Veterinary clinical teaching has changed worldwide dramatically over the last couple of years. Increasing student numbers, decreased availability of teaching animals and animal welfare issues have led to the development of veterinary simulators and models that are used to teach veterinary students clinical skills. A variety of veterinary models are commercially available from international companies, but the poor South African Rand/ US Dollar exchange rate, high costs for shipment, import tax and clearing agents rendered most models unaffordable. Furthermore, only a limited variety of veterinary models are commercially available, while there are many day one competency skills newly graduated veterinarians are expected to perform, that could be taught on simulators. These challenges made fully equipping the newly build Onderstepoort Skills Laboratory difficult, but also presented the opportunity for local simulator and model development.
In-house model development entails designing, testing and manufacturing of self-developed models. One of the work spaces in the Skills Laboratory was transformed into a model development laboratory. Collaboration with an artist led to the design and manufacturing of veterinary models to enhance the innovative teaching of clinical skills.
A future vision for the development laboratory is that young South Africans from local communities will be trained in model development and skills transfer, as part of the Universityâs community engagement. In a country facing very high unemployment rates amongst the youth, this project will create permanent positions in a sustainable work environment, leading to independent income generation for the participants. Applications for funding of this training project have been submitted and availability of funds will determine initiation.
Another aspect of the project is research in veterinary education, where the ongoing development and implementation of new simulators and models will initiate new research questions continuously. This will stimulate a growing research focus in veterinary education within the Faculty of Veterinary Science.
The validation of models will support the implementation of innovative teaching methods into the undergraduate veterinary student teaching program.
The overall objectives of the local in-house veterinary model development project are to 1. enhance the innovative teaching of clinical skills at our facility, 2. produce models for student training that are either too expensive to purchase commercially or do not exist yet, 3. enhance students’ competence and confidence while possibly decreasing stress and anxiety levels by providing these additional training opportunities before they are facing live patients, 4. to improve patient safety and welfare by a) decreasing student numbers for repetition of easy but slightly invasive procedures that can be performed on the models and b) decreasing anaesthetic and surgical times for procedures practised on the surgical models, 5. to create permanent positions for technicians through training in moulding and casting techniques for model development within a community engagement project, and 6. to produce publications on the validation and implementation of the models to enrich the knowledge within the field of veterinary education.
A collaboration was established between the project leader and an artist experienced in moulding and model development. The first models to be developed were chosen based on importance of procedures for veterinary undergraduate students that could be performed on these models. Funding for the development process was secured through numerous grant applications and sponsorships. Models chosen to be developed first were a canine spay model, a canine castration model, a cow dystocia model and a live size breeding soundness examination bull (please consult the supplemental materials for more detailed information on the individual models). A project protocol as well as ethical clearance was approved for the spay model project that was initiated upon completion of the spay model.
In order to overcome the artist’s inexperience in veterinary procedures, sufficient exposure opportunities to the relevant procedures through observations of spays and castrations as well as hands on practice of breeding soundness related examinations was provided under veterinary guidance. Relevant anatomical descriptions and pictures in conjunction with organs were used to start developing moulds for the silicone parts. Non-silicone related developments for the individuals models were outsourced to building contractors, a taxidermist and a private company designing plastic parts to individual needs based on 3-D-printed prototypes. The models were developed and improved with constant input of specialists in the specific fields. This development progress and improvement process was especially prominent for the spay model where six prototypes were built before the seventh was found professional enough to be tested by specialist veterinary surgeons performing the operation. These test runs led to more improvements and minor changes before the model was declared ready to be used by students. Specialist input played a big role in the development of all models to ensure correctness of procedures displayed. The spay model, the cow dystocia model as well as the breeding soundness examination bull model have already been implemented in student training and all three have received overwhelmingly positive feedback. Data collection for publication in veterinary education is ongoing until September for the spay model, for both quantitative as well as qualitative data. Quantitative data to test the effect of exposure to the spay model before the student’s first live animal spay on surgical time is collected via detailed anaesthetic monitoring sheets comparing surgical times for first live animal spays for students with or without exposure to the spay model before their first live animal spay. Qualitative data is collected via questionnaires completed by students exposed to the spay model.
Implementation of in-house developed veterinary models will improve undergraduate veterinary students’ clinical competency, increase confidence and decrease anxiety levels before performing clinical procedures on patients. Pre-clinical student learning will be improved by adding practical skills to theory before students reach their final clinical year. Students will be exposed equally to clinical skills, regardless of patient case load. Patient welfare will be increased as students will be better prepared for their first live animal encounter.
For the spay model, students felt more competent to perform a live animal spay by revising anatomical structures while spaying the model, handling of surgical instruments, placing ligatures, suturing, identifying the reproductive tract and executing the full operation. The effect of model exposure on surgical time for students’ first live animal spay will be evaluated by September 2015.
The impact of the castration model on student competence is expected to be similar to that of the spay model.
The BSE bull model will enable students to become competent in sheath wash and scrape, rectal examination of the accessory sex glands, palpation of normal and abnormal scrotal contents, passing of a stomach tube, epidural anaesthesia, and intramuscular and intravenous injections. Four live teaching animal bulls will not be over-utilised any more.
The bovine dystocia model will ensure that all students have equal opportunities to become efficient in handling bovine obstetrics cases independent of case exposure during the clinical year.
The community engagement component of the project will create permanent positions and independent income generation for participants.
The research component of the project has produced three abstracts accepted for presentation at VetEd Symposium (Cambridge, July 2015) and InVeST conference (Hannover, September 2015). A manuscript on the spay model project will be submitted to the Journal of Veterinary Medical Education before the end of 2015.
Next steps will be to finalize the castration model and the implementation thereof in the undergraduate veterinary training program, to publish the results of the spay model project, and to secure funding for the community engagement project to start the training program for technicians.
Additionally, more veterinary models like a lambing simulator, a bitch urinary catheterization and vaginoscopy model, a horse teeth ageing model and a sheep body condition scoring model, and more are in the planning and will be developed soon.
Once our existing models have been student tested and validated, sale and export to other veterinary skills labs worldwide is considered.