Veterinary Physical Diagnosis II

Course Directors:

Winchester Nyoni DVM, MVS
Clinical Instructor, LAMS Department|
Email: nwinches@sgu.edu
Phone: 1473-444-4175 ext. 3804

Haynes Jaelene DVM, BVSc
Clinical Instructor, LAMS Department
Email: jhaynes2@sgu.edu
Phone: 1473-444-4175 ext. 3236

Office Location: Large Animal Resource Facility (LARF) office blocks

Office Hours: By appointment. Please email anytime with questions or concerns.

This course is a multi-teacher course with Faculty members from the Large Animal Department supporting the course directors.

Additional LAMS 501 facilitators lecturing Faculty:

Catherine Werners-Butler DVM, PhD, MRCVS, Dipl. ECEIM, Dipl. RNVA cwerners@sgu.edu

Stacey Byers DVM, MS, DACVIM (LA) sbyers1@sgu.edu

Kerri Nigito DVM, CPH, MPH, DABVP (Food Animal Practice) knigito1@sgu.edu

Heidi Janicke, BVM, PhD, Dipl. ECVS, MRCVS, FHEA hjanicke@sgu.edu

Firdous Khan BVSC, MVSC, DVSC, DACT fkhan8@sgu.edu

Inga Karasek, DVM ikarasek1@sgu.edu

Bowen Louison, DVM blouison@sgu.edu

LARF, SIM Lab, lecture locations vary - see schedule for details. LAMS 501 course website on MyCourses SAKAI

Study material posted on MyCourses (Lessons, Panopto and Zoom recordings, assignments, test, quizzes, forums, journal articles, lecture slides and labresources)

For students online; Laptop with functional microphone and camera, and good internet access/

Supplemental reading will be posted on SAKAI and students are recommended to read these thoroughly, especially before attending lab sessions.

Other recommended resources include:

• Large Animal Internal Medicine, 5th Edition by Bradford P Smith
• Material covered in previous courses [LAMS 502 (Clinical Orientation), ANPH 503 (Veterinary Anatomy II) and ANPH 513 (Veterinary Physiology II)]

Further resources will be discussed during this class.

1. Students who need accommodations should contact Student Accessibility and Accommodations Services (SAAS), located in the Welcome Center inside the Internation Students Office.
2. Information can be found at mycampus.sgu.edu/group/saas
3. Please contact the course director PRIOR attending the clinical labs if you have a disability which mayneed accommodation for during the labs held at either the LARF or SIMlab.

Appropriate dress for laboratory is required/mandatory. Failure to comply will result in dismissal from the lab and be considered an unexcused absence.

Please leave your book bags/back-packs in lockers on campus or at home. Please leave your jewelry, valuable electronic accessories, and valuable sunglasses at home as we are not responsible for their loss or damage.

Hair needs to be tied back (no long ponytails), no dangling earrings, and nails must be cut short and no polish whatsoever. We will be monitoring this before every lab session, failure to adhere to the dress code will result in you being unable to participatein the labs. The following is compulsory attire for the SIM lab:

• A pair of clean coveralls or a complete set of clean scrubs.
• Closed toed shoes
• Your name tag or student ID
• A functional watch (if using a SMART watch, please ensure that it is set on an analog setting and on for the duration of the lab)
• Each student must have their own stethoscope
• Remember that CELLPHONE use in the SIM lab is prohibited
• You can bring a notebook, pencils will be provided, no other writing utensils are allowed

The following is compulsory attire for the LARF:

• A pair of clean coveralls or a complete set of clean scrubs.
• Rubber boots OR rubber pullover boots may also be worn if they are covering a pair of closed-toe shoes. They must be cleaned/disinfected at the end of each laboratory session. The boots must be at least mid-length and made of impervious material. Cracks or tears or duct tape on boots will not be accepted, please check your boots for patency before arriving at LARF area
• Your name tag or student ID
• A functional watch (if using a SMART watch, please ensure that it is set on an analog setting and on for the duration of the lab)
• Each student must have their own stethoscope
• It is also strongly recommended to bring a writing utensil.
• You can also bring a water bottle but ensure to be biosafe & do not forget it when you leave.

Please always be conscience of biosecurity: Do not wear farm boots from campus to the LARF (or from the LARF back to campus), this is a biosecurity hazard! Bring your boots with you and change at the LARF.

• Clinical Reasoning Lecture/Paper Cases: Normal professional attire is expected.

This 3rd term course is designed to instruct students in the fundamentals of physical diagnosis in the equine and bovine patient, utilizing a variety of diagnostic and system specific techniques (including hands-on laboratories, simulation laboratories and case-based teaching) serving as a foundation course for additional clinical skills in Term 6. In addition, to practice clinical reasoning while working up a simulated case.

1. To expand upon the large animal physical examination skills learned in the first-term veterinary clinical orientation course
2. To allow development of medical math skills
3. To introduce     basic clinical competencies    as well as musculoskeletal and gastrointestinal examination skills
4. To review common disease presentations of large animals
5. To introduce and practice clinical reasoning skills through didactic lectures, hands on laboratories and case simulation
6. To allow development of skills related to teamwork and communication during case simulation projects

Upon successful completion of this course, the student will be able to:

1. Discuss and demonstrate an advanced and complete physical exam on equine and bovine patients.
2. Identify and differentiate between normal and abnormal findings on physical examination especially related to gastrointestinal and musculoskeletal exams.
3. Determine an animal’s age by examining dentition.
4. Safely demonstrate handling of large animals.
5. Accurately perform medical math calculations.
6. Utilize basic clinical reasoning skills to work through a case.

The grading for this course will be based on the submission of a medical math assignment, pre-lab quizzes, a paper case-based group assignment and the final exam, OSCE for students in person and written exam on ExamSoft for online students. Note that professionalism is included in each module. See breakdown of the grade allocation for each assessment.

Medical Math Assignment: From the information presented during the medical math lecture, you will be given an assignment on Sakai. You get multiple-choice questions to work on and make sure to submit on or before the due date as stated on SAKAI. There are 50 questions to work on and submit. Make sure to submit on or before the due dates as stated on SAKAI or else you will receive a “0”. If you are having any difficulties, please contact the course directors PRIOR to the due date.

Pre-Lab Quizzes: There will be five (5) Sakai quizzes throughout the semester. Students will have assignments will be accepted when prior communication is absent.

Students learning in-person must review the learning resources and complete the pre-lab quiz on Sakai prior to attending each lab.

Online students must review the learning resources and complete the pre-lab quiz on Sakai with their respective group prior to participating in the LIVE Zoom sessions.

The quizzes will be a direct reflection of the information/skills provided on Sakai that is expectedto be learned at the end of the module. The questions will consist of multiple choice and short answer questions.

These quizzes are to ensure students review the resources for each lab before their lab date. We encourage students to use the Self-directed student time in the class schedule to review the materials on Sakai before each Module. This allows the students to be engaged and prepared during that lab session. The student will also be assessed on professionalism, be guided by your professionalism rubric.

Preparatory materials for each lab are posted on Sakai. It is HIGHLY recommended that you read the relevant materials before each lab.

If you are having any difficulties, please contact the course directors PRIOR to the due dates of each pre-lab quiz. Missing quizzes without a valid excuse will not be accepted without prior communication.

IF YOU ARE ABSENT FROM LAB (without an official excuse), you will receive a 0 (zero) for that day (refer to professionalism rubric below).

Online Students

Must complete and submit the pre-lab quiz before their respective lab group which they have been assigned. There will be one zoom lab session per module. All zoom lab sessions will be held with the last group for each module. Therefore, pre-midterm, zoom sessions will be held with group 3 and post-midterm, will be held with group 1. During the scheduled zoom lab times, all online students must login to the live Zoom session for the duration of the lab. If you do not attend, or partially attend, you will be graded accordingly (refer to professionalism rubric below). The assessment will be a direct reflection of the information/skills described in the PowerPoint slides, long notes and videos on SAKAI. The questions will consist of multiple choice and short answer questions.

If you are having any difficulties, please contact the course directors PRIOR to the due date, and if you are experiencing connection issues with the zoom, please email course directors as soon as the issue occurs.

“Paper Case” Clinic Assignment: The goal of the group assignment is to familiarize students with the process of working up a case. Each group will be assigned a case that needs to be diagnosed.

Each group will consist of both online and on campus students. It is the responsibility of the group to organize how they will discuss their case.

You will be grouped on Forums (in SAKAI) where you will receive notifications about the presenting complaint of the case and each client/facilitator will indicate meeting place & time according to their preference, either online or in person on Forums. Each group is expected to create a clinic name (e.g. True-Blue Vet Clinic), to dress appropriately as veterinarians (e.g., white coat, name badge) and be punctual for all meetings with their client/facilitator.

The clinic will have to gather a history from the “owner” during the first meeting and then after receiving physical examination findings, interpret these findings and develop an initial problem list, and upload a prioritized list of differential diagnoses on FORUMS in SAKAI.

The group will then request 3 diagnostic tests from their facilitator to rule in/out their differentials. The group will interpret the test results and determine a final diagnosis for the patient and then meet with their facilitator for the second meeting. During this second meeting, the group will discuss their problem list, differentials and how their test results helped them to their final diagnosis for the patient.

After this meeting, each group will be responsible for developing a discharge/owner information sheet which will then be posted on SAKAI in ASSIGNMENTS and graded by their facilitator. Please use the discharge template (posted on Sakai) as a guide for the information/format required to complete this assignment.

The Paper-case grading rubric is provided on Sakai.

The group assignment grade will be based on group performance/literature search/discharge form. One focus of these cases is to give the student practice working with others as a cohesive team. Part of this goal includes understanding group dynamics, conflict resolution and time management.

Specific information about the group presentations will be posted in Sakai and relayed to you

during a pre-paper case lecture at the Lecture Hall in person and on zoom for online students. The lecture would be available on Panopto Recording thereafter on March 15^th . All these sessions REQUIRE mandatory attendance.

FINAL EXAM: The importance of clinical skills in the course LAMS 501 must be emphasized and recognized. There will be a comprehensive OSCE format final exam, worth 35% of the final grade, to be held on May 4^th, 2022 starting at 8:30am at the LARF. Exam questions will require the student to demonstrate knowledge and skills related to the labs and clinical reasoning/medical math sessions taught during the term.

The Final OSCE assessment is MANDATORY. Students who complete the lab sessions in-person MUST also complete the final OSCE, in-person. If you are learning in person, you are obligated to take the OSCE in-person. Any student who completes the lab sessions in-person and does not complete the final OCSE in-person will receive a score of “0” for the Final OSCE Assessment. If you do not take the Final OSCE examination, you will receive 0 points for your final assessment grade.

Details regarding the format will be announced later in the term. Dates for practice sessions on the LARF were scheduled tentatively in your course schedule.

Online Students

Students who are learning online will be required to take the Written Final Exam on ExamSoft on May 4^th, 2022, 12:00 noon. Online students who complete the lab sessions via zoom are obligated to take this written OCSE exam. Kindly note that there will be accommodations to provide an online “OSCE” experience for your written assessment. The questions will be as practical as possible (including pictures) in the format of MCQ’s, Hotspots and FITB. A grade reduction of 5% will be applied to that exam if students do not observe the parameters listed in the Assessment Policy for Students.Each student will be responsible for using lab time to complete the required objectives. Students will be asked to demonstrate knowledge and clinical proficiency skills learned from each lab during the final exam OSCE. As in the case for online students, apply knowledge to answer questions.

Excuses

Students will only be accepted to be excused from the examination with the use of the online “Medical Excuse” policy. Please consult the SVM Dean of Students office for additional information regarding acceptable excuses. Make-up examinations may be essay or short answer questions using Exam Soft.

Remediation

Failure to remediate any OSCE (in person or written) before the end of the term will result in failure of the course (F Grade). Students who receive a grade of 70% or less on their final OSCE exam will be required to request remediation. The remediation will not change the student’s grade, however, students will be required to demonstrate (in-person) or describe (online) clinical proficiency skills taught during the term prior to progressing from this course.

*All students are expected to strictly adhere to the University’s Student Code of Conduct and to have reviewed the Honour Code Statement All other exam policies are followed according to the SGU Examination Policy and the Student handbook.

PROFESSIONALISM GRADING RUBRIC

Professional behavior is defined as, but not limited to punctuality, appropriate dress, adhering to appropriate safety standards around large animals, respectful attitude, open minded, positive, caring approach when interacting with professors/staff/fellow students and being fully engaged during laboratory sessions. During Zoom sessions, join meeting on time and remain for the duration of the session. Keep cameras on. Participate during meetings and maintain respectful communication either verbal or non-verbal.

• Prepare for each lab by reviewing the resources posted on SAKAI under each lab’s folder, as well as the practical skill videos posted on SAKAI
• Complete the prelab quizzes before each lab
• Use the clinical skills list, which will be posted, for review and practice of the skills
• Active participation in the Paper cases forums is highly recommended.

The student is expected to adhere to the guidelines provided throughout this syllabusincluding attendance, engagement, assessment submission and examination policies. The syllabus and all other course materialsare available online on the Sakai/MyCourseswebsite under the “Syllabus”, “Resources”, and “Lessons” tabs respectively.

All course announcements will be made online via email. Please check your sgu.edu email regularly to stay in touch with course announcements. You are responsible for keeping up to date with course changes as they may occur and for adhering tightly to all assessment deadlines.

Turn cell phones off or silence them during lectures and labs. See “In Lab Assessment” section for specifics n professional behavior in laboratory sessions.

Students are expected to abide by the University Code of Conduct outlined in the student manual. “Students attending St. George’s University are expected to conduct themselves with integrity, dignity, and courtesy, according to a code of conduct that defines the interests, reputation, and stature of the University community.

Learning experiences at St. George’s University are not only meant to develop strong academic skills, but also to cultivate students with positive professional attributes, who are well adjusted to the norms of social graces and good social behavior.”

(Please refer to the student manual page ifapplicable)

Attendance is mandatory for ALL activities. Students are allowed one unexcused absence. Two or more unexcused absences will result in course failure. Students are also expected to be on time! Arriving after attendance has been taken or leaving before the end of the lab will count as an absence. Any student unable to adhere to the attendance policies of this course is mandated to complete the online "Medical Excuse Submission" form PRIOR to missing the required activity. Failure to complete the "Medical Excuse Submission" form will result in an unexcused absence.

Each student will be assigned to a group and must report to the LARF or the classroom on the day and time specified on the schedule. A student CANNOT change lab times without Dr. Winchester’s or Dr. Haynes’ consent, which MUST be obtained PRIOR to the lab time. If the student shows up to a different lab session, you will not be granted admission, thus earning a zero for that day on your in-lab assessment grade.

For online students

Students are expected to be available during the standard 8-5am AST school day, to virtually attend, engage with online content, and participate in all classes and clinical rotations for which they have registered. Employment is not an excusable absence. Although attendance, engagement, and participation may not be recorded at every academic activity, attendance, engagement, and participation is graded for mandatory sessions. Students’ lack of attendance, engagement, and participation may adversely affect their academic status as specified in the grading policy.

Attendance to the indicated mandatory sessions and engagement in the course content is mandatory. This will be reviewed using weekly checklists and attendance logs. You are expected to utilize the checklists on the Lessons tool (on SAKAI) to allow course directors to track your progress and engagement with the course material. Students are to be on time for each session and stay for the entire session to avoid being marked as absent due to tardiness or premature leaving.

If failure to attend, engage, or participate inindividual classes, examinations, and onlineactivities, or from the University itself is anticipated, or occurs spontaneously due to illness or other extenuating circumstances, proper notification procedures must be followed.

Students who fail to attend an examination (Sakai quiz/test or Examsoft) or submit an assignment by the deadline without a valid reason (see student manual: SGUSVM POLICY ON AN EXCUSED ABSENCE (EA) FOR STUDENTS) will receive a score of “0” points for the examination.

Students who have technical issues during the examination MUST inform the Course Director (s) Dr. Nyoni Winchester, [nwinches@sgu.edu] and Dr. Jaelene Haynes, jhaynes2@sgu.edu, and IT (tellexaminationservices@sgu.edu OR support@sgu.edu OR call 1-631-665-8500 ext. 4444 (US, NU, International) OR 1-473-439-2000 ext. 4444 (Grenada), AND Dean of Students (DOS@sgu.edu) during the open period for the examination. Failure to do so immediately will result in the student receiving the highest score recorded at the time, but NOT being eligible to take a completion examination.

Scheduling of examinations (regular, re-sit, completion, comprehensive, or exemption) is at the discretion of the University.

All students are responsible for knowing and complying with the University’s Code of Conduct and the guidelines. Students must read and then sign the Honor Code statement at the start of examinations to indicate that they will comply with the University Code of Conduct.

Prior to Exam Day

1. Each student is required to have a laptop for the purpose of taking computer-based examinations (e-Exams) at SGU. Students must ensure that their laptops meet the current minimum system requirements prior to exam day:
2. Examinees must use their MY SGU Member Center username and password to access the Custom Home Page (www.examsoft.com/sgu) created by ExamSoft for the University.
3. Examinees are responsible for downloading and registering the latest version of Examplify on their laptop prior to exam day. Once Examplify has been successfully downloaded, examinees are strongly encouraged to familiarize themselves with the software by downloading and taking practice exams.
4. Examinees are responsible for setting their laptop up for ExamMonitor prior to the exam (see links below).
5. Examinees will be notified via MyCourses, of all exam related information. Email notifications will also be sent from ExamSoft Support to examinees, notifying them of examinations available for downloading.
6. Examinees experiencing difficulties with their laptop are encouraged to visit the IT department for assistance prior to exam day. Examinees needing a laptop must visit the Office of Institutional Advancement (OIA) to request an exam loaner.
7. Examinees should visit the following information to familiarize themselves with the online proctored exam format and set up their baseline photo.

• A Examsoft/ExamID quick guide for students (Please note that the current Examplify version is 2.3.8)
• The Examsoft student perspective video 30mins
• The Examsoft/ExamID FAQ
• Examsoft information page
• The general Reminders/Guidelines

The materials (such as slides, handouts and audio/video recordings) provided to students who are taking courses at St. George’s University (SGU) are the intellectual property of the Faculty and/or Administration of SGU. Students are free to use these materials solely for the purpose of group or individual study. Reproduction in whole or in part is prohibited.