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Because funding for many higher education institutions is based on student persistence and graduation rates, and because competition for online student enrollments is fierce among public and private institutions, quality and competitiveness in online course development, instruction, and administration is imperative. Additionally, because distance education processes and policies are reviewed by accrediting agencies, actions taken to improve quality are more likely to receive favorable reviews. In this paper, we provide a case study on the successful completion of the Online Learning Consortium (OLC) Quality Scorecard for the Administration of Online Programs by Middle Tennessee State University (MTSU). We highlight ways that other institutions can effectively use such an opportunity as they consider applying for certification of their online programs. In particular, we review MTSU's approach to completion of the scorecard, the outcome of the process, improvements made, and lessons learned.

Public health measures (PHMs) proactively and reactively reduce the spread of disease. While these measures target individual behaviour, they require broad adherence to be effective. Consequently, the World Health Organization issued a special appeal to young adults, a known non-adherent population, for increased adherence with COVID-19 guidelines. However, little is known about why these low-risk individuals do or do not adhere to PHMs. This study investigates why young adults in a low-risk setting adhered to PHMs implemented during the COVID-19 pandemic. A qualitative research approach was chosen to gain an in-depth understanding of participants' thoughts and experiences related to PHM adherence. Semi-structured interviews were conducted in April-May 2021 with 30 young adults living in Prince Edward Island (PEI), the province with the lowest COVID-19 case rate in Canada at that time. Thematic analysis was used to create a codebook based on the Theoretical Domains Framework, which was then inductively modified. The analysis identified eight themes that explained the adherence of young adults: (1) clear, purpose-driven adherence rationale, (2) developing trust in the local leadership, (3) adapting to novel measures, (4) manageable disruption, (5) adhering to reduce anxiety, (6) collective duty towards one's community, (7) moral culpability and (8) using caution rather than compliance. Together, these themes demonstrate that young adults adhered to PHMs because of their sense of connection to their community, public health leadership, and concerns over stigma. We further argue that clear guidelines and communication from public health officials during both periods of high and low COVID-19 cases facilitate adherence. These findings are important for mitigating future public health emergencies as they explain why young adults, an important segment of the population whose adherence is critical to the success of PHMs, follow PHMs. Further, these findings can inform public health officials and other stakeholders aiming to develop successful adherence strategies. [ABSTRACT FROM AUTHOR]

Simple Summary: In this article, we report on action research in the Canadian province of Alberta, based on forging alliances with officers who enforce federal, provincial, and municipal legislation involving animals. Some of these officers worked in rural areas, and others worked in urban areas. Some mainly enforced Alberta's Animal Protection Act, while a few specialized in enforcing Canada's Criminal Code. For the most part, however, participating officers had a mandate to enforce animal-related local bylaws. Such ordinances or rulebooks exist because Alberta's Municipal Government Act allows local councils to enact legislation regarding domestic and wild animals, particularly as regards people's health, property, safety, and welfare. Many professionals refer to policies such as these, which are deeply rooted in the western legal tradition, such as "animal control." Our findings illuminate how animal-control policies and personnel can help to protect domesticated animals, not just people. Even so, our research highlights that animal-control policies as well as animal-protection policies routinely fail to protect officers who enforce legislation involving animals. Furthermore, whenever officers who enforce legislation involving animals work in unsafe conditions, this endangers human as well as non-human lives. Across Canada and internationally, laws exist to protect animals and to stop them from becoming public nuisances and threats. The work of officers who enforce local bylaws protects both domestic animals and humans. Despite the importance of this work, research in this area is emergent, but growing. We conducted research with officers mandated to enforce legislation involving animals, with a focus on local bylaw enforcement in the province of Alberta, Canada, which includes the city of Calgary. Some experts regard Calgary as a "model city" for inter-agency collaboration. Based on partnerships with front-line officers, managers, and professional associations in a qualitative multiple-case study, this action-research project evolved towards advocacy for occupational health and safety. Participating officers spoke about the societal benefits of their work with pride, and they presented multiple examples to illustrate how local bylaw enforcement contributes to public safety and community wellbeing. Alarmingly, however, these officers consistently reported resource inadequacies, communication and information gaps, and a culture of normalized disrespect. These findings connect to the concept of "medico-legal borderlands," which became central to this study. As this project unfolded, we seized upon opportunities to improve the officers' working conditions, including the potential of relational coordination to promote the best practices. [ABSTRACT FROM AUTHOR]

Abstract Background Enteric outbreaks associated with child care centres (CCC) have been well documented internationally and in Canada. The current literature focuses on identifying potential risk factors for introduction and transmission of enteric disease, but does not examine why these risk factors happen, how the risk is understood and managed by the staff of CCCs, or what challenges they experience responding to enteric illness. The purpose of this study was to explore the understanding, knowledge and actions of CCC staff regarding enteric illness and outbreaks, and to identify challenges that staff encounter while managing them. Methods Focus groups were conducted with staff of regulated CCCs in Southern Ontario. Five focus groups were held with 40 participants. An open ended style of interviewing was used. Data were analyzed using content analysis. Results CCC staff play an important role in preventing and managing enteric illness. Staff used in-depth knowledge of the children, the centre and their personal experiences to assist in making decisions related to enteric illness. The decisions and actions may differ from guidance provided by public health officials, particularly when faced with challenges related to time, money, staffing and parents. Conclusion CCC staff relied on experience and judgment in coordination with public health information to assist decision-making in the management of enteric illness and outbreaks. Advice and guidance from public health officials to CCC staff needs to be consistent yet flexible so that it may be adapted in a variety of situations and meet regulatory and public health requirements.

This article features a partnership between a veterinary school and a charity that aims to enhance the wellbeing of low‐income people. Through this partnership, the charity periodically hosts veterinary clinics for clients and their pets. Even as the veterinarians and veterinary students duly examine people's pets, these pop‐up clinics aim to help people and their pets. Hence our analysis revolves around the ethics of 'more‐than‐human solidarity'. By 'more‐than‐human solidarity', we mean efforts to help others that either center on or that implicate non‐human beings. To delve into the ethical and sociological implications of subsidised veterinary services, and to assist with program planning, we conducted several in‐depth interviews with veterinarians. Most substantively, we found that the veterinary school's outreach clinics give rise to multi‐species biographical value, which is prized as a pedagogical resource for veterinary students. The veterinarians whom we interviewed felt troubled by the extent to which the pop‐up clinics ultimately benefited the veterinary school, but also by the shortage of subsidised veterinary services in the vicinity. Based on these interviews and our own reflections, we invite more scholarship on cultural, economic and political influences that shape the lives of human beings and non‐human animals alike. [ABSTRACT FROM AUTHOR]

Herd health and production consultancy are important aspects of the modern dairy veterinary practice; therefore, veterinary farm visits will likely be more successful if veterinary practitioners communicate effectively and meet farmers' expectations. Objectives were to assess dairy farmers' satisfaction with veterinary advisors and their perceived preparedness to adopt veterinary advice. Furthermore, we assessed whether farmers' satisfaction and preparedness to adopt advice were associated with specific predictor variables; that is, general (demographic) factors of veterinarians or farmers, communication tools used by veterinarians, and veterinarians' affective attributes during the farm visit. Audio-video recordings of 14 dairy veterinarians during 70 herd health and production management farm visits were analyzed using the Roter interaction analysis system. Demographic data, farmers' satisfaction, and farmers' preparedness to adopt advice were obtained by using questionnaires. Overall, farmers were satisfied with their veterinarian's communication during farm visits and 58% of farmers felt "absolutely" prepared to follow veterinary recommendations. Based on multivariable regression analysis, farmers' satisfaction was positively associated with their level of education and the amount of talk the veterinarian dedicated to counseling the farmer. However, satisfaction was negatively association with the ratio between veterinarian talk and farmer talk. In addition to various demographic variables, farmers' preparedness to adopt veterinary advice was positively associated with their satisfaction. Other predictor variables for farmers' preparedness to follow recommendations included increased veterinary counseling and frequent herd data discussions, whereas there was a negative relationship between number of farmer questions and dominance of the veterinarian during the farm visit. Identification of factors influencing farmers' satisfaction and preparedness to adopt advice will make veterinary communication more effective and could inform training of veterinarians in communication. [ABSTRACT FROM AUTHOR]

OBJECTIVE To describe client and veterinarian perceptions of client-centeredness during euthanasia discussions and assess agreement between measures of these perceptions. DESIGN Descriptive study. SAMPLE Stratified random sample of 32 companion animal veterinarians in southern Ontario. PROCEDURES 2 case scenarios (a geriatric dog with worsening arthritis and a cat with inappropriate urination) designed to initiate euthanasia discussions were presented by 2 different undisclosed standardized clients (USCs) to study veterinarian communication during clinical visits. At the end of appointments, the CISC's identity was disclosed, and questionnaires to measure veterinarian and client perceptions of client-centeredness were completed. Agreement was assessed by statistical methods. RESULTS Data were analyzed from 60 appointments (30/scenario). Of 10 questions, significant agreement was found between veterinarians and USCs for only I (extent to which relevant personal and family issues were discussed; k = 0.43) for the dog scenario and 3 (extent of discussion of respective roles [k = 0.43], better preparedness of the USC to make a euthanasia decision [k = 0.42], and discussion of relevant personal and family issues [k = 0.25]) for the cat scenario. When the USC and veterinarian disagreed, the veterinarian perceived that the client-centeredness components were addressed more thoroughly than did the USC. CONCLUSIONS AND CLINICAL RELEVANCE Lack of agreement was found between USC and veterinarian perceptions, with USCs perceiving less client-centeredness in euthanasia discussions. This communication gap suggested the need for training of veterinarians in eliciting client perspectives and assessing lifestyle-social information, including client social support systems. [ABSTRACT FROM AUTHOR]

Because funding for many higher education institutions is based on student persistence and graduation rates, and because competition for online student enrollments is fierce among public and private institutions, quality and competitiveness in online course development, instruction, and administration is imperative. Additionally, because distance education processes and policies are reviewed by accrediting agencies, actions taken to improve quality are more likely to receive favorable reviews. In this paper, we provide a case study on the successful completion of the Online Learning Consortium (OLC) Quality Scorecard for the Administration of Online Programs by Middle Tennessee State University (MTSU). We highlight ways that other institutions can effectively use such an opportunity as they consider applying for certification of their online programs. In particular, we review MTSU's approach to completion of the scorecard, the outcome of the process, improvements made, and lessons learned. [ABSTRACT FROM AUTHOR]

Effective communication with clients is an important skill for veterinary practitioners and is linked to clients' satisfaction with the consultancy and adherence to medical advice. Detailed description of veterinary communication styles in companion animal contexts has added to the communication knowledge base and informed veterinary curricula and postgraduate education programs. The objective here was to describe veterinary practitioners' communication patterns during dairy herd health and production management farm visits. Fourteen veterinarians in Alberta and Ontario, Canada, were provided with action cameras (Hero3 black edition; GoPro Inc., San Mateo, CA) and recorded 3 to 7 farm visits each. The resulting 70 audio-video recordings were analyzed using the Roter Interaction Analysis System. Additionally, demographic variables were obtained from study participants to investigate associations of these variables with communication patterns. Intraclass correlation coefficients were calculated for communication units, and multilevel negative binomial regression was used to compare communication patterns between demographic groups. Additionally, the relationship-centeredness of interactions was evaluated and compared between groups using linear regression models. Communication patterns varied considerably among recordings of the same veterinarian interacting with different clients. However, most veterinary talk focused on farmer education, counseling, and building a relationship, whereas especially open-ended questions were rare. When discussion revolved around health issues of an individual animal, veterinarians used less social talk but focused more on biomedical information gathering. Veterinarians' age and sex and the length of the veterinarian-farmer relationship had limited association with communications; however, if the farmer and veterinarian were both male, the conversation was more relationship centered. Communication of veterinarians with previous communication training was very similar to that of those without training. Detailed description of veterinary practitioners' communication patterns on dairy farms will contribute to establishing the importance of communication as a clinical skill and is critical to identifying unique aspects of veterinary on-farm communication. [ABSTRACT FROM AUTHOR]

Previous research has shown that housing insecurity contributes to animal relinquishment and that tenants with dogs face disadvantages in the rental market. Still, little is known about how dog owners navigate rental markets, nor how landlords and property managers perceive dogs and other pets. This case study reports on in-depth interviews with younger tenants with dogs and on open-ended survey responses from landlords and property managers. In their housing searches, tenants with dogs reported feeling powerless in negotiations and feeling discriminated against. They described settling for substandard properties, often located in less desirable neighborhoods. Also, some said they felt obliged to stay put in these rentals, given how difficult it had been to find a place that would accommodate their dogs. Meanwhile, landlords and property managers indicated that listings advertised as "pet-friendly" tend to receive more applicants than listings in which pets are prohibited. Suggestions for improvement included meeting pets prior to signing the lease; getting everything in writing; steering clear from furnished units; charging utilities to tenants; and speeding up the pet approval process when dealing with condominium boards. These suggestions offer implications for future research, partnerships, and policy options to improve the prospects of pets and their people in rental housing. [ABSTRACT FROM AUTHOR]

This article reports on video analyses of 110 veterinary appointments in which pet-directedI knowreceipts were uttered by 15 veterinarians as responses to companion animals’ vocal and visible signals of distress. Patients’ distress was typically occasioned by medical activities constituting the appointment. The dual functions ofI knowas a claim of (a) prior knowledge of animals’ experiences and (b) shared feelings and affiliation with animals’ experiences made it an interactional resource for addressing client anxiety arising from the disalignment of animal patients with the goals of the appointment. Analysis of prosody, prefacing, the presence or absence of repeats, and postpositioned components demonstrated the flexibility of theI knowreceipt in modulating veterinarians’ stances toward their patients’ expressions of distress. Findings are discussed in relation to studies on the management of patient distress and pain in pediatric procedures and to previous research on clinician–patient empathy in veterinary medicine. Data are in Canadian English. [ABSTRACT FROM AUTHOR]

Objective--To measure veterinarian satisfaction with companion animal visits through an adaptation of a previously validated physician visit satisfaction scale and to identify demographic, personality, appointment, and communication factors that contribute to veterinarian visit satisfaction. Design--Cross-sectional descriptive study. Sample--Random sample of 50 companion animal practitioners in southern Ontario, Canada, and convenience sample of 300 clients and their pets. Procedures--For each practitioner, 6 clinical appointments were videotaped, and the resulting 300 videotapes were analyzed by use of the Roter interaction analysis system. The physician satisfaction scale, Rosenberg self-esteem scale, and interpersonal reactivity index were used to measure veterinarian visit satisfaction, self-esteem, and empathy, respectively. Linear regression analysis was conducted to study the relationship between factors and veterinarian visit satisfaction. Results--Veterinarian visit satisfaction ranged from 1 to 5 (mean ± SD, 3.97 ± 0.99) and differed significantly between wellness appointments (mean scale score, 4.13) and problem appointments (mean scale score, 3.81). Various elements of client and veterinarian communication as well as personality measures of veterinarian self-esteem and empathy were associated with veterinarian satisfaction. The specific factors differed depending on the nature of the appointment. Conclusions and Clinical Relevance--Results suggested that veterinarian visit-specific satisfaction is enhanced through the use of communication that builds relationships with clients and is associated with degrees of veterinarian empathetic concern and veterinarian self-esteem. The implications extend to overall job satisfaction and its potential link to the health and well-being of individual veterinarians. [ABSTRACT FROM AUTHOR]

Objective-To characterize veterinarian-client communication with undisclosed standardized clients (USCs) during discussions regarding euthanasia of a pet. Design-Descriptive study. Sample Population-32 companion animal veterinarians (16 males and 16 females) in southern Ontario. Procedures-During 2 clinic visits, 2 cases (a geriatric dog with worsening arthritis and a cat with inappropriate urination) designed to stimulate discussion regarding euthanasia of a pet were presented by different USCs (individuals trained to consistently present a particular case to veterinarians without disclosing their identity). Discussions were audio recorded and analyzed by use of the measure of patient-centered communication (MPCC [a tool to assess and score physician communication behaviors]). Veterinarian and client statements were classified by means of 3 patient-centered components: exploring both the disease and the illness experience, understanding the whole person, and finding common ground. Results-60 usable recorded discussions were obtained (31 veterinarians; 30 discussions/case). Overall, MPCC scores were significantly lower for the geriatric dog case. For both cases, veterinarians scored highest on finding common ground and lowest on exploring both the disease and the illness experience. Lack of exploration of client feelings, ideas, and expectations and the effect of the illness on the animal's function resulted in low scores among veterinarians. Conclusions and Clinical Relevance-Results indicated that the use of USCs and the MPCC are feasible methods for analysis of veterinarian-client communication during companion animal euthanasia discussions. Findings suggested that some veterinarians do not fully explore client concerns or facilitate client involvement in euthanasia decision making. [ABSTRACT FROM AUTHOR]

Objective-To determine prevalence and nature of cost discussions between veterinarians and pet owners during clinical appointments in companion animal practice. Design-Cross-sectional descriptive study. Sample Population-20 veterinarians in companion animal practice in eastern Ontario and 350 clients and their pets. Procedures-200 veterinarian-client-patient interactions were randomly selected from all videotaped interactions and analyzed with the Roter interaction analysis system. Additional proficiency codes and blocking functions were developed to capture the prevalence, nature, and context of cost discussions. Results-58 of the 200 (29%) appointments that were analyzed included a discussion of cost. During 38 of these 58 (66%) appointments, the discussion involved costs associated with the veterinarian's time or with services provided by the veterinarian. Overall, reference to a written estimate was made during only 28 of the 200 (14%) appointments. Cost discussions were most common during appointments in which a decision related to diagnostic testing or dentistry was made. Appointments were significantly longer when a cost discussion was included than when it was not. Conclusions and Clinical Relevance-Results of the present study suggested that discussions related to cost were relatively uncommon during clinical appointments in companion animal practice and that written estimates were infrequently used to aid these discussions. When discussions of cost did occur, veterinarians appeared to focus on explaining costs in terms of the veterinarian's time or services provided by the veterinarian, rather than on the medical information that could be obtained or the benefits to the future health or function of the pet. [ABSTRACT FROM AUTHOR]

Children with autism might display unpredictable and volatile behavior that places them in considerable physical danger and creates stress for the family. Families of autistic children often have limited freedom and experience difficulty with everyday activities. In this qualitative ethology study, we examined the effect of integrating service dogs into ten families with an autistic child. Data included participant observation, video recordings of family-parent-dog interaction, and semistructured interviews with the parents. The themes were (a) the dog as a sentinel of safety, (b) gaining freedom through enhanced safety, facilitating public outings and family activities, and (c) improving social recognition and status, in which the presence of the dog promoted awareness of autism and affected social interaction. The triadic relationship between parent, autistic child, and service dog constantly evolves. This research provides valuable information for parents interested in having a service dog for their autistic child, and has implications for long-term human-animal companionship for children with special needs and their caregivers. [ABSTRACT FROM AUTHOR]

Objective—To compare the clinical interview process, content of the medical dialog, and emotional tone of the veterinarian-client-patient interaction during wellness appointments and appointments related to a health problem in companion animal practice. Design—Cross-sectional descriptive study. Sample Population—A random sample of 50 companion animal practitioners in southern Ontario and a convenience sample of 300 clients and their pets. Procedure—For each practitioner, 6 clinical appointments (3 wellness appointments and 3 problem appointments) were videotaped. The Roter interaction analysis system was used to analyze the resulting 300 videotapes. Results—Wellness appointments were characterized by a broad discussion of topics, with 50% of data-gathering statements and 27% of client education statements related to the pet's lifestyle activities and social interactions. Wellness appointments included twice as much verbal interaction with the pet as did problem appointments, and the emotional atmosphere of wellness appointments was generally relaxed. There were more social talk, laughter, statements of reassurance, and compliments directed toward the client and pet. In contrast, during problem appointments, 90% of the data gathering and client education focused on biomedical topics. Coders rated veterinarians as hurried during 30 of the 150 (20%) problem appointments; they rated clients as anxious during 39 (26%) problem appointments and as emotionally distressed during 21(14%). Conclusions and Clinical Relevance—Results suggested that veterinarian-client-patient communication differed between wellness and problem appointments. Owing to the emphasis on biomedical content during problem appointments, veterinarians may neglect lifestyle and social concerns that could impact patient management and outcomes, such as client satisfaction and adherence to veterinarian recommendations. [ABSTRACT FROM AUTHOR]

Objective—To compare veterinarians' and pet owners' perceptions of client expectations with respect to veterinarian-client communication and to identify related barriers and challenges to communication. Design—Qualitative study based on focus group interviews. Participants—6 pet owner focus groups (32 owners) and 4 veterinarian focus groups (24 companion animal veterinarians). Procedures—Independent focus group sessions were conducted with standardized open-ended questions and follow-up probes. Content analysis was performed on transcripts of the focus group discussions. Results—Five themes related to veterinarian-client communication were identified: educating clients lie, explaining important information, providing information up front, and providing information in various forms), providing choices (ie, providing pet owners with a range of options, being respectful of owners' decisions, and working in partnership with owners), using 2-way communication (ie, using language clients understand, listening to what clients have to say, and asking the right questions), breakdowns in communication that affected the client's experience (ie, owners feeling misinformed, that they had not been given all options, and that their concerns had not been heard), and challenges veterinarians encountered when communicating with clients (ie, monetary concerns, client misinformation, involvement of > 1 client, and time limitations). Conclusions—Results suggested that several factors are involved in providing effective veterinarian-client communication and that breakdowns in communication can have an adverse effect on the veterinarian-client relationship. [ABSTRACT FROM AUTHOR]

Background: Enteric outbreaks associated with child care centres (CCC) have been well documented internationally and in Canada. The current literature focuses on identifying potential risk factors for introduction and transmission of enteric disease, but does not examine why these risk factors happen, how the risk is understood and managed by the staff of CCCs, or what challenges they experience responding to enteric illness. The purpose of this study was to explore the understanding, knowledge and actions of CCC staff regarding enteric illness and outbreaks, and to identify challenges that staff encounter while managing them. Methods: Focus groups were conducted with staff of regulated CCCs in Southern Ontario. Five focus groups were held with 40 participants. An open ended style of interviewing was used. Data were analyzed using content analysis. Results: CCC staff play an important role in preventing and managing enteric illness. Staff used in-depth knowledge of the children, the centre and their personal experiences to assist in making decisions related to enteric illness. The decisions and actions may differ from guidance provided by public health officials, particularly when faced with challenges related to time, money, staffing and parents. Conclusion: CCC staff relied on experience and judgment in coordination with public health information to assist decision-making in the management of enteric illness and outbreaks. Advice and guidance from public health officials to CCC staff needs to be consistent yet flexible so that it may be adapted in a variety of situations and meet regulatory and public health requirements. [ABSTRACT FROM AUTHOR]

Objective-To compare veterinarians' and pet owners' perceptions of client expectations with respect to the monetary aspects of veterinary care and identify challenges encountered by veterinarians in dealing with pet owners' expectations. Design-Qualitative study based on focus group interviews. Participants-6 pet owner focus groups (32 owners) and 4 veterinarian focus groups (24 companion animal veterinarians). Procedures-Independent focus group sessions were conducted with standardized open-ended questions and follow-up probes. Content analysis was performed on the focus group discussions. Results-Pet owners expected the care of their animal to take precedence over monetary aspects. They also expected veterinarians to initiate discussions of costs upfront but indicated that such discussions were uncommon. Veterinarians and pet owners differed in the way they related to discussions of veterinary costs. Veterinarians focused on tangibles, such as time and services. Pet owners focused on outcome as it related to their pet's health and well-being. Veterinarians reported that they sometimes felt undervalued for their efforts. A suspicion regarding the motivation behind veterinarians' recommendations surfaced among some participating pet owners. Conclusions-Results suggested that the monetary aspects of veterinary care pose barriers and challenges for veterinarians and pet owners. By exploring clients' expectations, improving communication, educating clients, and making discussions of cost more common, veterinarians may be able to alleviate some of the monetary challenges involved in veterinarian-client-patient interactions. [ABSTRACT FROM AUTHOR]

Objective-To identify specific components of veterinarian-client-patient communication during clinical appointments in companion animal practice. Design-Cross-sectional descriptive study. Sample Population-A random sample of 50 companion animal practitioners in southern Ontario and a convenience sample of 300 clients and their pets. Procedure-For each practitioner, 6 clinical appointments (3 wellness appointments and 3 appointments related to a health problem) were videotaped, and the Roter interaction analysis system (RIAS) was used to analyze the resulting 300 videotapes. Statements made during each appointment were classified by means of a communication framework reflecting the 4 essential tasks of the appointment (ie, data gathering, education and counseling, relationship building, and activation and partnership). Results-57% of the veterinarians contacted (50/87) and 99% of the clients contacted agreed to participate in the study. Mean duration of the appointments was 13 minutes. Typically, veterinarians contributed 62% of the total conversation and clients contributed 38%. Fifty-four percent of the veterinarian interaction was with the client, and 8% was with the pet. Data gathering constituted 9% of the veterinarian-to-client communication and was primarily accomplished through closed-ended questioning; 48% of veterinarian-to-client communication involved client education and counseling, 30% involved relationship building, and 7% involved activation and partnership (the remaining 6% constituted orientation). Conclusions and Clinical Relevance-Results suggest that the RIAS was a reliable method of assessing the structure, process, and content of veterinarian client-patient communication and that some veterinarians do not use all the tools needed for effective communication. [ABSTRACT FROM AUTHOR]

There is limited information in the veterinary literature on veterinarian-client-patient communication, and what is available is predominantly based on expert opinion and anecdotal information, not peer-reviewed scientific studies. In contrast, the human medical communication literature contains a large number of empirical studies. Thus, a review of research of physician-patient interactions is a logical starting place to determine what steps veterinary researchers, educators, and practitioners could take to investigate and address veterinarian-client-patient interactions. The purpose of this report were to summarize recent advances in human medical communication research and education, link findings in human medical communication research to veterinary medicine, and provide a rationale for development of communication research and education programs in veterinary medical schools. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) has been largely attributed to antimicrobial use (AMU). To achieve judicious AMU, much research and many policies focus on knowledge translation and behavioral change mechanisms. To address knowledge gaps in contextual drivers of decisions made by dairy farmers concerning AMU, we conducted ethnographic fieldwork to investigate one community's understanding of AMU, AMR, and associated regulations in the dairy industry in Alberta, Canada. This included participation in on-farm activities and observations of relevant interactions on dairy farms in central Alberta for 4 mo. Interviews were conducted with 25 dairy farmers. The interviews were analyzed using thematic analysis and yielded several key findings. Many dairy farmers in this sample: (1) value their autonomy and hope to maintain agency regarding AMU; (2) have shared cultural and immigrant identities which may inform their perspectives of future AMU regulation as it relates to their farming autonomy; (3) feel that certain AMU policies implemented in other contexts would be impractical in Alberta and would constrain their freedom to make what they perceive to be the best animal welfare decisions; (4) believe that their knowledge and experience are undervalued by consumers and policy makers; (5) are concerned that the public does not have a complex understanding of dairy farming and, consequently, worry that AMU policy will be based on misguided consumer concerns; and (6) are variably skeptical of a link between AMU in dairy cattle and AMR in humans due to their strict adherence to milk safety protocols that is driven by their genuine care for the integrity of the product. A better understanding of the sociocultural and political-economic infrastructure that supports such perceptions is warranted and should inform efforts to improve AMU stewardship and future policies regarding AMU. [ABSTRACT FROM AUTHOR]

Objective--To determine the role of veterinary team effectiveness regarding job satisfaction and burnout in companion animal veterinary practice. Design--Cross-sectional observational study. Sample--48 companion animal veterinary health-care teams. Procedures--274 team members participated in an online survey. Overall job satisfaction was evaluated with a 1-item measure, and the 3 dimensions of burnout (exhaustion, cynicism, and professional efficacy) were measured with the Maslach Burnout Inventory- General Survey. Team effectiveness was assessed with a survey developed for this study. Demographic and team effectiveness factors (coordinated team environment, toxic team environment, team engagement, and individual engagement) associated with job satisfaction and burnout were evaluated. Results--Overall mean job satisfaction score was 5.46 of 7 (median, 6.00); veterinary technicians and kennel attendants had the lowest scores. According to the Maslach survey results, 22.4% of participants were in the high-risk category for exhaustion, 23.2% were in the high-risk category for cynicism, and 9.3% were in the high-risk category for professional efficacy. A coordinated team environment was associated with increased professional efficacy and decreased cynicism. A toxic team environment was negatively associated with job satisfaction and positively associated with exhaustion and cynicism. Individual engagement was positively associated with job satisfaction and professional efficacy and negatively associated with exhaustion and cynicism. Conclusions and Clinical Relevance--Results suggested the effectiveness of a veterinary team can significantly influence individual team members' job satisfaction and burnout. Practices should pay specific attention to the effectiveness with which their veterinary team operates. [ABSTRACT FROM AUTHOR]

In food animal production medicine (FAPM), the success of control programs for infectious diseases that have serious animal health and economic consequences frequently rely on the veterinarian's effective communication and producer adherence to veterinary recommendations. However, little research has been conducted on communication skills of practicing FAPM veterinarians. During this study, we developed a communication training workshop intervention to support the Atlantic Johne's Disease Initiative. Seventeen FAPM veterinarians across 10 clinics practicing within Maritime Canada participated in a pre-post intervention study design. Communication skills were evaluated utilizing 3 assessment tools; an objective structured clinical exam (OSCE), standardized client feedback, and an instrument designed for veterinary participants to assess their self-efficacy. Study results showed that before training, communication skills of participating veterinarians had limitations, including skill deficits in communication tasks strongly associated with increased adherence to veterinary recommendations. Based on the 3 assessment tools, communication skills of participating veterinarians improved with the training provided. Significant increases were detected in pre- to postintervention self-efficacy percentage scores, OSCE percentage and global scores from expert raters, and OSCE percentage and global scores from standardized client feedback. These improvements emphasize the importance of communication skills training specific to FAPM. [ABSTRACT FROM AUTHOR]

Objective—To explore the relationship between veterinarian-client-patient interactions and client adherence to dental and surgery recommendations and to test the a priori hypotheses that appointment-specific client satisfaction and relationship-centered care are positively associated with client adherence. Design—Cross-sectional study. Sample—A subsample of 19 companion-animal veterinarians and 83 clients from a larger observational study consisting of 20 randomly recruited veterinarians and a convenience sample of 350 clients from eastern Ontario. Procedures—Videotaped veterinarian-client-patient interactions containing a dentistry recommendation, surgery recommendation, or both were selected for inclusion from the larger sample of interactions coded with the Roter interaction analysis system. Client adherence was measured by evaluating each patient's medical record approximately 6 months after the videotaped interaction. The clarity of the recommendation, appointment-specific client-satisfaction score, and relationship-centered care score were compared between adhering and nonadhering clients. Results—Among the 83 veterinarian-client-patient interactions, 25 (30%) clients adhered to a dentistry recommendation, surgery recommendation, or both. The odds for adherence were 7 times as great for clients who received a clear recommendation, compared with clients who received an ambiguous recommendation from their veterinarian. Moreover, adhering clients were significantly more satisfied as measured after the interview. Interactions resulting in client adherence also had higher scores for relationship-centered care than did interactions leading to nonadherence. Conclusions and Clinical Relevance—Veterinarian use of a relationship-centered care approach, characterized as a collaborative partnership between a veterinarian and a client with provision of clear recommendations and effective communication of the rationale for the recommendations, has positive implications for client adherence. [ABSTRACT FROM AUTHOR]

Objective—To examine veterinarian solicitation of client concerns in companion animal practice. Design—Cross-sectional descriptive study. Sample—20 veterinarians in companion animal practice in Eastern Ontario and 334 clients and their pets. Procedures—Beginning segments of 334 appointments were coded for a veterinarian solicitation (open- or closed-ended question) used to elicit client concerns. Appointments including a solicitation were analyzed for completion of the client's response and its length. The association between veterinarian solicitations at the beginning and concerns arising at the closure of the interview was examined. Results—123 (37%) of the coded appointments contained a veterinarian solicitation, of which 93 (76%) were open-ended and 30 (24%) were closed-ended solicitations. Client responses to a solicitation were interrupted in 68 of 123 (55%) appointments. Main reasons for incomplete client responses were veterinarian interruptions in the form of closed-ended questioning (39/68) and noninterrogative statements (18/68). Median length of time clients spoke before interruption was 11 seconds (range, 1 to 139 seconds; mean, 15.3 seconds; SD, 12.1 seconds). The odds of a new concern arising during the closing segment of an appointment were 4 times as great when the appointment did not contain a veterinarian solicitation at the beginning of the interview. Conclusions and Clinical Relevance—Not soliciting client concerns at the beginning of an interview increased the odds of a concern arising during the final moments of the interaction. This required the veterinarian to choose among extending the appointment to address the concern, ignoring the concern at a possible cost to client satisfaction, or deferring the concern to another visit. [ABSTRACT FROM AUTHOR]

Objective—To identify communication patterns used by veterinarians during clinical appointments in companion animal practice. Design—Cross-sectional descriptive study. Sample Population—A random sample of 50 companion animal practitioners in southern Ontario and a convenience sample of 300 clients and their pets. Procedure—For each practitioner, 6 clinical appointments (3 wellness appointments and 3 appointments related to a health problem) were videotaped. The Roter interaction analysis system was used to analyze the resulting 300 videotapes, and cluster analysis was used to identify veterinarian communication patterns. Results—175 (58%) appointments were classified as having a biomedical communication pattern, and 125 (42%) were classified as having a biolifestyle-social communication pattern. None were classified as having a consumerist communication pattern. Twenty-three (46%) veterinarians were classified as using a predominantly biomedical communication pattern, 19 (38%) were classified as using a mixed communication pattern, and 8 (16%) were classified as using a predominantly biolifestyle-social communication pattern. Pattern use was related to the type of appointment. Overall, 103 (69%) wellness appointments were classified as biolifestyle-social and 127 (85%) problem appointments were classified as biomedical. Appointments with a biomedical communication pattern (mean, 11.98 minutes) were significantly longer than appointments with a biolifestyle-social communication pattern (10.43 minutes). Median relationship-centered care score (ie, the ratio of client-centered talk to veterinarian-centered talk) was significantly higher during appointments with a biolifestyle-social communication pattern (1.10) than during appointments with a biomedical communication pattern (0.40). Conclusions and Clinical Relevance—Results suggest that veterinarians in companion animal practice use 2 distinct patterns of communication. Communication pattern was associated with duration of visit, type of appointment, and relationship-centeredness. Recognition of these communication patterns has implications for veterinary training and client and patient outcomes. [ABSTRACT FROM AUTHOR]

Objective--To establish the types of initial questions used by veterinarians in companion animal practice to solicit nutritional history information from owners of dogs and cats, the dietary information elicited, and the relationship between initial question-answer sequences and later nutrition-related questions. Design--Cross-sectional qualitative conversation analytic study. Sample--98 appointments featuring 15 veterinarians drawn from an observational study of 284 videotaped veterinarian-client-patient visits involving 17 veterinarians in companion animal practices in eastern Ontario, Canada. Procedures--Veterinarian and client talk related to patient nutrition was identified and transcribed; conversation analysis was then used to examine the orderly design and details of talk within and across turns. Nutrition-related discussions occurred in 172 visits, 98 of which contained veterinarian-initiated question-answer sequences about patient nutritional history (99 sequences in total, with 2 sequences in 1 visit). Results--The predominant question format used by veterinarians was a w/iaf-prefaced question asking about the current content of the patient's diet (75/99). Overall, 63 appointments involved a single w/iaf-prefaced question in the first turn of nutrition talk by the veterinarian (64 sequences in total). Dietary information in client responses was typically restricted to the brand name, the subtype (eg, kitten), or the brand name and subtype of a single food item. When additional diet questions were subsequently posed, they typically sought only clarification about the food item previously mentioned by the client. Conclusions and Clinical Relevance--Results suggested that question design can influence the accuracy and completeness of a nutritional history. These findings can potentially provide important evidence-based guidance for communication training in nutritional assessment techniques. [ABSTRACT FROM AUTHOR]

Objective--To describe the relationship between veterinarian and client genders and veterinarian-client-patient communication. Design--Cross-sectional descriptive study. Sample--Random sample of 50 companion animal practitioners in southern Ontario and a convenience sample of 300 clients and their pets. Procedures--For each practitioner, 6 clinical appointments were videotaped, and the resulting 300 videotapes were analyzed with the Roter interaction analysis system (RIAS). Linear regression was conducted to study the relationship between demographic factors, measures of veterinarian-client-patient communication, and gender of the veterinarian and client. Results--Female veterinarians conducted more relationship-centered appointments, provided more positive and rapport-building statements, talked more to the patient, and were perceived as less hurried or rushed, compared with male veterinarians. Clients were more likely to provide lifestyle-social information to female veterinarians. Same-gender veterinarian-client interactions were relationship centered and included client provision of more lifestyle-social information. Conclusions and Clinical Relevance--Gender influenced veterinarian-client-patient communication, and previously described physician gender differences in medical communication were largely replicated in the veterinary context. (J Am Vet Med Assoc 2012;241:81-88) [ABSTRACT FROM AUTHOR]

Lameness in dairy cattle poses both an animal welfare and economic threat to dairy farms. Although the Canadian dairy industry has identified lameness as the most important health issue, lameness prevalence in the province of Alberta has not decreased over the last decade. Factors related to lameness have been reported, but the prevalence remains high. Therefore, this study was conducted to investigate dairy producers' perceptions on lameness and how these perceptions influence lameness prevalence in their cows. Qualitative interviews with open-ended questions were conducted with nine dairy producers in Alberta, Canada presenting farms with a wide variety of lameness prevalence. Thematic analysis of these interviews revealed five major themes, as well as five distinct types of producers regarding their perceptions. All nine producers mentioned similar challenges with lameness prevention and control. Identifying lameness, taking action, delays in achieving success, various approaches to prevention and control strategies, and differences between farms were the challenges encountered. However, producers' attitudes when dealing with these challenges varied. We concluded that understanding producers' perceptions is essential as no "one size fits all", when advising them regarding how to address lameness, as guidance and support will be most successful when it is aligned with their viewpoint., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Knauss, Adams and Orsel.)

Objective: To describe client and veterinarian perceptions of client-centeredness during euthanasia discussions and assess agreement between measures of these perceptions., Design: Descriptive study., Sample: Stratified random sample of 32 companion animal veterinarians in southern Ontario., Procedures: 2 case scenarios (a geriatric dog with worsening arthritis and a cat with inappropriate urination) designed to initiate euthanasia discussions were presented by 2 different undisclosed standardized clients (USCs) to study veterinarian communication during clinical visits. At the end of appointments, the USC's identity was disclosed, and questionnaires to measure veterinarian and client perceptions of client-centeredness were completed. Agreement was assessed by statistical methods., Results: Data were analyzed from 60 appointments (30/scenario). Of 10 questions, significant agreement was found between veterinarians and USCs for only 1 (extent to which relevant personal and family issues were discussed; κ = 0.43) for the dog scenario and 3 (extent of discussion of respective roles [κ = 0.43], better preparedness of the USC to make a euthanasia decision [κ = 0.42], and discussion of relevant personal and family issues [κ = 0.25]) for the cat scenario. When the USC and veterinarian disagreed, the veterinarian perceived that the client-centeredness components were addressed more thoroughly than did the USC., Conclusions and Clinical Relevance: Lack of agreement was found between USC and veterinarian perceptions, with USCs perceiving less client-centeredness in euthanasia discussions. This communication gap suggested the need for training of veterinarians in eliciting client perspectives and assessing lifestyle-social information, including client social support systems.

ABSTRACTThe objective of this study was to assess whether pet ownership contributes to social participation and life satisfaction for older adults. We used baseline data from the Canadian Longitudinal Study on Aging (CLSA) for this purpose, and logistic regression models to estimate associations between social participation and life satisfaction for pet owners and non-owners. One third of all older adults (≥ 65 years, n = 7,474) in our sample reported pet ownership. Pet owners were less likely than non-pet owners to report life satisfaction and to participate frequently in social, recreational, or cultural activities, but pet owners were no less satisfied than were non-owners with their current levels of social participation. For pet owners experiencing barriers to social participation, pets appeared protective of life satisfaction in some circumstances. Both individual characteristics and structural factors linked to the World Health Organization's age-friendly communities framework were relevant to understanding these findings.

Feline obesity has become a common disease and important animal welfare issue. Little is known about how, or how often, veterinarians and feline-owning clients are addressing obesity during clinical appointments. The purpose of this qualitative study was to characterize verbal and non-verbal communication between veterinarians and clients regarding feline obesity. The sample consisted of video-recordings of 17 veterinarians during 284 actual appointments in companion animal patients in Eastern Ontario. This audio-visual dataset served to identify 123 feline appointments. Of these, only 25 appointments were identified in which 12 veterinarians and their clients spoke about feline obesity. Thematic analysis of the videos and transcripts revealed inconsistencies in the depth of address of feline obesity and its prevention by participating veterinarians. In particular, in-depth nutritional history taking and clear recommendations of management rarely took place. Veterinarians appeared to attempt to strengthen the veterinary-client relationship and cope with ambiguity in their role managing obesity with humor and by speaking directly to their animal patients. Clients also appeared to use humor to deal with discomfort surrounding the topic. Our findings have implications for communication skills training within veterinary curricula and professional development among practicing veterinarians. As obesity is complex and potentially sensitive subject matter, we suggest a need for veterinarians to have further intentionality and training toward in-depth nutritional history gathering and information sharing while navigating obesity management discussions to more completely address client perspective and patient needs.

The objective of this qualitative study was to compare veterinarians' and Registered Veterinary Technicians' (RVT's) perceptions of the veterinary healthcare team with respect to the impact of toxic attitudes and a toxic environment. Focus group interviews using a semi-structured interview guide and follow up probes were held with four veterinarian groups (23 companion animal veterinarians) and four Registered Veterinary Technician groups (26 RVTs). Thematic analysis of the discussions indicated both veterinarian and RVT participants felt team members with manifestations of toxic attitudes negatively impacted veterinary team function. These manifestations included people being disrespectful, being resistant to change, always wanting to be the "go to person," avoiding conflict, and lacking motivation. When conflict was ignored, or when people with toxic attitudes were not addressed, a toxic environment often resulted. A toxic environment sometimes manifested when "broken communication and tension between staff members" occurred as a result of employees lacking confidence, skills, or knowledge not being managed properly. It also occurred when employees did not feel appreciated, when there was difficulty coping with turnover, and when there were conflicting demands. The presence of people manifesting a toxic attitude was a source of frustration for both veterinarian and RVT participants. Prompt and consistent attention to negative behaviors is recommended to reduce the development of a toxic environment.

The purpose of this paper is to describe the challenges of service-dog ownership for families with autistic children. Through a qualitative interview process, this study has found that the integration of a service dog into a home environment is a highly dynamic and interactive process with numerous benefits and challenges. Public-access issues, learning to interpret dog behavior, the time constraints of increased social interactions, and the time of year the dog is placed into the family are important components affecting parental satisfaction. Parent, family, and child challenges included the dog being extra work, finding added time to maintain training, financing care for the dog, and the impact on family dynamics. These factors and challenges were appraised in order to understand the impact that they could have on the perceived success of the placement, parental satisfaction, and the dog itself. Despite the effects and consequences of these challenges, the parents overwhelmingly reported that having a service dog to keep their child safe and to provide companionship was well worth the many inconveniences of service-dog ownership. Most importantly, attention needs to be drawn to these challenges to promote the safety of both the child and the dog, minimize stress on the family, and encourage veterinary support of these highly dynamic relationships.

This article describes the first use of undisclosed standardized clients (SCs) for research in the veterinary clinical setting. The study described here used SCs to investigate veterinarian-client communication during euthanasia discussions. Use of this methodology allowed us to avoid several ethical and logistical challenges associated with gathering observational data on sensitive subject matter. In medicine, standardized patients (SPs) are used extensively in teaching, medical school examinations, and licensing examinations. Increasingly, SPs are being used in research to evaluate physicians' performance in the clinical setting, including assessment of physician-patient communication. Several veterinary schools have recently introduced SCs for teaching and evaluation of student veterinarians. Until now, however, SCs have not been used for research in the veterinary clinical setting. Two cases were designed to reflect common reasons for discussion of euthanasia in private practice. A random sample of 32 consenting veterinarians in southern Ontario saw each case. Appointments were audio-recorded and analyzed using a communication assessment tool adapted from human medicine. At the end of each appointment, the SC disclosed his or her identity and both veterinarian and SC completed questionnaires to describe their perceptions of the communication that took place. This article describes in detail the use of SCs in this study, including case design, training, preparation for visits, use of animal patients, and challenges faced. The use of SCs was shown to be a feasible method of assessing veterinarian-client communication in the clinical setting.

The use of service dogs for children with autism spectrum disorder is a relatively new and growing assistance-dog application. The objectives of this article were to identify and describe the factors influencing an autism service dog's performance and the impact of this type of placement on the dog's welfare. A qualitative approach uses interview and observational data to characterize the dogs' behaviors and welfare with relevancy to the dogs' home environments. Identification of potential physical stressors included lack of rest or recovery time after working, unintentional maltreatment and prodding by children with autism, lack of predictability in daily routines, and insufficient opportunities for recreational activities. Results revealed that these dogs formed social relationships primarily with the parents and second with the children with autism. Failure to recognize and respond to the identified physical, emotional, and social needs can have serious impacts on the behavior, welfare, and performance of these autism service dogs, as well as parental satisfaction. As applications of service dogs expand to new domains, there is a need to assess and understand factors and variables affecting the relationship between family and service dog to ensure continued success of these programs.

Effective communication is necessary for achieving important outcomes in veterinary practice, including patient health, accuracy, efficiency, and economic viability. Communication is a series of learned skills. Daily practice, feedback, and refinement are the ingredients for continued practice success.

Communication is a core clinical skill of veterinary medicine and one that needs to be taught and learned to the same degree as other clinical skills. To provide this education and essential expertise, veterinary schools in many countries, especially including North America, the United Kingdom, and Australia, have begun to develop programs and communication curricula. Human medical education, however, has 30 years' experience in developing communication curricula, and is thus an excellent resource upon which veterinary educators can build and shape their own communication programs. This article describes a skills-based communication course that has been successfully implemented for veterinary medical education at Ontario Veterinary College (OVC) and was based on the University of Calgary Faculty of Medicine's well-established program. The Calgary-Cambridge Guides and supporting textbooks provide the scaffolding for teaching, learning, and evaluation in both programs. Resources such as space and materials to support the OVC program were also patterned after Calgary's program. Communication skills, and the methods for teaching and learning them, are equally applicable for the needs of both human medicine and veterinary medicine. The research evidence from human medicine is also very applicable for veterinary medicine and provides it the leverage it needs to move forward. With this extensive base available, veterinary medicine is in a position to move communication skills training forward rapidly.

Reflection, or the ability to step back from an experience and consider it critically, in an analytical, non-subjective manner, is an essential aspect of problem solving and decision making, and also of effective communication with clients and colleagues. Reflective practice has been described as the essence of professionalism and is therefore a core professional skill; rarely, however, has it been explicitly taught in veterinary curricula, and it has only a recent history in undergraduate human medical curricula. We describe here two preliminary case studies, one in a veterinary medical education context and the other within a human medical education framework, as examples of approaches to assessing a student's ability for ''reflection.'' The case studies also illustrate some of the key principles. Both of the case studies described had as their end goal the enhancement of communication skills through critical reflection. At Monash University, Australia, the majority of students were assessed as being at a level of ''reflection in development.'' The students in the Ontario Veterinary College case study showed moderately good use of self-awareness and critical reflection as a basis for modifying and integrating communication skills into practice. While both preliminary case studies point to the fact that students recognize the importance of communication and value the opportunity to practice it, few students in either case study identified the importance of reflection for lifelong learning and professional competence. Opportunities to complete critical reflection exercises in other parts of curricula and outside of communication would likely reinforce its importance as a generic skill. Ongoing scholarly approaches to teaching, learning, and evaluating reflection and self-awareness are needed.