News, Teaching Stories

Supporting graduate learners: Optimising the physical and digital environment for case-based learning in veterinary education

Last year, BILT funded a project looking into support for graduates on the Accelerated Graduate Entry Programme (AGEP), specifically looking at the impact physical and digital space had on learning.

The group, led by Emma Love, with additional support from Chloe Anderson, Lindsey Gould, Simon Atkinson and Sheena Warman undertook focus groups and test CBL sessions with students on their AGEP programme. Lindsey presented a poster (below) outlining their findings at the VetEd conference in July 2019.

Open a larger PDF version here.

One of their students, Cerise Brasier, has written a blog about her experience taking part in the project.

My experience during the pilot for case-based learning in veterinary graduate education was very positive. As the cohort for veterinary studies is usually large, the case-based learning enabled me to meet people on my course that I hadn’t spoken with yet, which helped build new working relationships and new friends.

We were given an opportunity to try different facilities and environments to learn in and prior to this experience, I hadn’t considered the learning environment as such a big factor towards effective studying, so this helped me to consider the best places for me to study.

The digital facilities made it easy for us to collaborate ideas as a group, meaning we could cover learning outcomes faster, more interactively and thus more effectively. Learning how to utilise the OneNote programme as a group meant that many of us went on to use this programme for future group and individual work, which enhanced our learning for the rest of the year. Solving hypothetical cases as a group encouraged use of evidence based medicine, communication between students which is important for future veterinary work and I felt solving these cases together helped me to retain information, which helped me with my end of year exams.

Having a facilitator within the group helped us to stay focused on the topic and delve further into the subject than perhaps we would have considered to do on our own. Release of material prior to the session was adequate for preparation of our learning outcomes and the delivery of material is most suitable for a graduate learner who would be used to independent self-directed studying. The programme allowed for active learning rather than passive learning, which resulted in a greater level of information retention.

Student Voice, Teaching Stories

Tales from a ‘School Trip’ to Langford

Last week, two of our student fellows, Marnie & Toby, went for a ‘school trip’ to Langford to visit the Clinical Skills Lab with Alison Catterall, and to meet with Chloe Anderson and Lindsey Gould. Chloe and Lindsey have developed the new Accelerated Entry Vet course which uses case-based learning as a primary teaching method, and the Clinical Skills lab is a way for Vet students to learn critical clinical techniques in an authentic, active way. As Marnie and Toby’s projects for the year focus on ‘Authentic, Challenge-Led Learning’ and ‘Active, Collaborative Learning’ respectively this was a great opportunity to talk about the successes and challenges the Vet School has faced. 

Marnie and ‘Toby’ at Langford
(Toby left before they got a picture together!)

Marnie’s Thoughts:

‘Everyone should have a Langford day’, this was a sentiment that was repeated to me by every vet I’ve met: and I couldn’t agree more. As a die-hard city center dweller (stoke bishop who?), the opportunity to visit the countryside campus and look at some of the ways vets were using authentic learning was a breath of fresh air. 

The clinical skills lab itself was a wonderland of models. I had never considered how many different uses there are for an IKEA dog, and honestly, they are underpriced. In a very real sense, this was authentic learning in it’s most literal form. Everything from the lab area, where students are required to follow the same rules they would in a real lab, to the scale models of horses, the skills lab epitomized learning by replicating ‘real-life’ situations.  

One of the components of the clinical skills lab really left me thinking about how stakeholders can be replicated in the classroom. In essence: teatowels. In order to practice sutures, vet students use teatowels, which has been demonstrated to be just as effective as prosthetic limbs. In order to do a good job, students have to match up the lines to ensure that their sutures are neat. Not only did this leave me very impressed with the innovation of Alison and her colleagues, but it also reminded me that in order to allow students to practice,  not every piece of work needs to have a fully realized client. Sometimes they just need a tea towel. 

On the flip side, the work that Lindsey and Chloe are doing represents the ‘fully realized clients’. Students are not only expected to work with a mock case, that has a variety of different stakeholders but also consider the person that comes attached to the animal, with issues that they may experience in a veterinary clinic. This can include customers having a lack of funds, or not wanting to pursue a certain line of treatment. Students are expected to work in groups of ten in facilitated sessions to try and work out how best to tackle a particular case. 

In terms of authentic learning, this hit the nail on the head, it provided an ill-defined problem that required sustained investigation while collaborating with other learners and engaging with multiple sources, with multiple interpretations and different outcomes. However, some of the challenges they were facing with students stemmed from just this. Students want to do well, and Bristol students, who are already academically high-achieving, often do not want to feel like they are jeopardizing their grades by giving an answer they think may be wrong. This to me, presented a very real issue. While students have seemed to be open to authentic learning, authentic assessments are an entirely different ball game. 

Students want to know how to do well and are used to their being a right answer, which leaves educators with a paradox. In the ‘real-world’ more often than not, there is no one right answer, and you are dealing with a multitude of different issues at the same time and doing your best to muddle through. So should educators be preparing students for this world, riddled with uncertainty, (at the possible expense of frustrated students) or should they just be imparting their knowledge? Either way, the work at the vet school is inspired, and I’d like to say a massive thank you to Lindsey, Chloe, and Alison for showing us around and taking the time to tell us about their work. 

Toby’s Thoughts:

In the clinical skills lab, one of the models I found most interesting (ignoring the haptic cow which was both fascinating and highly disturbing) was the plaque removal station. It’s pretty simple – just a bathroom tile with the outline of carnivore teeth on, some red insulating tape ‘gums’ and some plaque in the form of a hard putty. Students remove the plaque with the dental tools, then build it back up again once finished for the next student to use. But Alison made a really good point about it – not only are the students practicing an important clinical skill, they are also learning the layout of the teeth in a carnivore’s mouth.

For me, that’s a lot of what active learning is. It’s just about doing something with what you’re learning. I’m not suggesting Philosophy students learn about Aristotle by scraping plaque off of a paper on virtue ethics (although I guarantee you they would remember it). But the general idea can be applied across the university. The use of the dental tool is the ‘doing’ part, and the dental layout is the (in this case quite literally) underlying concept that they need to learn. 

Problem-based learning, a method of teaching that Lindsey and Chloe have introduced to the accelerated entry vet course, is one way to do this. The doing, in this case, is the working through of the case: researching the background, reading through the amazing materials provided on OneNote and working as a team to find potential solutions. This means the key knowledge the students need is learned in context, in an active way, alongside skills like communication and problem-solving. 

One thing that was clear from the visit to Langford was the Vet School’s willingness to identify weaknesses in teaching and change. Students were going into practice without the skills and confidence they needed so they developed the fantastic clinical skills lab. They needed to produce more complete vets with a broad skill set to excel after university, so they’ve introduced problem-based learning and a framework that looks at all of the aspects that make a Vet. In other subjects, it might not be as obvious whether students are graduating prepared for success or not. But it’s definitely a question worth considering – is Bristol producing complete students that can leave university confident that they will be able to handle what comes their way, or just walking textbooks with plenty of knowledge but no idea how to apply it?



Two cows at the gate
Teaching Stories

A BILT Project: Evaluating a clinical skills lab as an active learning space: sharing best practice and identifying areas for improvement

Alison Catterall, Rachel Christopher, Sam Brown, Sarah Baillie, Clinical Skills Lab Team, Bristol Vet School.

The Clinical Skills Lab (CSL) at Bristol Vet School provides a student-centred learning space that combines taught practicals with an open-access policy allowing students to practise as required. The CSL opened in 2012 and is now embedded in the BVSc curriculum. The CSL team considered it timely to undertake a review of the CSL teaching, which was based on factors considered important for active learning spaces (Peberdy 2014). We aimed to identify best practice, new ideas and ways to further enhance student learning. CSL usage data were collected from the timetable which showed that the CSL is in use most days of the week as practicals are now included throughout the BVSc (Years 1-5).

The open-access sign-in sheets illustrated that there was continuous use year-round, complemented by strategic use prior to assessments and clinical rotations. Focus groups were conducted with veterinary students (in year groups) and one group of veterinary nursing students. Questions covered aspects of the physical space, how students were using the CSL, and how the variety of resources supported learning.

A survey was sent to recent graduates to ascertain what aspects of the CSL had helped them prepare for work-placements and their job as a vet, and to identify additional skills that should be taught in the CSL. Students and recent graduates appreciated the benefits of being taught in a dedicated clinical skills facility throughout the curriculum and the open-access policy. Opportunities to further support student learning included enhanced communication and teaching additional skills.