“EVERY day is a new day” sounds like the sort of encouraging slogan that might be heard at an AA meeting. Certainly, the speaker is sober and clear-sighted, but he is on a voyage of discovery, not recovery.
He is Gary England, the Foundation Dean of the first new veterinary school to open in the UK for more than half a century. The School of Veterinary Medicine and Science at The University of Nottingham welcomed its first crop of students in 2006 and these have now entered their fourth year – and a pivotal stage in their transformation into members of the veterinary profession.
Professor England uses that phrase to remind colleagues that their task in creating from scratch a novel new veterinary curriculum is far from finished. By now, the staff have had three opportunities to re-fashion the content of the freshman year (“freshman” is probably not the most suitable term these days – in common with all the other UK schools the intake is about 75% female).
But the fourth year is uncharted territory and will end with the students beginning the 52-week period of clinical rotations that will be the litmus test of the Sutton Bonington “experiment”.
A blank sheet
Given the freedom of a blank sheet of paper on which to plan the new curriculum, Prof. England and his colleagues had the opportunity to try out new ideas. Their new approach begins even before the students arrive on campus as the school has been pioneering the use of on-line questionnaires in selecting students for interview and subjects them to a battery of other tests, including assessments of their practical, analytical and communications skills.
Successful applicants are issued on arrival with a laptop which will be used throughout the course to access the “virtual learning environment” where they download educational material and record their work; they are given no lecture notes in a hard copy format.
But the biggest departure from the model in place at the six existing UK veterinary schools is in breaking down the division between pre-clinical and clinical training. They have been trying to set everything that the student learns within a clinical context, using examples from diseases that they are likely to see often on graduation rather than text book examples of scientifically interesting but rare disorders, he says.
The course begins with a three week period in which students learn basic skills in animal handling, clinical examinations, first aid and diagnostic imaging. They will then absorb the key biological knowledge in a series of body system-based modules, beginning with the musculoskeletal, cardio-respiratory, nervous system and so on across the first two years.
“Within these body system modules, we then develop the skills learnt in the first three weeks. For example, in the first module we can use radiographic images to demonstrate aspects of particular diseases and show why understanding the basic science is important. It is not about making them a clinician in week four of the course. It is more about making them understand how the anatomy they are learning now will be used when they are qualified. It has relevance because there is a disease which produces that particular effect.”
Prof. England pays tribute to the hard work put in by the module convenors , the staff who have been responsible for developing the educational content for these modules, which are delivered through a variety of approaches: formal lectures, practicals and small group problem-based learning.
The evidence from the university’s own quality control procedures and the assessments of external experts suggests that the students are on course to achieve the ultimate goals of developing the Royal College’s day one skills by the end of their five years.
The situation should be clearer once they have begun their clinical rotations in spring 2010. Unlike the other schools, this training will not be based at university-based first opinion practice and referral hospital but within a network of partner practices and other institutions around the East Midlands.
For the equine element of their clinical training, for example, small groups of students will spend three two-week rotations at the nearby Oakham and Scarsdale Veterinary Hospitals seeing surgical and medical cases and there will be four university staff based permanently at the hospital to organise this training.
To compensate for any inconvenience resulting from the presence of the students, the practice benefits from having the university clinicians available to support the clinical services, as well as the willing hands of the undergraduate vets. However, both the veterinary and nursing staff at the practice will be expected to contribute to the training and over the coming months they will each be completing a recognised qualification in adult education.
A close eye
As the organisation which will decide on whether to recognise the Nottingham degree, the RCVS has obviously been keeping a close eye on the developments at the school. In February this year, RCVS Visitors carried out a one-week inspection of the teaching standards and delivered a glowing report on the progress so far.
“We were delighted because the report said some very positive things about the course and they recognised the effort, enthusiasm and dedication of our staff,” Prof. England said.
The university has also undertaken a detailed evaluation of the course and the way it is delivered. A report was made available to the inspection team and helped them understand what the school is trying to achieve.
Prof. England understands why there has been some scepticism about the innovations that he and his team have tried to create. “From an outsider’s viewpoint it is reasonable to ask why we have tried to do something different. If you look at the other six veterinary schools in the UK, they are all world class and produce a superb product. So if there is nothing wrong, why bother to fix it?”
Their motivation was a belief that the veterinary curriculum could be delivered in a different way to produce results which matched or exceeded those of the established schools. “We wanted to make the curriculum challenging for the students and to engage them in their own learning. We have a compulsory research project at the start of the third year and are trying to achieve a balance between basic science, clinical science and research which equips them with all the skills they will need.”
In February 2011 the RCVS Visitors will return for a further inspection which will determine whether the students graduating in July will automatically become members of the college. The RCVS makes its recommendation to DEFRA which in turn advises the Privy Council on whether to grant what is known as a Recognition Order for the degree.
Gary is confident that his students will become MsRCVS in July 2011. But that doesn’t mean that the first batch of students will mark the final version of what can be achieved through the educational process developed at Nottingham.
“Each year, we go through a very rigorous assessment process to ensure that the system delivers what we want it to. With the first-year course we have had several opportunities now to make modifications and the ones we do make are likely to be relatively small. But I think it is important to be always ready to look at what you are doing and be prepared to do it differently.
“We have tried very hard to establish a philosophy within the school which recognises that change is both necessary and normal.”
