Junior Surgery and Anesthesia Laboratory

Course Director: Marta Lanza-Perea, DVM, MRCVS, MSc Associate Professor (mperea@sgu.edu)

Office Hours/Communication:

• Faculty are available via email, response time within 24-48 hours
• Weekly rounds will serve as way of constant communication with students
• General course communication will occur within Sakai Email or Sakai announcements

Participating Faculty:

• Surgery:
  • Keith Kalasi, DVM. Assistant Professor (KKalasi@sgu.edu)
  • Amanda Marancik, DVM, Assistant Professor (amaranci@sgu.edu)
  • Adria Rodriguez DVM, MSc, CVA, CVCH. Associate Professor (airodriguez@sgu.edu)
  • Tara Paterson DVM, MSc Associate Professor (tpaterson@sgu.edu)
  • Heidi Janicke, DVM, PhD, MRCVS, Dipl. ECVS, SFHEA. Professor (hjanicke@sgu.edu)
  • Francesca Ivaldi, DVM, MSc Associate Professor (fivaldi@sgu.edu)
  • Tomas Guerrero, DVM, Dipl SAS. Professor,( tguerrer@sgu.edu)
  • Rodolfo Bruh Day, DVM,ChD.SAS, Dipl.CLOVE,EdD. Professor (rbruhl-day@sgu.edu)
  • VP’s: Dr Tara Walcott, Dr Katie Morris, Dr Merel Blonk Dr Tatiana de Oliveira

• Anesthesia:
  • Flavia Restitutti DVM, PhD Associate Professor(frestitu@sgu.edu)
  • Mercedes Miccio, DVM Assistant Professor(mmiccio@sgu.edu)
  • Mrs. Naudia Dundas, Instructor (ndundas@sgu.edu)
  • VP’s: TBA

Technicians

• Licensed Veterinary Technician: Ms. Elizabeth Peach (epeach@sgu.edu)
• Veterinary Technician: Mr. Jakobus Louw (jlouw@sgu.edu)
• Veterinary Technician: Mr. Quacy Matthew(qmatthew@sgu.edu)
• Veterinary Technician: Mr. Jude Modeste (jmodeste@sgu.edu)
• Veterinary Technician: Mr.Jemmon Wilkinson (jwilkinson@sgu.edu)
• Veterinary Technician: Reon Patrice (rpatrice@sgu.edu)

Community Canine Procurement Coordinator: Mr. Quacy Matthew Assistant Canine Procurement Coordinator: Ms. Diane Mckellar-Basset

The laboratory sessions take place in the Veterinary Surgical Facilities at the Ray and Jan Sis Hall Building each Tuesday and Thursday. Animal housing, pre-operative evaluations and post-operative care all occur in the same building. The lecture portion will take place in the regular classroom venue

Sakai Resources being utilized include but are not limited to Announcements, Calendar, Resources, Assignments, Forums, Tests and Quizzes

For remote students: Online Location

• Lectures will be available in Sakai via Panopto or Zoom, both live (synchronous) and recorded sessions (asynchronous). Rounds and Mock surgeries will be done using synchronous zoom sessions

• JSAL manual, updated for Spring 2022
• Veterinary Surgery: Small Animal, K Tobias and S Johnston Elsevier 2nd edition, 2017
• Pasquini et al. Veterinary Surgical Preparation and protocol, SUDZ Editor, 2011
• Fundamentals of Small Animal Surgery, FA Mann, Constantinescu & Hun-You, 2011
• Basic instruments and suture material (Remote students)
• Laptop with webcam and functional microphone (Remote students)

• Fossum et al. Small Animal Surgery. Mosby 5th edition, 2019
• Course notes and videos from term 4 SAMS 514 (Intro to Surgical Skills) and SAMS 520 (Anesthesia)
• SAMS527 Resource contents in Sakai
• The Library on the SGU Carnage is a great resource to access materials and journal articles.
• Stable Internet connection (Remote Students)

• Students who need accommodations should contact Student Accessibility and Accommodations Services (SAAS), located in the Welcome Center, inside the International Students Office.
• Information can be found at mycampus.sgu.edu/group/saas

• Backpacks, book bags, food, or drinks are not allowed in the laboratory rooms. There are lockers outside the lab to place your belongings. Bring a padlock to secure your items if you wish.
• A minimal amount of course material pertinent to the specific laboratory is permitted inside the lab (written notes, summaries, charts, whatever may help you to do a good job)
• Stethoscope, calculator, pen, thin-tip permanent maker are highly recommended.
• Conversations should focus on the tasks at hand and should be kept at a reasonable volume to minimize disturbance to other groups and patients.
• Students (other than the anesthetist) will be standing for the entire laboratory period, the reason why good quality footwear is essential to minimize leg and back strain.
• Students are expected to wear surgical scrub clothing at all times and closed toe comfortable and protected footwear with hard soles, and no upper holes (i.e. Dansko, Clogs). Sneakers may also be used. Please refer to OSHA (Occupational Safety and Health Administration) recommendations in the following link: http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=2543 9
• No bags, caps, sunglasses, sandals or rolled up scrubs are allowed in the lab. Please use your lockers for those items.
• On surgery lab days, no person is allowed inside the surgery suite without cap and mask.
• It is highly recommended that students have breakfast to prevent low glucose levels during surgery sessions.

For REMOTE students (but very recommendable for ALL SAMS527 students):

• Students will be required to create their own castration and spay models. This exercise is meant to be a learning experience to promote reflection and creativity as well as review of anatomy in preparation to perform mock surgeries to practice their skills.
• A good internet connection and the possibility to have a camera to show their models and hands while performing mock surgeries.

This is a hands-on, faculty supervised, surgery and anesthesia clinical skills course. Students will be divided into teams of four and will be expected to apply knowledge gained from previous courses (SAMS 520- Anesthesia, SAMS 514- Intro to surgical Skills) and concurrent courses (SAMS 518- Small Animal Surgery).

The goal of this course is to provide the student with he opportunity to put into practice in live patients what has been learned previously in the classroom and in dry labs. Student’s should get familiarized and have a practical understanding of surgical etiquette, general operating and anesthesia procedures. The ultimate goal is to provide clinical, “hands on,” experience by anesthetizing dogs undergoing elective surgical procedures (castration and ovariohysterectomy).

Students will also practice communication skills by presenting in pre-surgical and pre-anesthetic rounds. Rounds will include presentation of cases including signalment, physical examination and bloodwork findings, diagnostic procedures, and treatment plans, as well as discussions related to infectious diseases with/without zoonotic potential, behavior, ethical dilemmas, and other matters.

Anesthetic protocols and the surgical plan for either a spay or a neuter in client-owned surgical candidates will be reviewed. Students will perform MOCK canine sterilization surgical procedures while describing aseptic technique principles.

Students will maintain medical records using the SOAP format for every assigned patient, including the writing of surgery and anesthesia reports, postoperative treatment plans, discharge instructions, and will perform pain management assessments.

Team building and cooperative learning are an integral part of the course.

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

• Present surgical cases and execute peri-operative case management for Castration and Spay laboratories
• Perform a Spay procedure in healthy canine patients as an anesthetist, surgeon, assistant surgeon and scrub nurse and a Castration procedure in three of those roles
• Perform sedation and or anesthesia in healthy male and female canine patients for castrations and spays
• Demonstrate proficiency in medical record writing and keeping
• Professionally perform and contribute to a team environment
• Perform the minimum ophthalmic database
• Practice techniques used in routine dentistry
• Practice techniques used in osteosynthesis

For REMOTE/ONLINE learners:

• Present surgical cases and describe peri-operative case management for Castration and Spay laboratories
• Describe and perform a Castration and a Spay procedure in a male and female model patient as a surgeon
• Describe sedation and or anesthesia protocols in a male and female model patient for castrations and Spays
• Demonstrate proficiency in medical record writing and keeping
• Professionally perform and contribute to a team environment

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For REMOTE Students:

For REMOTE Students:

Please find a detailed description of Course Level Outcomes (CLOs) mapped to Program Level Outcomes (PLOs) at the end of the syllabus in Appendix 1.

1. Alignment of Course Learning Outcomes (CLOs) with Program Learning Outcomes (PLOs)-Detailed Description (REMOTE STUDENTS)

Schedule of REMOTE STUDENTS (subject to changes depending on time zones and others)

Week 1 and 2 will be review sessions for anesthesia and surgery for the whole class. The sessions can be followed via synchronous zoom sessions or asynchronous recorded lectures

After those initial compulsory preparatory session, each student will attend (time zone pending)

• Anesthesia Rounds (each student will attend the role of anesthetist once for castrations and once for spays
• Surgery Rounds (each student will attend in the roles of Surgeon, Assistant sx and Scrub nurse, twice for castrations and three times for spays
• Mock castration (1h) per student in a group of 4 students with one instructor
• Mock Spay (1:15 h) Individual, one to one with instructor The following will be assignments due per remote student:
• Formative: Draping a “dummy” video
• Formative: Intratesticular block and Mock IV catheterization
• Suspensory Ligament rupture article questions (spay)
• Surgery pre procedure video assessments x2 (1 castration, 1 spay)
• Anesthesia case assignment (anesthesia record and quiz) x2 (1 castration, 1 spay)
• SOAPS (2x castrations, 3x spays)
• Surgery Reports x 2 (1 castration, 1 spay)

ON SITE STUDENTS:

The first half of the term will not count towards the final grade of the course. It is a time for learning, practicing, and preparing for spays. From after midterms onwards, the course will be graded as follows:

• Formative Assessments: These assessments will not receive a formal grade, but they are a pre-requisite before being allowed to perform your castration and spay surgeries.

1. Castration Video Assessment
2. Spay Video Assessment
3. Suspensory Ligament Rupture Article Questions

• On-going assessments: Four roles performed during spays will be graded  75%
• Reports: to be completed appropriately in a timely fashion 20%
  • Spay Surgery Report due on the discharge day, in the patient’s medical record. This is an individual student submission and grade (5%)
  • Medical Records (Four graded) due by 8:30 am on the discharge day. This is a group grade, so everyone in the group will get the same (15%)
• Professionalism: 5%

• This portion will be graded throughout the term by peers, staff and faculty
• It is meant to be a combination of self-evaluation, reflection, participation and peer review. Two peer assessment assignments will be posted and due by midterms (2%) and final (3%) weeks.
• The final peer evaluation grade will include grades from a rubric completed by all members of one group, when preparing for their spay. Meant to be a learning and growing exercise to give and receive peer feedback

Grading scale:

This course is graded with letter grade in accordance to the SGUSVM grading scale:

REMOTE STUDENTS:

• Anesthesia Portion (This grade will only count from after midterms) 30% This grade includes:
  • Anesthesia Rounds Presentations
  • Anesthesia Record
  • Anesthesia oral case Quiz

Please note that there will be 1 anesthesia rounds, record sheet and oral case quiz for castrations before midterms (not counted in your final grade), in preparation for the spay anesthesia rounds, record sheet and oral case quiz (which will count as 30% of the final grade)

• Formative assignments: These assessments will not receive a formal grade, but they are a pre- requisite for the anesthesia case assignments grades. Students that do not submit their videos will receive an “I” on gradebook until submission. There are 2 formative assignments
  • Intra testicular block: Students must perform a mock intratesticular block on video and upload for the instructors. Performance of the student will be assessed with the appropriate rubric
  • IV catheterization: Students must perform a mock IV catheterization on video and upload on Panopto for the instructors. Performance of the student will be assessed with the appropriate rubric
  • Opening and deadline of the assignments: TBA
• Mock Surgeries: 40%
  • Castrations (10%) They will be conducted in groups of students with 1 instructor.
  • Spays (30%) They will be conducted individually, one student to one instructor

A comprehensive preparation guide and expectations will be available for students to prepare for this exercise. This guide will include ideas to construct the models as well as what to have ready to perform.

• Performance of the student will be assessed with the appropriate rubric (See Grading Rubric in Sakai)
  • Surgery Video Assignments (Castration Video and Spay Video) (x2): 5%
• Short answer quizzes to be submitted before performing the mock castration and mock spay.
• Due dates will be specified as soon as possible depending on instructor’s availability
• Formative assignments:
  • Draping a dummy: This assessment will not receive a formal grade, but it is a pre- requisite to be able to perform mock surgeries. Each student will upload a video of him/herself draping a dummy.
  • Suspensory Ligament Rupture Article Questions. Pre-requisite to perform mock spay
• Medical Records/ SOAPS (x4): 15%
  • Medical Records will be a group submission due the Sunday after rounds.
  • There will be 1 graded submission for Castrations and 3 for Spays (the first castration medical record submission will not count for grades)
  • The SOAP grades are based on group effort. Every person in the group will receive the same grade per patient.
  • Performance of the student will be assessed with the appropriate rubric (see grading rubric in Sakai
• Surgery Reports (x2): 5%
  • These reports will be an individual student submission due on the Sunday after each student’s Mock castration (2.5 %) and Mock OVH (2.5%) in the primary surgeon role.
  • Performance of the student will be assessed with the appropriate rubric (see grading rubric in Sakai)
  • Grades for medical records and surgery reports will be available in Sakai as they get corrected by instructors.

4. Professionalism: 5%

• It will be graded throughout the term by peers and faculty
• It is meant to be a combination of self-evaluation, reflection, participation and peer review. Two peer assessment assignments will be posted and due by midterms (2%) and final (3%) weeks.
• The final peer evaluation grade will include grades from a rubric completed by all members of one group, when preparing for their mock spay. Meant to be a learning and growing exercise to give and receive peer feedback

Grading characteristics for ONSITE students:

• Students will receive a grade for their daily performance and record keeping only after midterms. During the first half of the term students will be assessed and will receive written Exam Soft evaluations but the grades will not count for the final course grade. Think of it as a warm-up performance without added stress
• The SOAP grades are based on group effort. Every person in the group of 4 will receive the same grade per patient. The surgery report is an individual grade obtained when a student performs the OVH primary surgeon role. Grades for medical records and surgery reports will be available in the feedback sessions as the term progresses (as described in the table at the end of the schedule)
• Grades are determined by the faculty members involved in the course and are based on proficiency, participation, preparation and knowledge, professionalism, and clinical responsibility
• There will be no written mid-term or final examinations.
• Activities and participation may be restricted for any student not adequately prepared for a laboratory session. Lack of preparation is not acceptable for these patient-based exercises and can result in dismissal from the lab.
• DOPS (Direct Observation of Procedural Skills) are clinical proficiency tests and are graded differently to exams and coursework. The importance of clinical skills in this course must be emphasized and recognized. Due to their practical nature, grades for DOPS are calculated independently using rubrics
• Due to the nature of DOPS, subjective grading is used in whole or in part for the course. A rubric will be supplied to outline the criteria that are necessary to perform at an acceptable level. These are the course director’s expectations for a particular assignment or task. These rubrics provide a basis for self-evaluation, reflection, and peer review. This is necessary for fair assessment and student understanding.
• Rubrics are meant for student performance feedback, NOT for calculating grades. Different categories within a rubric have different weights associated depending on the importance of the skill

The final pass/fail rate will be at the discretion of the course director with input from all course instructors

• Student performance is expected to improve during the course.
• Performance is based on course learning objectives and expected clinical skills.
• Students will receive feedback for their daily performance and record keeping after each rotation.
• Pay attention to the instructor’s comments and try to improve on comments they made

There is a “Daily Performance” (pass/fail) element to the grading aside from the technical skills that MUST be passed in order to pass this course. “Daily Performance” refers to professional behavior, situational awareness, being safe to perform the procedure, collaboration with team members, and maturity. Students MUST pass that portion even if the technical skills grade is passed.

For On-Site students

It is recommended that the student keep on top of their preparations and review for each surgery day. Each student is expected to be familiar with all aspects of the laboratory session reviewing relevant class notes, textbooks, and any relevant materials from other courses in preparation for the laboratory. Students are expected to follow surgical protocols during the laboratory session and to perform appropriate pre- operative and post-operative duties (including proper patient care) as required.

All students are expected to bring forward skills attained in Term 4. Please practice suturing before coming to lab.

The feedback sessions are a good way to check in and stay on track of expected results. Check the schedule to find out specific time and dates. Office hours can be arranged via email with Dr. Lanza (mperea@sgu.edu) or Dr Kalasi (kkalasi@sgu.edu)

For Remote Students

It is recommended that the student prepares and reviews for each of the rounds  sessions and mock surgeries. Each student is expected to be familiar with all aspects of the laboratory session reviewing relevant class notes, textbooks, and any relevant materials from other courses in preparation for the laboratory.

All students are expected to bring forward skills attained in Term 4. Please practice suturing before performing mock surgeries. Students are responsible for supplying their own suture material, practice board and Castration/ Spay models.

Additional assistance or Office hours can be arranged via email with the course instructors (mperea@sgu.edu, kkalasi@sgu.edu, amaranci@sgu.edu) or the anesthesia team (frestitu@sgu.edu , mmiccio@sgu.edu). You can also contact the appropriate instructor.

For ON SITE students

• The student is expected to read and use the JSAL lab manual before each lab, as needed. Upon completion of this course, we would appreciate if you could take the time to complete the course & instructor evaluations. Your thoughts, comments and constructive criticisms are extremely important and valuable to us as we continue to develop and improve this course.
• Recognition and repeated avoidance of acceptable technique (ie. breaking aseptic technique without correcting the error or without asking for assistance) will be considered enough to be dismissed from the Surgery Lab.
• Students who are not performing up to an adequate standard will be notified the latest after midterm week. At the time of such an evaluation, methods to improve the student’s performance will be discussed and a date will be set for a follow-up meeting to discuss the student’s performance.
• Students that may be pregnant or are pregnant should immediately inform the Course Director and/or the Instructors.
• If you have any disability that may impair your performance should immediately inform the Course Director and/or the Instructors in order to receive the necessary assistance in the labs.
• Please note that the autoclave room is off limits to unauthorized personnel and students.

For REMOTE students

Students are expected to build their own castration and spay models to perform the “mock surgeries”. Guides and suggestions on how to do them, as well as a list of necessary components and anatomical structures will be provided

• The student is expected to read and use the JSAL lab manual before each session of rounds and mock surgery, as needed.
• The student is expected to submit all assignments and assessments on time. If there is an issue, students are required to reach out to the course director or the appropriate instructor via email: mperea@sgu.edu, kkalasi@sgu.edu, amaranci@sgu.edu, frestitu@sgu.edu, mmiccio@sgu.edu, ndundas@sgu.edu
• Students who are not performing up to an adequate standard will be notified the latest after midterm week or as needed. At the time of such an evaluation, methods to improve the student’s performance will be discussed and a date will be set for a follow-up meeting to discuss the student’s performance.
• If you have any disability that may impair your performance should immediately inform the Course Director and/or the Instructors in order to receive the necessary assistance in the class.
• Upon completion of this course, we would appreciate it if you could take the time to complete the course & instructor evaluations. Your thoughts, comments and constructive criticisms are extremely important and valuable to us as we continue to develop and improve this course.

• Punctuality is expected for rounds and surgeries.
• Cell phones are only allowed as calculators and should be switched off or in silent mode during live lectures and rounds. Ensure that all social media websites are logged off during class/ lab time.
• Students are expected to conduct themselves in an appropriate professional manner in their interactions with lecturers and fellow students (This applies to the remote students). Please be respectful, courteous and open to other people’s opinions.
• Please arrive on time for lectures and labs if the session is live and dress appropriately.
• Professional behavior is always expected.

Students are expected to virtually attend, engage with online content, and participate in all classes and clinical rotations for which they have registered.

Students are expected to be available during the standard 8:30am-5:20pm AST school day, to attend, engage with in-person/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.

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

Live Lecture/Lab Zoom Sessions Policy:

• Case presentations/ Rounds for anesthesia and Surgery will be live Zoom Sessions at a scheduled time. They are all mandatory for all students. These sessions will be the basis for the group work and the SOAP. If there is a major issue, an e mail to the correspondent instructor will be sent. The sessions will be recorded.
• The Mock Surgeries will be live group or individual sessions and MANDATORY for each student
• For attendance of live rounds sessions, students are strongly encouraged to turn on their cameras to increase class engagement and interaction. For the Mock surgeries, cameras are a MUST.
• Students are expected to behave in a professional manner and dress appropriately for all live sessions.
• If failure to attend, engage, or participate in individual classes, examinations, and online activities, 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 a lab (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 lab.
• Remote Students who have technical issues during the mock surgeries MUST inform the Course Director mperea@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 a fail for that rotation
• Make-up assignments/assessments are at the discretion of the course director

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.

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.