Veterinary student experiences in a community- and competency-based primary care rotation: A case study

Abstract

Background: Over the past 10–20 years, health professions' education has increasingly utilized community-based models of distributive medical education (CBDME) and competency-based education (CBE) frameworks. Although programs combining CBDME and CBE have reported enhanced student education and professional development outcomes, health professions' educators have also noted challenges integrating these frameworks, including vague university expectations regarding student performance, issues balancing efficiency with student learning in the private practice environment, lack of private practitioner training in pedagogy, and limited university faculty involvement in community-based clinical training of students. Aims and Objectives: The current paper describes the efforts of one veterinary school to refine a 4-week community-based primary care clinical rotation. The 2-year project aimed (1) to incorporate tracked competencies, improve preceptor training, and enhance involvement of university faculty through online student learning (Year 1) and (2) to use focus groups to solicit students' feedback on the course (Year 2). Settings and Design: Descriptive and Case-study. Methods and Material: Focus group, semi-structured interview. Statistical Analysis Used: Content analysis method of qualitative data, open and axial coding. Results: Compared to other “hospital rotations”, students reported that the CBDVE-equine primary care course gave them more opportunity to voice their professional opinions, determine course(s) of treatment, and discuss concerns/questions regarding case management. CBE helped students distinguish between competencies they had completed themselves versus procedures they had only been able to observe. The technology meant to support competency tracking in the field presented significant challenges to the student learning experience, including lack of internet access in remote locations, concerns regarding use of technology and appearance of professionalism, and redundancy of competency documentation. Conclusions: Veterinary student perceptions towards CBE and CBDVE are positive. Incorporating technology to track clinical competencies and support student learning during distributed clinical training requires an iterative process of feedback and negotiation with stakeholders, including students, university faculty, and private practice partners. The project approach and study findings described will be of interest to health professions educators who participate in, or plan to use, competency- and/or community-based models of education.