Simulated Clients In Junior Surgery Labs

1. Simulated Clients In Junior Surgery Labs Kelly Farnsworth DVM, MS Diplomate ACVS Assistant Professor in Equine Surgery Washington State University

2. Training surgeons requires more than teaching surgery! Surgical success begins with the first client communication! Life is precious!!

3. Junior Surgery and Communication?? Surgical lab groups consist of 2-3 students 1 surgeon 1 assistant surgeon 1 anesthetist Each lab group performs 3 terminal surgical procedures Patients consist of goats purchased at auction for purpose of the laboratory exercises

4. For each lab the group is assigned 1 goat Each goat is assigned 1 owner (simulated client) The primary surgeon must contact the owner by telephone the day prior to surgery to obtain surgical consent. Relax and have FUN!!!

5. Want to Own a Goat? Simulated Clients are recruited from all areas of the VTH Be yourself or play a realistic role Pet goat, production animal, child's goat etc.. Prior to student contact Goat was not doing well that AM Dropped off at hospital for examination Ask any questions that you think are relevant Give consent only if you feel comfortable with the discussion

6. Surgeon Pre-surgery Given owner contact information Discuss findings of physical examination, diagnosis, and treatment options and cost Discuss using terminology appropriate for the individual clients understanding Answer any client questions Obtain informed surgical consent NO CONSENT NO SURGERY!

7. Surgeon Post-Surgery Call client to discuss surgical outcome, prognosis, and after care if appropriate Discuss any complications that arose during surgery and implications to the animal and the bill Complications Actual Assigned

8. Feedback Self Assessment Oral in small group setting processing the surgical laboratory Client Assessment Goat ownership evaluation form Translated into oral feedback if needed Be careful of untrained simulated client feedback

9. Goat Ownership Evaluation Form Thank you for agreeing to participate in the junior surgery goat ownership program. The goal of this program is to help the junior students in this lab begin to develop skills associated with client communications. This lab has three terminal live animal (goat) surgical sections. Each goat will be assigned an owner (you). After the students have had an opportunity to examine your goat, they will give you a call to explain what is wrong with your goat, their plan for treatment, prognosis, and an estimate of costs. Feel free to ask them any questions you would normally ask if this were indeed your goat. Remember they are juniors, and do not have a lot of experience, however, if you feel uncomfortable about having the surgery you can decline surgery. If this happens please Email me immediately at farns005@vetmed.wsu.edu so I can make arrangements for the students. After surgery they will call you with an update on you animal and aftercare recommendations. Some animals will have randomly assigned complications ranging from peritonitis to death under anesthesia, so don’t be too shocked. If you have any questions please give me a call. Professionalism 1 2 3 4 5 Ability to answer questions 1 2 3 4 5 Use of appropriate terminology 1 2 3 4 5 Over all communication skills 1 2 3 4 5 Preparation & knowledge of topic 1 2 3 4 5 Comments:

10. Simulated Clients vs Standardized Clients Simulated Clients Different experience for each student Inconsistent feedback Easy to find volunteers and easy to coordinate with large class Standardized Clients Standardized experience for each student Consistent feedback More difficult to coordinate with student schedules with a large class

11. Results Students are better prepared for the actual lab/surgery Feedback from students has been very positive Some anxiety associated with the experience but less than if it were an actual client owned animal Glad to have opportunity to discuss difficult out comes Small group debriefing of entire procedure from start of communication to end on lab is very beneficial

12. Future Refine our feedback mechanism Train simulated clients More specific feedback forms Identify means of recording interactions via either video or audio Have fun!!

13. Questions?????