Manual transrectal palpations performed by veterinary students in cows: a Surrey - Palpaciones transrectales realizadas por estudiantes de veterinaria en las vacas: una encuesta

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REDVET - Revista electrónica de Veterinaria - ISSN 1695-7504

M a n u a l t r a n sr e ct a l pa lpa t ion s pe r for m e d by ve t e r in a r y

st u de n t s in cow s: a Su r r e y

- Palpaciones t ransrect ales

realizadas por est udiant es de vet erinaria en las vacas: una

encuest a

Joã o Sim õe s

Depart am ent o de Ciencias Vet erinarias. Escuela de Ciencias Agrarias y Vet erinarias. Universidad de Trás- os- Mont es e Alt o

Douro, 5001- 801 Vila Real, Port ugal ( Depart m ent of Vet erinary Sciences.

School of Agrarian and Vet erinary Sciences. Universit y of Trás- os- Mont es e Alt o Douro, 5001- 801 Vila Real, Port ugal)

Em ail: j sim oes@ut ad.pt

Abst r a ct

Vet erinary educat ion of novice vet erinary st udent s in bovine reproduct ion field, like rect um palpat ion t raining, represent som e handicaps m ainly relat ed w it h anim al w elfare. The aim of t he present st udy was t o det erm ine skills and com pet ences expect ed by vet erinary st udent s during bovine t ransrect al palpat ion in reproduct ion classes w it h live nonpregnant fem ales. A survey w as present ed t o st udent s, classified as Buiat ric- Mot ivat ed ( SBM; n= 22) and Non-Buiat ric- Mot ivat ed ( SNBM; n= 28) , at t he end of t he vet erinary reproduct ion m odule. Bot h SBM and SNBM groups w ere in accordance w it h anim al alt ernat ion

use in successive classes ( 86.8 ± 4.7% vs. 77.3 ± 6.5% ; ± SEM; P> 0.05) and

t hey considered t he proport ion 1 cow: 2 st udent s in each class adequat e in 68.6 ± 5.0% and 58.2 ± 5.8% ( P> 0.05) of t he cases, respect ively. The SBM had less

difficult y t han SNBM t o ident ify right and left ut erine horns ( 71.4 ± 5.7 % vs.

52.1 ± 4.5 % ; P= 0.01) , ident ify t he right ( 69.6 ± 4.4 % vs. 52.1 ± 4.0 % ; P <

0.01) or left ( 63.6 ± 4.4 % vs. 47.5 ± 3.9 % ; P< 0.01) ovaries and t he presence

of follicles > 10 m m ( 55.5 ± 6.5 % vs. 31.1 ± 5.0 % ; P< 0.01) . The SBM group

( 61.8 ± 5.2 % ) also show ed a m ore expect ed self- t raining com pet ence in dairy farm s t han SNBM ( 38.8 ± 4.8 % ; P< 0.01) . I n conclusion, we suggest an alt ernat ion of cows used for daily m anual t ransrect al t raining purpose, regarding t he anim al w elfare and st udent sensibilit y. The st udent m ot ivat ion and expect at ion appear t o be det erm inant fact ors t o m axim ize t heir t raining.

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Palpaciones transrectales realizadas por estudiantes de veterinaria en las vacas: una encuesta.-

http://www.veterinaria.org/revistas/redvet/n030312/031218.pdf

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Re su m e n

La educación vet erinaria de est udiant es de vet erinaria en el cam po de la reproducción bovina, en el caso del ent renam ient o m ediant e la palpación t ransrect al, t iene algunas desvent aj as, principalm ent e relacionadas con el bienest ar anim al. El obj et ivo del present e est udio fue det erm inar las habilidades y com pet encias esperadas por los est udiant es de vet erinaria durant e la palpación t ransrect al en vacas no preñadas, en las clases de reproducción. Al final del m ódulo de reproducción, los est udiant es fueron clasificados com o m ot ivados en la buiat ria ( SBM, n = 22) y no m ot ivados en la buiat ria ( SNBM; n = 28) realizando una encuest a. Am bos los grupos, SBM e SNBM, est aban de acuerdo con la alt ernancia del uso de anim ales en las sucesivas clases ( 86,8 ±

4,7% vs. 77,3 ± 6,5% ; ± EEM; P> 0,05) y consideraron adecuada, en cada

clase práct ica, la proporción de una vaca para dos est udiant es en 68,6 ± 5,0% and 58,2 ± 5,8% ( P> 0,05) de los casos, respect ivam ent e. El grupo SBM t uvo m enos dificult ades que SNBM para ident ificar cuernos ut erinos derecho e

izquierdo ( 71,4 ± 5,7 % vs. 52,1 ± 4,5 % ; P= 0,01) , ident ificar el ovario

derecho ( 69,6 ± 4,4 % vs. 52,1 ± 4,0 % ; P < 0,01) o izquierdo ( 63,6 ± 4,4 %

vs. 47.5 ± 3,9 % ; P< 0,01) y la presencia de folículos > 10 m m ( 55,5 ± 6,5 %

vs. 31,1 ± 5,0 % ; P< 0,01) . El grupo SBM ( 61,8 ± 5,2% ) t am bién m ost ro una

m ayor expect at iva en su capacidad de aut o- form ación en las explot aciones lecheras que el SNBM ( 38,8 ± 4,8% , p < 0,01) . En conclusión, t eniendo en cuent a con el bienest ar de los anim ales y la sensibilidad de los est udiant es, se sugiere una alt ernancia de las vacas ut ilizadas para fines de form ación diaria en palpación t ransrect al. La m ot ivación de los est udiant es y sus expect at ivas parecen ser fact ores det erm inant es para m axim izar su ent renam ient o.

Pa la br a s cla ve : Reproducción Bovina, Educación Vet erinaria; Bienest ar Anim al

1 . I n t r odu ct ion

The curricular pract ical t raining using live anim als by vet erinary st udent s assum es a great im port ance in several fields of Vet erinary Medicine and Anim al Product ion, including basic t heriogenology educat ion and t raining at schools

( Root Kust rit z et al., 2006) . I n Port ugal, like in ot hers European count ries, t he

adapt ed curriculum of Vet erinary Medicine courses t o Bologna Process have 5 t o

6 years of durat ion, e.g. 10 t o 12 sem est ers, including a large pract ical class’s com ponent . Many clinical and zoot echnical pract ices are perform ed in classroom s of vet erinary hospit als, experim ent al large anim al facilit ies and regional anim al farm s w it h sm all st udent s groups ( 6 t o 12 persons) . I n general,

t hese pract ices increase from t he 7t h sem est er unt il t he end of t he course, w hen

t he basic t heory background was previously learned. These clinical “ ent ry- level” st udent s have several handicaps in t heir t raining regarding et hical procedures

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The m anual t ransrect al palpat ion in cow s, for reproduct ion m anagem ent purposes, is one of t hese classical polem ic pract ices t hat should be acquired by vet erinary st udent s, especially if t hey expect a professional buiat ric act ivit y. I t is a com m only vet erinary pract ice applied t o reproduct ion program s m anagem ent in cow indust ry ( Sprecher et al., 1994) , due t o easy accessibilit y of reproduct ive st ruct ure from rect um , low cost , accurat e and efficient m et hod. How ever, it is a t raum at ic and subj ect ive t echnique but , t oday, is usually accom plished by t he ult rasonographic exam inat ions w it h t ransrect al probes applicat ion ( Fricke, 2002;

Lam b et al., 2003) during t he herd’s reproduct ion m anagem ent .

Som e part ial solut ions for t he st udent t raining purposes w ere st udied, like t he use of live anim als in slaught erhouses ( Lopes and Rocha, 2006) or com put er

assist ed learn wit hout living cow s ( Baillie et al., 2005a; Forrest et al., 2009) .

Each of t hem present s advant ages and also som e lim it at ions. Bot h m et hodologies can m inim ize t he use of live anim als at “ laborat ory” schools. However, in t he slaught erhouses, anim al m inim ized st ress should be provided before dead. On t he ot her end, t he use of virt ual sim ulat ors cannot subst it ut es t he real case t raining sit uat ions. We believe t hat skills and com pet ences expect ed by t he st udent s are crit ical point s t o resolve t hese pert inent quest ions, in ot her t o m axim ize each t eaching m et hod and m inim ize t he live anim al’s uses ( Jaarsm a, 2008) .

The m ain aim of t he present work was t o det erm ine skills and com pet ences expect ed by vet erinary st udent s during bovine t ransrect al palpat ion, in reproduct ion classes using live nonpregnant fem ales.

2 . M a t e r ia l a n d M e t h ods

2.1 Anim als and t eaching facilit ies

The experim ent al bovine st at ion of universit y of Trás- os- Mont es e Alt o Douro, locat ed at Vila Real- Port ugal, w as used t o t rain 50 vet erinary st udent s in order

t o evaluat e nonpregnant ut erine st ruct ures, during reproduct ion classes ( 7t h

sem est er of t he Vet erinary curriculum course) . I nit ially, six adult s Holst

ein-Frisian ( dairy cat t le breed) and four Barrosã ( local Port uguese beef cow s breed) w ere daily disposed for t his purpose, during 6 consecut ive weeks, from Monday t o Friday.

The st udent s w ere divided in 8 sm all groups, having a t ot al of 3 lessons, 2

hours lengt h each, t hroughout t hese w eeks. The 1st, 2nd and 3rd lessons aim ed

t o ident ify and charact erize t he cervix, t he ut erine horns and t he ovarian st ruct ures, respect ively.

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Palpaciones transrectales realizadas por estudiantes de veterinaria en las vacas: una encuesta.-

4 2.2 Survey m et hodology

An anonym ous survey w as present ed t o st udent s at t he end of t he 3rd lesson.

All answers t o quest ions were present ed in a scale score from 0 t o 100% of expect ed result s ( Table 1) and considering t heir previous experience.

Ta ble 1 Qu e st ion s a n d a n sw e r scor e s in t h e m ode l su r ve y

Qu e st ion

An sw e r scor e d in pe r ce n t a ge of ca se s a ccor din g t h e st u de n t pe r ce pt ion *

Buiat ric- Mot ivat ed or Non- Buiat ric- Mot ivat ed? * * No Yes

You part icipat e( d) in t he ERASMUS program ? * * No Yes

I s your first t ransrect al palpat ion in cow s? * * * No Yes

I s t he num ber of anim als sufficient ( 1 per 2 st udent s) in all classes?

0 10 20 30 40 50 60 70 80 90 100 ( % )

A daily anim al alt ernat ion w ill be considered? 0 10 20 30 40 50 60 70

80 90 100 ( % ) What t he percent age of cow s w it h adequat e

behavior for t raining?

0 10 20 30 40 50 60 70 80 90 100 ( % )

What t he percent age of cow s w it h rect al bleeding? 0 10 20 30 40 50 60 70

80 90 100 ( % ) What is your success percent age t o locat e t he right

ut erine horn?

0 10 20 30 40 50 60 70 80 90 100 ( % )

What is your success percent age t o locat e t he left ut erine horn?

0 10 20 30 40 50 60 70 80 90 100 ( % )

Can you evaluat e t he ut erine horns conform at ion? 0 10 20 30 40 50 60 70

80 90 100 ( % )

Can you ident ify t he right ovary? 0 10 20 30 40 50 60 70

80 90 100 ( % )

Can you ident ify t he left ovary? 0 10 20 30 40 50 60 70

80 90 100 ( % )

Can you evaluat e t he relat ive ovarian diam et er? 0 10 20 30 40 50 60 70

80 90 100 ( % )

Can you ident ify follicles > 10 m m ? 0 10 20 30 40 50 60 70

80 90 100 ( % ) Can you det ect “ anoest rous” ( bot h t ypical sm all)

ovaries?

0 10 20 30 40 50 60 70 80 90 100 ( % )

I s t he num ber of lessons sufficient ? 0 10 20 30 40 50 60 70

80 90 100 ( % ) Have you self- t raining com pet ence t o carry t he

t raining in privat e dairy farm s?

0 10 20 30 40 50 60 70 80 90 100 ( % )

* Except for the first three questions. **The first two questions concerned the independent variables. *** Nominal dependent variable.

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2.3 St at ist ical analysis

A fact orial ANOVA w as used and int eract ions bet w een groups t est ed. All dependent variables w ere considered cont inues, except t he classificat ion for t he previous experience in bovine t ransrect al palpat ion ( cat egorical variable) w hich w as analysed by t he chi- square t est . Result s, in percent age of response, w ere show ed as m ean ± S.E.M..

3 . Re su lt s a n d D iscu ssion

The m aj orit y of st udent s ( 78 % , 39/ 50 vs. 22 % , 11/ 50; P< 0.001) never had a

previous experience in t ransrect al palpat ion of cows, before t he reproduct ion classes. I t ´ s a preoccupant report , because t his presupposes few cont act s w it h t he realit y bovine farm s, e.g. client - ow ned anim als, and vet erinary t ut orial

assist ance, e.g. short durat ion ext ram ural placem ent s, unt il t he 7t h Sem est er of

som e Vet erinary Medicine Courses. This aspect can creat e som e difficult ies t o choices opt ional Curricular Unit of anim al’s species product ion and herd healt h m anagem ent subj ect in last sem est ers of vet erinary courses.

No differences ( P> 0.05) w ere observed bet w een Erasm us and non- Erasm us st udent s for t his previous experience fact or or all follow ing described param et ers. No significant differences ( P> 0.05) int eract ions w ere observed bet w een ( Non- ) Erasm us and ( Non- ) Buiat ric- Mot ivat ed groups for alls variables.

Bot h SBM and SNBM groups w ere in accordance w it h anim al alt ernat ion use in

successive classes ( 86.8 ± 4.7 % vs.77.3 ± 6.5 % ; P> 0.05) and t hey

considered t he proport ion 1 cow : 2 st udent s in each class adequat e in 68.6 ± 5.0 % and 58.2 ± 5.8 % ( P> 0.05) of t he cases, respect ively.

The successive ut ilizat ion of cows for palpat ion induces rect al bleeding by m ucosal w ounds due t o t hat t raum at ic t echnique. I n ext rem e, a diffuse perit onit is can occurs conduct ing t o fem ale dead. I n t he present st udy, high rect al bleeding percent ages w ere det ect ed by bot h groups, but no differences of awareness rect al bleeding were observed bet ween SBM ( 68.9 ± 4.9 % ) and SNBM ( 66.7 ± 7.2 % ; P> 0.05) groups. This suggest s a high sensibilit y of all st udent s for anim al w elfare subj ect s. However, SNBM ( 40.0 ± 4.1 % ) t ended t o consider anim als w it h non adequat e behavior for t raining purposes in com parison t o t he SBM group ( 29.0 ± 4.9 % ; P = 0.09) . We t hink t hat m ot ivat ion represent s a posit ive fact or relat ed w it h t he anim al cont act , despit e t he obj ect ive of all st udent s t o obt ain a posit ive final evaluat ion record. I n fact , t w o beef cow s rem ained always unusable for t his pract ice during whole classes and, som et im es, t he use of som e rem ained cows was part ially rest rict ed.

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Manual transrectal palpations performed by veterinary students in cows: a survey

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Fig. 1a Identification and conformation evaluation of bovine uterine horns, in percentage, by

Buiatric-Motivated (SBM; n=22) and Non-Buiatric-Motivated (SNBM; n=28). The bars represent ±S.E.M.

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Fig. 1c Detection of follicles greater than 10 mm in diameter and “anoestrous” ovaries, in percentage.

The SBM group had less difficult y t han SNBM st udent group t o ident ify right and left ut erine horns or ovaries, t heir conform at ion or relat ive size, and follicles great er t han 10 m m in diam et er. These result s suggest t hat self- m ot ivat ion is an im port ant aspect t o achieving high perform ance learning at reproduct ion pract ical classes. Several cases st udies, described in vet erinary lit erat ure, provide scient ific consist ency t o t his “ psychological st at us” . A high st udent

m ot ivat ion was observed by Parkinson et al. ( 2006) w hen new subj ect s, issues

relat ed w it h clinical pract ice, live anim als or ent husiast ic persons w ere direct ly involved in learning process. However, som e t eaching act ivit ies can im prove t he st udent m ot ivat ion: t he presence of act ive learning environm ent s ( Doucet et al., 2009) , pre- clinical and clinical st udent - cent ered learning m odels ( Elsheikha and

Kendall, 2009) or curriculum int egrat ion like im aging, vet erinary pract ical

classes and visit at ion t o bovine farm s ( Baillie et al., 2005b) .

Nor SBM ( 48.6 ± 5.5 % ) neit her SNBM ( 42.3 ± 3.7 % ; P> 0.05) considered t he t ot al num ber of classes sufficient for ideal t ransrect al t raining com pet ence acquisit ion in order t o ident ify ut erine horns or ident ify and evaluat e t he ovarian st ruct ures. An effect of num ber of “ laborat ory” experiences classes t o acquire com pet ences in t his area, before palpat ing client - owned anim als, was observed

by Sprecher et al. ( 1994) . More classes w it h live anim als or m ore anim als per

class increasing sim ult aneously t he st udent num ber should be a reliable response t o our result s. Addit ionally, and/ or in alt ernat ive, previous hapt ics

sim ulat or t raining could resolve t he problem , like t he t est ed by Baillie et al.

( 2005b, 2008, 2009, 2010) . St udent s augm ent ed perform ance during real t ask aft er com put er sim ulat or use was observed by t his researchers group. I n

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sim ulat ion m odel for rect al palpat ion t eaching ( Breed'n Bet sy) were used. I n t his case, st udent s who used t he live cows t raining were m ore skilled at localizing t he ut erus and ovaries t han t hose who used t he sim ulat ion m odel. However, t hese last researchers also consider t he use of t heir sim ulat ion m odel a pot ent ial value t o t he classical t eaching m et hod.

When quest ioned, SBM ( 61.8 ± 5.2 % ) showed a m ore expect ed self- t raining com pet ence in privat e dairy farm s t han SNBM ( 38.8 ± 4.8 % ; P< 0.01) . This indicat es t hat t he basic skill acquired w it h 3 lessons ( 6 hours) is presum ably sufficient for a significant num ber of Buiat ric- Mot ivat ed st udent s in order t o develop experience evaluat ing t he reproduct ive t ract in privat e’s dairy cat t le

farm s. How ever, and according t o t he st udy of Root Kust rit z et al. ( 2006) ,

st udent s are not able t o at t ain adequat e com pet ency for t his evaluat ion, im m ediat ely at graduat ion in schools. A specific curricular st age wit h a vet erinary t ut or should be realized by each int erest ed st udent in t hese farm s. Addit ionally, t he carefulness assessm ent of early pregnant cow s by st udent s lit t le experience rem ains a prem ise, like t he suggest ed in t he st udy report ed by

Vaillancourt et al. ( 1979) .

According t o Bossaert et al. ( 2006) , quit e possibly m ore t han palpat ion of t w o

hundred cows are necessary t o reach a consist ent level of expert ise. This individual t raining can be possible by final year ext ram ural placem ent s ( Baguley, 2006) t o prepare st udent s for bovine vet erinary pract ice. I n t his case, sim ulat ors, sim ulat ion m odels or ot her soft w are like com put er- aided learning

packages ( Bishop et al., 2009; Bell et al., 2010) , and 3D visualizat ion ( Kinnison

et al., 2009) including Web- based int eract ive solut ions ( Pet ersson et al., 2009) , adapt ed t o reproduct ion subj ect s can help t o im prove t he preparat ion of st udent s for t hese placem ent s.

4 . Con clu sion s

I n conclusion, t he reproduct ive t ract palpat ion t raining in experim ent al universit y facilit ies appears essent ial for com pet ence acquisit ion of fut ure vet erinarian, independent ly of t heir m ot ivat ion.

I n our case, w e suggest an alt ernat ion of cow s used for daily m anual t ransrect al t raining purpose, regarding t he anim al w elfare and st udent sensibilit y. Addit ionally, ot her resources like t he abat t oir and t he assist ed learn by

com put ers can be used for a bet t er im plem ent at ion curriculum program s.

A great cont act w it h t he realit y farm s during t he first t hree years w ill be necessary for a m ore accurat e st udent choice regarding t he opt ional Curricular Unit s in last sem est ers of t he Vet erinary Medicine courses.

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RED VET: 2 0 1 2 , Vol. 1 3 N º 3

Recibido 25.01.2012 / Ref. prov. ENE1214_REDVET / Aceptado 14.02.2012 Ref. def. 031218_REDVET / Publicado: 01.03.2012

El contenido de este artículo foi apresentado en “2nd Annual International Symposium on Agricultural Research” en Grécia en 2009 (ver: http://www.atiner.gr/docs/2009AAAPROGRAM_AGR.htm y fue publicado recientemente como capítulo de libro em 2011 por ATINER: Recent Developments in Energy and Environmental Research. Edited by Eva Maleviti. ISBN:

978-960-85411-2-2, 206 pages (ver: http://www.atiner.gr/docs/2011MalB_CONT.htm) con el título “Bovine Practice Reproduction: Skills and Competences Expected by Entry-level Veterinary Students in Manual Transrectal Palpations”pp181-188. Tras confirmar que ATINER no retiene el copyright su autor lo cede a Veterinaria.org para que sea

difundido a través de REDVET, así pues está disponible en http://www.veterinaria.org/revistas/redvet/n020212.html concretamente en http://www.veterinaria.org/revistas/redvet/n030312/031218.pdf

REDVET®Revista Electrónica de Veterinaria está editada por Veterinaria Organización®. Se autoriza la difusión y reenvío siempre que enlace con Veterinaria.org® http://www.veterinaria.org