'You can't do good medicine without good communication skills'
Actors and veterinarian-coaches help veterinary medicine students become great communicators.
By Collene Ferguson
Molly, a nine-year-old black Labrador retriever, has been Hal Simpson’s constant companion since his wife died of cancer 18 months ago. Molly was really his wife’s dog — she trained her as a puppy and walked her every day — but Simpson loves her and finds comfort in caring for her.
Six week ago, Molly was diagnosed with advanced lymphoma that spread to her kidneys. She’s lost a lot of weight, can’t keep food down and is clearly suffering. Simpson feels putting her to sleep would be the kindest option, but is struggling with the decision and wondering what his life will be like once his “purpose” is gone.
Today, Simpson is sitting in his veterinarian’s exam room, waiting to talk about euthanizing Molly.
This is one of the mock or simulated scenarios students in the University of Calgary Faculty of Veterinary Medicine (UCVM) are given as part of the Clinical Communication Skills program. Professional actors play the role of clients; they’re given detailed back stories about each client they portray and their pet. Students, however, enter each simulated office visit knowing very little about the case. It's up to them to draw on the most appropriate set of communication skills to gather all of the information needed to come up with the best plan for the patient and client.
“Some of the scenarios can be nerve-wracking,” says Lauren Bradshaw, a first-year UCVM student. “I was quite nervous about the euthanasia scenario. It was one of the first times our actors had expressed sadness during the interaction, and in my case specifically my client was very emotional.”
Students are taught to communicate effectively over three years of dedicated professional skills training. The simulated client interactions give students the opportunity to learn how to acquire an animal’s history from a client and how to build a relationship of trust. Listening, asking the right questions, being empathetic, and communicating medical information clearly are just a few of the many skills a good veterinarian needs.
“You can’t do good medicine without good communication skills,” says Cindy Adams, PhD, MSW, and professor, Clinical Communication, who, along with Dr. Jack Wilson, oversees the program. “What we’re trying to do is enhance their accuracy, their efficiency and their supportiveness.”
Easier said than done
“When you first start out it’s really weird to just get out the kinks,” says Tracy Ho, a second-year student. “I remember when I did my first case I had to come through the door six times and repeat my introduction six times to get it right.”
“It is difficult at times to not get flustered or lose your sense of direction,” says Bradshaw. “But the support from your peers and mentors during the interactions is immensely reassuring. I’m grateful to have a chance to experience these scenarios in an environment where I can learn and grow, rather than my very first appointment with an actual client.”
In the first year, students learn the basics of effective communication. In year two, those skills are built upon and students must also complete a physical exam on a live animal as they communicate with a client.
“We’ve been working on professional skills and handling animals and physical exams since first year,” says Rebecca Tees, a second-year student. “This is just integrating them into one. Putting the pieces together and using the tools in the toolbox a little more.”
“It’s different than human medicine because in medicine you’re talking to a client who is sick, while veterinarians are dealing with a client and an animal,” adds Ho. “You’re examining the animal but at the same time you’re explaining to the client what you’re doing. So it’s an extra element we have to deal with and balance.”
Veterinarians in the community volunteer as coaches
Along with actors playing clients, an important part of the learning process is having veterinarians coach and mentor the students. Practitioners from the community volunteer to help students in their simulated client interactions.
“They’re critical,” says Adams. “These people come from practice, they have street-level experience, and they know the importance of communication.”
Dr. Ted Shacklady, an Okotoks veterinarian who started practice in 1972, wasn’t taught communication skills when he was a student. He’s been volunteering for the past five years as a way to give a little back and help students.
“One thing I’ve observed is the improvement in students from year to year, from their first year til their third year,” Shacklady says. “Each year is evolving and the program is really making a big difference.”
Building a foundation of professional, communication skills
As students develop greater proficiency, the game is upped a bit. In year three, students take part in a service learning project in partnership with the Calgary Urban Project Society (CUPS). Under the supervision of a veterinarian, students interact directly with CUPS clients and their pets, providing preventive medicine, deworming, vaccines, nutrition education, and wellness education. The program provides benefits for both the student and the client, creating a win-win situation.
“Communication skills in veterinary practice impact the health outcomes of animals and quite likely their owners,” says Adams.
The program’s aim is to give students a solid foundation in professional and communication skills — and to ensure those skills stick once they graduate and start to practice.
“Down the road I think what we’ve learned will provide us, both veterinarians and our clients, with a greater sense of satisfaction,” says Bradshaw, who will graduate in 2019.
“If we leave every appointment knowing we did our best to communicate and listen to our clients, it will help us provide the best possible care to our patients. And at the end of the day, that is what we are there to do.”