Since the beginning of the 21st century, health professionals (eg, veterinarians and medical doctors) involved in global health systems have been confronted with a number of challenges.1–4 As Frenk et al4 described, persistent challenges with respect to “our collective failure to ensure the equitable sharing of health progress,” together with new challenges such as “new infectious, environmental, and behavioral threats, superimposed upon rapid demographic and epidemiological transitions” threaten our global health systems. In addition, health systems within and among countries are becoming more complex, which places additional demands on health workers who are struggling to keep pace with developments.4,5 There is evidence that professional education in medicine and veterinary medicine have not always developed in parallel with these challenges.6–9 For instance, described program outcomes (ie, competencies) may not be appropriately aligned with patient and population needs.4 Owing to global interdependence and the international migration of health professionals, an increasing range of health and education-related challenges have developed, including global mobility of people, livestock, and food; lack of international accreditation systems for education; and limited resources for educational and patient care needs. Considering these contemporary issues and future challenges, a redesign of professional health education is necessary and timely.4
Veterinary professionals are playing an increasingly crucial role in global health systems. The international One Health Initiative, which promotes worldwide interprofessional collaboration in all aspects of human and animal health care, recognizes this critical position for veterinarians.10–13 However, recent scientific evidence has pointed out inconsistencies among the demands of modern veterinary medicine, veterinary curricula, and career success.2,14,15 Jaarsma et al6 and Doucet and Vrins16 reported in survey studies that graduates feel insufficiently prepared regarding nontechnical veterinary competencies such as communication skills and business management. As veterinarians are vital members of global health care teams, the increasingly international and interdependent veterinary profession must strive to find consensus regarding what might be expected of a competent veterinary professional and how veterinary education can best meet the needs of all its stakeholders. We believe that an international discussion about relevant competencies is an essential prerequisite for producing competent veterinary professionals ready for the challenging global needs of the 21st century.
Over the years, the medical profession has seen several initiatives at achieving better-performing health systems underpinned by a sound educational philosophy.17–20 For instance, in Canada, the Canadian Medical Educational Directives for Specialists was developed through consultation with patients and medical or paramedical staff.21,22 It has since been adopted by many medical associations around the world.23–26 Throughout the medical continuum, similar frameworks (eg, Tomorrow's Doctors [the General Medical Council summary of medical education standards in the United Kingdom] and the Accreditation Council for Graduate Medical Education core competencies in the United States) provide guidelines to align education with professional practice.25–28
To help inform an international discussion on the competencies required for veterinary education and veterinary professional practice, we used a previously described veterinary competency framework29 as our starting point. This framework has been used as a foundation for veterinary educational and certifying programs in The Netherlands.30,31 The purpose of the study reported here was to determine the perceived importance of competencies described in this framework for professional veterinary practice and education by means of an international survey of veterinary professionals.
Materials and Methods
Veterinary competency framework—The framework used in the study comprises 7 domains (veterinary expertise, communication, collaboration, entrepreneurship, health and welfare, scholarship, and personal development), which are subdivided into 18 competencies (Appendix 1).29 The framework was developed in The Netherlands through a qualitative multimethod study by conducting focus groups and a Delphi procedure with clients and veterinarians representing the full range and diversity of the veterinary profession.29
Study population—Participation in the survey was voluntary. All participants were assured of confidentiality and gave written informed consent for the use of their responses in the study. The ethical review board of the Dutch Association for Medical Education approved the study.
Veterinarians in The Netherlands, Spain, Norway, the United States, South Africa, Switzerland, Canada, the United Kingdom, Malaysia, and Australia were invited to participate in the study. These countries were included because of existing professional relationships between the Faculty of Veterinary Medicine in The Netherlands and participating veterinary schools in these regions. The number and funding sources of veterinary schools in the selected countries as well as the number and employment distribution of veterinarians at the time of the study was collected from other sources32–35,a–f and summarized (Appendix 2).
To cover as wide a range of veterinary activities as possible, veterinarians working in clinical practices (eg, small animal medicine, farm animal medicine, and equine medicine) and veterinarians working in other facility types (eg, at government facilities, in industry, at universities, or at research centers) were recruited for participation. Within The Netherlands, all licensed veterinarians were invited to complete the questionnaire. Within the other 9 countries, a coauthor from that country coordinated the distribution of invitations. Convenience sampling was used to select participants in each of the 10 countries.36 Based on a published procedure for determining sample sizes, the minimum number of veterinarians solicited from each country was 60.37 Within each country, potential participants were selected with the intent of achieving a maximum variation in gender, age, and employment type among respondents.
Particular regions may have been overrepresented on the basis of a coauthor's appointment, especially in countries with multiple veterinary schools and large geographic area (eg, Spain, Norway, United States, South Africa, Canada, and Australia), where participant recruitment was predominantly from the region of the veterinary school where the coauthor was appointed. In Spain, veterinarians from the Madrid province were mainly invited from the graduate lists of the Spain Professional College. In other participating countries, co-authors' personal or professional contact lists and databases were used to recruit respondents: in Norway, veterinarians were mainly invited from the province of Akershus (ie, Oslo and surrounding areas); in the United States, these were mostly from the state of California; in South Africa, from the province of Pretoria; in Canada, mainly from the province of Alberta; and in Australia, primarily from the province of New South Wales. In the United Kingdom, Switzerland, and Malaysia, invitations to participate were distributed to veterinarians throughout the country.
Questionnaire—Respondents were asked to provide some demographic information (ie, year of graduation, gender, age, current position, city, and employment). Respondents did not provide their name. On another page, they were asked to give their opinions on the importance of the 18 competencies described in the veterinary competency framework (Appendix 1) on a 9-point Likert scale (where 1 = not important and 9 = very important). Each domain was accompanied by a description of the underlying competencies.38 Respondents answered 2 questions regarding each of the 18 competencies. The first question was, “How important do you think the described competency is for a veterinarian in your country?” This question was used to gather information regarding the perceived importance of the competencies for professional practice (ie, professional practice importance rating). The second question was, “How important is it that the described competency is taught at the veterinary schools in your country?” This question was used to determine the perceived importance of the competencies for veterinary education (ie, educational importance rating).
Questionnaire administration—The questionnaire was available online, and invitations that included a link to the questionnaire were distributed by email. If an invitation went unanswered for 2 weeks, a follow-up invitation was sent once. Incorporated in the questionnaire was a cover letter explaining the purpose of the study and how the data would be used. A translation of the questionnaire was available in Dutch, English, Spanish, and German. After submitting the completed questionnaire, participants were automatically prevented from filling in another questionnaire on the basis of IP address. The responses were accepted between March 1 and September 30, 2012. Only the primary investigator who coordinated data collection (HGJB) had access to the original data.
Data analysis—Validity of the a priori scales for the 7 domains of the veterinary competency framework was checked by performing a CFA for the corresponding measurement model and reliability analyses for each of the 7 competency domains.39,40 This scale construction procedure was applied to professional practice importance ratings because these aspects were regarded as most essential for the study concept.29
For ease of comparison between professional practice and educational importance ratings, the scales for educational importance ratings were taken to be identical to those for professional practice importance ratings. In the scale construction procedure for the CFA, the following indices were used to check the fit of the measurement model: the minimum discrepancy divided by degrees of freedom, the goodness-of-fit index, the Tucker-Lewis index, the comparative fit index, and the root mean square error of approximation.39,40 In the reliability analysis, a Cronbach α ≥ 0.70 was accepted as sufficient reliability. On the basis of the results of the scale construction, it was decided whether the existing scales in the veterinary competency framework could be maintained or should be modified.
The resulting 2 sets of domain variables, 1 each for professional practice and educational importance, were used in subsequent analyses. The rating for a domain variable was obtained by calculating the mean response value for the ratings of the competencies within that domain. To investigate whether the pattern of ratings for domains was consistent among countries, ratings for professional practice and educational importance were each analyzed at the country level (10 mean ratings/domain). Because of the small sample size (10 countries), a nonparametric test (Friedman test) was performed.
Differences among countries in domain ratings for professional practice and educational importance were each investigated at the rater level with a 1-way ANOVA over the 10 countries for each domain. When significant differences were detected, post hoc 1-sample t tests were performed comparing the sample of ratings at rater level within a country (single country mean) with the overall mean rating. In this procedure, the overall mean rating was calculated by mathematically averaging the country means and was considered to represent the population mean rating. The procedures involved 10 comparisons, 1 for each of the 10 countries. Therefore, a Bonferroni-corrected value of P < 0.005 (0.05/10 countries) was accepted as significant for each of these comparisons. Effect sizes were calculated as the difference between a country's mean domain rating and the overall mean rating, divided by the SD of the within-country ratings (Cohen d).41 Significant deviations with ES > 0.50 were considered most important in assessment of deviations from the overall mean.41 Statistical software was used for general statistical analysesg and for the CFA.h
Results
Responses were received from 1,137 veterinarians; because of the methods used to recruit participants for the study, a response rate could not be calculated. Characteristics of respondents in each participating country were summarized (Table 1).
Self-reported characteristics of 1,137 veterinarians in 10 countries who completed an online questionnaire regarding the perceived importance of 18 professional competencies in 7 domains (veterinary expertise, communication, collaboration, entrepreneurship, health and welfare, scholarship, and personal development) described in a veterinary competency framework29 between March 1 and September 30, 2012.
| Country | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Variable | NL | SP | NO | USA | SA | SW | MA | CA | UK | AU | All |
| No. of participants | 493 | 170 | 61 | 64 | 61 | 62 | 69 | 55 | 41 | 61 | 1,137 |
| No. (%) females | — | 99 (58.2) | 31 (50.8) | 37 (57.8) | 14 (23.0) | 25 (40.3) | 37 (53.6) | 30 (54.5) | 20 (48.8) | 28 (45.9) | 321* (49.8) |
| Age (mean ± SD) | — | 39.7 ± 9.92 | 44.7 ± 10.06 | 43.7 ± 11.69 | 42.2 ± 11.34 | 46.8 ± 9.78 | 39.0 ± 11.32 | 45.1 ± 12.34 | 44.9 ± 9.89 | 48.4 ± 11.10 | 43.0 ± 11.11* |
| No. (%) working as employees (nonemployers) | 247 (50.1) | 108 (63.5) | 46 (75.4) | 47 (73.4) | 43 (70.5) | 42 (67.7) | 50 (72.5) | 38 (69.1) | 29 (70.7) | 27 (44.3) | 677 (59.5) |
| No (%) in clinical practice | 395 (80.1) | 98 (57.6) | 25 (41.0) | 41 (64.1) | 31 (50.8) | 30 (48.4) | 31 (44.9) | 35 (63.6) | 20 (48.8) | 39 (63.9) | 745 (65.5) |
Values reported on the basis of 644 respondents in 9 countries who provided the information.
— = Not applicable (information was not requested). AU = Australia. CA = Canada. MA = Malaysia. NL = The Netherlands. NO = Norway. SA = South Africa. SP = Spain. SW = Switzerland. UK = United Kingdom. USA = United States of America.
For the CFA to be representative of all countries involved in the study, a balanced sample was obtained by resampling the original sample of 1,137 participants. For the CFA sample, random samples of 50 participants/country were obtained (except that, for the United Kingdom, there were only 41 participants in total), resulting in a sample size of 491. The CFA for the 7 domains defined by the a priori scales revealed a satisfactory fit according to 4 of the 5 fit indices, with a goodness-of-fit index of 0.93 (criterion for acceptance, > 0.9), Tucker-Lewis index of 0.93 (> 0.9), comparative fit index of 0.95 (> 0.9), and root mean square error of approximation of 0.06 (< 0.08). The minimum discrepancy divided by degrees of freedom yielded a value of 3.00, which failed to meet the criterion for acceptance (< 2). The reliability analysis yielded a reliability value of α = 0.68 for the veterinary expertise domain; this did not reach the criterion level of 0.70 but was considered acceptable because all other variables met the predefined criteria (Table 2). Reliability values of the other 6 domains ranged from 0.78 to 0.87, indicating scales of sufficient internal consistency The results of the CFA and the reliability analyses were found to be supportive for the a priori scales, and, therefore, these scales were used in subsequent analyses.
Results of reliability analysis of the a priori scales for the 7 domains of the veterinary competency framework.
| Domain | No. of competencies | α |
|---|---|---|
| Veterinary expertise | 2 | 0.68 |
| Communication | 2 | 0.80 |
| Collaboration | 2 | 0.82 |
| Entrepreneurship | 4 | 0.85 |
| Health and welfare | 3 | 0.83 |
| Scholarship | 3 | 0.78 |
| Personal development | 2 | 0.87 |
The sample comprised a subset of 50 respondents/country randomly selected (except for the United Kingdom, for which all 41 respondents were included) from the respondents in Table 1. The total sample size was 491. A Cronbach α ≥ 0.70 was accepted as indicating sufficient reliability.
Importance of each of the 18 competencies in the veterinary competency framework was rated by all 1,137 veterinarians who responded to the questionnaire. Overall mean professional practice and educational importance ratings were summarized for each domain (Table 3). The mean ± SD rating for all domains was 7.8 ± 0.7 for professional practice importance and 7.4 ± 0.7 for educational importance. Results of the Friedman test were significant (P < 0.001 for both comparisons) for professional practice and educational importance, indicating that the typical pattern of the 10 overall mean rating sequences per domain was significant (ie, a consistent pattern of mean domain ratings among countries) for professional practice and education.
Overall mean ratings for professional practice and educational importance of competencies in 7 domains and results of analysis of differences between each country's mean rating and the overall mean rating for all countries.
| Country | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Competency domain and rating category | NL | SP | NO | USA | SA | SW | MA | CA | UK | AU | Overall rating (mean ± SD) | P value* |
| Veterinary expertise | ||||||||||||
| Professional practice | 7.41†‡ (0.69) | 8.01† (0.27) | 8.43 (0.11) | 8.68†‡ (0.56) | 8.34 (0.01) | 8.77†‡ (0.86) | 7.92 (0.30) | 8.65† (0.46) | 8.63 (0.41) | 8.45 (0.11) | 8.33 ± 0.43 | 0.000 |
| Education | 7.60†‡ (0.56) | 8.52 (0.20) | 8.56 (0.27) | 8.60 (0.34) | 8.34 (0.01) | 8.65† (0.46) | 7.66† (0.49) | 8.49 (0.19) | 8.52 (0.18) | 8.34 (0.01) | 8.33 ± 0.38 | 0.000 |
| Communication | ||||||||||||
| Professional practice | 8.06 (0.12) | 7.64† (0.41) | 7.80 (0.32) | 8.43 (0.31) | 8.33 (0.21) | 7.99 (0.15) | 8.29 (0.15) | 8.43 (0.27) | 8.34 (0.23) | 8.39 (0.26) | 8.17 ± 0.28 | 0.000 |
| Education | 7.71† (0.18) | 7.32 (0.09) | 7.25 (0.14) | 7.61 (0.10) | 7.68 (0.17) | 6.76 (0.35) | 7.37 (0.06) | 7.60 (0.08) | 7.80 (0.29) | 7.58 (0.08) | 7.47 ± 0.31 | 0.000 |
| Collaboration | ||||||||||||
| Professional practice | 7.70† (0.14) | 7.52† (0.22) | 7.76 (0.07) | 8.09 (0.26) | 7.80 (0.05) | 7.90 (0.05) | 8.01 (0.15) | 7.90 (0.04) | 7.71 (0.13) | 8.08 (0.26) | 7.85 ± 0.18 | 0.003 |
| Education | 7.37† (0.18) | 7.34 (0.14) | 7.15 (0.01) | 6.95 (0.11) | 7.02 (0.07) | 6.40 (0.34) | 7.27 (0.09) | 7.20 (0.06) | 7.22 (0.06) | 7.34 (0.18) | 7.13 ± 0.29 | 0.001 |
| Entrepreneurship | ||||||||||||
| Professional practice | 7.40 (0.06) | 7.43 (0.07) | 7.29 (0.04) | 7.09 (0.18) | 7.80† (0.44) | 7.56 (0.19) | 7.76† (0.41) | 6.88 (0.34) | 6.46†‡ (0.62 | ) 7.62 (0.31) | 7.33 ± 0.42 | 0.000 |
| Education | 7.28† (0.46) | 7.05† (0.24) | 6.54 (0.10) | 6.10 (0.31) | 7.50†‡ (0.67) | 6.31 (0.19) | 6.68 (0.01) | 6.14 (0.30) | 6.10 (0.35) | 6.96 (0.21) | 6.67 ± 0.51 | 0.000 |
| Health and welfare | ||||||||||||
| Professional practice | 8.09 (0.07) | 8.35 (0.20) | 7.95 (0.16) | 8.17 (0.01) | 8.23 (0.09) | 8.11 (0.05) | 8.23 (0.06) | 8.05 (0.10) | 8.05 (0.09) | 8.38 (0.29) | 8.16 ± 0.14 | 0.087 |
| Education | 8.03 (0.02) | 8.42† (0.44) | 8.05 (0.03) | 7.99 (0.02) | 8.01 (0.00) | 7.73 (0.18) | 7.78 (0.16) | 7.86 (0.13) | 8.00 (0.01) | 8.26 (0.23) | 8.01 ± 0.21 | 0.000 |
| Scholarship | ||||||||||||
| Professional practice | 6.12† (0.23) | 6.96† (0.35) | 6.39 (0.04) | 6.43 (0.01) | 6.34 (0.07) | 5.90 (0.32) | 7.42†‡ (0.61) | 6.22 (0.16) | 5.98 (0.28) | 6.76 (0.23) | 6.45 ± 0.47 | 0.000 |
| Education | 6.67 (0.03) | 7.42†‡ (0.56) | 6.70 (0.06) | 6.29 (0.19) | 6.43 (0.13) | 6.20 (0.25) | 7.10 (0.31) | 6.26 (0.21) | 6.14 (0.26) | 7.02 (0.27) | 6.62 ± 0.44 | 0.000 |
| Personal development | ||||||||||||
| Professional practice | 7.95† (0.24) | 7.52† (0.42) | 8.04 (0.13) | 8.51† (0.42) | 8.51† (0.48) | 7.94 (0.19) | 8.22 (0.02) | 8.54† (0.46) | 8.39 (0.23) | 8.40 (0.24) | 8.20 ± 0.33 | 0.000 |
| Education | 7.67 (0.05) | 7.24† (0.23) | 7.93 (0.26) | 7.71 (0.07) | 7.73 (0.08) | 6.94 (0.33) | 7.38 (0.14) | 7.88 (0.20) | 7.82 (0.15) | 7.82 (0.19) | 7.61 ± 0.32 | 0.000 |
The 1,137 veterinarians in Table 1 rated the importance of 18 competencies (organized into the 7 domains) by use of a 9-point Likert scale (where 1 = not important and 9 = very important). Values in parentheses indicate the ES for a given country. Bonferroni-corrected values of P < 0.005 were considered significant.
P value for differences among mean ratings from all 10 countries.
Mean rating for the given country was significantly different from the overall mean rating.
Significant differences for countries with ES > 0.50 were considered to be substantial deviations.
See Table 1 for remainder of key.
For all competency domains, overall mean ratings were > 6.4. Results of all 14 ANOVAs investigating intercountry differences were significant (P ≤ 0.003), except for the professional practice importance ratings of competencies in the health and welfare domain (P = 0.087). Significant differences between a single country mean and the overall mean were summarized with the corresponding ES (Table 3).
For the veterinary expertise, entrepreneurship, and scholarship domains, some substantial differences (ES ≥ 0.50) were found when comparing a single country mean importance rating with the overall mean for all countries. In The Netherlands, veterinary expertise competencies received substantially lower ratings (ES, 0.69; P < 0.001 for professional practice importance and ES, 0.56; P < 0.001 for educational importance) compared with that for all countries. In contrast, substantially higher professional practice importance ratings were indicated in the same domain by respondents from the United States (ES, 0.56; P < 0.001) and Switzerland (ES, 0.86; P < 0.001), compared with the overall rating. Respondents from the United Kingdom rated the importance of entrepreneurship domain competencies lower (ES, 0.62; P < 0.001) for professional practice, whereas South African respondents rated these same competencies as having higher educational importance (ES, 0.67; P < 0.001) than did respondents from all countries. Competencies in the scholarship domain received higher professional practice importance ratings from Malaysian respondents (ES, 0.61; P < 0.001) and higher educational importance ratings from Spanish respondents (ES, 0.56; P < 0.001), compared with the mean ratings for all countries.
Discussion
By conducting a survey of veterinarians engaged in a wide variety of professional activities in 10 countries, we sought to determine the perceived importance of specific competencies needed for professional veterinary practice and being taught in veterinary education, with the intent of helping to start an international discussion on the needs of veterinary professionals in the increasingly interdependent and challenging veterinary profession. These competencies were described in a previously validated veterinary competency framework (Appendix 1).29,38 Quantitative analysis of the data indicated a general consensus regarding the degree of importance of various competencies in veterinary professional practice and education among participants in the 10 countries. This was illustrated by a similar overall pattern of importance ratings among countries and by the finding that for most domains, the importance ratings in most countries (132/140 possible equations) did not differ substantially from the overall mean for all countries.
The international nature of this study allowed us to explore whether veterinarians living in different countries have different perceptions about the importance of the 18 predefined competencies described in the veterinary competency framework. As would be expected, respondents from all participating countries perceived technical competencies related to veterinary expertise as having importance (with an overall mean rating of 8.33 [range, 7.41 to 8.77] on the Likert scale of 1 to 9) for both professional practice and veterinary education.
Nontechnical competencies (eg, competencies related to communication, collaboration, health and welfare, and personal development in the framework used) also received overall mean ratings > 7 on the Likert scale for importance in professional practice and being taught in veterinary education. These results are in line with findings of a survey-based study by Lane and Bogue42 among faculty members of 5 North American colleges of veterinary medicine, in which results supported the perceived importance of nontechnical competencies for veterinary graduates among participating faculty members and veterinarians. Also, Rhind et al43 reported in a survey-based study of final-year students and recent graduates from 3 veterinary schools in the United Kingdom that the nontechnical competencies of communication skills, recognition of own limitations, ability to cope with pressure, and problem-solving and decision-making skills were rated unanimously as important or very important by students and graduates. In a systematic review of literature regarding veterinary business skills, Cake et al44 described the importance of business skills for career success but also discussed the issue of veterinarians perceiving those skills almost universally of relatively lower importance. However, in a qualitative study based on focus group interviews, Coe et al45 identified a general unease among veterinarians in discussing the costs of veterinary care with clients and emphasized the importance of training veterinarians regarding these nontechnical competencies.
Consistent with literature reporting that veterinary professionals are increasingly playing a crucial role in global health systems,10–13 our results indicated that veterinarians from all participating countries perceived competencies within the health and welfare domain as having importance (with ratings ≥ 7.95 and ≥ 7.73 on the Likert scale for professional practice and educational importance, respectively). However, as described elsewhere,23 competencies in medical fields are context and time dependent, and cultural and historical issues can influence the degree to which certain competencies are perceived as important. As a consequence, some competencies may receive more or less emphasis in different countries or regions.46 This was reflected in our data by some substantial intercountry variations with respect to the perceived importance of competencies in the veterinary expertise, entrepreneurship, and scholarship domains for professional practice and veterinary education. However, the results also suggested that on a higher conceptual level (ie, for the competency domains), there was an overall consensus (where the importance ratings in most countries did not differ significantly from the overall mean) about the importance of specific types of competencies for veterinary professionals. While the clinical functions of veterinarians are becoming increasingly homogenous throughout the developed world, there are still distinct differences in terms of educational expectations required for graduation. Differences in educational traditions might explain some of these differences, but there are likely more factors that influence how education is aligned with the needs of stakeholders.47 More research focusing on participants in education (ie, teachers and students) and the beneficiaries of a well-trained veterinarian workforce (ie, veterinary clients) could help elucidate and describe these factors and help shape the future of education. That future does not require an international consensus on all aspects of the educational system. In terms of international accreditation, international collaboration, and the exchange of professionals among countries, reaching an agreement on which competencies are important could be essential. On the other hand, at a national or regional level, a contextualized elaboration of required competencies could strengthen the way in which the veterinary profession contributes to one health.
Several limitations must be taken into account in considering the reliability and validity of the results of the present study. First, because of the sampling procedure used (inviting recipients by email), exact response rates could not be calculated. The number of respondents only represented a small percentage of veterinarians in specific countries, and selection bias could have affected the results. One country could harbor multiple cultures,48 and this could negatively affect the validity of the study. Cultural differences could have influenced the interpretation of the questions and described competencies, and therefore, representativeness of a country's mean perceived importance ratings could not be claimed. Furthermore, the proportions of respondents from different countries varied, with 1 country (The Netherlands) comprising almost a third of the total sample. This bias was corrected for evaluation of the overall means for each competency domain by using the mean of the 10 individual country means as a reference. We predominantly surveyed veterinarians from countries in which private practice was the main employment form. Veterinarians from other countries, such as those where veterinarians are mostly employed by the government (eg, countries in the Middle East), could have different viewpoints in regard to the competencies discussed in this report. However, this underscores the importance of an international dialogue on these subjects.
By opening up an international discourse on the definition of competencies essential for veterinary professionals, commonly perceived important competencies could be further identified to empower international and interdisciplinary collaboration and the sharing of educational resources along the continuum from undergraduate to postgraduate and professional veterinary education. Differences in perceptions among regions or countries regarding specific competencies should be acknowledged and discussed. Further research in this field will help to build a shared understanding and anticipation of national or regional differences within the veterinary profession, providing direction for developing veterinary education programs that are aligned with local, national, and international stakeholder needs.
ABBREVIATIONS
| CFA | Confirmatory factor analysis |
| ES | Effect size |
Vilas, F. Analisis de la profesion veterinaria en España, con especial referencia a la Comunidad de Madrid. PhD thesis, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, Spain, 2010.
Blakstad E, Norwegian Veterinary Association, Oslo, Norway: Personal communication, Oct 15, 2013.
Havinga L, South African Veterinary Council, Pretoria, Gauteng, South Africa: Personal communication, 2013.
McEvoy K, Canadian Veterinary Medical Association, Ottowa, ON, Canada: Personal communication, 2013.
Strous J, Australasian Veterinary Boards Council Inc, Melbourne, Australia: Personal communication, 2013.
Kamarudin D, Federal Government Administrative Centre, Malaysian Veterinary Council, Putrajaya, Malaysia: Personal communication, 2013.
SPSS, version 20, SPSS Inc, Chicago, Ill.
AMOS 18.0, SPSS Inc, Chicago, Ill.
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Appendix 1
The 7 domains and 18 competencies of the veterinary professional competency framework.29,38
| Domain | Competency |
|---|---|
| The veterinarian is able to: | |
| Veterinary expertise | 1. Perform veterinary activities in an adequate manner |
| 2. Perform adequately in veterinary emergency situations | |
| Communication | 3. Communicate effectively with clients, colleagues, other personnel, and third parties |
| 4. Establish and maintain functional relationships | |
| Collaboration | 5. Collaborate effectively with colleagues, practice assistants, and third parties within and outside one's own organization |
| 6. Effectively guide personnel, clients, and third parties | |
| Entrepreneurship | 7. Plan and organize one's own practice activities |
| 8. Manage the pharmacy and product stock in accordance with quality standards | |
| 9. Efficiently contribute to business administration | |
| 10. Ensure a responsible and transparent system of quality assurance in one's professional work environment | |
| Health and welfare | 11. Take responsibility in relation to public health |
| 12. Take responsibility in relation to animal health and animal welfare | |
| 13. Balance different interests in relation to public health, animal health, animal welfare, and practice management in a responsible manner | |
| Scholarship | 14. Critically appraise, use, and discuss scientific and professional publications |
| 15. Design and conduct scientific research | |
| 16. Educate and teach using didactically sound approaches | |
| Personal development | 17. Critically reflect on the quality of (one's own) professional activities and take action to improve it |
| 18. Act in accordance with appropriate standards of individual professional behavior |
Professional practice and educational importance of the competencies in each domain were rated by 1,137 veterinarians in 10 countries through an online questionnaire. Adapted from Bok HG, Jaarsma ADC, Teunissen PW, et al. Development and validation of a competency framework for veterinarians. J Vet Med Educ 2011;38:262–269. Reprinted with permission from University of Toronto Press (www.utpjournals.com; doi:10.3138/jvme.38.3.262). © 2011 AAVMC.
Appendix 2
Number and funding sources of veterinary schools and employment distribution of veterinarians in the 10 countries from which study participants were recruited.
| Veterinary schools | Employment type (% of veterinarians) | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Country | No. funding | Public funding | Private funding | No. of veterinarians | Government | Industry | Academia | Private practice | Unknown |
| The Netherlands32 | 1 | 1 | 0 | 4,434 | 6.7 | 7.9 | 9.1 | 72.7 | 3.6 |
| Spaina | 11 | 9 | 2 | 26,760 | 29.4 | 28.0 | 5.1 | 37.2 | 0.3 |
| Norwayb | 1 | 1 | 0 | 2,650 | 23.0 | 5.0 | 8.0 | 64.0 | 0.0 |
| United States33 | 28 | — | — | 97,111 | 3.8 | 5.6 | 6.8 | 66.4 | 17.4 |
| South Africac | 1 | 1 | 0 | 2,541 | 12.0 | 2.0 | 3.0 | 83.0 | 0.0 |
| Switzerland34 | 2 | 2 | 0 | 3,746 | 5.5 | 5.2 | 8.4 | 73.2 | 7.7 |
| Canadad | 5 | 5 | 0 | 12,590 | 10.0 | 6.0 | 5.0 | 75.0 | 4.0 |
| United Kingdom35 | 7 | 7 | 0 | 25,221 | 7.9 | 3.2 | 5.5 | 80.5 | 2.9 |
| Australiae | 7 | 7 | 0 | 10,724 | 5.0 | 7.0 | 5.0 | 67.0 | 16.0 |
| Malaysiaf | 1 | 1 | 0 | 1,894 | 19.4 | 48.4 | 12.4 | 19.8 | 0.0 |
Values are shown for the year in which the study was conducted (2012), except Spain and the United Kingdom (2010).
— = Not assessed.
