Vet med instructors take 'gold standard' communication training online during pandemic

Before the pandemic, communication skills labs were held in-person. Jager and Kokemor

April 1, 2021

Vet med instructors take 'gold standard' communication training online during pandemic

Interactive clinical communication labs host guests from around the world

Along with clinical skills, a veterinarian’s ability to communicate efficiently and effectively with their clients is critical to the health of their patients. Animals can’t tell you how they feel, so veterinarians need to be able to interact with owners in a way that builds trust and results in shared decision-making.

From day one, students in the (UCVM) learn how to do just that, through a program that is world-renowned for excellence in teaching professionalism and relationship-centred clinical communication skills.

“We have an incredible team of highly trained coaches and simulated clients who work with students in half- or full-day communication labs,” says Dr. Cindy Adams, PhD, clinical communications professor at UCVM, who created the program. “The cases are developed from the experiences of veterinarians in practice. Simulated clients are carefully trained in case content and skilled feedback delivery. Students work through cases with a simulated client and under the watchful eyes of coaches to enhance their communication skills.”

Cindy Adams, (left) who created the clinical communications program, is gratified the program gives UCVM students like Brock Chappell tools to help them navigate through complex situations.

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In this pandemic year, methods of teaching UCVM students required some radical changes in approach. In the second of a two-part series, we look at how the communications labs were adapted to work on Zoom.

Adding tools to their communication skills toolbox one client at a time

“The program’s goal is for students to learn to take a relationship-centred approach with clients,” says Mandy Dale, a professional skills facilitator who works alongside Adams.

Students receive only basic information about their ‘case’ at the start of each lab. The simulated clients (SCs), however, have full details of complex and often emotionally challenging scenarios such as having to euthanize a patient.

The students are coached in using a set of 73 clinical communication skills to gather a patient’s history, draw out important information through insightful questioning, and work collaboratively with clients to develop care plans. They have to build strong relationships, empathize with clients, and ensure proper care for animals once they leave the clinic.

An important element of the communications program is students learning to recognize good communication practices in their fellow students and provide effective feedback to their peers.

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Fellow students watch these interactions, taking detailed notes. “It's teaching them not just to demonstrate the skills themselves, but to recognize their use and be able to provide effective feedback to their peers,” says Dale.

“And we work hard on perceptual skills,” says Adams. “To help raise students’ self-awareness of their inherent biases and their values and how their life thus far has enabled them to work across a number of different issues or people, or not.”

Coaches help students improve communication in real-time

The coaches, many of whom are community veterinarians, are trained in facilitating students through each interview. If it appears things aren’t going well, the coach may call a ‘time-out’ and let the student ‘rewind’ or start over. They might ask the SC for their perspective in the moment.

“You can’t do that in real life. You can’t say during an appointment, ‘Time out. I'm sorry. I think what I just said might have offended you. How are you feeling right now?’ Students learn how to stop in those moments, then learn from them and adapt,” says Dale.

The program Adams built — considered by many as the gold standard of communication training in veterinary medicine — was designed for in-person, face-to-face labs. Would it be as effective if it was transitioned to online delivery?

Pre-Covid, vet med students in simulated clinical appointments were watched by their peers on the other side of two-way glass. Now, with Zoom, they’re viewed virtually.

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Taking an immersive in-person learning experience virtual

“When we learned that we weren't going to be in-person in the fall, Mandy and I got super busy with the help of others and started to think about what was going to be necessary to make this successful,” says Adams.

“We wanted to create the same experience, or as close to it as we could,” adds Dale. “We developed Zoom manuals for the coaches, students, and SCs, screenshots of how to navigate between different zoom features, chat room etiquette guidelines, troubleshooting tips, and more. Our team spent innumerable hours getting the coaches and SCs comfortable in Zoom.”

During the virtual labs, Dale orchestrates the complex distribution of resources, management of schedules, and movement of dozens of students, SCs, coaches, and guests into various Zoom rooms like a maestro conducting a symphony — and there is no room for error.

During the virtual labs, Mandy Dale orchestrates the movement of dozens of students, simulated clients, and coaches into various Zoom rooms like a maestro conducting a symphony.

Mandy Dale

“One little mis-click of the mouse has a domino effect on everyone in the lab which can cause confusion and delays.”

You’re on mute

Through hard work, trial and error, and a few hiccups along with way, they successfully adapted the program.

“I still forget I’m on mute occasionally,” says Dale with a laugh. “But I’m getting better.”

“We are really proud to be leading the way,” says Adams. “We've had numerous guests from around the world join us on Zoom to observe our work, an option that wasn’t available when we were doing the labs in person. We’ve shared our experiences to help other veterinary schools, as well as an array of simulation and communication training platforms better inform the development of their own programs. That’s been super collaborative.”

“The underlying premise, whether it’s virtual or in person, is evidence-based approaches to teaching and learning these skills, and we’ve set the bar high,” says Adams. “I’m thrilled to know that we've equipped our graduates with tools to help them navigate through complex situations and succeed in this profession over time.”