Introduction
What started in 2013 as a humble idea to provide subsidized veterinary care to houseless pet owners in Madison, Wisconsin, has since grown into an innovative educational model that teaches cultural humility and competency to the next generation of veterinarians while simultaneously addressing the social crisis of homelessness and its attendant challenges.
Developed and managed by an interdisciplinary team at the University of Wisconsin School of Veterinary Medicine, the Wisconsin Companion Animal Resources, Education, and Social Services (WisCARES) program provides access for low-income individuals and their pets to a full-service community veterinary clinic that includes examination rooms, a surgical suite, dentistry, digital radiography, ultrasound services, a drug dispensary, an in-house laboratory, a boarding and foster program, and a pet food pantry. Clients experiencing homelessness can also access wraparound services, such as housing advocacy, so that families and their pets can stay together. It’s a holistic approach to care that embodies not only the one-health philosophy that humans, animals, and their environment are inextricably linked, but also the Wisconsin Idea, a major pillar of the University of Wisconsin-Madison’s mission of reaching beyond campus borders to improve people’s lives.
For students of veterinary medicine, WisCARES also serves as an ideal learning environment. Through a combination of experiential learning in a low-resource veterinary medical environment and opportunities for facilitated self-reflection, students learn how cultural humility and competency can play an important role in improving health outcomes for humans and animals alike—skills that the AVMA now recognizes as required educational competencies and that also align with the spectrum-of-care model. Each year, WisCARES hosts fourth-year veterinary students for 2-week rotations, along with preveterinary and veterinary students early in the curriculum, certified veterinary technician students, and students from the University of Wisconsin-Madison Schools of Pharmacy and Social Work. Their respective experience at WisCARES is guided by a comprehensive 3-part curriculum:
Culture
Faculty working at WisCARES model cultural humility, allowing student engagement at a deeper level. Through demonstration of vulnerability and acknowledgment of their own implicit biases and how they manage them, faculty create a safe and open environment that underscores the importance of interpersonal relationships and normalizes the learning process. Clinicians actively work with students in a nonjudgmental way to reveal possible biases and help them process the complexity of their perspective.
Structure of clinical experience
The goal of WisCARES is to develop relationships rather than focus on the number of animals served, so students have hour-long appointments with clients and lead most of the client communication and education. As they progress through the curriculum, students in their clinical rotations provide comprehensive care to patients and their families and process more complex clinical information while continuing to have case ownership. This approach is a method of scaffolding that balances the expected depth of client connection to the complexity of clinical case management.
Guided self-reflection
Finally, students are encouraged to explore their experiences through facilitated discussion and reflective journaling. Informal yet intentional debriefing takes place before, during, and after students’ experiences with clients and most commonly takes place through one-on-one conversations with supervising faculty members. Students also engage in small group discussions to help them process the whole picture of a client’s and patient’s situation.
Since the program’s inception, more than 250 veterinary students have completed a WisCARES rotation, working alongside peers from other academic disciplines to not only consider social determinants of poverty and health, but also reflect on their own worldviews and learn how to provide the highest level of care to people and their pets, regardless of their cultural and socioeconomic backgrounds.
