Real-world veterinary experience: AAEP student chapter short courses

The American Association of Equine Practitioners (AAEP) Foundation recently announced its funded programs for 2012-2013, among which are the AAEP student chapter short courses on equine veterinary dentistry and equine podiatry and farrier work.

The AAEP Foundation provides $30,000 to support the short courses, which take place annually at selected AAEP student chapters at various veterinary school venues. Both courses are conducted 12 times a year. Each school has the opportunity to host a dental or farrier program on an equal rotation that occurs over a three-year period. A total of six courses each are conducted during the spring and six each during the fall. Since the inception of these short courses, more than 250 courses have been conducted, educating more than 4,000 veterinary students.

Hands-on care: At recent AAEP student chapter short courses, Robert Menzies, BVSc

Dentistry short course presenters are volunteer AAEP practitioner members. Stipends are not paid to these presenters. However, funds are used to support speaker travel expenses and other needs and equipment for the courses. Pfizer Animal Health helps support the dentistry short courses as a sponsor. The farrier and podiatry short courses also involve volunteer AAEP practitioners as well as local invited farriers.

Randall Verink, DVM, demonstrate the details of dental care for horses.

Equine dentistry short course

The purpose of the dentistry short course is to ensure that veterinary students are introduced to the recommended dentistry core competencies for entry-level and first-year veterinarians. Core competencies for entry-level veterinarians include:

1. An understanding of the anatomy and physiology associated with equine dentistry

2. Knowledge of the dental formula and eruption schedules of equids

3. Recognition of oral pathology

4. Performance and documentation of an oral examination

5. An understanding of the dentistry treatment principles and performance of primary dental care procedures.

Recommended dentistry core competencies for first-year veterinarians include:

1. Understanding deciduous tooth management

2. Performing regional nerve blocks of the head

3. Performing dental radiography.

Bruce Whittle, DVM, of Honey Creek Veterinary Hospital in Trenton, Mo., is an instructor and has participated in the AAEP student chapter dentistry short course program for a number of years. He usually conducts about two courses a year. Student participation varies greatly from school to school, depending on examination schedules. The dentistry course on average accommodates up to 30 students.

"When we have high participation at a given short course," Whittle says, "we have to be creative to make sure as many students as possible get as much hands-on experience as possible in the limited time we have available.

"Since it's voluntary for the students, those who do participate are extremely interested," continues Whittle. "I love doing the short courses—interacting with the students—as I often learn things from them, too. It's a very neat experience."

Whittle says that sometimes he has to tailor the course to the students, depending on their experience. "The lecture remains pretty much the same, but what we're able to do in the lab varies a lot," he says. "Sometimes we get more first- and second-year students and sometimes more third- and fourth-year students. There's a lot of difference between the first- and fourth-year students as far as confidence, experience, etc., since those in their later years are more advanced and already involved in clinical rotations."

At some schools, it's more difficult to conduct a live horse lab segment of the course because of the regulations of the Institutional Animal Care and Use Committee (IACUC) and its specific guidelines for using live animals. "Hopefully, we can do the live horse work, as it's my favorite part of the entire lab," Whittle says. "When the students work on a live animal they can be tentative, apprehensive at first—afraid they might injure it. It's fascinating watching the students as they mature in front of your eyes and begin to get it."

In addition to the live portion, the dentistry course has a cadaver lab, which gives the students the experience of examining the oral cavity and using the instrumentation without the concern of working around a live animal.

"Though each instructor teaches a little differently, we're working toward a more standardized curriculum, so it will be more consistent from school to school," Whittle says. "For the most part our biggest emphasis is on a thorough examination—the basis of equine dentistry. There isn't time to teach everything, but we try to hit the highlights of what's most important—anatomy, physiology and the primary pathologies—and briefly touch on sedation and restraint. We also discuss and show the basic floating techniques and the use of the different instrumentation."

The AAEP sends out equipment that provides the most important items necessary to do a proper dental examination and treatment.

Because of concerns surrounding who should be the appropriate person to perform dentistry on horses—a lay person or a veterinarian—Whittle says, "We have tried to stress that you really can't do anything without a proper physical examination of the oral cavity, as well as a general health history of the horse. Proper dentistry, therefore, should be left to the licensed equine veterinary practitioner."

Stephen Galloway, DVM, an equine fellow of the Academy of Equine Dentistry, chairman of the AAEP Dentistry Committee in 2011 and owner of Animal Care Hospital in Somerville Tenn., also conducts the dentistry short course. He has been actively involved in planning and executing the dental short course program for many years.

"Since the majority of the horses that veterinarians see in general practice have some degree of dental disease, it is personally rewarding to teach students techniques and procedures that they can use daily to improve the health of their patients," Galloway says. "The students are very open to new concepts, especially to equine dentistry, which is not a major part of the veterinary curriculum at most schools. And it's refreshing that most students have not been exposed to the nonveterinary equine dental procedures and philosophies that have been practiced during the past 20 years. It's easier to teach students with unbiased open minds."

Since most of the fourth-year students are involved with clinical rotations and many of the third-year students have other priorities, most of the students participating in the dental courses are first- and second-year veterinary students.

"Typically, we try to minimize the lecture portion and focus on the lab portion of the course because these students normally spend eight hours a day in lectures," Galloway says. "We try to do most of our training in a case-based lab format. For example, in the cadaver lab, the students will perform and document their oral examinations, identify pathologies and make the associated diagnoses, formulate a treatment plan and perform nerve blocks and dental procedures. The students practice on the cadavers until they're comfortable with the instruments and procedure.

"On the last day of the course, under the supervision of the instructors, they examine and perform dental procedures on live horses," Galloway continues. "They get real-world experience in a controlled environment."

So what's the student perspective? "We have 30 students sponsored for the dental short course that will take place October 12, 2012," says Patrick First, a veterinary student and AAEP student chapter member at Mississippi State University College of Veterinary Medicine. The course will be a collaboration of the local dental club of 10 members and 20 AAEP student chapter members. The course will be held over one weekend, including a Friday lecture on oral anatomy and dental procedures, with most of Saturday consisting of a wet lab using cadaver heads and Sunday using live horses on which various dental procedures will be performed.

"We should have a pretty good turnout," First says. Although at press time student signups were incomplete for this year's course, two years ago the course had an excellent response. "My fiancée, a senior now, mentioned that she was very pleased by the course and got a lot out of it," First says. "She said it was very helpful, so we decided to do it again. We're all looking forward to it."

For First, equine medicine is his emphasis since he has trained horses and given riding lessons. "Horses have always been my passion," First says. "I got involved with the AAEP chapter organization through veterinary student friends my freshman year. We did a few things, held our own dental wet lab, though not as organized as the short course we're doing this year. I got real excited about that. I then worked with veterinarians doing dentals. Equine dentistry is just something that interests me, and I got to know several other AAEP students with a strong interest in equine dentistry, so that fostered our interest in getting this course done this year."

The dental short course was recently completed at the University of California-Davis (UC Davis) in August. The focus was on oral examinations and pathology. Most of the lecture material was based on practical dentistry, as well as some common pathology and instrumentation. Because of some difficulties, the students did not have a chance to work with live animals at this particular session. The course included about 14 students with one AAEP veterinarian, an ideal number of students to instruct.

"This was the first time that UC Davis used the cadaver head, which was very helpful," says Tyler Newton, a UC Davis veterinary student and AAEP student chapter co-president. "The students definitely enjoyed the cadaver head portion, as they did not have to worry about the horse at all—getting bit or kicked or the horse moving its head in opposition to the oral exam procedures.

"All in all, the coursework was very good," Newton continues. "The materials were good as provided, and the knowledge that the students gained was very positive. We cover a lot of material as part of our equine track, and the hands-on experience of the short course was definitely worth it. It's kind of a nice supplement to our curriculum."

Podiatry and farrier short course

Under the guidance of the AAEP student chapters, the podiatry course work is voluntary, which provides a great service for those students who participate. Each veterinary school offers the course every three years. Because there are 36 veterinary schools in North America and the West Indies, it is necessary to schedule the coursework out to limit the work for the instructors.

"The podiatry course came about because there was a lack of basic podiatry information, basic horseshoeing information, and foot-trimming in the veterinary curriculum," says Tracy Turner, DVM, MS, DACVS, of Anoka Equine Veterinary Services in Minnesota, a podiatry short course instructor. "The idea of the course was to allow students a hands-on opportunity for learning about what constitutes good trimming, good hoof care."

A major benefit of the course is the student interaction and lab portion, but first the basics are covered. "What we do in preparation is a lecture to get everybody on the same page," Turner says. The wet lab is designed to have a high instructor-to-student ratio. The AAEP brings in local farriers so that a large number of instructors is available to assist students in the lab.

"We begin with cadaver limbs and then hook them up to mimic what the proper posture is and to let them go through the process," Turner says. The students then have one-on-one instruction as to how to perform proper foot care—what it feels like, what to look for, how to trim and shoe. Sometimes they also have live demonstrations. "It's basically a hands-on course, which has really not changed over the past 20-plus years we've been doing it," Turner says.

The students get to interact with horses and meet local farriers. They also have a chance in the future to ride with the farriers to get more experience. "They get to understand the bridging of the two professions," says Turner. "It's a good opportunity to begin to build relationships early in their careers. Part of the whole idea is for the veterinary students to get a better respect for the farriers and their profession. They learn how to talk to farriers, work with farriers, and help to increase the healthcare of the horses."

"When I took the course, I was a second-year student," says Kathryn Livesey, now a third-year student at the University of Wisconsin School of Veterinary Medicine. Livesey was always interested in horses and rode for the University of Wisconsin Equestrian Team.

"I was mostly interested in the farrier course as a great opportunity to interact with local farriers," Livesey says. "There were quite a few local farriers to come and help us with the lab portion of the course. In addition, a farrier was sent by AAEP from California as well as Dr. Turner, the instructing veterinarian. With some additional university participating veterinarians, there was a very good ratio of instructors to students. All were absolutely wonderful, very knowledgeable, very willing to help and explain. The lectures were wonderful, and it was very helpful to get the hands-on experience.

"In the past, I'd seen farriers trimming or shoeing and veterinarians working on horses feet, but I had not had the experience of watching how well the two professions worked together, especially to solve the difficult cases and see how valuable a farrier could be," continues Livesey. "Since that course, I've spent time with local farriers to get even more experience watching and working with them. Two of the farriers are associated with the university, so I have had good access working with them, as well as with the other farriers I met through the course."

Livesey says she hopes to continue to be involved in equine podiatry and participated again in the AAEP farrier course offered on Sept. 15.

Ed Kane, PhD, is a researcher and consultant in animal nutrition. He is an author and editor on nutrition, physiology and veterinary medicine with a background in horses, pets and livestock. Kane is based in Seattle.