In response to restrictions imposed by the COVID-19 pandemic, clinicians in the Virginia-Maryland College of Veterinary Medicine’s Small Animal Community Practice (CPRAC) — which trains Doctor of Veterinary Medicine (DVM) students in a veterinary practice setting — put into action a creative plan to ensure essential hands-on experiences.

In the clinicians’ estimation, these adaptations were critical: Hands-on training has always been the cornerstone of preparing students to become good veterinarians.

“Because we can’t talk to our patients and ask them what’s going on, we have to look, listen, and feel for all of those things,” said Michael Nappier, clinical associate professor of community practice in the Department of Small Animal Clinical Sciences. “You have to actually do a physical examination of the patient to be able to find the problems, to be able to recognize and identify what needs to be addressed.”

Much like medical students, DVM students in their fourth and final year of the program work nearly exclusively with real patients in real scenarios through a series of three-week clerkships and externships that ready them to enter the workforce as competent, well-trained veterinarians.

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In the CPRAC clerkship, which is carried out in the college’s Veterinary Teaching Hospital (VTH), fourth-year students are trained in clinical medicine and surgery under the direction of experienced veterinary practitioners. They participate in veterinary practice routines, interact with clients and clinic personnel, and improve surgical and diagnostic skills.

With the onset of the COVID-19 pandemic, the VTH immediately implemented emergency operating procedures that included limitations on the number of persons allowed in hospital spaces. For CPRAC, the restrictions meant reducing the number of students in the practice’s main treatment room from eight to four.

Logistically, the challenge posed by required social distancing was relatively easy to overcome. Two conference rooms across the hall from the regular treatment space were converted into extended touchdown spaces for both faculty and students.

In addition, because pet owners were no longer allowed to enter the hospital, curbside drop-off was initiated, which freed up space that had once been used for client interactions. Chairs and sofas were removed and replaced with treatment tables, lights, and medical supplies, creating another treatment area that effectively met social distancing guidelines as people were able to move out of the main treatment area.

While the physical logistics were relatively straightforward, they did introduce unintended consequences. Missing were the necessary back-and-forth interactions with owners who could describe their pets’ symptoms, timelines, and behavior changes.

To offset this gap, a questionnaire was developed and provided to clients to complete before their pet’s visit. In turn, when faculty and students needed answers to additional questions, phone calls were made. At times, however, an inability to immediately reach owners affected efficiency.

As expected, the new normal was emotionally hard both for students who weren’t able to interact with clients the way they normally would and for owners who weren’t able to be with their pets inside the hospital. Despite the imperfections and challenges, however, everyone adapted and made the setup work.

Along with additional rooms to allow for physical distancing, new clinical rotations in theriogenology (reproduction, or puppies!) and rehabilitation were introduced to move students out of CPRAC’s main treatment area and give them more hands-on time with patients, as well as focused experiences they would not have had.

Because students on the CPRAC clerkship were spread out as a result of the additional spaces and service areas in different parts of the hospital, morning topic rounds with faculty were no longer viable. In their place, Nappier created an asynchronous online course, which included videos and quizzes that students could complete at home outside of the clinical environment.

“I feel like I’ve grown as a veterinarian the most this year, getting to work with animals of all different species and being put in those situations where you have to act as a veterinarian, which you don’t have to do when you’re a classroom student,” said Class of 2021 DVM candidate Joanna Kania. “It’s been really helpful that the school has really put in so much effort for us for our education, trying to graduate the best veterinarians that they can.”

Fourth-year student Jessica Wooleyhand, who aspires to specialize in theriogenology, especially benefited from her CPRAC clerkship. “I loved it. I mean, there’s nothing like being able to take an ultrasound probe to a dog and see a bunch of little puppies growing in the abdomen. That’s an awesome first experience for me to be able to do that.”

Mark Freeman, clinical assistant professor of community practice in the Department of Small Animal Clinical Sciences, agreed that the modifications to CPRAC’s procedures have been productive.

“For me, a student who passes the rotation is a student that I feel is ready, that if they were to go into practice tomorrow, they could do this job successfully,” he said. “So number one, they get to succeed. And number two, they can do the job well so that the patients get the care they need. And that for me is a deciding criterion for any circumstance, especially in coronavirus when we’ve had to modify our procedures so significantly.”

Nappier concurred: “It’s not the same; it’s not normal. But I am going to be happy that, come May, when these students graduate, they’ll be competent and prepared to go out and practice as veterinarians.”

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