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To quantify veterinary students' retention of surgical skills after a 5-month period without practice.Prospective longitudinal descriptive study.Convenience sample of second year veterinary students (n = 57).Students practiced ovariohysterectomy (OVH) on a model during 4 clinical skills laboratories during spring 2021. Students were assessed performing OVH on their model using a validated 22-item rubric. Students not meeting expectations repeated their assessment 2 weeks later. All students had a 5-month period, including summer break, without skills practice. Students were again assessed performing OVH on their model in the fall. Students' rubric scores and pass rates were compared before and after summer break.Students scored lower on their retention test in fall (median = 43) than at the spring assessment (median = 56, P .001). No difference was detected between lower and higher performing students. Five students (9%) did not meet expectations on their first assessment; more students (17/57, 30%) failed to meet expectations on their retention test (P = .004).Students experienced a decay in the surgical skills required to perform OVH after a 5-month period without practice, regardless of the quality of their initial performance.Veterinary educators should emphasize the importance of continual practice to maintain skills and should consider assisting students in regaining skills during review sessions on models to improve surgical skill retention after a prolonged break.

Objectives The aim of this study was to compare the publication rate (PR) and report descriptive findings from abstracts presented at the American College of Veterinary Surgeons (ACVS), the Veterinary Orthopaedic Society (VOS), and those presented at both conferences. Study Design All conference abstracts from 2001 to 2010 ACVS and VOS meetings were reviewed. PR in peer-reviewed journals was evaluated and compared between Group 1 (abstracts presented at ACVS only; n = 1,277), Group 2 (abstracts presented at VOS only; n = 645), and Group 3 (abstracts presented at both conferences; n = 121) abstracts. Abstracts were assigned a level of evidence (LoE) score. Results Approximately 6% of all abstracts evaluated were presented at two scientific meetings (Group 3). The PR of Group 1 (66%) and Group 3 (62%) abstracts was significantly higher than that of Group 2 (45%). The majority of abstracts were assigned a low LoE (3 or 4). Once presented, most Group 3 abstracts took Conclusion This study found that a limited number of abstracts were presented at both ACVS and VOS, and PR was significantly different between those presented at ACVS only or both ACVS and VOS compared with VOS only. There was no significant difference in PR between Group 1 and Group 3 abstracts. This study has provided the initial comparison between abstracts presented at two veterinary surgical conferences.

OBJECTIVE To provide a systematic assessment of the efficacy of preoperative skin asepsis using chlorhexidine versus povidone-iodine based protocols for surgical site infection (SSI) prevention in veterinary surgery. STUDY DESIGN Systematic meta-analytical review according to PRISMA-P guidelines. SAMPLE POPULATION Studies comparing preoperative skin asepsis protocols using chlorhexidine versus povidone-iodine in veterinary surgery identified by systematic search between 1990 and 2020. METHODS A search using MEDLINE/Pubmed, Web of Science and CAB Abstracts was performed, followed by secondary searches of Google Scholar, Proquest Dissertation and Theses, and relevant bibliographic articles. Primary and secondary outcome measures were the efficacy of skin asepsis protocols using chlorhexidine versus povidone-iodine on SSI incidence and skin bacterial colonization, respectively. A meta-analysis was performed with a random-effect model, with effect size calculated as risk ratio (RR) or mean standard deviation (MSD) with 95% CI. Statistical significance was set at P

OCCUPATIONAL APPLICATIONSVeterinarians provide comprehensive health services for animals, but despite exposure to similar occupational and safety hazards as medical physicians, physical risk factors for these doctors and healthcare teams have not been characterized. In this pilot study, we used wearable sensor technology and showed that veterinary surgeons commonly experience static and demanding postures while performing soft tissue and orthopedic surgeries. Observations showed that muscle activation was highest in the right trapezius. Job factors such as surgical role (attending vs. assisting) and surgical specialty (soft tissue vs. orthopedics) appeared to influence exposure to physical risk factors. These findings suggest a need to consider the unique demands of surgical specialties in order to address the key risk factors impacting injury risks among veterinarians. For example, static postures may be a priority for soft tissue surgeons, while tools that reduce force requirements are more pressing for orthopedic surgeons.Although musculoskeletal fatigue, pain, and injuries are commonly reported among surgeons in veterinary medicine, few studies have objectively characterized the exposure to physical risk factors among veterinary surgeons.

OBJECTIVE To determine the influence of a custom 3D-printed guide for placement of cortical bone screws in the equine navicular bone. STUDY DESIGN Ex vivo study. SAMPLE POPULATION Eight pairs of normal adult equine forelimbs. METHODS A 3.5 × 55 mm cortical screw was placed in the longitudinal axis of each intact navicular bone. Screws were placed with a 3D-printed guide (3D) in one bone and with a traditional aiming device (AD) in the contralateral bone within each pair. Duration of surgery and the number of fluoroscopy images were compared between techniques. Screw placement was subjectively evaluated by gross examination and scored by three boarded veterinary surgeons. RESULTS The use of a 3D-printed guide reduced the duration of surgery by 6.6 min (±1.5 min) compared to traditional screw placement (20.7 min ± 4.8 min, p

OBJECTIVE To determine which attributes of residency applicants were most commonly assessed by large and small animal American College of Veterinary Surgeons diplomates and to determine which evaluation methods were perceived to assess those attributes. STUDY DESIGN Online survey. SAMPLE POPULATION American College of Veterinary Surgeons board-certified surgeons as of March 2019. METHODS An online survey was sent to eligible individuals. Respondents rated the importance of 23 attributes assessed by the Veterinary Internship and Residency Matching Program (VIRMP) application as well the usefulness of interviews, conversations with people knowledgeable with the applicants, and review of the VIRMP packet for evaluating each of these attributes. Responses were compared between large and small animal practitioners and between individuals involved in residency selection (supervisors) and individuals not involved in residency selection (nonsupervisors). RESULTS Surveys were completed by 221 individuals (14.6% response rate). Seventeen of the 23 attributes were considered important by most respondents. Grade point average (GPA) and class rank were used as screening tools by 73% and 65% of supervisors, respectively. Letters of reference (LOR) were ranked as the most important part of the VIRMP packet. Conversations with people knowledgeable with the applicant was the only method judged by most respondents to be appropriate to evaluate all 23 attributes. Responses were similar between large and small animal supervisors and nonsupervisors. CONCLUSION Respondents considered conversations with people knowledgeable with the applicant to be the most useful methods for assessing a resident applicant, but LOR, GPA, and class rank were also important. IMPACT Resident applicants and mentors can use this information to strengthen applications.

OBJECTIVE To evaluate the influence of instructor to student ratio on the effectiveness and efficiency of teaching suturing skills to veterinary students. STUDY DESIGN Prospective randomized study. SAMPLE POPULATION Second-year veterinary students (N = 121). METHODS Students were randomly divided into three groups to participate in four 2-hour skills laboratory sessions in which suturing of the subcutaneous tissue was taught by using a simple continuous pattern, suturing of the skin was taught by using continuous patterns, suturing of the skin was taught by using interrupted patterns, and suturing of hollow organs was taught by using inverting patterns. For each laboratory, the groups were taught by using instructor-to-student ratios of 1:6, 1:8, and 1:10 on a rotating basis. Students were surveyed at the end of each laboratory, and underwent individual performance assessments at the end of each laboratory session and again at the end of the semester in an objective structured clinical examination (OSCE). RESULTS For each of the four in-laboratory assessments and the OSCE, no difference in performance was detected between groups. When they were surveyed, students in all groups reported that there was an adequate number of instructors in the laboratory and that they received help in a timely fashion when help was requested (median for all groups = agree). CONCLUSION For students with prior surgical skills education and with the use of prelaboratory instructional videos, teaching at the 1:10 instructor-to-student ratio was efficient and effective. CLINICAL SIGNIFICANCE Good educational outcomes may be reached with a 1:10 instructor-to-student ratio or, potentially, fewer instructors, depending on the educational aids present in the laboratory and students' prior level of experience.

OBJECTIVE: The goal of this study was to evaluate and report details of a remotely taught surgical laboratory. STUDY DESIGN: Observational. SAMPLE POPULATION: Second-year veterinary students (n = 143) enrolled in a surgical laboratory; 9 weeks were taught traditionally, and 6 weeks were taught remotely. METHODS: Because of the global pandemic, remote laboratories were developed and delivered. Students performed surgical procedures in model organs remotely while being observed by and receiving feedback from instructors on an internet-based video platform. Methods for remote surgical teaching were explored, and successes and challenges were detailed. Surveys were administered to the students and faculty to gather perspectives on their experience and subsequent confidence. RESULTS: Surveys were completed by 81 of 143 (57%) students and seven of seven (100%) instructors. The mean overall student satisfaction score (1 not at all satisfied, 10 very satisfied) for in-person instruction was 8.2, and the mean score for remote instruction was 6.2 (P < .001). Overall, the instructors had a mean satisfaction score of 8 for in-person laboratories and a mean satisfaction score of 6 for remotely taught laboratories. Most students had a perception of greater one-on-one instructor attention in remote laboratories. Students reported similar confidence levels for three surgical procedures. CONCLUSION: The described remote teaching method resulted in the perception of greater instructor attention given to students. Student and instructor satisfaction was lower with remote teaching than with in-person teaching. IMPACT: The described method of remote teaching may be applied to teaching surgical students in settings when face-to-face instruction cannot be achieved and may be developed further to create an experience equivalent to face-to-face instruction.

OBJECTIVE: To determine the use and barriers to uptake of a surgical safety checklist (SSC) after implementation in a veterinary teaching hospital. STUDY DESIGN: Voluntary online survey and retrospective study. SAMPLE POPULATION: All personnel actively involved in the Ontario Veterinary College Health Sciences Centre small animal surgery service between October 2, 2018 and June 28, 2019. METHODS: Surgical case logs and electronically initiated SSC were reviewed to calculate checklist use. The sample population was surveyed to identify factors and barriers associated with use of the SSC. Participants were allowed 1 month to respond, and five reminder emails were sent. RESULTS: Forth‐one of 50 (82%) participants completed the survey. The SSC was used in 374 of 784 (47.7%) surgeries. Use rates declined over sequential three‐month intervals (P

In the UK, it is currently recommended that owned cats be neutered from four months of age. However, its uptake is inconsistent across the veterinary profession. Here we assess the effect of a brief video intervention that aimed to encourage four month neutering, whilst preserving clinical autonomy. We compare this theory-driven approach with traditional information giving and a control group. Veterinary surgeons who regularly undertook feline neutering work in the UK but did not routinely neuter cats at four months and/or recommend four month neutering for client owned cats were randomised into three groups (n = 234). Participants received either no information, a written summary of evidence or the video. The primary behaviour outcomes were the recommending and carrying out of neutering cats at four months. Evaluative, belief and stages of change measures were also collected. Self-reported outcomes were assessed pre-intervention, immediately post-intervention, two months post-intervention and six months post-intervention. At two months, participants that had received the video intervention were significantly more likely to have started recommending neutering cats at four months. At six months, participants that had received the video intervention were significantly more likely to have started carrying out neutering cats at four months. There were no significant behaviour changes for the other groups. At two months, the video intervention was associated with a significant increase in thinking about, and speaking to colleagues about, four-month neutering, relative to the control group. The written summary of evidence had no similar effect on stages of change, despite it being perceived as a significantly more helpful resource relative to the video. To conclude, a brief one-off video intervention resulted in an increase in positive behaviours towards neutering cats at 4 months, likely mediated by the social influences of the intervention prompting the opportunity to reflect and discuss four-month neutering with colleagues.

Aims: To compare the duration of anaesthesia, surgery, and postoperative hospitalisation, the proportion of tumours excised with complete histologic margins and immediate postoperative surgical sit...

Objective To determine attributes of applicants to small animal surgery residency programs (SRP) that are considered important, favorable, or detrimental according to surgeons at SRP registered with the American College of Veterinary Surgeons (ACVS). Study design Online survey. Sample population Residency-trained surgeons at ACVS-registered SRP. Methods An online survey was advertised to eligible surgeons. Respondents anonymously provided information about their professional backgrounds and SRP interview practices and rated candidate attributes in terms of importance during application screening and favorable or detrimental effects during selection or ranking. Responses were compared by respondent practice setting and sex. Results Surveys were completed by 148 of 289 (51%) invited surgeons. Male and female surgeons were equally represented, and 61% worked in academia. Most respondents' SRP offered in-person interviews, typically to a select applicant group from whom residents were ultimately chosen. Letters of recommendation were the most influential factor in all phases of application review, particularly when respondents knew the writers. Other critical attributes were academic record, internship reputation, research activity, and indices of interpersonal skills. Nearly all respondents considered multiple prior unsuccessful applications detrimental. Academic respondents emphasized academic performance and academic internships; private practice respondents valued personal contact with applicants and surgical specialty internships. Responses did not differ by self-identified gender. Conclusion Surgery residency program surgeons preferred first- or second-time applicants with excellent academic credentials, specific internship and research experiences, and letters of support from trusted colleagues as well as strong interpersonal skills. Clinical impact Prospective residents can use this information to assess their candidacies, identify potential weaknesses, and prepare competitive applications.

Although desexing surgeries are considered a core clinical skill for small animal veterinary practice, it can be challenging for veterinary schools to provide students with adequate training opportunities in the traditional curriculum. At the Massey University School of Veterinary Science, we recently established an innovative extracurricular volunteer program designed to have students teaching other students how to perform different elements of desexing procedures as they progress through their degree. This program includes administrative and assistant roles for first-year students (responsible for client communication, patient restraint, and medical record keeping), physical exam and recovery roles for second-year students (responsible for assessing patient fitness for surgery, drawing up anesthetic drugs, and monitoring patients in recovery), anesthesia and neuter surgeon roles for third-year students (responsible for inducing, preparing, and monitoring spay patients and performing cat neuter surgeries), and spay surgeon roles for fourth- and fifth-year students (responsible for performing cat spay surgeries, discharging patients, and following up with clients to monitor recovery). This program has been successful in improving student confidence and competence while also providing a valuable low-cost desexing service to the community. In this article, we discuss the practical considerations and processes involved in implementing this program, including mapping the existing surgical curriculum, recruiting patients, setting up the surgical facilities, purchasing equipment and supplies, establishing standard operating procedures, developing training materials, maintaining clinic records, and monitoring program outcomes. These resources can serve as guidelines for other veterinary schools looking to expand desexing surgery training opportunities for students.

Surgical excision is the foundation of treatment for early-stage solid tumors in man and companion animals. Complete excision with appropriate margins of surrounding tumor-free tissue is crucial to survival. Intraoperative imaging allows real-time visualization of tumors, assessment of surgical margins, and, potentially, lymph nodes and satellite metastatic lesions, allowing surgeons to perform complete tumor resections while sparing surrounding vital anatomic structures. This Review will focus on the use of near-infrared imaging and optical coherence tomography for intraoperative tumor visualization.

Background Calf disbudding is a welfare-relevant invasive husbandry procedure. While it is widely recognized that disbudding elicits acute pain, its chronic consequences are currently unknown. Objectives Primary aim of this study was to investigate whether disbudding leads to chronic pain in calves; secondary aim was to evaluate the influence of age at disbudding (1 week versus 4 weeks). Methods Thirty-four Holstein bull calves, enrolled in a prospective, controlled, randomized trial, underwent either early disbudding (ED) or late disbudding (LD) or sham treatment (control) at 1 and 4 weeks of age. Pain scoring and quantitative sensory tests (von Frey filaments and algometry) were performed at regular intervals up to 105 days of life; neurophysiological determination of nociceptive reflex thresholds and conditioned pain modulation (CPM) up to 90 days. Data was analyzed with the Brunner and Langer model followed by post-hoc test, with level of significance set at 0.05. Results Thirty-one calves completed the data collection. Signs of chronic sensitization were observed in 38% of disbudded calves (4 in ED and 4 in LD). Pain scores (until 105 days) and allodynia scores (until 60 days) were significantly higher while pressure thresholds (until 105 days) were significantly lower in both groups ED and LD compared to control. Late disbudded calves showed impairment of trigeminal CPM. Lower laser-evoked trigeminal reflex thresholds were found in clinically painful calves compared to control. Conclusions The sequelae of disbudding can extend beyond the acute post-procedural phase. Chronic trigeminal sensitization, independently from the age at disbudding can affect individual calves.

OBJECTIVE To evaluate the perceived efficacy of a high-fidelity synthetic canine model for simulating common gastrointestinal surgical procedures. STUDY DESIGN Survey of students and experienced clinicians. SAMPLE POPULATION Twelve clinicians with >2 years of postgraduate experience in the field of small animal surgery and 102 senior year veterinary students. METHODS The model was subjectively evaluated by 12 clinicians with >2 years of postgraduate experience in the field of small animal surgery. Senior year veterinary students (n = 102) were asked to complete questionnaires before and after a laboratory on common gastrointestinal surgical procedures that included rating of perceived proficiency, anatomical knowledge, and the use of synthetic models compared with live animals. RESULTS Clinicians assessed most aspects of the model as moderately realistic and unanimously agreed that it would be helpful for students to train on this model prior to live surgery. Student survey response rates were 91% and 99% before and after the laboratory, respectively. The proportion of students that felt moderately-to-highly proficient with the procedures increased from 8% prior to the laboratories to 59% after the laboratories (P

OBJECTIVE To determine complication rates for elective gonadectomy procedures performed by veterinary students on dogs and cats in an animal shelter, characterize these complications, and compare rates with those for shelter-employed veterinarians (SEVs). DESIGN Retrospective cohort study. ANIMALS 10,073 dogs and cats for which gonadectomy was performed by a veterinary student (n = 3,048 surgeries) or SEV (7,025 surgeries) at an urban animal shelter over a 16-month period. PROCEDURES Electronic medical records for included dogs and cats were reviewed and data collected regarding patient signalment, duration of gonadectomy, surgeon type (student or SEV), and types of surgical complications recorded (including death or euthanasia) during the period from anesthetic induction to 72 hours after surgery. Complication and mortality rates were compared between veterinary students and SEVs. RESULTS No significant differences were identified between students and SEVs regarding rates of overall complications for both species, minor complications for both species, major complications for both species, and overall complications for dogs or cats specifically. The most common complications were self-limiting, with no long-term consequences, for both students and SEVs. Differences in mortality rates between students and SEVs could not be definitively determined owing to low numbers of nonsurviving patients. CONCLUSIONS AND CLINICAL RELEVANCE With judicious case selection and as a part of a surgical training program, complication rates for veterinary student–performed gonadectomy procedures for dogs and cats were no different from those for SEV-performed gonadectomy procedures. We believe such information regarding patient outcomes will allow shelter staff to make informed decisions and help them in discussions with stakeholders who may have concerns about student participation.

is a locum vet at All Creatures Healthcare in Horsford, Norfolk It was the middle of summer and I was standing in the stiflingly hot, airless surgery room. I was swaddled head-to-toe in full scrubs, a surgical gown, hat, mask and sticky latex gloves. The heat felt overwhelming and my mask was making it difficult to breathe. I could hear the clock ticking in the corner, and I kept praying that its hands would miraculously turn backwards to give me just a little bit more time. I was in the middle of performing a spay on an extremely overweight Rottweiler. Blood was slowly oozing to the surface – but where exactly it was coming from, I wasn’t sure. > The longer I tried to locate the bleeding vessel, the more stressed I became. And the more stressed I became, the more difficult it was …

Background: Drilling accuracy is essential in the correct positioning of implants and avoidance of iatrogenic damage to surrounding tissues. The use of augmented drilling methods has been documented as an approach to improving the accuracy of drilling. The aim of this study was to compare the accuracy of two augmented drilling methods (fluoroscopy, aiming device) to free-hand drilling. Methods: Three experienced specialist surgeons and three veterinary surgeons without primary orthopaedic experience drilled into synthetic bone towards a target using the three different methods at three different angles (0o, 10o and 20o). The duration of drilling was recorded, and the accuracy of drilling measured using photographs before and after drilling.Results: The two augmented methods were more accurate than free-hand drilling in synthetic bone with the aiming device producing the greatest accuracy. Increased angulation of drilling decreased the drilling accuracy. Surgeon experience did not impact on drilling accuracy. Surgeon inexperience and augmented drilling methods both increased the time taken to drill.Conclusion: The use of augmented drilling methods improved the accuracy of drilling and surgeons should consider their use when drilling in anatomical regions where the margin of error is small.

Objective To assess the prevalence of work-related musculoskeletal disorders (WRMD) associated with laparoscopy in veterinary surgery. Study design Cross-sectional survey. Sample population Veterinary surgeons who perform laparoscopy. Methods Responses were collected with data regarding laparoscopic activities and experience as well as whether the respondents experienced pain as a result of laparoscopy and, if so, additional information on this topic. Variables associated with the risk of experiencing pain were determined by using χ2 tests and odds ratios (OR). Results There were 149 respondents, an estimated 6% response proportion. Forty percent experienced pain that they attributed to the use of laparoscopic instruments during or after laparoscopic surgery. Surgeons who perform laparoscopic surgery frequently (at least monthly) were more likely to experience pain as a result of laparoscopic surgery compared with those who perform laparoscopic surgery infrequently (OR 2.25; 95% confidence interval 1.07-4.75; P = .033). Pain during or after laparoscopic surgery was most often experienced in the neck (81%), back (77%), and shoulders (75%), with 90% of respondents reporting that surgery exacerbated their pain. Fifty-four percent of respondents experienced the pain at home, 64% had taken painkillers for the pain, and 46% had sought other treatment for the pain such as physiotherapy, chiropractic treatment, or seeing a doctor. Conclusion Laparoscopic surgery was a potential source of pain in a proportion of surgeons. Surgeons who frequently perform laparoscopic surgery were more likely to experience a WRMD. Clinical significance Work-related musculoskeletal disorders may occur as a result of performing laparoscopic surgery.

OBJECTIVE To quantify noise levels in veterinary operating rooms (OR) and evaluate factors affecting them. STUDY DESIGN Pilot study. SAMPLE POPULATION Seventy-seven small-animal surgical procedures at the University of Florida College of Veterinary Medicine Small Animal Hospital. METHODS A decibel-measuring device was used to measure mean A-weighted, median, and maximum decibel readings within the OR. The number of people present in the OR, the number of people scrubbed in, the surgery service, and whether or not music was playing were recorded. RESULTS The mean, median, and maximum decibel levels for all surgeries were 71.7 A-weighted decibels [dB(A)], 69.4 dB(A), and 90.3 dB(A), respectively. Neurologic surgeries were associated with higher noise levels. OR with music playing were louder than those without music (P

OBJECTIVE To develop and validate a simulation model for laparoscopic ovariectomy in standing horses. DESIGN Prospective cohort study. SAMPLE 15 third-year veterinary students and 4 equine surgeons with experience in laparoscopy. PROCEDURES A simulation model that mimicked laparoscopic ovariectomy in standing horses was developed. Face validity of the model was determined with a questionnaire completed by the equine surgeons. Construct validity was determined by comparing performance scores (based on time to completion and accuracy completing various operative tasks) for simulated laparoscopic ovariectomy performed in the model for the students with scores for the equine surgeons. Concurrent validity was assessed by comparing performance scores with scores obtained with the validated McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS). RESULTS Questionnaire responses indicated that the simulation model replicated the operative experience to a high degree (face validity). Performance scores for simulated laparoscopic ovariectomy performed in the model were significantly different between the students and the equine surgeons (construct validity). Performance scores for the simulation model were significantly correlated with scores for the MISTELS (concurrent validity). CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that the simulation model had face, construct, and concurrent validity, suggesting that it may be useful when training students to perform laparoscopic ovariectomy in standing horses.

OBJECTIVE: To evaluate the safety and usability of a wearable, waterproof high‐definition camera/case for acquisition of surgical images by sterile personnel. STUDY DESIGN: An in vitro study to test the efficacy of biodecontamination of camera cases. Usability for intraoperative image acquisition was assessed in clinical procedures. METHODS: Two waterproof GoPro Hero4 Silver camera cases were inoculated by immersion in media containing Staphylococcus pseudointermedius or Escherichia coli at ≥5.50E+07 colony forming units/mL. Cases were biodecontaminated by manual washing and hydrogen peroxide plasma sterilization. Cultures were obtained by swab and by immersion in enrichment broth before and after each contamination/decontamination cycle (n = 4). The cameras were then applied by a surgeon in clinical procedures by using either a headband or handheld mode and were assessed for usability according to 5 user characteristics. RESULTS: Cultures of all poststerilization swabs were negative. One of 8 cultures was positive in enrichment broth, consistent with a low level of contamination in 1 sample. Usability of the camera was considered poor in headband mode, with limited battery life, inability to control camera functions, and lack of zoom function affecting image quality. Handheld operation of the camera by the primary surgeon improved usability, allowing close‐up still and video intraoperative image acquisition. CONCLUSION: Vaporized hydrogen peroxide sterilization of this camera case was considered effective for biodecontamination. Handheld operation improved usability for intraoperative image acquisition. CLINICAL SIGNIFICANCE: Vaporized hydrogen peroxide sterilization and thorough manual washing of a waterproof camera may provide cost effective intraoperative image acquisition for documentation purposes.

Objective To evaluate a method to assess surgical skills of veterinary students that is based on digital recording of their performance during closure of a celiotomy in canine cadavers. Sample population Second year veterinary students without prior experience with live animal or simulated surgical procedure (n = 19) METHODS: Each student completed a 3-layer closure of a celiotomy on a canine cadaver. Each procedure was digitally recorded with a single small wide-angle camera mounted to the overhead surgical light. The performance was scored by 2 of 5 trained raters who were unaware of the identity of the students. Scores were based on an 8-item rubric that was created to evaluate surgical skills that are required to close a celiotomy. The reliability of scores was tested with Cronbach's α, intraclass correlation, and a generalizability study. Results The internal consistency of the grading rubric, as measured by α, was .76. Interrater reliability, as measured by intraclass correlation, was 0.64. The generalizability coefficient was 0.56. Conclusion Reliability measures of 0.60 and above have been suggested as adequate to assess low-stakes skills. The task-specific grading rubric used in this study to evaluate veterinary surgical skills captured by a single wide-angle camera mounted to an overhead surgical light produced scores with acceptable internal consistency, substantial interrater reliability, and marginal generalizability. Impact Evaluation of veterinary students' surgical skills by using digital recordings with a validated rubric improves flexibility when designing accurate assessments.

Objective To describe a modified rib pivot thoracotomy and its clinical application in client-owned dogs and cats. Study design Case series of 24 dogs and 1 cat requiring a thoracotomy. Methods A lateral thoracic incision over the required thoracic segment was made. The latissimus dorsi muscle was reflected dorsally. The predetermined rib was identified and the periosteum overlying the rib was elevated circumferentially, avoiding the intercostal neurovascular structures. Holes were pre-placed above and below the proposed osteotomy site. The rib was osteotomised and pivoted cranially. The pleura was incised and the required intrathoracic procedure was then performed. The thoracic cavity was closed by pre-placement of a suture through the pre-placed holes within the osteotomised rib. The pleura and intercostal musculature were closed, avoiding the intercostal neurovascular structures. The rib was re-apposed and the lateral approach was closed. The cases included were reviewed for both the rib pivoted as per the procedure required and postoperative complications. Results The study group comprised 8 Staffordshire Bull Terriers, 2 Poodles, 2 German Shepherd Dogs, 1 each of Basset Hound, Rhodesian Ridgeback, Golden Retriever, Australian Shepherd, Vizsla, Bull Mastiff, Schnauzer, Jack Russell Terrier, Bulldog, Deerhound, Labrador Retriever and Australian Terrier, and 1 cat. A modified rib pivot thoracotomy was performed for lung lobectomy (n = 11), oesophagectomy (7), subtotal pericardectomy (5), patent ductus arteriosus ligation (1) and thoracic duct ligation (1). Follow-up ranged from 2 to 40 weeks postoperatively. Postoperative complications included seroma formation in two dogs. Conclusion A modified rib pivot thoracotomy should be considered as an alternative lateral thoracic approach with good exposure, minimal complications and low morbidity.

Summary Pancreatic islet β cells secrete insulin in a biphasic manner when sensing high blood glucose level. This protocol describes the evaluation of different phases of insulin secretion, as well as basal, glucose-stimulated and total insulin secretion abilities, thereby enabling precise assessment of β cell function both in vivo and ex vivo. The in vivo assay consists of intravenous tube imbedding surgery and hyperglycemic clamp. The ex vivo assay consists of islet isolation, dynamic perfusion and static immersion. For complete details on the use and execution of this protocol, please refer to Sun et al. (2021)., Graphical abstract, Highlights • Glucose-stimulated biphasic insulin secretion (GSIS) in mouse islet β cells • Optimized and detailed tube embedding surgery for in vivo GSIS assay • Careful islet isolation and verification is essential for ex vivo GSIS assay • Adaptable procedure to monitor both human and murine islet β-cell function ex vivo, Pancreatic islet β cells secrete insulin in a biphasic manner when sensing high blood glucose level. This protocol describes the evaluation of different phases of insulin secretion, as well as basal, glucose-stimulated and total insulin secretion abilities, thereby enabling precise assessment of β cell function both in vivo and ex vivo. The in vivo assay consists of intravenous tube imbedding surgery and hyperglycemic clamp. The ex vivo assay consists of islet isolation, dynamic perfusion and static immersion.

OBJECTIVE To define learning curves for fourth-year veterinary students performing ovariohysterectomy procedures in dogs and cats and castration in dogs. DESIGN Retrospective study. SAMPLE 3,196 ovariohysterectomies or castrations performed in dogs and cats by 88 veterinary students during a spay-neuter surgery and animal shelter rotation (n = 3,056) or by 1 experienced general practitioner (n = 140). PROCEDURES Data collected from medical records included patient signalment, type and duration of procedure, and sequence (by date and time) of the procedure within a list of procedures of the same type generated for each student. For each procedure type, geometric mean surgery time and 95% confidence intervals were determined for each number of surgeries completed by ≥ 10 students. Median surgery times for the same procedure types were determined for the experienced practitioner. The learning curve for each procedure was modeled with nonlinear (3-factor exponential equation with a nonzero asymptote) and linear regression. For each procedure, the asymptote (optimal surgery time) for students was compared with the experienced practitioner's median surgery time. RESULTS 2,945 surgeries (mean, 33/student) performed by ≥ 10 students were analyzed. Surgery time decreased in a nonlinear manner as student experience increased for castration of adult or pediatric dogs and ovariohysterectomy of pediatric dogs and adult or pediatric cats. Surgery time decreased in a linear manner as experience increased for ovariohysterectomy of adult dogs. CONCLUSIONS AND CLINICAL RELEVANCE To the authors' knowledge, this was the first study to map surgery times for common surgical procedures consecutively performed by veterinary students. Results clearly indicated the value of repetition to improve surgical skills (as measured by surgery time) during a 3-week period.

Objective To compare design features and mechanical properties of 13 commercially available Veress needles (VN). Study design In vitro biomechanical study. Sample population Veress needles from 9 manufacturers (6 reusable, 6 disposable, and 1 with a reusable stylet combined with a disposable cannula) were included in the study. Methods Veress needles are designed with a spring-loaded stylet to protect the tip of the cannula following insertion into the abdomen. Stylet forces were measured with a scale in a test jig by moving the stylet in 0.5 mm steps into the hollow cannula. Forces and spring rates were derived from force-displacement plots. Mass, mechanical dimensions, and the bevel angle and geometry were assessed. Differences between VN models were analyzed with a univariate analysis of variance. Results are reported as mean ± SD or median (range). Results Physical and mechanical parameters differed between models. The exposed stylet length was 3.5 mm (2-7). Three bevel geometries (bias, lancet type, and back-cut) with angles between 20° and 40° were identified. Reusable VN weigh more (24.9 ± 2.2 g) than disposable designs (6.0 ± 2.3 g). The mean values for the spring rate and the residual stylet force were 0.23 ± 0.08 Nmm−1 and 0.94 ± 0.28 N, respectively. The mean force required to move the stylet to the cannula tip was 1.81 ± 0.29 N and 2.77 ± 0.54 N to move to the proximal end of the bevel. Conclusion Commercially available VN use diverse bevel geometries and have different mechanical characteristics. Studies investigating laparoscopic entry complications should explicitly report the type of VN model used.

OBJECTIVE To describe the learning curve for veterinary surgery residents performing hemilaminectomy surgeries in dogs. DESIGN Retrospective case review and learning curve evaluation. SAMPLE 13 individuals who completed a 3-year surgery residency program at a university teaching hospital and who had no prior experience performing hemilaminectomies. PROCEDURES The 13 residents performed hemilaminectomies on 399 dogs between July 2006 and July 2013. Medical records were reviewed, and operative time was recorded. Data were examined with a linear mixed-effects model to quantify fixed and random effects, a curve-fitting technique to find the best-fit curve, and a segmented 2-phase linear model to describe the domains and learning rates for 2 phases of learning. RESULTS The linear mixed-effects model indicated that increasing patient body weight and increasing surgical complexity (graded on the basis of number and contiguity of hemilaminectomy sites) were associated with longer operative times and that increasing exposure number was associated with shorter operative times. The monoexponential and biexponential parametric curves were of similar quality in modeling the data. The segmented 2-phase linear model showed an early phase of learning during which operative time decreased rapidly and a late phase when operative time decreased more gradually. CONCLUSIONS AND CLINICAL RELEVANCE The learning curve for the residents suggested that for early exposures, instruction in the form of direct supervision provided substantial benefit. By the tenth exposure, the benefit of instruction diminished and ongoing improvement was primarily a result of refinement. If validated by further study, this understanding of a 2-phase learning curve may inform the design of training programs in veterinary surgery.

The diagnosis and treatment of cancer in exotic species is a rapidly evolving area of veterinary medicine. In general, surgical excision remains pivotal in cancer treatment, although optimal outcomes are achieved when a coherent and thorough diagnostic and therapeutic plan is created prior to surgery. While surgical cure is not always achieveable, multimodal treatment plans can offer a variety of options, and palliative procedures may be used to improve quality of life. Treatment goals, whether curative intent or palliative intent, should be identified before surgery, and practitioners should endeavor to adhere to surgical principles in order to attain the best outcomes.

Lack of confidence and self-efficacy are the main causes of negative emotions experienced by veterinary students when performing surgery. A surgical training model (STM) was developed to test the hypothesis that practical training on an STM before performing live surgery would enhance the students' confidence. In addition, low-cost and easily accessible materials were used for the construction. In the STM, neodymium magnets that were detached if too much traction was applied were used to ensure careful tissue handling during ligation of the ovarian pedicles and cervix. A pilot study was performed to evaluate veterinary undergraduate students' confidence when using the STM before performing their first live feline ovariohysterectomy (OHE) as lead surgeon. The results showed that the students rated their confidence level higher after performing feline OHE if they had practiced with the STM before surgery. Voluntary written comments revealed that live surgery as a learning situation could have a very negative emotional impact on some students.

The objective of this study is to present a high-fidelity bench model of cryopreserved stomachs that can be used while learning surgical skills. Thirty stomachs were harvested from Wistar rats at the end of non-abdominal research studies. The stomachs were washed with cold saline solution and filled with hyaluronic acid solution. The organs were then placed into cryovials and cryopreserved at −30 °C for 60 days. The stomachs were thawed to room temperature on the day of the surgical skills practice and two full-thickness incisions were made. Reporting on their experiences, 22 participants (73.33%) felt that the cryopreserved stomach was identical to in vivo rat stomachs, 24 (80.00%) reported that the stomach was easy to handle, and 27 (90%) reported the tissue was non-friable. Moreover, 29 participants (96.6%) finished the suturing without tears and 100% recommended it as a biomaterial for surgical training. The cryopreserved stomach is a practical, reproducible, low-cost, and high-fidelity bench model that allows surgical fellows to learn how to handle a stomach and improve their surgical abilities before performing surgery on patients or laboratory animals.

Background Reflection has been widely acknowledged to contribute to professional development, the ability to manage tension and enhanced resilience. However, many practitioners struggle to reflect productively due to a lack of clarity of what constitutes effective reflection.\ud \ud Methods To help develop reflective competence among future professionals, 30 veterinary students’ reflective assignments were analysed by thematic text analysis. Theoretical frameworks were based on published criteria for critical and core reflection.\ud \ud Results Reflection was described through resources (the tools used), practices (the ways of using these tools) and outcomes (what was achieved). This helped to distinguish simple skills based reflection from higher-level core reflection. Simple skills-based reflection was associated with an identity of expert learner: students perceive that their task is to identify a knowledge deficit that can be easily rectified through new learning. Core reflection was associated with students articulating an identity of adaptable professionals: rather than veterinary challenges being resolved simply through application of a body of knowledge, wider complexities of professional practice are recognised, including a need to resolve tension between their own and other stakeholders’ priorities, values and beliefs.\ud \ud Conclusion Scaffolding an iterative, cyclical reflection process may support outcomes oriented towards resilience and the management of tension.

Experimental and human studies have reported the advantages of a suture length to wound length (SL:WL) ratio greater than 4:1 in midline abdominal closure. This is achieved when the tissue bite (TB) is equal to or larger than the stitch interval (SI). Although TB and SI values are recommended in some textbooks, SL:WL ratios are rarely reported in veterinary textbooks. Additionally, no clinical data regarding these parameters could be found in small animals. Therefore, the aim of this study was to evaluate the SL:WL ratio of midline laparotomy closure in dogs and cats performed by surgeons with different levels of expertise and to compare the findings with current textbook recommendations. Midline laparotomy incisions of 100 dogs and 75 cats were closed in continuous pattern by diplomates and residents of both the European College of Veterinary Surgeons (ECVS) and the European College of Animal Reproduction (ECAR). The mean SL:WL ratio was 2.5 ± 0.7:1. The surgeons´ level of experience and the species and body weights of the animals did not have any significant influence on the SL:WL ratio. A moderate negative correlation was observed between the mean SI to mean TB (SI:TB) ratio and the SL:WL ratio. In this study, the mean SI matched the textbook recommendations both in feline and canine species, whereas the TB in cats was different. In this study, the SL:WL ratio was less than 4:1 without apparent complications. Because of the low prevalence of incisional hernia in dogs and cats larger studies are necessary to evaluate clinical significance of the presented data.

This study evaluated whether one supervised simulated ovariohysterectomy (OVH) using a locally developed canine OVH model, decreased surgical time for final-year veterinary students’ first live-animal OVH. We also investigated student perceptions of the model as a teaching aid. Final-year veterinary students were exposed to an OVH model (Group M, n = 48) and compared to students without the exposure (Group C, n = 58). Both groups were instructed similarly on performing an OVH using a lecture, student notes, a video, and a demonstration OVH performed by a veterinary surgeon. Students in Group M then performed an OVH on the model before performing a live-animal OVH. Students in Group C had no exposure to the OVH model before performing a live-animal OVH. Surgical time data were analyzed using linear regression. Students in Group M completed a questionnaire on the OVH model after performing their first live-animal OVH. The OVH model exposure reduced students’ first canine live-animal OVH surgery time ( p = .009) for students without prior OVH experience. All students ( n = 48) enjoyed performing the procedure on the mode; students practicing an OVH on the model felt more confident (92%) and less stressed (73%) when performing their first live-animal OVH. Results suggest that the canine OVH model may be helpful as a clinical training tool and we concluded that the OVH model was effective at decreasing students’ first OVH surgical time.

Objective To determine the influence of self-directed learning, peer feedback, or expert feedback on suturing technique of novice veterinary student surgeons. Study design Prospective, blinded, video feedback study. Sample population Three groups of surgery naive veterinary students, two groups of 37 students and one group with 36 students. Methods Each student completed three cruciate sutures in SynDaver skin. Student performance was video recorded and scored with a validated pro forma. Students were randomly divided into three groups: (1) students critically evaluated their own performance, (2) students critically evaluated peer's performance, and (3) students received a peer's evaluation. Each student repeated the surgical task and assessed his or her own performance, guided by the pro forma. Each student received a video with individualized feedback from an expert prior to repeating the task. Scores and times were analyzed. Student and expert evaluations were compared. Results Task composite score, time to completion, and completion rate did not differ between groups. Student self-assessed scores did not correlate with expert scores. Forty-three percent and 62% of students stated that self-feedback and peer feedback, respectively, were acceptable forms of learning, and 96% of students felt expert feedback was superior to both. Conclusion Video-based self-evaluation and peer-assisted learning were as effective as expert feedback after didactic lecture in teaching suturing technique to novice veterinary surgeons. Clinical significance Video-based self-evaluation and peer feedback were viable alternative teaching strategies to didactic lecture and expert feedback alone for instructing novice veterinary surgeons.

Objective To determine access to and use of minimally invasive surgery (MIS) simulators among American College of Veterinary Surgeons (ACVS) small animal residents and to identify barriers to simulator use and perceptions of simulator training. Study design Voluntary online survey. Sample population One hundred forty-one ACVS small animal residents. Methods American College of Veterinary Surgeons residents were identified by contacting ACVS residency program directors. An emailed online survey was sent to residents along with a reminder email 2 weeks later. All surveys were collected within 1 month. Participation was voluntary but incentivized. Results Response rate to the survey was 79 of 141 (56%) residents. Twenty-eight of 77 (36%) residents have access to a simulator, with box simulators being most common. Lack of time was the most frequent reason for not using the simulator more. Sixty-eight of 77 (88%) and 65 of 77 (65%) residents agreed or strongly agreed that simulator-based training improves laparoscopic skills and that simulator skills are transferable to the operating room, respectively. Residents with access to a simulator were more comfortable with basic laparoscopic surgeries at the end of their residency than those without such access (P = .04). Conclusion There is substantial room for improved access to and use of MIS simulator training in ACVS residency programs. Despite lack of simulator access, residents believed that simulator training improved their skill and comfort level with basic laparoscopic procedures. Clinical significance The results of this study inform us about access to and perceptions of MIS simulator training among residents. This information is important to surgeons responsible for training residents and may help guide the creation of a surgical skills curriculum.