Ryane Englar
- Associate Professor of Practice
- Executive Director, Clinical and Professional Skills
- Oro Valley Veterinary Medicine, Rm. 130
- Tucson, AZ 85721
- renglar@arizona.edu
Biography
Education:
2008 DVM Degree, Cornell University College of Veterinary Medicine
2004 BS (Animal Science), Cornell University
Board Certification:
2014 - Present Diplomat of the American Board of Veterinary Practitioners (DABVP)
Concentration: Canine and Feline Practice
Professional Certificates:
November 2022 Certificate of Diversity and Inclusion in Veterinary Medicine
Advancing Inclusion through Human-Centered Veterinary Medicine Purdue University
Professional Licensure:
2014 – Present DVM, State of Arizona
Veterinary Academia and Practice Experience:
Feb 2020 – Present Associate Professor of Practice and Executive Director, Clinical and Professional Skills
Founding Faculty Member at the University of Arizona College of Veterinary Medicine
2017 – Jan 2020 Assistant Professor / Clinical Education Coordinator
Kansas State University
2014 – 2017 Assistant Professor / Small Animal Primary Care, Founding Faculty
Midwestern University
2013 - 2014 Instructor / Community Practice Service
Cornell University
2011 - 2014 Consultant / Feline Health Center Louis J. Camuti Hotline
Cornell University
2009 - 2013 Robert W. Kirk Practitioner-in-Residence
Cornell University
2009 - 2013 Full-Time Associate Veterinarian
Towne & Country Veterinary Hospital
2008 - 2009 Full-Time Associate Veterinarian
Falls Road Animal Hospital
Degrees
- D.V.M. Veterinary Medicine
- Cornell University College of Veterinary Medicine, Ithaca, New York, United States
Interests
Research
veterinary medical education, curricular design, pre-clinical curricular design, clinical communication, communication models, Calgary–Cambridge guide (CCG), relationship-centered care, critical thinking, self-reflection, self-awareness, cultural humility, awareness of others, diversity and inclusion (D&I)
Teaching
clinical skills, professional skills, performing the comprehensive physical examination, medical record-keeping (SOAP notes) and other forms of documentation
Courses
2024-25 Courses
-
Advanced Professional Skills I
VETM 815A (Spring 2025) -
Clinical Skills
VETM 803B (Spring 2025) -
Professional Skills
VETM 802B (Spring 2025) -
Clinical Skills
VETM 803A (Fall 2024) -
Clinical Skills
VETM 803D (Fall 2024) -
Professional Skills
VETM 802A (Fall 2024) -
Professional Skills
VETM 802D (Fall 2024)
2023-24 Courses
-
Advanced Professional Skills
VETM 815B (Summer I 2024) -
Clinical Skills
VETM 803C (Summer I 2024) -
Professional Skills
VETM 802C (Summer I 2024) -
Advanced Professional Skills I
VETM 815A (Spring 2024) -
Clinical Skills
VETM 803B (Spring 2024) -
Professional Skills
VETM 802B (Spring 2024) -
Clinical Skills
VETM 803A (Fall 2023) -
Clinical Skills
VETM 803D (Fall 2023) -
Professional Skills
VETM 802A (Fall 2023) -
Professional Skills
VETM 802D (Fall 2023)
2022-23 Courses
-
Advanced Professional Skills
VETM 815B (Summer I 2023) -
Clinical Skills
VETM 803C (Summer I 2023) -
Professional Skills
VETM 802C (Summer I 2023) -
Advanced Professional Skills I
VETM 815A (Spring 2023) -
Clinical Skills
VETM 803B (Spring 2023) -
Professional Skills
VETM 802B (Spring 2023) -
Clinical Skills
VETM 803A (Fall 2022) -
Clinical Skills
VETM 803D (Fall 2022) -
Professional Skills
VETM 802A (Fall 2022) -
Professional Skills
VETM 802D (Fall 2022)
2021-22 Courses
-
Advanced Professional Skills
VETM 815B (Summer I 2022) -
Clinical Skills
VETM 803C (Summer I 2022) -
Professional Skills
VETM 802C (Summer I 2022) -
Advanced Professional Skills I
VETM 815A (Spring 2022) -
Clinical Skills
VETM 803B (Spring 2022) -
Professional Skills
VETM 802B (Spring 2022) -
Clinical Skills
VETM 803A (Fall 2021) -
Clinical Skills
VETM 803D (Fall 2021) -
Professional Skills
VETM 802A (Fall 2021) -
Professional Skills
VETM 802D (Fall 2021)
2020-21 Courses
-
Clinical Skills
VETM 803C (Summer I 2021) -
Professional Skills
VETM 802C (Summer I 2021) -
Clinical Skills
VETM 803B (Spring 2021) -
Professional Skills
VETM 802B (Spring 2021) -
Clinical Skills
VETM 803A (Fall 2020) -
Professional Skills
VETM 802A (Fall 2020)
Scholarly Contributions
Books
- Englar, R., & Dial, S. M. (2023). Low-Cost Veterinary Clinical Diagnostics. Wiley-Blackwell.More infoLow-Cost Veterinary Clinical DiagnosticsA practical guide to maximizing the diagnostic value of in-house quick assessment tests (QATs)In Low-Cost Veterinary Clinical Diagnostics, the authors provide a hands-on resource designed to facilitate healthcare delivery across the spectrum of care.Historically, clinicians have been taught to apply the gold standard approach to the practice of medicine. However, recent advances in veterinary medical care and associated technologies have made practitioners question whether a one-size-fits-all approach is truly best. After all, when we perform diagnostic tests, are we testing out of the desire for completeness, to cover all bases for the good of the patient? Or are we testing because we are expected to?The reality is that gold standard care is not always advisable and not always possible. In clinical practice, veterinarians frequently encounter obstacles that limit their approaches to case management. Cost of care is a significant constraint that requires practitioners to rethink which diagnostic tests are essential.Not every patient requires a complete blood count (CBC), chemistry profile, urinalysis, and fecal analysis to obtain diagnostic value. This text suggests that the “best” approach to case management be determined by the situation, the context, the patient, and the client.While sophisticated panels of tests may remain the recommended approach to case management, Low-Cost Veterinary Clinical Diagnostics outlines entry-level, in-house diagnostic blood, urine, fecal, and body cavity fluid tests: how to perform them as well as the breadth and depth of patient-specific data that can be gleaned from quick assessment tests (QATs).
- Englar, R. (2021). Pet-Specific Care. Hoboken, New Jersey: Wiley-Blackwell.More infoPet-specific care refers to a practice philosophy that seeks to proactively provide veterinary care to animals throughout their lives, aiming to keep pets healthy and treat them effectively when disease occurs. Pet-Specific Care for the Veterinary Team offers a practical guide for putting the principles of pet-specific care into action. Using this approach, the veterinary team will identify risks to an individual animal, based on their particular circumstances, and respond to these risks with a program of prevention, early detection, and treatment to improve health outcomes in pets and the satisfaction of their owners. The book combines information on medicine and management, presenting specific guidelines for appropriate medical interventions and material on how to improve the financial health of a veterinary practice in the process. Comprehensive in scope, and with expert contributors from around the world, the book covers pet-specific care prospects, hereditary and non-hereditary considerations, customer service implications, hospital and hospital team roles, and practice management aspects of pet-specific care. It also reviews specific risk factors and explains how to use these factors to determine an action plan for veterinary care. This important book: Offers clinical guidance for accurately assessing risks for each patient Shows how to tailor veterinary care to address a patient’s specific risk factors Emphasizes prevention, early detection, and treatment Improves treatment outcomes and provides solutions to keep pets healthy and well Written for veterinarians, technicians and nurses, managers, and customer service representatives, Pet-Specific Care for the Veterinary Team offers a hands-on guide to taking a veterinary practice to the next level of care.
- Englar, R. (2021). The Veterinary Workbook of Small Animal Clinical Cases. U.K.: 5M Books.More infoThis workbook is intended to be a bridge between classroom learning and clinical training; to improve patient care and clinician confidence in practice. Common presentations in small animal practice are presented as real-world case studies while the reader is guided through work-up, critical thinking and problem solving to run the consultation efficiently. Key concepts of anatomy, physiology, radiology, clinical pathology, medicine and surgery are covered and readers are guided through history-taking and diagnostics to perform an effective consultation. Cases discussed include vaccinating the new kitten, castrating the new puppy, the puppy with diarrhoea, the blind cat, the head-shaking dog, the itchy dog. Categories of complaints covered include body weight, urinary problems, the digestive system, respiratory issues, eye problems, skin and soft tissue complaints, cardiovascular, reproductive, aural and neurological complaints. The aim is to present a problem-first approach and to encourage readers to think like clinicians rather than students by instilling a case-based problem solving approach.
- Englar, R. E., Craig, M., Lobprise, H. B., Ward, E., Downing, R., Kendall, K., McLeod, K. C., Becker, M., Haworth, D., Weinstein, P., Howell, A., & Ley, J. (2021). Pet‐Specific Considerations. doi:10.1002/9781119540687.ch6
- Englar, R. (2020). A Guide to Oral Communication in Veterinary Medicine. U.K.: 5M Publishing.More infoGood communication skills provide better clinical outcomes and help avoid minor as well as major mistakes. Approximately 60-80% of negligence claims against vets are related to poor communication, with new graduates especially vulnerable. Communication skills are a growing part of the curriculum in veterinary schools, recognising how fundamental clear communication is to good practice. A Guide to Oral Communication in Veterinary Medicine covers why communication skills are important, the structure of typical communications and suggested approaches, veterinary specific communication pathways, and sample scripts between vet and client. Scenarios covered include everyday communication, dealing with challenging situations, different species, different settings, and communication within the veterinary team. The aim is to instill confidence and competence, build professionalism, and avoid problems. Most current teaching is based on a toolbox approach developed from the human medicine model. However, there is no set standard for teaching methodology, which is why this is primarily a book for students, but also includes a section for educators to provide guidance in this nascent subject.
Journals/Publications
- Englar, R. (2023).
Diagnosis, treatment and outcome of pheochromocytoma in a cat
. Journal of Small Animal Practice, 64(6), 415-420. doi:10.1111/jsap.13601 - Englar, R. E. (2023).
Teaching Tip: Designing Three-Dimensional (3-D) Printed Struvite and Calcium Oxalate Crystals for Microscopic Examination
. Journal of Veterinary Medical Education, 50(2), 192-204. doi:10.3138/jvme-2023-0098 - Englar, R. E. (2023). Recasting the gold standard - part I of II: delineating healthcare options across a continuum of care. Journal of Feline Medicine and Surgery, 25(12).
- Englar, R. E. (2023). Recasting the gold standard - part I of II: delineating healthcare options across a continuum of care. Journal of feline medicine and surgery, 25(12), 1098612X231209855.More infoThis is the first part of a two-part series on spectrum of care that encourages practitioners to embrace a non-binary approach to healthcare delivery. When care is not framed as all-or-none, either/or or best versus lesser, the provider and client can agree to diagnostic and/or treatment plans that individualize the practice of veterinary medicine. Care is tailored to the patient along a continuum of acceptable options. Care may also be intentionally incremental, with plans to reassess the patient and revise case management as needed.
- Leith, G. S., Hallam, L., & Englar, R. E. (2023). Teaching Tip: Design and Implementation of a Safe Equine Radiation-Free Radiographic Simulator for Veterinary Skills Training in the Pre-clinical Curriculum. Journal of veterinary medical education.
- Molina, C. C., Dias, M. J., Domingues, T. D., Englar, R. E., & Leal, R. O. (2023). Clinical findings and prognostic factors for mortality in hospitalized dogs with leishmaniosis: aretrospective study. Comparative immunology, microbiology and infectious diseases, 101, 102041.More infoThis retrospective study evaluated factors responsible for mortality of dogs hospitalized for Canine Leishmaniosis. Medical records of 31 dogs with leishmaniosis from a Portuguese Veterinary Teaching Hospital were examined between August 2018 and January 2022. Females (n = 18) and pure breed dogs (n = 27) were overrepresented, with higher frequency of Labrador Retriever (n = 4). Median age was 7 years (interquartile range=7). Most had historical findings of lethargy (n = 26) and the commonest clinicopathological abnormality was hypoalbuminemia (n = 26). Eleven dogs were classified as LeishVet stage II, 10 stage III and 10 stage IV. Fourteen dogs (45.2%) died or were euthanized, with azotemia, leukocytosis, stage IV, absence of diagnosis before hospitalization and lack of leishmaniosis specific treatment during hospitalization contributing to mortality. Absence of hypoalbuminemia and stages II/III increased survival. Mean hospitalization length prior to discharge was 5.41days ( ± 1.84) and diarrhea prolonged hospital stay.
- Molina, C. C., Dias, M. J., Domingues, T. D., Englar, R. E., Leal, R. O., & College, o. (2023). Clinical findings and prognostic factors for mortality in hospitalized dogs with leishmaniosis: a retrospective study. Comparative immunology, microbiology and infectious diseases.
- Prego, M. T., Dias, M. J., Mestrinho, L., Englar, R., Grinwis, G., Galac, S., & Leal, R. O. (2023). Diagnosis, treatment and outcome of pheochromocytoma in a cat. The Journal of small animal practice, 64(6), 415-420.More infoPheochromocytoma in cats is a rare clinical condition characterised by the development of a secretory endocrine tumour that arises from the adrenal medulla. An 8-year-old castrated male, domestic shorthair cat was referred for further investigation of a 4-month history of progressive weight loss with normal appetite, polyuria/polydipsia, generalised weakness, and severe hypertension. Sonography and computed tomography of the abdomen disclosed a mass arising from the left adrenal gland. The contralateral adrenal gland was normal in size and shape. Results from a low dose dexamethasone suppression test and measurements of plasma aldosterone concentration and plasma renin activity ruled out a cortisol-secreting tumour and aldosteronoma. The clinical presentation made a sex-steroid secreting tumour unlikely. Increased plasma metanephrine and normetanephrine concentrations prioritised the differential diagnosis of pheochromocytoma. The cat underwent adrenalectomy of the left gland and histopathological diagnosis with immunohistochemical markers confirmed the diagnosis.
- Englar, R. E., & Graham, B. T. (2022). Integrating Communication Skills, Awareness of Self and Others, and Reflective Feedback into One Inclusive Anatomical Representation of Relationship-Centered Health Care. Journal of veterinary medical education, 50(4), 399-412.
- Englar, R. E., Leal, R. O., Galac, S., Ferreira, R. L., Vicente, G., Fontes, A. P., Dias, M. J., & Oliveira, J. (2022). Ultrasonographic Detected Adrenomegaly in Clinically Ill Cats: A Retrospective Study. Veterinary Sciences. doi:10.3390/vetsci9080420More infoThis retrospective study aimed to assess the prevalence of ultrasonographic detected adrenomegaly in clinically ill cats, evaluating the final established diagnosis, describe adrenal ultrasound findings and if the adrenomegaly was suspected or incidental. Abdominal ultrasonography reports of cats presenting to a veterinary teaching hospital between October 2018 and February 2021 were retrospectively reviewed. Cats showing adrenomegaly (one or both glands having a dorsoventral axis >4.8 mm) were selected and medical records respectively evaluated. Nine-hundred and eighty-three ultrasonographical reports were selected, of which, 68 (7%) disclosed adrenomegaly. European/Domestic Short-Hair (62/68; 91%) male (44/68; 65%) castrated (35/44; 80%) cats were overrepresented. Adrenomegaly was an incidental finding in 62/68 (91%) cats while in 6/68 (9%) it was identified in the context of investigating a potential adrenal disease. Concerning established diagnosis, chronic kidney disease was overrepresented (25/68; 37%), followed by endocrinopathies (20/68; 29%). Adrenomegaly was bilateral in 53% (36/68) of cases. In unilateral cases (32/68; 47%), it was more prevalent on the left side (23/32; 72%), with a normal-sized contralateral adrenal gland. Left adrenal demonstrated a larger size and a tendency to oval shape. This study assesses the prevalence of adrenomegaly in clinically ill cats, reinforcing it can be an incidental ultrasound finding.
- Jesus, L., Arenas, C., Domínguez-Ruiz, M., Silvestrini, P., Englar, R. E., Roura, X., & Leal, R. O. (2022). Xanthinuria secondary to allopurinol treatment in dogs with leishmaniosis: Current perspectives of the Iberian veterinary community. Comparative immunology, microbiology and infectious diseases, 83, 101783.More infoXanthinuria is a significant adverse effect in dogs on long-term allopurinol for treatment of leishmaniosis. The study aims to investigate how the Iberian veterinary community (IVC) identifies, manages, and proactively prevents xanthinuria secondary to allopurinol treatment. A cross-sectional study was conducted using an online survey, translated into two languages, and disseminated to the IVC via social networking forums. Respondents were asked to share their treatment regimens, adverse effects attributed to treatment, as well as preventive and reactive measures against xanthuria. Of two-hundred and thirty respondents, 99.6% prescribe allopurinol for canine leishmaniosis. Xanthinuria was estimated to happen in less than one out of every four dogs by 91.7% of the clinicians. Xanthinuria has been detected by 71.6% of respondents at least once. Three out of every four respondents inform owners about deleterious effects of allopurinol, and 28.4% consider implementing a change in diet in advance of treatment as a proactive measure. To monitor xanthinuria, urinalysis and diagnostic imaging are used by 71.2% and 31% of clinicians respectively. When xanthinuria is detected, 43.2% of the respondents discontinue allopurinol, 24% replace it by nucleotide-analogs, 14.9% reduce its dosage, and 3.1% split its dosage but increase administration frequency. Additional measures are taken by 72.1% of the respondents, 59.4% of whom prescribe a low-purine diet. The IVC recognizes xanthinuria as a fairly common secondary effect of long-term allopurinol treatment in dogs with leishmaniosis and recommends periodically monitoring and preventive measures.
- Baptista, R., Englar, R., São Braz, B., & Leal, R. O. (2021). Survey-Based Analysis of Current Trends for Prescribing Gastrointestinal Protectants among Small-Animal General Practitioners in Portugal. Veterinary sciences, 8(5).More infoIn both human and veterinary healthcare, gastrointestinal protectants (GIPs) are considered a staple of clinical practice in that they are prescribed by general practitioners (GPs) and specialists alike. Concerning GIP use, overprescription of proton pump inhibitors (PPIs) has become a growing concern among human healthcare providers. This trend has also been documented within veterinary practice, prompting the American College of Veterinary Internal Medicine (ACVIM) to publish a consensus statement in 2018 concerning evidence-based indications for GIP use. This observational cross-sectional study evaluated self-reported prescribing protocols among Portuguese GPs to determine whether there is adherence to the consensus guidelines. Respondents were Portuguese GPs recruited by social media posts in veterinarian online forums. Data were collected from 124 respondents concerning their GIPs of choice and their rationales for prescribing them. Data were mined for prescription patterns and protocols. Among GIPs, PPIs were prescribed more often. Rationales for use included gastrointestinal ulceration and erosion (GUE), prophylactic management of nonerosive gastritis, pancreatitis, reflux esophagitis, and steroid-induced ulceration. Once-daily administration of PPIs was the most frequent dosing regime among respondents. Ninety-six percent of PPI prescribers advocated that the drug be administered either shortly before or at mealtime. Forty-nine percent of respondents supported long-term use of PPIs. Fifty-nine percent of respondents acknowledged discontinuing PPIs abruptly. This study supports that Portuguese GPs commonly prescribe GIPs in accordance with ACVIM recommendations to medically manage GUE. However, misuse of GIPs does occur, and they have been prescribed where their therapeutic value is debatable. Educational strategies should target GPs in an effort to reduce GIP misuse.
- Englar, R. (2021). Use of Deoxycorticosterone Pivalate by Veterinarians: A Western European Survey. Veterinary Sciences, 8(11), 271. doi:https://doi.org/10.3390/vetsci8110271More infoThis study aims to gather knowledge about the use of deoxycorticosterone pivalate (DOCP) by Western European Veterinarians (WEV) in dogs with typical hypoadrenocorticism. An observational cross-sectional study was conducted using an online survey, translated into four languages and disseminated to veterinary affiliates and mailing lists in six countries of Western Continental Europe. Respondents were tasked to share their therapeutic approach to hypoadrenocorticism, whether they preferred DOCP or fludrocortisone and the specific practical use of DOCP. One-hundred and eighty-four responses were included. Of these, 79.9% indicated that they preferred prescribing DOCP over fludrocortisone as a first-line treatment for mineralocorticoid supplementation. A total of 154 respondents had used DOCP at least once. Eighty percent of those who reported their initial dosage prescribed 2.2 mg/kg. After starting DOCP, 68.2% of the respondents assess electrolytes 10 and 25 days after administration following manufacturer instructions. In stable dogs, electrolytes are monitored quarterly, monthly, semi-annually, and annually by 44.2%, 34.4%, 16.9%, and 4.6% of respondents respectively. When treatment adjustment is required, 53% prefer to reduce dosage while 47% increase the interval between doses. Overall, DOCP is the preferred mineralocorticoid supplementation among WEV. Reported variability underlies the need to investigate the best strategies for DOCP use and therapeutic adjustments.
- Englar, R. E., Schettler, K. A., & Ostrom, S. A. (2021). Survey of communication challenges that impact relationships between veterinarians and dog or cat breeders and proposed solutions for retaining breeders as clients. Journal of the American Veterinary Medical Association, 258(4), 407-415.More infoTo characterize communication challenges between veterinarians and dog or cat breeders and elicit their perspectives on how professional relationships between the two might be improved.
- Englar, R., Brett, T. G., Soltero, E. H., & Villalobos, C. (2021). Evaluating Diversity within the Standardized Client (SC) Pool at AVMA/COE Accredited Colleges of Veterinary Medicine. Journal of Veterinary Medical Education.
- Rebocho, R., Domínguez-Ruiz, M., Englar, R. E., Arenas, C., Pérez-Alenza, M. D., Corsini, A., Fracassi, F., Bennaim, M., & Leal, R. O. (2021). Use of Deoxycorticosterone Pivalate by Veterinarians: A Western European Survey. Veterinary sciences, 8(11).More infoThis study aims to gather knowledge about the use of deoxycorticosterone pivalate (DOCP) by Western European Veterinarians (WEV) in dogs with typical hypoadrenocorticism. An observational cross-sectional study was conducted using an online survey, translated into four languages and disseminated to veterinary affiliates and mailing lists in six countries of Western Continental Europe. Respondents were tasked to share their therapeutic approach to hypoadrenocorticism, whether they preferred DOCP or fludrocortisone and the specific practical use of DOCP. One-hundred and eighty-four responses were included. Of these, 79.9% indicated that they preferred prescribing DOCP over fludrocortisone as a first-line treatment for mineralocorticoid supplementation. A total of 154 respondents had used DOCP at least once. Eighty percent of those who reported their initial dosage prescribed 2.2 mg/kg. After starting DOCP, 68.2% of the respondents assess electrolytes 10 and 25 days after administration following manufacturer instructions. In stable dogs, electrolytes are monitored quarterly, monthly, semi-annually, and annually by 44.2%, 34.4%, 16.9%, and 4.6% of respondents respectively. When treatment adjustment is required, 53% prefer to reduce dosage while 47% increase the interval between doses. Overall, DOCP is the preferred mineralocorticoid supplementation among WEV. Reported variability underlies the need to investigate the best strategies for DOCP use and therapeutic adjustments.
- Salah, E., Abouelfetouh, M. M., Englar, R. E., Ding, M., & Ding, Y. (2021). Cardiorespiratory Effects of Three Infusion Doses of Adenosine in Conscious Goats: A Preliminary Study. Veterinary sciences, 8(8).More infoAdenosine (AD) has been implicated in human healthcare as an endogenous signaling nucleotide in both physiologic and pathologic states. The effects of AD on cardiorespiratory parameters in ruminants has not yet been studied. The objective of this study was to evaluate the cardiac and respiratory changes that resulted from an intravenous AD infusion in goats. Six clinically healthy adult goats weighing 28 ± 2 kg were randomly assigned to one of four treatments in a crossover design with a seven day washout period. The goats received a 0.9 % saline solution (SAL treatment) and three AD treatments (AD 50, 100 and 200) intravenously at a dose rate of 50, 100 and 200 μg/kg/min. Cardiorespiratory and key cardiac parameters were measured before the treatment (baseline), during the infusion (dInf) and at 1, 3, 5 and 10 min after each infusion was discontinued. The AD 100 produced a significant increase in HR ( = 0.001) and the AD 200 resulted in significant rises in HR ( = 0.006) and RR ( = 0.001) compared with the baseline. This study concluded that the AD infusion could trigger an increase in HR and RR in a dose-dependent manner in healthy goats.
- Dias, M. J., Mouro, S., Englar, R. E., & Leal, R. O. (2020). Nasal foreign bodies identified by rhinoscopy in dogs: 42 cases. The Journal of small animal practice, 61(12), 752-756.More infoTo evaluate signalment, clinical presentation, location and type of nasal foreign bodies identified by rhinoscopy in dogs.
- Englar, R. E. (2019). Tracking Veterinary Students' Acquisition of Communication Skills and Clinical Communication Confidence by Comparing Student Performance in the First and Twenty-Seventh Standardized Client Encounters. Journal of veterinary medical education, 46(2), 235-257.More infoThe American Veterinary Medical Association's Council on Education mandates that veterinary students graduate with competence in clinical communication. Communication competence facilitates the successful transition of students into clinical practice by improving veterinary client satisfaction and reducing the risk of litigation. Curricular experimentation with communications training has led to innovative approaches to this content area, including the adoption of standardized patients from human health care education. Although the use of standardized clients (SCs) is time and resource intensive, their use by veterinary educators has allowed students to work through authentic cases in a safe learning environment in which learner goals drive training. Despite the increasing popularity of SC-based communications curricula, outcomes assessment studies that track the resultant student growth are lacking. Ninety students in the inaugural class of 2018 at Midwestern University College of Veterinary Medicine participated in 27 SC encounters over eight consecutive quarters. Students' use of Calgary-Cambridge Guide communication skills was compared in the first and twenty-seventh encounters. On the basis of SC evaluations of student performance, students increased their use of all communication skills in the final encounter compared with baseline. Students were also more likely to take a comprehensive patient history, build rapport, and retain the client. Mean scores for pre- and post-encounter communication confidence, as self-reported by students, also increased. These findings support that a SC-rich curriculum facilitates student acquisition of communication skills and promotes confidence when students approach entry-level clinical tasks such as history taking.
- Englar, R. E. (2019). Using a Standardized Client Encounter to Practice Death Notification after the Unexpected Death of a Feline Patient Following Routine Ovariohysterectomy. Journal of veterinary medical education, 46(4), 489-505.More infoDeath notification is an important skill for health care providers to carry out, yet few clinicians feel adequately prepared to complete this task. To address these gaps in clinical training, some medical educators have incorporated standardized patients (SPs) into the curriculum to allow students to practice death notification in a safe, controlled environment. Veterinary educators agree that end-of-life communication skills are essential for success in clinical practice, and many rely on standardized clients (SCs) for role-play concerning euthanasia. However, anticipatory loss is distinct from unexpected death, and death notification is strikingly absent from the veterinary literature. To introduce students to death notification, Midwestern University College of Veterinary Medicine (MWU CVM) developed a communications curriculum that culminated in a scripted encounter, "Basil, the Scottish Fold." Students must explain to an SC that his kitten died following routine ovariohysterectomy. Pre- and post-event surveys completed by 19 students demonstrated valuable lessons in death notification word choice, particularly what to say. I hope that this teaching tool may be adapted for use by other colleges of veterinary medicine to allow students to practice death notification.
- Jones, J. L., Rinehart, J., & Englar, R. E. (2019). The Effect of Simulation Training in Anesthesia on Student Operational Performance and Patient Safety. Journal of veterinary medical education, 46(2), 205-213.More infoA veterinary anesthesia simulated environment (VASE) with clinical scenarios has been integrated into the pre-clinical curriculum at Midwestern University College of Veterinary Medicine to simulate anesthesia of a live patient within a surgical suite. Although this modality was shown to significantly improve veterinary students' perceived preparedness to perform anesthesia on live patients, whether this would improve anesthesia competency in the actual clinical environment, described as operational performance, remained unclear. Our goal was to examine the relationship between anesthesia simulation training and student anesthesia operational performance. Anesthesia operational performance assessment of students was determined by quantifying critical event occurrences that negatively impacted patient safety during the anesthesia of 287 patients during students' initial surgical experience in 2015 and 2016. The relationship between total numbers of critical incidents to students having anesthesia simulation training was determined through evaluation of anesthesia records from 2015 and 2016, where students did not have anesthesia simulation training or they had pre-clinical training, respectively. Results showed a significant relationship between simulation training and critical incident occurrence, with a critical incident more likely to occur during patient anesthesia for students who did not experience pre-clinical anesthesia simulation training. Of the total critical incidents that occurred in the two-year study, 88% were in patients anesthetized by students who did not have simulation training. Our findings suggest that students who were given the opportunity to participate in anesthesia-focused simulations before a live-animal anesthesia encounter demonstrated significant improvements in anesthesia operational performance and improved patient safety.
- Englar, R. E. (2018). Using a Standardized Client Encounter in the Veterinary Curriculum to Practice Veterinarian-Employer Discussions about Animal Cruelty Reporting. Journal of veterinary medical education, 45(4), 464-479.More infoAnimal cruelty is the antithesis of animal welfare. Because veterinarians take an oath to protect animal welfare, they are professionally obligated to report animal cruelty. Several US states have mandatory reporting laws for veterinarians, and both the American Veterinary Medical Association (AVMA) and the American Animal Hospital Association support reporting. Some state veterinary practice acts, such as Arizona's, also require reporting. Despite this, animal cruelty is not always emphasized in veterinary curricula. As a result, not all veterinary students and graduates feel comfortable recognizing signs of animal cruelty and may not be aware of the resources that are available to them when considering reporting. AVMA suggests that practices develop their own protocols for identifying signs that patients may have been victims of cruelty and consulting on cases with senior colleagues with regard to when to report. To enhance student comfort with these conversations, Midwestern University College of Veterinary Medicine developed a standardized client encounter titled "Grizabella's Final Fight." I hope that other colleges of veterinary medicine will adapt this teaching tool to allow students the opportunity to practice discussions surrounding animal cruelty reporting in the context of state-specific legislation that guides their code of professional conduct.
- Englar, R. E., Jones, J. L., Rinehart, J., Spiegel, J. J., Sidaway, B. K., & Rowles, J. (2018). Teaching Tip: Development of Veterinary Anesthesia Simulations for Pre-Clinical Training: Design, Implementation, and Evaluation Based on Student Perspectives. Journal of Veterinary Medical Education, 45(2), 232-240. doi:10.3138/jvme.1016-163r
- Englar, R. E., Show-Ridgway, A., Noah, D. L., Appelt, E., & Kosinski, R. (2018). Perceptions of the Veterinary Profession among Human Health Care Students before an Inter-Professional Education Course at Midwestern University. Journal of veterinary medical education, 45(3), 423-436.More infoConflicts among health care professionals often stem from misperceptions about each profession's role in the health care industry. These divisive tendencies impede progress in multidisciplinary collaborations to improve human, animal, and environmental health. Inter-professional education (IPE) may repair rifts between health care professions by encouraging students to share their professional identities with colleagues in unrelated health care disciplines. An online survey was conducted at Midwestern University (MWU) to identify baseline perceptions about veterinary medicine among entry-level human health care students before their enrollment in an inter-professional course. Participation was anonymous and voluntary. The survey included Likert-type scales and free-text questions. Survey participants expressed their interest in and respect for the discipline of veterinary medicine, but indicated that their unfamiliarity with the profession hindered their ability to collaborate. Twenty percent of human health care students did not know the length of a Doctor of Veterinary Medicine (DVM) program and 27.6% were unaware that veterinarians could specialize. Although 83.2% of participants agreed that maintaining the human-animal bond is a central role of the veterinary profession, veterinary contributions to stem cell research, food and water safety, public health, environmental conservation, and the military were infrequently recognized. If IPE is to successfully pave the way for multidisciplinary collaboration, it needs to address these gaps in knowledge and broaden the definition of veterinary practice for future human health care providers.
- Show, A., & Englar, R. E. (2018). Evaluating Dog- and Cat-Owner Preferences for Calgary-Cambridge Communication Skills: Results of a Questionnaire.. Journal of veterinary medical education, 45(4), 534-543. doi:10.3138/jvme.0117-002r1More infoVeterinary client retention by companion animal practices is influenced by whether the client feels connected to the healthcare provider. Effective communication between the veterinarian and the client facilitates that connection. To prepare new graduates for success in clinical practice, many colleges of veterinary medicine are now incorporating communication into the curriculum to emphasize its importance in establishing and maintaining the veterinarian-client relationship. A 2016 focus group study by Englar et al. evaluated dog and cat owner communication preferences for Calgary-Cambridge Guide (CCG) communication skills and concluded that dog and cat owners may have different communication needs. This study was conducted to confirm whether species-based communication preferences exist among veterinary clients. A questionnaire was distributed online and on-site, within veterinary teaching hospitals and private practices. Based upon 215 submissions from dog owners and 166 from cat owners, the communication preferences of dog and cat owners overlap. Both dog and cat owners prioritize reflective listening as the most important foundational CCG communication skill, and both prioritize asking permission as the most important core CCG skill. However, dog owners valued open-ended questions more than cat owners, and cat owners valued empathy more than dog owners. Survey limitations were largely demographic: participants were predominantly female and between the ages of 18-40 years. Survey data may therefore not be representative of the perspective of males and/or those >40 years of age.