“There are many students, faculty, staff, and administrators that helped me get here,” says Colleen Hickey, ’20 DVM, who graduated from the University of Minnesota College of Veterinary Medicine (CVM) in mid-May. “These are people I won't get to say goodbye to, hug, or properly thank. A global pandemic requires us to make sacrifices, to put the needs of others above ourselves. Veterinary medicine, by nature, is a selfless profession. I am grateful to do my part and set a good example for the rest of the world.” 

Hickey and DVM students across class years at the CVM had to adjust to remote learning this spring. And while the learning curve was a little steep at first, faculty and students alike have experienced surprisingly satisfying outcomes. 

More hands-on practice, less pressure

Susan Spence, DVM, Clinical Skills lab coordinator in the Department of Veterinary Clinical Sciences (VCS), usually hosts students in the Practice Zone on campus. There, she says, they can practice clinical skills while she “hovers” and provides in-the-moment feedback. Under the shelter-in-place orders, Spence had to get creative—a skill she says is essential to any veterinarian, as they sometimes have to deliver care with whatever is available to them.

So, Spence has taken her program online, hosting periodic Zoom sessions for any student who wants extra practice. Her models are crafted from items that are affordable, reusable, and easy to find around the house. Under Spence’s guidance, students can practice suturing on a model made from a bundle of socks and a T-shirt to simulate the various layers veterinarians need to close. They can also make near-true-to-size models of a large animal jugular vein to help practice skills at a real-life height and angle to solidify their understanding of anatomy. Spence has also constructed model IV catheters out of paper wrapped around toothpicks to help students practice placement.

The point, she says, is not to replace live practice with modeling, but rather to establish the muscle memory needed to eventually perform these procedures. “We want to help the brain remember the motions. With practice, we retain the skill, so that’s one less thing to worry about.”

An added bonus is how this approach allows students to compartmentalize stimuli as they learn—suturing socks and rolled T-shirts has lower stakes than suturing a live patient. Spence also notes the pressure felt by large animal veterinarians, who carry their “exam room” in their coverall pockets and perform most clinical tasks under the scrutinous purview of owners. 

Treating any animal demands extensive preparation. With at-home models, students can practice the motions of a procedure without the added variables and pressure of a real patient. Later, when social distancing measures lift, veterinary students can introduce these additional elements. But for now, students can spend time becoming more confident and competent in the basics. 

“What’s so important when students are learning any skill is that instructors catch the right moments that they are doing well and moments when students can specifically make an improvement for next time,” Spence says. “If we can do that in real time, students can adjust and improve, whether they are learning in-person or online in real-time. That specific help can be a huge benefit.” 

Students can record their at-home practice to review with Spence via Zoom, or they can show her their practiced skills live on video conferencing. Spence says her goal is to help students become active learners who can think things through rather than regurgitate memorized facts. 

“Dr. Spence's approach to teaching clinical skills online is so creative and helpful when trying to re-create the content we would cover in labs,” says Olivia Dengel, a first year veterinary student who hopes to practice mixed animal medicine. Spence’s models inspired Dengel to create one herself—she replicated an IV with a mechanical pencil. “Our class has done really well coming together this year. There are lots of different resources that people create to help each other learn, which is so refreshing.”

New strategies for a lasting impact 

“The students have been amazing,” says Erin Wendt-Hornickle, DVM, DACVAA, assistant professor in the VCS. “We've never navigated any of this before. I give them a lot of credit that, on top of the stress of veterinary school, they're doing their best to adapt to our new reality.”

Wendt-Hornickle recently collaborated with Spence, as well as Wanda Gordon-Evans, DVM, PhD, DACVS, DACVSMR, associate professor in the VCS, in applying for an internal grant to help mimic — through virtual reality — the in-the-moment decision-making that happens when performing anesthetic management on a patient. They were recently awarded the funds necessary to purchase an iPhone, head and chest mounts for the iPhone, a webcam, and a document reader. Using these tools in combination with Zoom, the clinicians will stream live videos of patients while sharing their physiological parameters with a group of students, who can then direct the management in real time while maintaining a physical distance. The goal is to use this approach with second, third, and fourth year students. 

Wendt-Hornickle has observed that veterinarians in private practice do not often have the chance to practice hands-on anesthesia, but they do oversee the technicians who perform it. She wants to prepare CVM students to be “day one practice-ready,” by training in that specific role.

“Not only will our solution for distance learning help us test this method for teaching our students the supervision of anesthesia—rather than being the anesthetist, a role that will very likely be filled by a technician—it will also do so while fulfilling the CDC’s goals for educators during social distancing,” she says. 

This remote strategy will also give students the perspective of a surgeon. Students can manage surgical complications during a lecture or lab in which the video is streamed or played. Video conferencing allows students to replay recordings to look back on decisions made and outcomes caused. It also enables faculty to deliver immediate feedback. 

The grant proposal was approved on April 10. “Our goal would be to have new content for the upcoming fall semester,” says Wendt-Hornickle.  

Wendt-Hornickle says CVM students have been patient as faculty strive to improve their teaching and try to navigate new technology. “The distance-teaching aspect of our job as clinicians has been a new but very rewarding challenge, and I'm grateful for their adaptability.”

Pausing to reflect

Some students say this pause in their standard learning routine has provided them with key practice, boosting their confidence in their skills. And for students like Hickey, using this time to pursue knowledge gaps is a welcome opportunity. “I was able to look back on my clinical year and ask myself, ‘What day one knowledge am I missing? Where can I improve to increase my confidence in the exam room with my patients and clients at my first job?’”

Sonja Helgeson, ’20 DVM, agrees: “The best part of this new reality is being able to take time to really dive back into things I haven’t reviewed in a while, to brush up on topics I know I personally need more time with right before starting my job as a new vet.”

Helgeson also says that this process has allowed her to discover many free online resources that she will continue to use out in practice. “And I’ve also had a chance to build up a library of reference papers.” 

CVM faculty who teach in the DVM program are working hard to overcome learning curves and provide meaningful instruction on par with that typically available to students in person. They are also making themselves accessible, and students can tell. 

“With the hospital open on an emergency-only basis, many of the senior clinicians have time to sit down and discuss cases at length with us,” Hickey says. “We review physiology, how the case might be different in general practice, all the treatment possibilities, and more. We are one of the busiest veterinary hospitals in the country. When we are running at full capacity during normal rotations, there isn't always time to get this kind of in-depth training.”

Margaret Root, DVM, PhD, MMedEd, associate dean of education, and Erin Malone, DVM, PhD, interim associate dean of curriculum, have been moderating an interactive spreadsheet to answer student questions—as well as remind them they are not alone. All CVM students can add their questions to the document. Root and Malone then post their responses for all to see.

Full speed ahead

Mike Miller, class of 2023, hopes certain elements from distance learning live past the pandemic. “This process has taught me that switching up my everyday learning routine can be remarkably beneficial,” he says. 

Miller has noticed that recorded basic pathology lab sessions, for example, present necropsy findings via video footage—a more dynamic experience than static images on PowerPoint slides. “I also retain anatomy information better when I draw out the paths of arteries, veins, and nerves from a specimen, instead of just looking at them in the lab. This forces me to actively think of the positioning of certain branching patterns and networks.”

Granted, video conference–based learning presents its own challenges. For example, students are recognizing that focusing for long periods can be a challenge. But faculty are working hard to develop creative solutions to keep students engaged, and each instructor brings their own personal touch to the task. 
 

“I think each professor has their own way of supporting us,” says Jessi Coryell, a third year veterinary student, “whether that's trying to provide us with more strong, credible resources for our learning, reducing our stress load by removing an assignment or two, or working to modify how the session is handled to provide as much normalcy as possible.” 

“I’m proud to be a University of Minnesota student during these times,” says Helgeson, “and I am so proud of the CVM for how they have handled this crisis. This wasn’t the spring any of us imagined, but the CVM has risen to the challenge, found creative solutions, and been a supportive community as we all deal with the psychological effects of the pandemic.”