The official title of this week's rotation is "Soft Tissue Diagnostics."
However, that vague course name could easily be clarified to "Restrain This Dog For A Bandage Change."
When we were ranking our electives for this year, the Soft Tissue Diagnostics (SD) rotation description clearly said "This is NOT a surgery laboratory."
That's fine.
However, I really expected my 4 mornings of SD rotation thus far to encompass a little something more than restraining the same 4 or 5 dogs every morning for the first of their twice-daily bandage changes.
Don't get me wrong, it is definitely cool to see wounds and infected surgical sites healing on a day-to-day basis.
But come on. Us juniors don't even get to do anything with the bandages! We just keep the dogs from biting the senior students, interns, residents, and faculty, who are the ones who actually change the bandages. (Well, I guess our job is important if they want to keep their fingers. Also, hooray for chemical restraint, i.e. heavy-duty sedatives!)
Among this week's recurrent SD patients are:
- An old golden retriever who came in for a small mass on his forearm, which was removed and diagnosed as a low-grade soft tissue sarcoma; the tumor was sitting right on his cephalic vein (the main vein draining the foot), so they had to resect part of that vein; his surgical closure had too much tension in the sutures, causing a tourniquet effect and horrible swelling in his paw, so they cut open several of the sutures in the middle to relieve some tension; after a few days there was still too much swelling so they just cut open all the rest of the sutures and have been managing the surgery site as an open wound with bandaging; yesterday the wound culture came back and surprise, poor dog has MRSA! (an antibiotic-resistant superbug)
- A middle-aged *psychotic* Australian cattle dog who will try to rip your face off unless he can hold his leash in his mouth; had some sort of degloving injury to his paw, which had lost so much skin that they had to take a piece of skin from his abdomen and graft it onto the wound on his paw; so now he has a huge bandaged leg to keep him from getting at his paw, a draining disgusting hole on his abdomen, and a wonderful e-collar
- A sweet black lab who presented several weeks ago for a migrating foreign body in the tissues on her face (turned out to be a grass awn); they removed the grass awn but after surgery she developed a baseball-sized seroma on her cheek; hot compresses at home have been ineffective, so today they placed a drain to get some of the fluid out
- A *beautiful* long-haired mini Dachshund who had a hemilaminectomy to relieve pressure on her spinal cord from an extruded intervertebral disc; she has been slowly regaining function to her bladder, bowels, and hind legs, but still has a long way to go and can't urinate on her own, so she's been living at the hospital and having her bladder manually expressed every 6-8 hours
- An enormous, rambunctious, bone-headed 90 lb hound mix who tried jumping over a fence and ended up with a huge laceration across his stifle; it was a couple days before his owners got him to their regular vet to have the laceration repaired; the rDVM sewed it up but Mr. Hound got his stitches out the next day and came into the vet school with a fantastically huge gaping horizontal wound across his knee, all the muscles showing, etc.; he has been a true Houdini in getting his e-collar off and removing his bandage on an almost daily basis, and everybody is straining to keep coming up with creative options to make him be good (the current solution is basically round-the-clock sedatives)
- A 5-month-old golden puppy who got an intussusception resulting in removal of a large piece of her small intestine, and placement of a feeding tube
- A tiny, ancient Italian Greyhound with a laceration on his shoulder that was sutured, but he keeps biting or scratching at it, resulting in Mom & Dad making him wear an e-collar so he can't lick/chew AND booties on his feet so he can't scratch -- pretty darn pathetic
- A Jack Russell Terrier (JRT, or "jert" as everyone calls them here) who got hit by a car and unfortunately his owners have no money, so he's been getting the leftover bandaging supplies (half rolls of cast padding, gauze, etc.) from everybody else's bandages, and free drugs from somebody in the pharmacy with a soft spot for jerts; we all liked this little guy a lot better until today, when he bit one of the interns; now he has to wear a muzzle for all of his treatments, and unfortunately for him, the only muzzle in his size is neon pink; guess that's what you get for starting to be nasty, little guy!
There have been a few surgeries this week -- I guess the caseload really varies from week to week -- but almost all of them start later in the morning or not until the afternoon, at which point we juniors need to head upstairs for class. There have been some cool ones, though:
- A 7 year old cat who came in for persistent swelling on a hind limb several months after having her leg shut in a door; after biopsy, the swelling turned out to be totally unrelated to the previous injury and was actually a fibrosarcoma (horrible aggressive tumor sometimes induced by vaccines in cats), resulting in poor kitty having her entire leg amputated yesterday
- A 2 year old lab who was hit by a car in June, and was apparently fine since, until last night when he developed acute respiratory distress, had some chest x-rays, and had some very obvious loops of intestine in his thoracic cavity compressing his lungs; hellooooo, diaphragmatic hernia! He stabilized overnight and went into surgery today; usually these hernias can be fixed through the abdominal cavity, but his was so chronic that he had built up adhesions between his intestinal loops and the lining of his thoracic cavity, so they had to open up both his thorax and his abdomen
- A middle-aged border collie with a brachial plexus avulsion (dislocation of all the nerves in the armpit that supply the front leg), resulting finally in an amputation this week
- A cystotomy to remove yet another bladder stone from a poor 14 year old kitty with apparently very recurrent bladder stones; he has had a cystotomy every year for the last 5 years, plus had 1 cancerous kidney removed two years ago
I might actually get to do something cool tomorrow -- this is the first week they are offering the Junior Surgery Lab elective (aka "pig lab") where juniors practice terminal surgeries on culled pigs. One of my classmates got pretty sick today and had to leave before noon, and isn't sure if she'll be there tomorrow. Most of the surgeries take 2 people scrubbed in, so someone is potentially without a partner for tomorrow, and the lab coordinator invited either me or my fellow SD junior to take the place in the lab as long as there isn't too much SD stuff going on. I have a Dr appt early tomorrow morning that might interfere, but I've got my fingers crossed that I'll get to go into the lab. I'm sick of bandages changes!!!
Thursday, October 7, 2010
Sunday, October 3, 2010
Up next
Now that I've finished my 5 page reflection on my DVD-recorded performance in this week's communication labs (no fun, that paper writing), let's see what else I need to do:
Small animal neuro exam covering 3 weeks/15 hours of lecture material; opened on Friday afternoon and closes tomorrow night, and I'd really, really like to get it done tonight.
First radiology exam of the semester; covers 6 weeks of urinary tract and reproductive radiographs and ultrasound; opens on Monday night and closes on Thursday night; I actually feel pretty good about this one because I've gone through all the material very thoroughly one time, and I usually do well on radiology.
Bovine reproduction exam covering about 10 hours of lecture material; opens on Wednesday evening and closes on Friday; fortunately the professor provided very good, comprehensive lecture notes, so I think with a couple reviews of that I'll be all set.
So there's just a bunch of medium things coming up, not any one huge thing to worry about, but in combination with yesterday's early morning, long hospice visit, coupled with a general less-than-usual quantity of sleep this weekend, and no nap today, and spending the last 4 hours writing my communication paper, I'm feeling like next weekend can't come soon enough.
Small animal neuro exam covering 3 weeks/15 hours of lecture material; opened on Friday afternoon and closes tomorrow night, and I'd really, really like to get it done tonight.
First radiology exam of the semester; covers 6 weeks of urinary tract and reproductive radiographs and ultrasound; opens on Monday night and closes on Thursday night; I actually feel pretty good about this one because I've gone through all the material very thoroughly one time, and I usually do well on radiology.
Bovine reproduction exam covering about 10 hours of lecture material; opens on Wednesday evening and closes on Friday; fortunately the professor provided very good, comprehensive lecture notes, so I think with a couple reviews of that I'll be all set.
So there's just a bunch of medium things coming up, not any one huge thing to worry about, but in combination with yesterday's early morning, long hospice visit, coupled with a general less-than-usual quantity of sleep this weekend, and no nap today, and spending the last 4 hours writing my communication paper, I'm feeling like next weekend can't come soon enough.
Saturday, October 2, 2010
Communication: works in real life!
Sounds like one of those headlines where you think "Why on earth did they need to spend 2 years and $10 million to figure that out?"
The remainder of my CCS rotation since my post on Tuesday was fairly uneventful.
Wednesday's 4 hours of class covered topics including expressions of empathy, non-verbal behavior, and handling difficult communication situations (e.g. angry client, tearful client, panicked client, breaking bad news, etc.). They brought in 3 of the clinicians from the hospital and 3 of the students from the class role-played clients in different situations -- a woman who wanted to euthanize her cat because it had a very treatable medical problem but would no longer be a winner in the show ring, a person whose horse died under anesthesia for a routine elective procedure, and a guy who was mad about getting a bill for services rendered when his cow died a couple days after a c-section. It was really interesting to watch how experienced clinicians handle these sorts of things. Throw in some very genuine tears and amazing acting from my classmate playing the women whose horse died, and it was a pretty intense thing to watch.
Thursday was another day in the communication "lab" (aka the Law & Order rooms... choink choink). They had prepared us that Thursday's simulated client scenarios would be more challenging than Tuesday's, and I think we all expected them to throw way more problems at us than we actually ended up having to deal with.
There were angry clients, worried clients, sad clients. I thought I ended up with the easiest of all the scenarios. My client was just a little... let's call it "high maintenance." Other than that, there weren't really any new emotions for me to deal with. Which maybe means I did a good job communicating? And avoided whatever potential there was for things to break down? Who knows.
Friday started with a trip to a pet cemetery and crematory (no better way to start your Friday, right?). I couldn't decide which was less fun: standing outside in the 45 degree 8 am chill looking at the cemetery, or standing inside where it was warm because we were in the room with the crematory ovens... (here's one thing I learned: you can allow owners to observe their pet's cremation if they really want to, but don't let them get too close to the ovens because some of them will try to reach into the 1000-degree heat and get their animal's body back out, a.k.a. "don't change your mind once Fluffy's in the furnace")
But don't worry. The morning didn't really go uphill from there. Once we got back to the VTH, we spent the remain 2.5 hours of our rotation talking all about death and euthanasia and end-of-life decisions. They brought in clinicians again, this time for no apparent purpose other than to share with us their horror stories of "euthanasias gone wrong" -- when the owner has already shot the horse in the head 3 times before you get there and it's still standing, when you give all of the euthanasia drug that you have in your truck and the animal won't stop breathing, when the dog lets out an ear-splitting scream immediately before dying... oh, don't you worry, there are plenty of ways things can go wrong. Fortunately it usually doesn't.
So CCS is over (well, CCS-1 is over; CCS-2 comes in April). And it's not really over -- I still get to write a 4-6 page paper tomorrow reflecting on my communication skills during my two videotaped sessions (assuming of course that I actually get up the nerve to watch my DVDs). Nothing like a fun paper to get to write on the weekend when you have a huge small animal neuro exam open online from Friday through Monday, with the first radiology exam of the semester opening on Monday and a bovine reproduction exam opening on Wednesday...
But who needs free time? Or sleep?
Just to torture myself, I volunteered for another Pet Hospice case yesterday (my third in the last 8 months).
My new hospice patient is a 15.5 year old chihuahua who lives with an adult couple and two other chihuahuas. I know a lot of people consider their animals to be like their children, but this is the first family I've met where I actually believe that to these wonderful people, their dogs are their children. Their level of adoration and devotion to their dogs is really remarkable.
Anyway, the main concern for these folks was administering subcutaneous (SQ) fluids to their dog twice a day. She's a tiny thing -- less than 4 lb -- so it would be a challenge even for those of us who are experienced giving fluids. Our primary goal this morning was to help them find a way that felt comfortable to everyone involved -- the husband restraining, the wife injecting, and of course the dog getting the fluids.
The visit ended up being over two and a half hours. My first visits on other hospice cases have been 1.5-2 hours each, so I was expecting a long morning (we started at 8:30, meaning I left the house at 8) but this one took the cake.
I wouldn't change a minute of it, though. On both of my previous hospice cases, I have been paired with someone much more experienced at hospice than I am. In both cases, my partner really took the lead in directing the conversation and raising difficult topics, and I really just observed.
Today, though, was the first day on a case for my partner (a very nice sophomore student). And while he did a fantastic job of chiming in and asking questions of his own (he really held his own during the whole visit), it was the first time that I had really felt comfortable with the sort of discussions we had, and being in more of the leadership position between the two of us. It felt easy and natural.
I think that is in large part to my experiences with CCS this week. If you remember some of my past posts, you'll know that I haven't been looking forward to CCS (okay, maybe "dreading" is a better term). I was afraid that it would be completely hokey and lame, and that nobody else would want to take it seriously.
But I have transformed from a CCS skeptic to a wholehearted supporter. No longer will I be telling prospective students on tours "It sounds a little bit horrifying to me, being videotaped and everything... but it's probably a good experience in the end."
Although I would have loved to sleep in this morning (I'm typically up between 9 and 11 am on Saturdays, rather than this morning's 7:15), and a multiple-hour nap is definitely on my mind for tomorrow, I can't think of a better way to spend my Saturday morning. I left the clients' home feeling so positive about the visit, and knowing that my partner and I had really been able to help these folks -- not just teaching them how to give the fluids, which they did before the end of our morning visit, with our guidance, and on their own (!) this evening without us there -- but just providing a nonjudgmental ear to listen to everything they wanted to tell us about the stress in their lives.
This is why I want to be a vet. I love feeling like I will actually be there someday.
The remainder of my CCS rotation since my post on Tuesday was fairly uneventful.
Wednesday's 4 hours of class covered topics including expressions of empathy, non-verbal behavior, and handling difficult communication situations (e.g. angry client, tearful client, panicked client, breaking bad news, etc.). They brought in 3 of the clinicians from the hospital and 3 of the students from the class role-played clients in different situations -- a woman who wanted to euthanize her cat because it had a very treatable medical problem but would no longer be a winner in the show ring, a person whose horse died under anesthesia for a routine elective procedure, and a guy who was mad about getting a bill for services rendered when his cow died a couple days after a c-section. It was really interesting to watch how experienced clinicians handle these sorts of things. Throw in some very genuine tears and amazing acting from my classmate playing the women whose horse died, and it was a pretty intense thing to watch.
Thursday was another day in the communication "lab" (aka the Law & Order rooms... choink choink). They had prepared us that Thursday's simulated client scenarios would be more challenging than Tuesday's, and I think we all expected them to throw way more problems at us than we actually ended up having to deal with.
There were angry clients, worried clients, sad clients. I thought I ended up with the easiest of all the scenarios. My client was just a little... let's call it "high maintenance." Other than that, there weren't really any new emotions for me to deal with. Which maybe means I did a good job communicating? And avoided whatever potential there was for things to break down? Who knows.
Friday started with a trip to a pet cemetery and crematory (no better way to start your Friday, right?). I couldn't decide which was less fun: standing outside in the 45 degree 8 am chill looking at the cemetery, or standing inside where it was warm because we were in the room with the crematory ovens... (here's one thing I learned: you can allow owners to observe their pet's cremation if they really want to, but don't let them get too close to the ovens because some of them will try to reach into the 1000-degree heat and get their animal's body back out, a.k.a. "don't change your mind once Fluffy's in the furnace")
But don't worry. The morning didn't really go uphill from there. Once we got back to the VTH, we spent the remain 2.5 hours of our rotation talking all about death and euthanasia and end-of-life decisions. They brought in clinicians again, this time for no apparent purpose other than to share with us their horror stories of "euthanasias gone wrong" -- when the owner has already shot the horse in the head 3 times before you get there and it's still standing, when you give all of the euthanasia drug that you have in your truck and the animal won't stop breathing, when the dog lets out an ear-splitting scream immediately before dying... oh, don't you worry, there are plenty of ways things can go wrong. Fortunately it usually doesn't.
So CCS is over (well, CCS-1 is over; CCS-2 comes in April). And it's not really over -- I still get to write a 4-6 page paper tomorrow reflecting on my communication skills during my two videotaped sessions (assuming of course that I actually get up the nerve to watch my DVDs). Nothing like a fun paper to get to write on the weekend when you have a huge small animal neuro exam open online from Friday through Monday, with the first radiology exam of the semester opening on Monday and a bovine reproduction exam opening on Wednesday...
But who needs free time? Or sleep?
Just to torture myself, I volunteered for another Pet Hospice case yesterday (my third in the last 8 months).
My new hospice patient is a 15.5 year old chihuahua who lives with an adult couple and two other chihuahuas. I know a lot of people consider their animals to be like their children, but this is the first family I've met where I actually believe that to these wonderful people, their dogs are their children. Their level of adoration and devotion to their dogs is really remarkable.
Anyway, the main concern for these folks was administering subcutaneous (SQ) fluids to their dog twice a day. She's a tiny thing -- less than 4 lb -- so it would be a challenge even for those of us who are experienced giving fluids. Our primary goal this morning was to help them find a way that felt comfortable to everyone involved -- the husband restraining, the wife injecting, and of course the dog getting the fluids.
The visit ended up being over two and a half hours. My first visits on other hospice cases have been 1.5-2 hours each, so I was expecting a long morning (we started at 8:30, meaning I left the house at 8) but this one took the cake.
I wouldn't change a minute of it, though. On both of my previous hospice cases, I have been paired with someone much more experienced at hospice than I am. In both cases, my partner really took the lead in directing the conversation and raising difficult topics, and I really just observed.
Today, though, was the first day on a case for my partner (a very nice sophomore student). And while he did a fantastic job of chiming in and asking questions of his own (he really held his own during the whole visit), it was the first time that I had really felt comfortable with the sort of discussions we had, and being in more of the leadership position between the two of us. It felt easy and natural.
I think that is in large part to my experiences with CCS this week. If you remember some of my past posts, you'll know that I haven't been looking forward to CCS (okay, maybe "dreading" is a better term). I was afraid that it would be completely hokey and lame, and that nobody else would want to take it seriously.
But I have transformed from a CCS skeptic to a wholehearted supporter. No longer will I be telling prospective students on tours "It sounds a little bit horrifying to me, being videotaped and everything... but it's probably a good experience in the end."
Although I would have loved to sleep in this morning (I'm typically up between 9 and 11 am on Saturdays, rather than this morning's 7:15), and a multiple-hour nap is definitely on my mind for tomorrow, I can't think of a better way to spend my Saturday morning. I left the clients' home feeling so positive about the visit, and knowing that my partner and I had really been able to help these folks -- not just teaching them how to give the fluids, which they did before the end of our morning visit, with our guidance, and on their own (!) this evening without us there -- but just providing a nonjudgmental ear to listen to everything they wanted to tell us about the stress in their lives.
This is why I want to be a vet. I love feeling like I will actually be there someday.
Thursday, September 30, 2010
Music nerdiness is...
...watching a commercial for a video game and immediately realizing the background music is 'Thaxted.'
Tuesday, September 28, 2010
Breaking news: Vet school does something efficiently!
One of my favorite moments of this school year thus far occurred in my Week 3 Community Practice/Surgery rotation (and I can't remember if I already wrote about it here, so maybe you'll get to hear it twice).
My single CPS week happened to begin on the same day that a 4-week rotation for the senior students began, so we started Monday morning with a general orientation for everyone.
One of the first activities was to go around the (very small, crowded) room and have each of the 16 people tell their name, where they're from, their vet med interests, several goals for what they wanted to get out of CPS, and one thing about their junior or senior year so far that has surprised them.
One of my classmates' surprises went something like this:
"Now that we've been in the hospital for a couple weeks, and had a chance to see different departments and learn the procedures and paperwork and forms and charts and rules, my biggest surprise of the year is that anything ever gets done around here."
She wasn't joking, and I can understand her feelings. Because it's a teaching hospital, many things are more redundant than how you'd operate in private practice or elsewhere in the "real world" -- and I think that redundancy is probably to our benefit as students while we're learning, but it definitely slows things down and makes you want to bang your head against the wall sometimes.
Well, today I encountered an example of how the vet school does one thing better than anywhere else I've gone: giving flu shots to staff and students.
Since the student health service on main campus has very limited vaccine hours (M-F 9-12 and 1-4) that are completely incompatible with the schedules of most clinicians, technical staff, and 3rd & 4th year students, the VTH kindly brings over a couple of nurses once a year in the fall to spend a couple hours administering flu shots.
This year's flu shots were available from 1:30-3:30 this afternoon. Since I and all of my classmates had lectures until 2:50, I hurried over to the diagnostic lab for my vaccine as soon as I could once class got out. I was fully prepared to wait for awhile, anticipating a rush of other junior students eager to build up some herd immunity among ourselves.
Well, there was a bit of a rush, but it was literally no more than 2 minutes for me to sign in, pay my $20, fill out a consent form, discuss with the nurse my allergies and prior vaccinations, get the shot and get out of there. I was so impressed. The student health center on campus is pretty darned efficient -- I can usually be in and out for a vaccine within 15-20 minutes** -- but that's nowhere near today's awesome assembly line of flu prevention. Go VTH!
**And I've had lots of experience at the immunization dept at student health: As a freshman I got an MMR, tetanus, flu, and 3 rabies vaccines. As a sophomore I got a regular flu shot and the H1N1. I scoff at people who fear giving their pets too many vaccines! At least you aren't giving them 8 vaccines in less than 2 years! (Ok, you might be if you go to a shall-remain-nameless Giant Veterinary Corporation at which I have been employed, but let's not open that can of worms tonight.)
My single CPS week happened to begin on the same day that a 4-week rotation for the senior students began, so we started Monday morning with a general orientation for everyone.
One of the first activities was to go around the (very small, crowded) room and have each of the 16 people tell their name, where they're from, their vet med interests, several goals for what they wanted to get out of CPS, and one thing about their junior or senior year so far that has surprised them.
One of my classmates' surprises went something like this:
"Now that we've been in the hospital for a couple weeks, and had a chance to see different departments and learn the procedures and paperwork and forms and charts and rules, my biggest surprise of the year is that anything ever gets done around here."
She wasn't joking, and I can understand her feelings. Because it's a teaching hospital, many things are more redundant than how you'd operate in private practice or elsewhere in the "real world" -- and I think that redundancy is probably to our benefit as students while we're learning, but it definitely slows things down and makes you want to bang your head against the wall sometimes.
Well, today I encountered an example of how the vet school does one thing better than anywhere else I've gone: giving flu shots to staff and students.
Since the student health service on main campus has very limited vaccine hours (M-F 9-12 and 1-4) that are completely incompatible with the schedules of most clinicians, technical staff, and 3rd & 4th year students, the VTH kindly brings over a couple of nurses once a year in the fall to spend a couple hours administering flu shots.
This year's flu shots were available from 1:30-3:30 this afternoon. Since I and all of my classmates had lectures until 2:50, I hurried over to the diagnostic lab for my vaccine as soon as I could once class got out. I was fully prepared to wait for awhile, anticipating a rush of other junior students eager to build up some herd immunity among ourselves.
Well, there was a bit of a rush, but it was literally no more than 2 minutes for me to sign in, pay my $20, fill out a consent form, discuss with the nurse my allergies and prior vaccinations, get the shot and get out of there. I was so impressed. The student health center on campus is pretty darned efficient -- I can usually be in and out for a vaccine within 15-20 minutes** -- but that's nowhere near today's awesome assembly line of flu prevention. Go VTH!
**And I've had lots of experience at the immunization dept at student health: As a freshman I got an MMR, tetanus, flu, and 3 rabies vaccines. As a sophomore I got a regular flu shot and the H1N1. I scoff at people who fear giving their pets too many vaccines! At least you aren't giving them 8 vaccines in less than 2 years! (Ok, you might be if you go to a shall-remain-nameless Giant Veterinary Corporation at which I have been employed, but let's not open that can of worms tonight.)
Client Communication Rotation = Fight Club?
The first rule of Client Communication rotation is: You don't talk about Client Communication rotation.**
The second rule of Client Communication rotation... well, you get the picture.
I am pleased to announce that I have thus far survived 40% of this semester's much-dreaded week-long Client Communication Skills (CCS) rotation!
(trumpets sound)
Now, let's be honest.
As much as I would like to be able to commiserate with my being-videotaped-impaired, communication-phobic, distressed and tearful classmates with the misfortune to experience this rotation before me, I would be lying if I told you that my rotation so far has been an absolutely fantastic experience.
The truth is out. Don't tell my friends, or I won't have any.
I think I approached CCS with the following attitude:
"I am going to go into this rotation being able to say that I came in trying to keep a positive attitude, but I am really not going to have a good time."
But.... the things we've done so far have been really beneficial.
(Really, I don't mean to sound so astonished. I'm truly excited that this hasn't turned out to be an absolute waste of 20 hours of my time.)
Yesterday we did some semi-hokey stuff, talking about feelings, what we did over the summer, how to ask open-ended questions and let your clients know that you're empathizing with them.
(Oh, and the instructor started off the week by saying "Good morning" to the class of 25 students repeatedly until she got a satisfactory chorus of "Good morning"s in return. Talk about a surefire way to come off as condescending and make your students feel like 8 year olds. Thankfully, things went uphill from there.)
Today was the first of two days of "simulated client interactions." The vet school hires actors to come in and portray clients bringing in their dog, cat, horse, or (if you're unlucky) hedgehog to see us students. The actors also work with the state's medical school, doing the same thing pretending to be actual medical patients so the med students can practice communication and history-taking.
Let me tell you, these actors are amazingly good. Invariably, in each of the 5 simulations it was a matter of moments before everybody forgot that the "client" wasn't really some person bringing in a sick pet.
We were divided into 5 groups of 5 students. Each small group had a "coach" (all were vets, two from the vet school and three from private practices). Some of the newer coaches got their own coaches who were coaching them on how to coach us.
Each student got 45 minutes for their simulated interaction:
-- In the first 5 minutes, the interviewing student got to find out what the case was about (owner's name, pet's name, breed, age, and the apparent reason for the visit [wellness exam, behavioral problem, medical problem, etc.]). Among the group of students, we discussed things that may come up during the interview, what the interviewing student's objectives were, how they were going to approach certain subjects, etc.
-- The next 15 minutes comprised the actual interview. The client was seated in the exam room (with 1 or 2 coaches in there too). The other 4 students were in the observation room next to the exam room, which has a one-way mirror looking in on the exam room. The student entered the room, introduced herself, and started the interview. You got to pause, take breaks, or rewind if you needed a minute to gather your thoughts, needed some advice from your coach, or realized that something didn't go well and you had something you wanted to try again.
-- The next 20 minutes were "debriefing" -- first the interviewing student discusses how she felt the interview went. Then the 4 observing students take turns critiquing different facets of the interview technique (initiation, gathering information, logical flow, etc.). Then the actor/client gives their feedback on how they felt as the one in the conversation, what they liked and didn't etc.
-- The last 5 mninutes are a discussion of what everybody learned from the case.
**The Fight Club rules (I named them that, not the rotation instructors) mean that we are bound by the honor code (and it's even extra-official, since they made us sign something) to not discuss the simulated case scenarios with anybody who hasn't taken the rotation yet. And that's with good reason -- as they point out, the learning experience is a lot less effective if you know ahead of time what sort of situation you're getting into, what hidden information is there for you to discover if you make your client feel comfortable enough to open up to you, etc.
I ended up going last among my group of 5 -- not really by choice, but the first 3 people kept volunteering to go next, then the last person and I flipped a coin to see who would go 4th and 5th.
It was a very surreal experience. During the past few weeks when I've been thinking ahead to upcoming rotations and remembering that I had CCS during week 6, I'd been getting progressively more nervous about it. During our initial Pet Hospice volunteer training during fall semester freshman year, we had a similar training session where we role-played with actor clients about how to talk about their ill pet, how to start conversations about quality of life and euthanasia, etc. -- and that experience was pretty awkward.
But I was surprised when I showed up this morning and really didn't feel that anxious about the whole thing. Sure, I didn't want to make a fool of myself, but everyone in my group was very supportive of each other and good at giving plenty of positive feedback along with a few suggestions for improvement. Yesterday as the instructors discussed today's exercise, they were very clear about the fact that none of our grade for this rotation comes from how well we perform in the simulated interactions -- our grade is all about a reflective paper we write, and how well we are able to analyze what we did well, what needs improvement, where our strengths are, phrasing that sounded good, moments that felt awkward and how they could be made more comfortable, etc. That really took the pressure off and made me feel like if I totally got tongue-tied or off-track or distracted during my simulated interview, it would all be ok.
CCS really has a terrible reputation among the upper-level vet students, and I don't think that's deserved. I know that some people really have a problem with the more "touchy-feely" style of communication, for whatever reason, but I think the next 3 days just might make a believer out of me... stay tuned!
P.S. If you have read this entire post, holy cow, I'm impressed! Way to be a dedicated reader! Here's hoping you find my rantings, ramblings, and reflections interesting and not just completely self-absorbed...
The second rule of Client Communication rotation... well, you get the picture.
I am pleased to announce that I have thus far survived 40% of this semester's much-dreaded week-long Client Communication Skills (CCS) rotation!
(trumpets sound)
Now, let's be honest.
As much as I would like to be able to commiserate with my being-videotaped-impaired, communication-phobic, distressed and tearful classmates with the misfortune to experience this rotation before me, I would be lying if I told you that my rotation so far has been an absolutely fantastic experience.
The truth is out. Don't tell my friends, or I won't have any.
I think I approached CCS with the following attitude:
"I am going to go into this rotation being able to say that I came in trying to keep a positive attitude, but I am really not going to have a good time."
But.... the things we've done so far have been really beneficial.
(Really, I don't mean to sound so astonished. I'm truly excited that this hasn't turned out to be an absolute waste of 20 hours of my time.)
Yesterday we did some semi-hokey stuff, talking about feelings, what we did over the summer, how to ask open-ended questions and let your clients know that you're empathizing with them.
(Oh, and the instructor started off the week by saying "Good morning" to the class of 25 students repeatedly until she got a satisfactory chorus of "Good morning"s in return. Talk about a surefire way to come off as condescending and make your students feel like 8 year olds. Thankfully, things went uphill from there.)
Today was the first of two days of "simulated client interactions." The vet school hires actors to come in and portray clients bringing in their dog, cat, horse, or (if you're unlucky) hedgehog to see us students. The actors also work with the state's medical school, doing the same thing pretending to be actual medical patients so the med students can practice communication and history-taking.
Let me tell you, these actors are amazingly good. Invariably, in each of the 5 simulations it was a matter of moments before everybody forgot that the "client" wasn't really some person bringing in a sick pet.
We were divided into 5 groups of 5 students. Each small group had a "coach" (all were vets, two from the vet school and three from private practices). Some of the newer coaches got their own coaches who were coaching them on how to coach us.
Each student got 45 minutes for their simulated interaction:
-- In the first 5 minutes, the interviewing student got to find out what the case was about (owner's name, pet's name, breed, age, and the apparent reason for the visit [wellness exam, behavioral problem, medical problem, etc.]). Among the group of students, we discussed things that may come up during the interview, what the interviewing student's objectives were, how they were going to approach certain subjects, etc.
-- The next 15 minutes comprised the actual interview. The client was seated in the exam room (with 1 or 2 coaches in there too). The other 4 students were in the observation room next to the exam room, which has a one-way mirror looking in on the exam room. The student entered the room, introduced herself, and started the interview. You got to pause, take breaks, or rewind if you needed a minute to gather your thoughts, needed some advice from your coach, or realized that something didn't go well and you had something you wanted to try again.
-- The next 20 minutes were "debriefing" -- first the interviewing student discusses how she felt the interview went. Then the 4 observing students take turns critiquing different facets of the interview technique (initiation, gathering information, logical flow, etc.). Then the actor/client gives their feedback on how they felt as the one in the conversation, what they liked and didn't etc.
-- The last 5 mninutes are a discussion of what everybody learned from the case.
**The Fight Club rules (I named them that, not the rotation instructors) mean that we are bound by the honor code (and it's even extra-official, since they made us sign something) to not discuss the simulated case scenarios with anybody who hasn't taken the rotation yet. And that's with good reason -- as they point out, the learning experience is a lot less effective if you know ahead of time what sort of situation you're getting into, what hidden information is there for you to discover if you make your client feel comfortable enough to open up to you, etc.
I ended up going last among my group of 5 -- not really by choice, but the first 3 people kept volunteering to go next, then the last person and I flipped a coin to see who would go 4th and 5th.
It was a very surreal experience. During the past few weeks when I've been thinking ahead to upcoming rotations and remembering that I had CCS during week 6, I'd been getting progressively more nervous about it. During our initial Pet Hospice volunteer training during fall semester freshman year, we had a similar training session where we role-played with actor clients about how to talk about their ill pet, how to start conversations about quality of life and euthanasia, etc. -- and that experience was pretty awkward.
But I was surprised when I showed up this morning and really didn't feel that anxious about the whole thing. Sure, I didn't want to make a fool of myself, but everyone in my group was very supportive of each other and good at giving plenty of positive feedback along with a few suggestions for improvement. Yesterday as the instructors discussed today's exercise, they were very clear about the fact that none of our grade for this rotation comes from how well we perform in the simulated interactions -- our grade is all about a reflective paper we write, and how well we are able to analyze what we did well, what needs improvement, where our strengths are, phrasing that sounded good, moments that felt awkward and how they could be made more comfortable, etc. That really took the pressure off and made me feel like if I totally got tongue-tied or off-track or distracted during my simulated interview, it would all be ok.
CCS really has a terrible reputation among the upper-level vet students, and I don't think that's deserved. I know that some people really have a problem with the more "touchy-feely" style of communication, for whatever reason, but I think the next 3 days just might make a believer out of me... stay tuned!
P.S. If you have read this entire post, holy cow, I'm impressed! Way to be a dedicated reader! Here's hoping you find my rantings, ramblings, and reflections interesting and not just completely self-absorbed...
Subscribe to:
Posts (Atom)
