Deficient basic skills coming out of vet school

[Frozenshades]

Cool, I'm glad to hear that some schools are already putting the new AVMA stuff into practice. I know that UF is working on getting our "clinical skills" lab up and running but it's still in the works. We don't use E-value for checklists or anything, just for scheduling but yes...it's awful

It probably is good but I really don't like the system here. We have a similar thing as others have listed where you have a checklist of things you need to do before entering fourth year which is fine, except they want you to work at other clinics and then charge you for the credit. So we'll end up with three credit hours of coursework completed 100% outside the school at other clinics, yet we'll be charged tuition fees for said credit hours just so they can be put on our transcripts. I wouldn't care at all (if anything would be supportive of the idea) if it wasn't a load of bull and charging us for someone else to teach us something...

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[bunnity]

Surgery just seriously takes a lot of practice and conscientiousness. The most important things are being sterile and being safe, and to just keep practicing under the eye of a good mentor surgeon. The people who are scary in surgery are those that are overconfident, don't pay attention to where their sterile field is, don't ask questions, and are rough with the tissue. People who are unsure, but aware of their own skill level/limitation, end up doing fine. Practicing knots and sutures ahead of time until you could do them in the dark is also really helpful because if you're trying to learn something during one of your first surgeries you may have so much adrenaline going that it's hard to actually learn something like that.

 

[pinkpuppy9]

It probably is good but I really don't like the system here. We have a similar thing as others have listed where you have a checklist of things you need to do before entering fourth year which is fine, except they want you to work at other clinics and then charge you for the credit. So we'll end up with three credit hours of coursework completed 100% outside the school at other clinics, yet we'll be charged tuition fees for said credit hours just so they can be put on our transcripts. I wouldn't care at all (if anything would be supportive of the idea) if it wasn't a load of bull and charging us for someone else to teach us something...

Sounds like my internship. Required for my degree program, so I had to pay tuition even though it was 100% off-campus. They said it was for insurance purposes/liability...

Surgery just seriously takes a lot of practice and conscientiousness. The most important things are being sterile and being safe, and to just keep practicing under the eye of a good mentor surgeon. The people who are scary in surgery are those that are overconfident, don't pay attention to where their sterile field is, don't ask questions, and are rough with the tissue. People who are unsure, but aware of their own skill level/limitation, end up doing fine. Practicing knots and sutures ahead of time until you could do them in the dark is also really helpful because if you're trying to learn something during one of your first surgeries you may have so much adrenaline going that it's hard to actually learn something like that.

Can pre-vets practice suturing and knots without actual surgical material/tissue? In other words, is sewing thread a suitable replacement? Sounds kind of pathetic when I say it outloud haha

 

[orca2011]

Sounds like my internship. Required for my degree program, so I had to pay tuition even though it was 100% off-campus. They said it was for insurance purposes/liability...



Can pre-vets practice suturing and knots without actual surgical material/tissue? In other words, is sewing thread a suitable replacement? Sounds kind of pathetic when I say it outloud haha

We used dental floss for hand ties. And you could probably use it in an eyed needle. Ask around at vet practices. The equine practice I worked at gave me a ton of suture material because they don't use it often and a lot of their stuff is expired that they end up having to toss anyways.

 

[BlackDog17]

Sounds like my internship. Required for my degree program, so I had to pay tuition even though it was 100% off-campus. They said it was for insurance purposes/liability...



Can pre-vets practice suturing and knots without actual surgical material/tissue? In other words, is sewing thread a suitable replacement? Sounds kind of pathetic when I say it outloud haha

You can use real suture material and a "Daisy" or similar model. Not quite as good as real tissue, but it's a start and will get you used to the movements.

You can also find opportunities to practice in wetlabs. Symposiums and conferences often have cool wetlabs as well. I learned how to suture teat lacerations using fresh cadaver teats at the CVMA symposium - first time I've done any suturing and it was a great learning experience! The upper year student I was sitting next to also showed me that I was holding my needle drivers and forceps the wrong way, so I've been making a conscious effort to hold all my tools the proper surgical way when I use them in anatomy lab, even though it really doesn't matter for that. I think being very hands on in the anatomy lab is good practice too. Preserved tissue isn't the same as live tissue, but you still get a feel for the tools, how much force is takes to move/cut/tear things, etc.

 

[Coquette22]

so I've been making a conscious effort to hold all my tools the proper surgical way when I use them in anatomy lab, even though it really doesn't matter for that. I think being very hands on in the anatomy lab is good practice too.

You'll need to for surgery lab next year, so great that you're getting the hang of it now!

 

[Coquette22]

What happens if you guys (vet students) feel that you aren't competent in a surgical skill, or just can't get the hang of it? I feel overwhelmed just reading about what you learn. I bet it comes with a lot of practice, but I still worry that I might end up being that one student who just sucks at something.

It's entirely possible you will be the one student who just sucks at something. You'll probably be awesome at something that someone else sucks at though. I've been told my surgical instrument ties are pretty good. My intradermal suture is a nightmare though. Small animal blood draws? Not great, especially cats. But I can scruff a mouse and move a horse around and tie a quick release knot with my eyes closed. Try not to take it personally, breathe, remember that tomorrow is another day and y0u'll get better.

 

[DVMDream]

Surgery just seriously takes a lot of practice and conscientiousness. The most important things are being sterile and being safe, and to just keep practicing under the eye of a good mentor surgeon. The people who are scary in surgery are those that are overconfident, don't pay attention to where their sterile field is, don't ask questions, and are rough with the tissue. People who are unsure, but aware of their own skill level/limitation, end up doing fine. Practicing knots and sutures ahead of time until you could do them in the dark is also really helpful because if you're trying to learn something during one of your first surgeries you may have so much adrenaline going that it's hard to actually learn something like that.

This.

Practice knots early and often because you would be amazed at how the suture material can get caught up and moved around while doing surgery (and suture memory can be a nightmare). Also, practice holding instruments the proper way, a good rule that the vet told me was that if it feels awkward, you are probably holding something incorrectly or could hold something better to make it less awkward. I had practiced knots and patterns a lot last semester and I still had instances where things didn't give me a good square knot while I was on this externship, just be aware of your knots as you are tying them.

Also, the vet told me to practice posture now, because it will save your back when you are standing forever in surgery. She told me don't be afraid to get your belly right up against the table (make sure your sterile drape is there if you are gowned). Getting that close helps with your posture, your ability to see what you are doing and helps you to remain in your sterile field.

 

[that redhead]

What happens if you guys (vet students) feel that you aren't competent in a surgical skill, or just can't get the hang of it? I feel overwhelmed just reading about what you learn. I bet it comes with a lot of practice, but I still worry that I might end up being that one student who just sucks at something.

If there's one thing I've learned in vet school (and life) it's that you will never feel ready for anything when it's first asked of you. You will constantly have to push yourself outside of your comfort zone and perceived boundaries. It's about biting the bullet and taking that tiny step forward even though you're terrified you're going to mess up because you really will have the skills, you just need to find the self-confidence.

Surgery still scares the ever loving crap out of me, even after two and a half surgeries as primary surgeon. But I know that if push comes to shove, I can do it. It may not be pretty or perfect or as good as my teammate's, but it will fall into the acceptable category at the very least. Part of being the caliber of student (and hopefully people) that we are selected to be is that we want to improve our skills. So while there will definitely be things that you just suck at, you will put in the effort to bring yourself up to par.

 

[pinkpuppy9]

Thanks all!

 

[dovelover]

What happens if you guys (vet students) feel that you aren't competent in a surgical skill, or just can't get the hang of it? I feel overwhelmed just reading about what you learn. I bet it comes with a lot of practice, but I still worry that I might end up being that one student who just sucks at something.

Well, not worrying to much and having confidence helps I mean, not overly confident or cocky, of course. I generally go into everything assuming it'll go great (not just clinical skills, but exams too...) and if it deosn't, well I shrug and say I'll give it a shot next time. An important thing to remember is that if you don't get something on the first try, make sure you try again the next chance you get. Don't shy away from it because it gave you trouble.

 

[LetItSnow]

What happens if you guys (vet students) feel that you aren't competent in a surgical skill, or just can't get the hang of it? I feel overwhelmed just reading about what you learn. I bet it comes with a lot of practice, but I still worry that I might end up being that one student who just sucks at something.

You will definitely be that one student who sucks at <something>, because we all do. The thing to do isn't worry about whether it will happen; it's to mentally prepare yourself so that when it does, you can say "Hey, can you show me that one more time? I'm still not getting it" without feeling like your world just imploded.

Can pre-vets practice suturing and knots without actual surgical material/tissue? In other words, is sewing thread a suitable replacement? Sounds kind of pathetic when I say it outloud haha

You need something to practice on. Bananas are fine, but then I'm always hungry. So I suggest something like:

http://www.r-vets.org/Make_a_Suture_Board.pdf

It's very similar to what we made here for a club and frankly, it works well enough that spending money on something else is unnecessary. You'll need needle driver, forceps, and suture (expired cheapest) that you can find on amazon or wherever. Buy cheap. It's just for practice.

That said ... I wouldn't actually recommend it. You're better off waiting until someone can teach you so that you don't learn bad habits that you have to undo later.

 

[WhtsThFrequency]

You will definitely be that one student who sucks at <something>, because we all do. The thing to do isn't worry about whether it will happen; it's to mentally prepare yourself so that when it does, you can say "Hey, can you show me that one more time? I'm still not getting it" without feeling like your world just imploded.

Cannot emphasize this enough. You cannot be perfect. There will always be something (more likely multiple things) in veterinary medicine that you will suck at. Yes, you will suck at it. Sometimes permanently, sometimes temporarily.

I think a lot of us get so caught up in being perfect through high school, college, etc. we have never experience failure and have a deathly fear of it.

 

[Lissarae06]

It probably is good but I really don't like the system here. We have a similar thing as others have listed where you have a checklist of things you need to do before entering fourth year which is fine, except they want you to work at other clinics and then charge you for the credit. So we'll end up with three credit hours of coursework completed 100% outside the school at other clinics, yet we'll be charged tuition fees for said credit hours just so they can be put on our transcripts. I wouldn't care at all (if anything would be supportive of the idea) if it wasn't a load of bull and charging us for someone else to teach us something...

So like preceptors?

 

[Frozenshades]

So like preceptors?

Yeah I suppose so. They call them 'mentorships.' I guess it's like a mini externship

 

[pinkpuppy9]

That said ... I wouldn't actually recommend it. You're better off waiting until someone can teach you so that you don't learn bad habits that you have to undo later.

Good point. My anatomy lab TA said it is common that pre-vets bring in suture material after the last practical to practice, which immediately had me thinking "Geez, am I that far behind in my experience? Is this something I should be doing?" It doesn't make sense for me to really practice suturing when I'd just be playing around with it for the most part.

 

[shortnsweet]

Good point. My anatomy lab TA said it is common that pre-vets bring in suture material after the last practical to practice, which immediately had me thinking "Geez, am I that far behind in my experience? Is this something I should be doing?" It doesn't make sense for me to really practice suturing when I'd just be playing around with it for the most part.

Start with knots, then work up to simple interrupted. It's a matter of learning how to hold the instruments and getting a feel for material. The rest comes later.

I prefer oranges to bananas to practice on, not as squishy. I have also used chicken and old stuffed animals.

 

[bunnity]

The formatting is ghastly, but this has all the info on sutures and instruments and how to hold everything and different suture patterns!
http://cal.vet.upenn.edu/projects/surgery/index.htm

 

[Minnerbelle]

That said ... I wouldn't actually recommend it. You're better off waiting until someone can teach you so that you don't learn bad habits that you have to undo later.

+1 Seriously, rather than learning from a pictured website/book or youtube, the best thing to do is have someone who knows what they're doing just do it with you for a few different sessions. You'll "get it" after a few tries the first session. Then you'll forget it inevitably... even if you practice a few times at home. Then you'll "get it" again a little faster the second session. Rinse and repeat. After a few of these sessions and practice at home, it'll become second nature (especially hand ties) to the point where you won't forget it again. Once you're in vet school, there are wetlabs and stuff usually run by surgery club and such that will give you the opportunities to have these sessions like once or twice a year. If you participate in those, and it get reinforced by the few times they make you learn in school, you'll be a pro by the time you enter junior surgery. It's really not anything to worry about, there are plenty of opportunities to learn during your first 2-3 years in school. Just seek some of them out on your own time, and you'll be just fine. If you feel super anxious, just ask a friendly third or fourth year, and it only really takes like 15 min to temporarily learn a proper hand tie. Instrument ties are even quicker. You just have to have someone periodically check to make sure you're still doing it right.

The entrepreneur in me sees the demand for one-on-one tutorials in suturing skills, and wonders if I can make $$ by scaring pre-vets (or even pre-meds) in the area that they will be far behind without it . All it would take is a board, some expired suture material, tools i already have, and some pigs feet that are super cheap at the supermarket.

 

[LetItSnow]

The entrepreneur in me sees the demand for one-on-one tutorials in suturing skills, and wonders if I can make $$ by scaring pre-vets (or even pre-meds) in the area that they will be far behind without it . All it would take is a board, some expired suture material, tools i already have, and some pigs feet that are super cheap at the supermarket.

Hahahahahahahaha!

"Don't want to be the slowest suturer in class?

Worried that you'll still be at the surgery table long after everyone else is done?

Call 1-800-MB-knots for information on my one-on-one suture program, taught by a FULLY CREDENTIALED VET STUDENT!

Hand ties, instruments ties, suture patterns, and MORE! With successful completion of my full program you will be suturing like a pro surgeon in no time! <insert video of some hot young co-ed in a white coat turning toward the camera: 'It worked for me! My hand ties are the best in the class!'

Call now! That's 1-800-MB-knots!"

 

[nyanko]

Call 1-800-MB-knots for information on my one-on-one suture program, taught by a FULLY CREDENTIALED VET STUDENT! VETERINARIAN

...very soon