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Course Description

This course is canine physical examination; basic behavior, animal handling, and restraint; medical record keeping.

• Organization: ISU College of Veterinary Medicine
• Course Name: BMS/VCS 339 Clinical Foundations
• Current Semester and Year: Fall 2023
  
• Credit Hours: 1
• Course Prerequisites: None
• Dates: 08/21/2023 - 12/14/2023
• Number of Weeks: 15
• Course Meeting Time/Location:

Lectures: Wednesdays 10:00- 10:50; room 1226

Laboratory Sessions:

• • • Tuesday  9:00, 10:00, 11:00 - Two fifty-minute sessions – one in 1010 (Anatomy Lab) and the other in Clinical Skills Lab                   
    • Thursday 9:00, 10:00, 11:00 - Two fifty-minute sessions – one in 1010 (Anatomy Lab) and the other in Clinical Skills Lab     
• Course Format:

The course is divided into three units designed to prepare veterinary students for hands on clinical experiences and the development of clinical skills.  The course will help prepare students for subsequent small animal courses, including Surgery, Anesthesia, and Community Outreach courses and senior year rotations and preceptorships.  The goal of this course is to teach basic clinical skills and critical thinking that provide the foundation of clinical practice.  Students will be introduced to basic animal behavior, low-stress handling restraint techniques, physical examination skills, and basic clinical skills such as medication calculations and administration.  Students will gain these basic skills through didactic classroom lectures, live animal laboratories, Clinical Skills laboratories, and online exercises. 

Lectures focus on basic animal behavior and cognition, low stress handling and restraint techniques that help manage fear and anxiety in patients, physical examination skills, and basic medication and fluid calculations and administration.  Laboratories involve two components: a live animal section that focuses on behavior and restraint and development of physical examination skills and a Clinical Skills Laboratory component that focuses on development of basic pharmacology skills such as drug and fluid dose calculations, medication administration, and oral examinations.  The laboratory exercises will be repetitive.  Students are encouraged to utilize models and other resources to gain both confidence and competence in their skill development.

Required and recommended reading will be available through the college library or posted on Canvas.  Required and recommended reading could include information from textbooks, journals, and online resources.  Additionally, instructional videos will be available on Canvas.  Students are expected to be prepared for lectures and laboratories. 

Instructor Information

Course Coordinator: Joyce Carnevale, DMV, DABVP (Canine/Feline)

Co-instructors:

Brian Collins, DVM – Clinical Skills Laboratory

Jennifer Langel, PhD – Clinical Skills Laboratory

Veterinary technicians: Jackie Jens RVT, Emily Price, RVT

Additional faculty instructors: Dr. LeAnn Anderson, Dr. Rodney Bagley, Dr. Rachel Allbaugh, Dr. Melissa Kubai, Dr. Suzanne Millman

Instructor: Dr. Joyce Carnevale

Email Address: joycec@iastate.edu

Phone: 515-291-9091

Office location: 1581 Lloyd, College of Vet Med

 Office Hours – by appointment with Drs. Carnevale, Collins, or Langel         

Learning Objectives and Outcomes

Upon completing this course, students will be able to do the following:

1: Choose an appropriate syringe and needle, draw up a correct amount of medications, and administer medications

2: Calculate appropriate amounts of medications and fluids to administer to patient

3: Describe and recognize learning theory strategies for dogs and cats

4: Read patient body language to assess level of fear and anxiety in patients and implement strategies to manage read and anxiety

5: Utilize low stress handling restraint principles and techniques to restrain dogs and cats for various activities including physical examinations, phlebotomy, other procedures

6: Perform a general physical examination on dogs and cats as well as oral, ocular, and neurological examinations

Course Materials

Required materials

• Read appropriate chapters prior to lectures and laboratory sessions.  The textbooks are on reserve in the CVM library.

  • Yin, Sophia. Low stress handling, restraint, and behavior modification of dogs and cats.  Cattle Dog Publishing. 2009
  • Englar, Ryane. Performing the small animal physical examination. Wiley Blackwell. 2017
  • Bill, Robert. Medical mathematics and dosage calculations for veterinary technicians, 3^rd Wiley Blackwell. 2019

  BMS 339 Course reserve guide: https://instr.iastate.libguides.com/vm123-fall/BMS339

Required Supplies:

Professional surgical scrub top and bottoms

Clean white laboratory coat

Closed toed shoes

Pen (black or blue ink)

Stethoscope

Thermometer

Pen light

Watch with second hand or phone with stopwatch/timer

Assignments:

Please watch the video about assessments and review the documents and rubrics on assessments located in the Start Here module on Canvas.  Your grade is calculated on a percentage of accumulated points.  Required assessments total 195 points.  You can earn up to 8 additional bonus points as well.  Your final grade is calculated out of 195 points. 

• Graded and non-graded quizzes - Three required take home quizzes will be completed throughout the course.  Quiz questions may be designed with a clinical vignette that requires you to come to a diagnosis or determination prior to arriving at the answer (structured like a NAVLE question).  Questions will be true/false, multiple choice, or short answer and are administered through Canvas.  Quizzes will be open for 5 days.  You will have one attempt and a limited amount of time to complete the quiz.  Quizzes are an individual evaluation.  Please do not work with other students or share answers.  Quiz statistics are monitored for evidence of academic dishonesty.

  Quizzes must be completed during scheduled times.  Contact Dr. Carnevale via email prior to the opening of the quiz if you cannot complete it during the open time.  Valid reasons for not completing a quiz include presenting a paper at a scientific meeting, having surgery yourself, or an unanticipated medical problem.  Reasons such as attending weddings, family reunions, etc. are not automatic valid reasons and may not be granted.  Failure to complete the quiz without prior approval for an extension will result in a grade of 0.  Please take time at the beginning of the semester to add the quiz dates to your calendars to ensure you complete them during the open periods.

  Three take home quizzes  - 60 points

  1. Quiz 1 – 9/6 @ 12 pm – 9/12 @ 8 am – Medication and fluid calculations and administration (15 points)
  2. Quiz 2 – 10/11 @ 12 pm – 10/18 @ 8 am - Animal Cognition and Feline and Canine handling and restraint (20 points)
  3. Quiz 3 – 11/29 @ 12 pm – 12/6 @ 8 am - Physical examination, Dentistry, Ophthalmology Neurological exams (25 points)

  The week before the graded quizzes, students will have access to a non-graded quiz that can be taken repeatedly, and the correct answers are provided and explained

• Clinical skills group evaluations - For this evaluation, members of your group or individuals will go to a station in the Clinical Skills Laboratory and be asked to perform tasks in front of an evaluator.  These evaluations are timed, and the tasks must be completed in the allotted time.  The evaluator will not answer questions (other than clarifying directions) or be able to instruct you in any way during the evaluation.  Feedback from the evaluator may or may not be provided upon completion of the tasks.  There will be different versions of the evaluations and different evaluators.  The ISU CVM assessment team will oversee fair grading practices.  It is required that you and your group pass all three evaluations.  Should you or your group fail an evaluation, Drs. Collins and Langel will determine a course of remediation.

Clinical Skills group evaluations - 60 points

1. 1. Evaluation 1 (20 points) – week 7 – needles, syringes, injections (medication administration)
   2. Evaluation 2 (20 points) – week 12 – dental examinations, phlebotomy
   3. Cumulative evaluation (20 points) – week 15

• • Group and individual live animal clinical evaluations – Three different assessments will be used to help you develop hands on skills with live animals.  

Each student will complete a physical examination log (form is on Canvas) and a self-reflection on your approach to continuous improvement in developing physical examination skills.  The log and reflection letter must be posted by 12/10/23 at 8 am.  When you complete the log, you will record a) the date and species of your examination, b) what you felt was successful in the process, c) identify 1-3 things you would like to focus on improving the next time, and d) how you will go about improving the areas you identified.  The log will include at least 4 entries from attending the PE labs in the course.  You may add additional examinations completed out of class as well.  You’re encouraged to complete at least two physical examinations on your own pets or friend’s pets throughout the course.  The self-reflection should be 1 page double spaced and typed and include an honest evaluation on your current level of confidence and competence in performing physical examinations and how you will continue to build your skills.  Points for the PE log and self-reflection plan are awarded for completing the process thoroughly and graded as did not meet expectations, meets expectations, and exceeds expectations.  Please see the rubric on Canvas for details. Failure to complete this assignment will result in an incomplete grade and must be completed to receive a final grade

During the second species physical examination labs, each group will complete a SOAP form on their patient including assessing the pet’s health status.  Using the physical examination rubric, the group will assess their skills and discuss ways for improvement.  Both forms, SOAP, and PE Rubric, will be turned in.   There is a brief video explaining the forms and expectations for the project and the forms are located on Canvas.  Each evaluation is graded on completeness using the criteria – did not meet expectations, meets expectations, and exceeds expectations.  Please see the rubric in Canvas for more details.  Students absent from the lab will receive a 0 unless they made prior arrangements with Dr. Carnevale to make up the laboratory and the project.

Individuals will complete two work-based assessments.  A work-based assessment is a performance evaluation of a specific skill (eg a specific form of restraint or demonstrating how to examine a certain part of the physical examination).  Students choose what WBA they would like to demonstrate to faculty/staff and request an evaluation in lab.  There is a list of available WBA and expectations for performance listed on Canvas. To ensure that everyone can complete a WBA during the 6 live animal laboratories, only 3 members from each group can be evaluated during the laboratory.  Each group member participating in the WBA must choose a different assessment from their groupmates.  Students will demonstrate the WBA in front of a faculty/staff member as well as group members, so everyone benefits from the learning opportunity.  In a given lab session, you may have 2 opportunities to demonstrate the same skill.  If you need to refine skills after the first presentation, you will have time to prepare for the second.  The assignment is graded as pass/fail and full points are awarded for passing and 0 points are awarded for failing.  This is a fun, low stakes, learning opportunity!

To request a WBA

• • Index cards will be available in laboratory. Pick up a card and fill out your name, the date, and the chosen WBA. 
  • During laboratory, hand the card to an instructor and ask to demonstrate a WBA
  • The instructor will provide immediate feedback and grade the demonstration. Points are assigned as 0 or 5.  If you did not receive a 5, you will have one additional opportunity to redo the demonstration.
  • Once completed and a grade assigned, the instructor will initial the index card and the grade will be entered into the gradebook

Physical examination logs and self-reflection continuous learning plan – 20 points.

Group physical examination projects – 2 cases (1 canine and 1 feline) 5 points each – 10 points total

Two work based assessments – complete one of a canine patient and the other on a feline patient – 5 points each = 10 points total

• Fear Free Certification - Completion of a Fear Free program is a requirement.  The accepted courses include the Individual Fear Free Veterinary Certification program or the Veterinary Professional Certification Course Level 2 or 3.  If you’ve completed all three small animal courses, please email Dr. Carnevale to discuss additional options. 

  To access the courses, go to www.fearfreepets.com.  The first step is to register as a student if you have not done so previously - click on the veterinary professional’s tab at the top, and follow the instructions in the student and faculty application section.  All Fear Free programs are free to students.  Once registered, you can access the courses.  Go to the veterinary professionals drop down on the website, click on programs and courses, click on Individual Certification programs, and enroll in the Fear Free Veterinary Certification Program.  To access the Level 2 or 3 courses, click on the veterinary professional’s tab, click on programs and courses, choose the additional courses tab and scroll down to find the Veterinary Profession Certification Courses, Level 2 or Level 3.

  Once the course has been completed, please upload a copy of the certificate into Canvas.  Certificates must be uploaded by December 8, 2023 and must reflect completion between May 1, 2023 and December 8, 2023. Failure to complete this assignment will result in an incomplete grade and must be completed to receive a final grade. It takes approximately 8 hours to complete the program. 

  Fear Free Certification – 10 points - Completion of a Fear Free course during the semester (5/1/23 - 12/8/23).  Courses include the Fear Free Certification Program or Veterinary Professional Certification Courses Level 2 or Level 3

• Final Examination – There will be a cumulative final examination for the course.  The examination will occur on campus and using lock-down browser.  The examination will evaluate your understanding of the knowledge and skills presented in class and primarily focus on applying and evaluating cased based information. Examination questions types will include multiple choice, matching, short answer, selection of all multiple correct answers. 

  Final Examination – 25 points

• Additional Bonus Points:

  Surveys – You will complete 3 surveys – one at the beginning, middle, and end of the course.  Links for course surveys will be sent to you through an announcement.  The surveys are anonymous and help shape the learning experiences in the course.  Thanks in advance for your participation!

  Three course surveys – 1 bonus points - Survey 1 completed during week 1 and Survey 2 completed during week 15 and the midterm survey completed during week 9.

  Clinical Skills Medication and Fluid Unit Case 1 and Case 2 – Each group may voluntarily complete 1 case study worth 5 bonus points.  Instructions to complete the cases will be posted during week 2 of the course.  The case will be posted in CSL and will involve a clinical scenario where you have to calculate drug or fluids for a pet, select appropriate equipment to administer the medication, and describe how you would administer the drug on a model.  You will record your results in a video that will be uploaded into Canvas.  The video results will be graded as does not meet expectations (0 points) or meets expectations (5 points).  Please see the rubric associated with the assignment.  Feedback will be provided for the assignment. 

Due Dates of Assignments:  

Quiz 1 – 9/25 @ 8am – 10/2 @ 8 am

Quiz 2 – 10/11 @ 12 pm – 10/18 @ 8 am

Quiz 3 – 11/29 @ 12 pm – 12/6@ 8 am

CSL Evaluation Module 1 – Week 7

CSL Evaluation Module 2 – Week 6

CSL Evaluation Final Assessment – Week 15

Physical Exam Logs and Self Reflection – Due 12/10 @ 8 am

Canine Group Physical Exam Projects – Due week 14 at lab

Feline Group Physical Exam Projects – Due week 15 at lab

Work based assessments – complete by week 15 lab

Fear Free Certification – due by 12/8 @ 8 am

Survey 1 – complete in week 1

Midsemester survey – complete in week 9

Survey 2 – complete in week 15

CSL Medication and Fluid Case 1 – 8/31 @ 8 am – 9/25 @ 8 am

CSL Medication and Fluid Case 2 – 10/18 @ 8 am – 11/17 @ 8 am

Course Policies

Attendance

• Required in all laboratory sessions
  • Attendance will be taken in the laboratory; being late without an approved reason will result in an absence.
  • If you need to miss a laboratory due to illness, email and let Dr. Carnevale know as soon as possible (joycec@iastate.edu) Please also notify your group mates so they know that you will not be in attendance that day.
    • If you need to arrive late at lab or miss a laboratory for an approved reason, request permission from Dr. Carnevale at least 2 weeks in advance of the absence; you will need to include a reason for requesting the absence.
    • Remember that missing a laboratory day affects many people, including your classmates, instructors, etc. Valid reasons for an absence may include: presenting a paper at a scientific meeting, having surgery yourself, etc.  Reasons such as attending weddings, family reunions, etc. are not automatic valid reasons and may not be granted an excused absence.
  • You may be required to make up laboratory sessions in the clinical skills laboratory (at the discretion of the instructors).

Public Health:

If you are not feeling well, you should stay home and focus on your health. Should you miss class due to illness, it is your responsibility to work with your instructor to arrange for accommodations and to make up coursework, as consistent with the instructor’s attendance policy.

You may choose to wear a face mask and/or receive the COVID-19 vaccine and boosters, as well as other vaccines such as influenza, but those options are not required. Thielen Student Health Center will continue to provide COVID-19 vaccinations free-of-charge to students. The university will continue to offer free masks and COVID-19 test kits during the fall 2022 semester. Other wellbeing resources for students are available at:  https://www.cyclonehealth.iastate.edu/wellbeing-resources/

• • Lecture sessions
    • You are responsible for all information presented in the lectures.
    • Echo captures will be available for each week.

Public health information for the campus community continues to be available on Iowa State’s public health website. All public health questions should be directed to publichealthteam@iastate.edu.

Preparedness:

This is a special opportunity to learn clinical skills on models and live animals and you will be held to a high standard of preparation to get the most from the course.    Unpreparedness will not be tolerated.  It is your professional responsibility and you are expected to come ready for the laboratory procedures.  This means that you need to review the required material prior to lab (listed in the weekly lab information), which may include reading material, videos, self quizzes, etc.

Interactions with Animals:

The cats and dogs used in laboratory come from shelters and rescues and it is our responsibility to minimize their fear and anxiety and help them be adoption ready when leaving ISU.  Handling animals without appropriate regard to their fear and anxiety may result in being asked to leave the live animal section of laboratory and lose attendance points for that day.  Dr. Carnevale or one of the core faculty will make the decision for a student to be asked to leave the live animal laboratory.  The student will need to meet with Dr. Carnevale to discuss a remediation plan and schedule a follow up evaluation. 

Confidentiality:

The use of live animals is a privilege. Our ability to continue this important hands-on aspect of clinical teaching has been potentially jeopardized in the past by students posting pictures and written information about laboratory activities (or material that could be interpreted as such) on websites assessable to and viewed by the general public.  ALL activities related to the laboratory exercises are CONFIDENTIAL.  As such, students are instructed to NOT post any information about laboratory activities on ANY public forum (i.e. Facebook, YouTube, Instagram, Twitter, etc.). Any student that violates this important policy may be expelled from the course and receive a grade of F in BMS 339. Transmission of any information about lab (pictures, written descriptions, e-mail messages, text messages etc.) outside of the Iowa State College of Veterinary Medicine will require prior written approval from Dr. Carnevale.

Computers:

Computers in class are only to be used for following along and taking notes on the files associated with that lecture or taking examinations.  Computers may be brought into the laboratory session for supplemental support, but all laboratory materials should be viewed prior to the session.  Students are responsible for proper disinfection of the machines as required.

Online Learner Support:

https://canvas.iastate.edu/courses/23702/pages/online-learner-support