Learning self-reflection as an advanced veterinary practitioner

Victoria examining a puppy in practice

Postgraduate certificate in advanced veterinary practice

With a general practitioner certificate under my belt, I wanted to look deeper into the aspects of being a veterinary professional. Investigating the value of further academic pursuits and how they applied to my everyday work in first-opinion practice, I decided to do a postgraduate certificate (PgC) in advanced veterinary practice. The PgC has introduced me to a different approach to academic learning. It doesn’t only focus on theoretical learning, but looks at how learning has an impact on me through self reflection.

Not only that, but I’ve also had a chance to consider how my professional learning has evolved and the skills I need to become an advanced practitioner. A critical aspect of this uses recognised strategies to develop self-reflective skills. Honestly, when I first heard such terms, I had no idea how I would write essays on these subjects and thought I would struggle to find reference material. However, with the support of Harper Adams and my study group, I found material used by medical professions where the formal use of reflective strategies are already an intrinsic part of everyday working.

Reflecting on veterinary profession work

Having said that, reflecting on our work is something that I feel veterinary professionals do in order to improve our clinical practice. Faced with unexpected or unintended outcomes, we often question our decision making by asking ourselves, ‘What could I have done differently?’ or ‘What can I change next time?’.

For a more structured assessment, within the guidelines of the PgC, we were asked to start a learning journal. This involved noting reflections of our day-to-day work, past events, professional development, etc, and not forgetting to include our own emotions in this task. Developing this idea aims to help us reflect on our learning to date and the key aspects of what we feel make a good practitioner. We’ve all had stand-out moments that have impacted our own clinical practice and reflecting on these can have an impact on our own work and the practices where we work.

During my studies I came across structured models of reflection, such as the Gibbs reflective cycle. It encourages us to think about the phases of an experience or activity and I was surprised to find that –without knowing it – I had applied the model as a new graduate when I had panicked during a bitch spay.

"Being aware of coping strategies can help us identify the ones that work best for us"

Reflecting on the experience, I decided that in a similar situation I would calm myself down by talking through what was happening, what my options were and discuss a plan of action with my nurse. It seemed to me that hearing it out loud would give me the time and space to realise that I was thinking rationally.

Later in my career, I applied this technique when faced with a bleeding bitch spay. Talking out loud really helped me focus and control the rising panic within me. I am sure that many people have used this technique to help with stressful situations, but it’s interesting to learn that this is a recognised style of coping. It demonstrates psychosocial adaptation - confronting the issue, assessing the situation and solving the problem.

Being aware of coping strategies such as these can help us identify the ones that work best for us.

What does it mean to be an "Advanced veterinary practitioner"?

Is an advanced practitioner someone with a certificate, or someone with wider clinical knowledge? My suggestion would be to consider what makes a good veterinary surgeon. Some essential qualities include:

  • Reflecting on work to identify developmental needs;

  • Undertaking appropriate CPD activities to meet the developmental need identified;

  • Applying what has been learnt in practice;

  • Measuring the impact of CPD on practice and patient health; and

  • Identifying further developmental needs.

Impact of professional learning

Evaluating the impact of professional learning is crucial for advanced practitioners. This addresses a move towards outcome-based learning, where we guide our own learning and are encouraged to evaluate the impact on our practice. It demonstrates the responsibility of individuals to examine the impact of continued education on the health of our patients and our own professional performance.

Advanced veterinary practice also requires us to consider areas of practice where there is need for improvement and to identify changes in order to achieve this. This includes reflection on the environment as well as the work itself.

Communication and relationships

As undergraduates we are taught to follow consultation models, including the seven main concepts of the Calgary-Cambridge model:

  • Greeting

  • Rapport building

  • History taking

  • Clinical examination

  • Explanation

  • Treatment planning

  • Closure

Being a competent clinician is not only about having an excellent knowledge base, it’s also about communication. This is essential for good compliance, managing client expectations and achieving the best outcome for the patient.

In order to build trust with a client and improve communication, it is imperative to express empathy. Forming a good relationship with our clients involves actively listening to their situation and working with them. Building on that relationship with the owner is what allows us to have open and frank discussions about an animal’s wellbeing.

Ethical reasoning is a vital skill for any veterinary professional and having a good understanding of animal welfare and how to communicate this to clients is vital too. We also need to build good relationships with our colleagues. Typically, the veterinary profession attracts highly motivated personalities, people who strive for perfection. This can lead to us being highly critical of our own performance, sometimes with a negative emphasis. It is, however, very important to also examine positive outcomes and realise what we are doing well.

"Communication is essential for good compliance, managing client expectations and achieving the best outcome for the patient"

This can involve the whole practice team, such as tracking performance in client communication and patient care, and can be essential in promoting a good team atmosphere and building morale.

An appetite for learning and openness 

Overall, I would say that the most important factor for me as I have progressed through my career has been to constantly maintain an appetite for learning and an openness to new perspectives and techniques. Being able to evaluate my own strengths and weaknesses has helped to direct my continued professional development to be in a position to maintain and improve the service that I provide to animals in my care. This is a mature system of review, evaluation and improvement and is a style of learning that requires motivation and self-assessment or self-regulation. Self-regulation is linked to academic motivation and can be used as feedback for learning. This is important because it relates to educational goal setting and lifelong learning.

I have found that working within a motivated and knowledgeable clinical team has helped make discussing cases easier and has also increased opportunities for complex problem solving. Inter-professional collaboration is highly valuable and proven to improve the delivery and service of clinical practice. Unquestionably, a good skill set and knowledge base are vital to be a good veterinary surgeon, and a strong motivation to constantly better these aspects throughout a career is necessary. But, there is also a more human level to our profession. A good veterinary surgeon also requires the ability to express empathy with clients and patients and to always have their health and welfare at the heart of their care.

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