Since 1952, the AVMA COE has been the US Department of Education–approved accrediting body for veterinary professional education. Furthermore, since 1973, the AVMA Educational Commission for Foreign Veterinary Medical Graduates has been the credentialing body for foreign veterinary medical graduates who wish to enter the licensure process in the United States. It is in part through these 2 processes, professional school accreditation and foreign graduate credentialing, that a set of educational standards and competencies for the veterinary medical profession have been developed and applied.
Factors that have increased the pressure for identification and use of educational outcomes assessment in veterinary medicine include a growing imperative to move closer to national and global standards for entry-level veterinary medical professional competency, partial loss of confidence in the integrity of other self-regulated professions (eg, accounting1) resulting in increased scrutiny of professional competencies, guidance from the Council for Higher Education Accreditation and the AVMA COE, and national trends in accreditation of other health professions (eg, medicine, dentistry, and nursing).
Assessment of the outcomes resulting from preclinical education is important because it often comprises more than half the time invested in the education of medical professionals. In the case of the College of Veterinary Medicine and Biomedical Sciences at Texas A&M University, preclinical education occurs over a 3- year period, in addition to baccalaureate preparation. Some elements of clinical education (eg, entry-level history taking and physical examination and rudimentary clinical reasoning) are introduced via a series of clinical correlates and other clinical experiences administered throughout the preclinical years. The belief that students will be able to draw on the biomedical science information taught during these preclinical years when they are presented with clinical problems constitutes a major reason for the willingness of medical educators to make such a heavy investment of time and resources in this effort. Although some investigators have questioned the role of knowledge of the biomedical sciences in the clinical reasoning used in routine diagnosis,2 recent studies have identified advantages of preclinical instruction in the development of diagnostic expertise. For example, Woods et al3 found that undergraduate students who received instruction concerning the mechanisms underlying a particular disease exhibited better diagnostic performance 1 week after that instruction than students in a control group. The design of that research, however, did not reveal how long this advantage was maintained. This question may have been answered by Van de Wiel et al,4 who found that knowledge of the biomedical sciences does not decay over time when it becomes encapsulated within a network of clinically relevant information through the protracted reapplication of detailed biomedical and clinical knowledge in the diagnostic process. It is not clear what happens to biomedical science information if it is not encapsulated through the process of sustained clinical experience.
Unlike their counterparts in human medicine, veterinarians are responsible for treating a wide variety of animal species. Although there are similarities across species, differences in diagnostic and therapeutic approaches exist. Many colleges of veterinary medicine have responded to the challenge of preparing their students to care for the wide variety of animal species by allowing them to choose a clinical track that concentrates their studies in selected areas. Students complete a core requirement of clinical rotations across all species and then have the opportunity, through a combination of track-specific requirements and electives, to complete additional rotations within their specific areas of interest. Although students are allowed to concentrate their studies, they are still required to sit for national and state board examinations requiring in-depth knowledge of all major species. A potential consequence of clinical tracking is differential proficiency across the species spectrum.
The objective of the study reported here was to examine the effect of various clinical tracks within the veterinary medical clinical curriculum on clinical diagnostic proficiency as determined by assessment of pre- and postclinical training. Specifically, we anticipated that students would have greater diagnostic efficiency and improvement in diagnostic proficiency in the fields in which they had tracked during their clinical training. Improvements in diagnostic proficiency were perceived to reflect advancement attributed to experiential learning in the clinical setting.
Council on Education
Grade point average
Graduate Record Examination
Intercooled Stata, version 9.2 for Windows, Stata Corp, College Station, Tex.
Patel VL, Groen GJ, Scott HM. Biomedical knowledge in explanations of clinical problems by medical students. Med Educ 1988;22:398–406.
Woods NN, Brooks LR, Norman GR. The value of basic science in clinical diagnosis: creating coherence among signs and symptoms. Med Educ 2005;39:107–112.
Van de Wiel MWJ, Boshuizen HPA & Schmidt HG, et al. The explanation of clinical concepts by expert physicians, clerks, and advanced students. Teach Learn Med 1999;11:153–163.