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- Author or Editor: Jason B. Coe x
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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 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 explore veterinarians’ use of virtual veterinarian-client-patient consultations before and during the coronavirus disease 2019 (COVID-19) pandemic and examine veterinarians’ attitudes toward virtual consultations.
SAMPLE
135 companion animal veterinarians in Canada, the US, and Europe.
METHODS
An anonymous online survey was distributed to gather participating veterinarians’ use of information and communication technologies and their perception of virtual consultations’ effect on patient care, client communication, and their own well-being. Willingness to recommend virtual consultations was evaluated using the Net Promoter Score. Multivariable logistic regression explored factors associated with willingness to recommend virtual consultations.
RESULTS
Percentage of participating veterinarians using the telephone and videoconferencing increased significantly (P < .001) from before (83.6% and 3.0%, respectively) to during the COVID-19 pandemic (97.0% and 22.4%, respectively). Participants were significantly less confident (P < .001) about their ability to reach a diagnosis using a virtual consultation as compared to a hands-on patient examination. Participants perceived client communication to be more challenging during virtual as compared to face-to-face consultations, particularly for building rapport and expressing empathy. Participants were extremely unwilling to recommend virtual consultations (Net Promoter Score = –41.4) with 21.6% (24/111) promoters and 63.1% (70/111) detractors. Confidence doing a virtual patient examination and comfort using videoconferencing technology were both positively associated (P < .05) with willingness to recommend virtual consultations.
CLINICAL RELEVANCE
Veterinary practices and organizations interested in encouraging virtual veterinarian-client-patient consultations likely need to prioritize veterinarians’ acceptance as an initial focus. The veterinary profession would benefit from further research and education to inform virtual veterinary care.
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.
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 describe and compare veterinary professionals’ use of shared decision-making during companion animal appointments.
DESIGN
Multi-practice cross-sectional study.
SAMPLE
A purposive sample of 4 companion animal veterinary clinics in a group practice in Texas.
PROCEDURES
A convenience sample of veterinary appointments were recorded January to March 2018 and audio-recordings were analyzed using the Observer OPTION5 instrument to assess shared decision-making. Each decision was categorized by veterinary professional involvement.
RESULTS
A total of 76/85 (89%) appointments included at least 1 decision between the client and veterinary professional(s), with a total of 129 shared decisions. Decisions that involved both a veterinary technician and veterinarian scored significantly higher for elements of shared decision-making (OPTION5 = 29.5 ± 8.4; n = 46), than veterinarian-only decisions (OPTION5 = 25.4 ± 11.50; P = .040; n = 63), and veterinary technician-only decisions (OPTION5 = 22.5 ± 7.15; P = .001; n = 20). Specific elements of shared decision-making that differed significantly based on veterinary professional involvement included educating the client about options (OPTION5 Item 3; P = .0041) and integrating the client’s preference (OPTION5 Item 5; P = .0010).
CLINICAL RELEVANCE
Findings suggest that clients are more involved in decision making related to their pet’s health care when both the veterinary technician and veterinarian communicate with the client. Veterinary technicians’ communication significantly enhanced client engagement in decision-making when working collaboratively with the veterinarian.
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 evaluate veterinarian-client communication before and after a 15-month on-site communication skills training intervention.
PROCEDURES
Multipractice, pretest-posttest intervention study.
SAMPLE
A convenience sample of 4 companion animal practices owned by a single practice group in Austin, Texas (n = 9 veterinarians; 170 audio recordings).
RESULTS
After intervention, visits were 8 minutes longer (P = .005), and veterinarians’ client-centered scores increased significantly (2.30 vs 2.72; P = .006). Veterinarians’ biomedical questions decreased by nearly a third (P = .0007), while veterinarians’ facilitation (ie, partnership-building) statements were 1.15 times as great (P = .04) after intervention due to an increase in asking for the client’s opinion (P = .03) and use of back-channel statements (P = .01). Agenda-setting skills, including agenda-setting questions (P = .009), summary of the client’s agenda (P = < .0001), and a check for remaining concerns (P = .013), increased significantly after intervention. Clients asked 1.9 times as many lifestyle-social related questions (P = .02) and provided 1.3 times as much lifestyle-social information (P = .0004) after the intervention. Additionally, clients offered 1.4 times as many emotion-handling statements (P = .0001), including showing concern (P = .03) and optimism, reassurance, or encouragement (P < .0001), after intervention. Paraverbally, clients presented as more anxious/nervous (P = .03) and emotionally distressed/upset (P = .02) after the intervention.
CLINICAL RELEVANCE
Results suggest that client-centered communication skills increased after intervention. This study builds upon previous case-based studies examining practice-based communication training, emphasizing that long-term interventions positively enhance veterinarian-client communication, which is likely to have a positive impact on client and patient care.
Abstract
OBJECTIVE
To explore pet owners’ use of information and communication technologies (ICTs) during virtual veterinarian-client-patient consultations and to examine pet owners’ attitudes toward virtual consultations.
SAMPLE
714 pet owners.
METHODS
In an anonymous online survey distributed using snowball sampling, all participants were asked about utilization of ICTs, preferred method of interaction (face-to-face and 5 ICTs), opinion on virtual communication, and demographics. Sentiment toward virtual veterinarian consultations was measured for participants who had experienced a “virtual only” or “combination virtual and face-to-face” consultation in the previous 6 months using the Net Promoter Score. For these participants, multivariable logistic regression was used to explore factors associated with recommending virtual consultations.
RESULTS
92% (583/632) of participants resided in Ontario, Canada. Most (85.6% [611/714]) participants had experience using the telephone for veterinary care, while only 5.2% (37/714) had used live videoconferencing. Participants ranked face-to-face interactions as most preferred (P < .001), followed by telephone and then live videoconferencing. Participants were significantly (P < .001) less confident communicating during virtual consultations, particularly for building rapport. For participants experiencing a virtual consultation in the previous 6 months (n = 348), the overall Net Promoter Score was neutral at –1.43. Participants were divided about recommending virtual consultations, with 33.3% (116/348) being promoters and 34.8% (121/348) being detractors. Age of participant and comfort using videoconferencing were positively associated (P < .05) with recommending virtual consultations.
CLINICAL RELEVANCE
Although participating pet owners significantly preferred face-to-face consultations with veterinarians, many appear willing to consider virtual consultations. Further exploration of pet owners’ preferences and concerns around virtual care, including communication, is needed.
Abstract
Discrete choice methods (DCMs) are a suite of research techniques for identifying individual preferences using choice information. Widely utilized by other fields yet rarely employed in veterinary research, DCMs have tremendous potential to improve veterinary healthcare by understanding and incorporating owner and veterinary professionals' (encompassing veterinarians, veterinary clinicians, technicians, receptionists, attendants, etc) preferences to optimize the care continuum. DCMs have several advantages over other stated preference methods, such as ranking and ratings, including improved data quality and actionability. However, they are not a panacea, and limitations that may affect DCMs' application to the veterinary field are outlined alongside realistic mitigation strategies. The information provided aims to increase awareness of DCMs and their utility in veterinary research and encourage greater uptake as a more robust method for measuring preferences.