Critical thinking for critical care: Conner guides emergency care course at veterinary college

Emergencies find everyone in life, eventually. The same is true in veterinary medicine, even for clinicians who have purposely gone into a field other than emergency care.

“We need to get our students comfortable with managing emergencies because even if they don't choose to go into emergency-specific veterinary medicine, they’re going to see emergencies,” said Bobbi Conner, clinical associate professor of emergency and critical care medicine at the Virginia-Maryland College of Veterinary Medicine. “If they’re going into clinical medicine, they’re going to see things that clients didn't realize was an emergency, or if they’re working in a rural area, people are going come to them with an emergency. So, for me, it's really important that all of our students have that foundation.”

Conner teaches the emergency and critical care (ECC) course, required for third-year students in small animal, mixed animal and public corporate tracks, and also is a key mentor and leader at the Veterinary Teaching Hospital for residents, interns and students in clerkships learning the ropes of emergency veterinary medicine.

Conner says that the word “critical” in the course’s name could just as easily be for critical thinking as it could be for critical emergencies. 

“I focus a lot more on the why, rather than the what,” Conner said. “For their exams -- here's the scenario, tell me what you're going to do and justify your answer. And what they don't seem to believe until they go through it is that I'm going to grade them on their justification, not on their answer.”

Veterinary medicine is not just about making a diagnosis and prescribing a pre-determined treatment from rote memory of facts and figures. Multiple treatments are potentially effective for the same diagnosis in the same animal, with possibly differing results from case to case. And then there are clients’ finances, limited resources, and ethics to consider, all of which are amplified in the crucible of emergency care requiring quick decisions with animals’ lives and human emotions at stake.

“So what about when you've got two patients who both need a transfusion, but you've got one unit of blood?” Conner asked rhetorically. “That’s happened to me many times, and so I ask them now, what are you going to do? How are you going to choose?”

Veterinary medicine also doesn’t avoid people – human interactions can be at their most intense with the welfare of beloved pets on the line, and Conner’s course helps students learn how to manage those interactions. 

“You get really challenging things in the ER that you don't necessarily see in general practice,” said Anna Horowitz, a Class of 2025 veterinary student from Bethesda, Maryland. “People are under a ton of stress. They love their pets, this may be the worst day of people's lives. In the ER you will meet the angriest, the saddest, and the most intense people you will ever meet. So it's good to talk about how to manage those and I think it's really good she focuses entire lectures on that.”

Horowitz originally aspired to be an equine veterinarian, but quickly changed her course after spending a summer during her undergraduate college years in Vermont at an emergency veterinary hospital. That eventually led her to the veterinary college at Virginia Tech with ambitions to pursue a career in emergency veterinary care. 

“This is my life,” Horowitz said. “I am amazed by the variety of the different types of cases you see every day. Every once in a while, something is going to walk in and you’re thinking ‘I have never seen that before.’”  

Amy Lin, a 2024 veterinary college graduate from Northern Virginia, isn’t decided yet on whether she wants to enter emergency care or steer more toward veterinary oncology, but she said she has benefited from Conner’s teaching and influence.   

“She's really actively thinking of ways to help us learn these concepts, to present them in a fun and interactive way,” said Lin, who will be undertaking an internship at a veterinary clinic in New York City to further her experience. “She made it very applicable to clinical reasoning. It wasn't just here’s the science behind it, it’s more about what you will see when you’re out there. This is the logic pattern, your thought process when you approach this. Which I really thought was a new perspective. What is the animal telling you? And just based off of that, what can you do to help the animal?”