinarian's time or services provided by the veterinarian, rather than on the medical information that could be obtained or the benefits to the future health or function of the pet.
Abstract
Objective—To compare veterinarians' and pet owners' perceptions of client expectations with respect to the monetary aspects of veterinary care and identify challenges encountered by veterinarians in dealing with pet owners' expectations.
Design—Qualitative study based on focus group interviews.
Participants—6 pet owner focus groups (32 owners) and 4 veterinarian focus groups (24 companion animal veterinarians).
Procedures—Independent focus group sessions were conducted with standardized open-ended questions and follow-up probes. Content analysis was performed on the focus group discussions.
Results—Pet owners expected the care of their animal to take precedence over monetary aspects. They also expected veterinarians to initiate discussions of costs upfront but indicated that such discussions were uncommon. Veterinarians and pet owners differed in the way they related to discussions of veterinary costs. Veterinarians focused on tangibles, such as time and services. Pet owners focused on outcome as it related to their pet's health and well-being. Veterinarians reported that they sometimes felt undervalued for their efforts. A suspicion regarding the motivation behind veterinarians' recommendations surfaced among some participating pet owners.
Conclusions—Results suggested that the monetary aspects of veterinary care pose barriers and challenges for veterinarians and pet owners. By exploring clients' expectations, improving communication, educating clients, and making discussions of cost more common, veterinarians may be able to alleviate some of the monetary challenges involved in veterinarian-client-patient interactions.
Abstract
Objective—To explore the nature and content of information publicly posted to Facebook by early-career veterinarians.
Design—Cross-sectional descriptive study.
Sample—352 early-career veterinarians.
Procedures—Publicly accessible Facebook profiles were searched online from March to May 2010 for profiles of early-career veterinarians (graduates from 2004 through 2009) registered with the College of Veterinarians of Ontario, Canada. The content of veterinarians’ Facebook profiles was evaluated and then categorized as low, medium, or high exposure in terms of the information a veterinarian had publicly posted to Facebook. Through the use of content analysis, high-exposure profiles were further analyzed for publicly posted information that may have posed risks to an individual's or the profession's public image.
Results—Facebook profiles for 352 of 494 (71%) registered early-career veterinarians were located. One-quarter (25%) of profiles were categorized as low exposure (ie, high privacy), over half (54%) as medium exposure (ie, medium privacy), and 21% as high exposure (ie, low privacy). Content analysis of the high-exposure profiles identified publicly posted information that may pose risks to an individual's or the profession's reputation, including breaches of client confidentiality, evidence of substance abuse, and demeaning comments toward others.
Conclusions and Clinical Relevance—Almost a quarter of veterinarians’ Facebook profiles viewed in the present study contained publicly available content of a questionable nature that could pose a risk to the reputation of the individual, his or her practice, or the veterinary profession. The increased use of Facebook and all types of social media points to the need for raised awareness by veterinarians of all ages of how to manage one's personal and professional identities online to minimize reputation risks for individuals and their practices and to protect the reputation and integrity of the veterinary profession.
Abstract
OBJECTIVE
To examine variables of veterinary team effectiveness and personal empathy for associations with professional quality of life (ie, compassion satisfaction, burnout, and secondary traumatic stress) and job satisfaction in companion animal practice personnel.
DESIGN
Cross-sectional survey.
SAMPLE
Data from 232 surveys completed by personnel from 10 companion animal veterinary practices in 2 regions of the United States between April 7 and December 20, 2016.
PROCEDURES
Online surveys were used to collect practice-level data (eg, practice type, setting, and staffing) and individual-level data (eg, demographics, job position, and years in the position and profession). Instruments used in developing the surveys included the Team Effectiveness Instrument, Davis Interpersonal Reactivity Index, Professional Quality of Life Scale, and a measure for job satisfaction. Data were evaluated for associations with professional quality of life and job satisfaction.
RESULTS
Individual engagement was positively associated with job satisfaction, negatively associated with secondary traumatic stress, and moderated by levels of personal distress for compassion satisfaction and burnout. Toxic team environment was positively associated with burnout and negatively associated with job satisfaction. Empathetic concern and personal distress were both positively associated with secondary traumatic stress. Empathetic concern was moderated by team engagement for compassion satisfaction.
CONCLUSIONS AND CLINCAL RELEVANCE
Results indicated that variables influencing professional quality of life and job satisfaction were multimodal and included aspects of team effectiveness and empathy; therefore, workplace strategies that enhance individual and team engagement and mitigate toxic team environments could potentially improve professional quality of life and job satisfaction in veterinary personnel.
Abstract
Objective
To assess the impact of a 15-month, in-practice communication skills intervention on client visit satisfaction.
Sample
4 purposely selected veterinary clinics, 9 veterinarians, and 930 appointment-specific client satisfaction surveys.
Procedures
The study was designed as a multipractice, preintervention-postintervention study. Practice teams participated in a 15-month communication skills intervention that included interactive group workshops and one-on-one communication coaching with the entire practice. Client Satisfaction Questionnaires were completed 3 months before (mean, 55 questionnaires/veterinarian) and after (mean, 48 questionnaires/veterinarian) the intervention. The impact of the intervention and factors associated with client visit satisfaction were evaluated with mixed logistic regression.
Results
Client satisfaction scores were dichotomized owing to extreme negative skewness. In total, 57% (284/496) of clients were completely satisfied on pretest questionnaires, and 67% (290/434) were completely satisfied on postintervention questionnaires. The odds of clients being completely satisfied were significantly higher after the communication skills intervention (OR = 1.56; P = .002). When controlling for the intervention, predictors of client visit satisfaction included appointment type (odds of being completely satisfied were significantly higher for recheck appointments than for preventative care appointments [OR = 1.71; P = .02] and health problem appointments [OR = 1.99; P = .003]) and duration of the veterinarian-client relationship (probability increased by 0.52 with each 1-year increase in relationship duration; P = .008).
Clinical Relevance
Results suggested that the client-centered, skills-based communication intervention resulted in increased client visit satisfaction. Findings contribute to current evidence that client-centered communication and duration of the veterinarian-client relationship promote client satisfaction during veterinary visits.
Abstract
OBJECTIVE
To assess the impact of a communication program on a cohort of veterinary students’ knowledge and performance of communication skills.
SAMPLE
Class cohort of veterinary students at Colorado State University.
PROCEDURES
Year 3 students’ knowledge of communication skills was evaluated using quizzes, administered before and after the fall 2016 and spring 2017 Clinical Communication Skills-I and II junior practicum. In year 4, student performance of 22 Calgary-Cambridge Guide communication skills was assessed by coding video-recordings of student-client interactions collected during their second and fourth weeks of the Community Practice rotation in the summer and fall of 2017 and spring of 2018. The impact of training, association with demographic factors, and correlation between knowledge and performance of communication skills were investigated.
RESULTS
In year 3, 136 students completed both fall and spring quizzes; in year 4, 65 week-2 and 29 week-4 appointments were video-recorded during Community Practice rotation. Students’ knowledge assessed via quizzes containing skill spotting and skill demonstrating questions increased significantly after the fall and spring junior practicums; however, knowledge of communication skills was not associated with performance during year 4 Community Practice rotations. Communication skills most frequently demonstrated by students during the fourth year Community Practice rotation were open-ended questions, closed-ended questions, empathy toward the client and patient, providing “chunks” of information, and signposting. Students received high quality scores for non-verbal behaviors and logical clinical interview structure.
CLINICAL RELEVANCE
Results suggest that experiential learning techniques, including a flipped classroom approach, role-play, and communication laboratories contributed to increased student knowledge of communication skills.
