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clinical skills are becoming increasingly common in veterinary education (Read and Hecker, 2013; Dilly et al., 2014; Dilly et al., 2017). These facilities allow students to practice a range of professional and technical skills in a safe and nonconfrontational environment, before performing them in “real‐world” settings such as a veterinary teaching hospital. Furthermore, many models and simulations are now available to assist the learning in this environment and are discussed at length in other chapters in this book. Other venues where clinical skills may be taught include university farms, teaching hospitals, external affiliated practices, and a wide range of agricultural and veterinary premises during extramural studies.
Funding
Funding for a clinical skills curriculum should include all the direct financial costs and faculty compensation, as well as any other hidden costs (Schneiderhan et al., 2018). Annual budgets for clinical skills training are highly variable among veterinary programs but can run into the hundreds of thousands of dollars if all costs are included. In determining an appropriate budget for a clinical skills curriculum, careful consideration should be given not only to the costs for development of the curriculum but also the ongoing costs of personnel and equipment for teaching activities, as well as assessments to ensure its sustainability.
Buy‐in
The next step in implementation is obtaining support internally from stakeholders to the curriculum, and at times externally when funding or support for other resources is needed (Schneiderhan et al., 2018). Stakeholders are those most directly impacted by implementation of a clinical skills curriculum and may include students, the faculty who are responsible for the teaching, as well as administrative personnel (e.g. Dean of the College). Having their support and enthusiasm is crucial to the success of any curriculum.
External support may become necessary when resources beyond what is available to the program or school are needed, either financially or in terms of facilities, and has been described in a number of veterinary programs (Morin et al., 2020).
Management Plan and Roll Out
The final phases in this step are the design of a management plan and roll out. The management plan should detail the actual step‐by‐step process of how the curriculum will be delivered and include the who, what, where, and how for each component or teaching strategy, as well as anticipating where any barriers might arise during the roll out of the curriculum (Schneiderhan et al., 2018). Some of these barriers may be anticipated in advance, along with a plan to mitigate them.
The last step in implementation is the actual roll out. Before this occurs, it may be helpful to initially pilot sections of the clinical skills curriculum to enthusiastic stakeholders, both to gain more support and to identify and rectify any barriers to implementation so that the odds of success are increased (Schneiderhan et al., 2018). This pilot can be followed by a phasing‐in, where new portions are added until the full curriculum is ultimately implemented.
Step 6: Evaluation
The final step in the curricular design process is evaluation. This is a process of determining the merit, value, or worth of a program that has been implemented (Kern et al., 2016). Although evaluation is often considered to be the final phase of curriculum development, it should span the entire process and is often cyclical and iterative. Furthermore, evaluation of a curriculum should be conducted early on, or at key points, in order to inform changes and identify opportunities for improvement. Alternatively, evaluations can be made after full implementation to determine whether a curriculum was successful, and for whom, in order to report back to stakeholders (Schneiderhan et al., 2018).
The major steps of a curricular evaluation involve five components, which will be discussed briefly below.
1: Develop a clear plan to use evaluation results
Although it may seem counterintuitive, the first step of an evaluation is to consider who will use the evaluation results and how they will be used. An evaluation that is never used will not be worth the effort (Schneiderhan et al., 2018). A utilization plan should include a dissemination plan (e.g. written reports, presentations, discussion sessions) and the specific audience for each. In addition, the utilization plan should detail what types of actions may be anticipated based on the results; for example, could the report lead to changing, ending, or expanding the clinical skills program?
2: Determine how to measure objectives
The next step is to determine how to measure the outcomes of the learning objectives for the curricular initiatives and whether these were met by the students. This step mostly incorporates assessment and includes consideration of the different assessment strategies that are most appropriate to assess student learning of clinical skills, as well as the timing of these assessments, whether they will be repeated, and what ultimately demonstrates proficiency for more complex clinical activities that incorporate multiple competencies and skills.
3 & 4: Collect and analyze data
Data collection might involve tests, interviews with students or instructors, performance assessments, or other methods (Schneiderhan et al., 2018). Analyzing pre‐post differences can be particularly helpful in assessing whether learning has been enhanced (or otherwise) due to curricular changes.
5: Use evaluation results by applying lessons learnt
The final step is to use the evaluation results and apply lessons learnt to the curriculum (Kern et al., 2016). Guided by the utilization plan, this step consists of disseminating information to relevant stakeholders and making use of the results to improve learning outcomes or the learning experience. This evaluation process should also be iterative as educators apply lessons learnt and then subsequently evaluate and implement further improvements to the curriculum.
Conclusions
The education of veterinary and veterinary nursing students so they are optimally prepared to enter the veterinary profession with entry‐level veterinary knowledge and appropriate mastery of many clinical skills can be achieved by starting with the precise design of both theoretical and clinical skills curricula. In essence, the end result should be an integrated curriculum. This becomes more obvious if it is considered that the same principles of theoretical curriculum design are also applied to the design of a clinical skills curriculum.
By conducting a needs analysis and statement, identifying and prioritizing content, and formulating a clinical skills program in a backward design process, a curriculum that will educate students in aspects of applied knowledge, clinical skills, and clinical reasoning can be produced. A clinical skills curriculum can be successfully implemented depending on resources. It is vital that the newly implemented curriculum is assessed and subsequently improved. If the steps and processes described in this chapter are followed, the clinical curriculum design process will be focused and simplified, with a resultant well‐prepared qualified veterinarian and veterinary nurse.
References
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2 American Veterinary Medical Association. 2017. Council on Education Accreditation Policies and Procedures: Requirments [Internet]. 2017 Sept, 2017 [cited 2020 Jan 2] Accessed January 2, 2020.
3 Baillie, S., Shore, H., Gill, D., et al. 2009. Introducing peer‐assisted learning into a veterinary curriculum: A trial with a simulator. J Vet Med Educ, 36, 174–179.
4 Bates, L. S. W., Warman, S., Pither, Z., et al. 2016. Development and evaluation of vetPAL, a student‐led, peer‐assisted learning program. J Vet Med Educ, 43, 382–389.
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