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The collection of cerebrospinal fluid (CSF) plays a pivotal role in the diagnosis of central nervous system diseases. Prior training in this invasive procedure is essential to minimize the risk of harming animals. Because of this risk, stress and anxiety can influence the learning process. Simulators can be used to teach and learn invasive procedures. The aim of this mixed-methods study was to validate a CSF collection simulator and investigate students’ perceptions of the simulator as an educational tool. The quantitative approach validated the simulator for face and content validity, and students provided a general evaluation of the simulator using surveys. The simulator’s construct validity was measured by means of a global rating scale. Students’ perceptions were investigated qualitatively using semi-structured interviews. Experts (n= 13) confirmed the simulator’s face and content validity. Students (n= 16) evaluated the simulator as supportive of their learning. Results for construct validity demonstrated higher global rating scores from experts than from students. The scores for procedural performance and procedural knowledge and flow showed significant differences (p≤ .05). Analysis of interviews with students (n= 10) revealed four main themes: emotions, learning process, evaluation of the model, and CSF collection procedure. In conclusion, this study validated the use of the CSF simulator as an educational tool that can help students overcome some of their anxiety in relation to performing an invasive procedure.

With the aim of improving students’ ability to handle the complexity of surgery, we introduced a creative assignment in a veterinary surgical course. We hypothesized that by using this active, inductive educational method, reflection, creativity and self-efficacy in student novice surgeons could be improved. During a companion animal surgical course an intervention group was investigated against a control group. Twenty-nine fourth-year students were instructed in ovariohysterectomy by classical lectures, while 23 fourth-year students were provided with creative materials and assigned to consider and illustrate how to perform the procedure themselves. Surgical performance was assessed for both groups using a modified Objective Structured Assessment of Technical Skills (OSATS) while performing a simulated ovariohysterectomy. Furthermore, both groups were investigated with respect to how they would handle a specific hypothetical surgical complication. Semi-structured interviews were conducted with 17 intervention-group students and were analyzed using thematic analysis. The intervention group showed a significantly better performance and needed significantly less help with the surgical complication than the control group students. Data from interviews furthermore demonstrated that students believed the creative intervention produced increased reflection, more creative initiatives, and a feeling of security before surgery. Our study results thus indicate that an educational tool which stimulates creative thinking can promote reflection, creativity, and self-efficacy in novice surgeons without compromising surgical performance.

In recent years, veterinary educational institutions have implemented alternative teaching methods, including video demonstrations of surgical procedures. However, the power of the dynamic visual input from videos in relation to recollection of a surgical procedure has never been evaluated. The aim of this study was to investigate how veterinary surgical students perceived the influence of different educational materials on recollection of a surgical procedure. Furthermore, we investigated if surgical technique was associated with a certain method of recollection or use of educational material. During a basic surgical skills course, 112 fourth-year veterinary students participated in the study by completing a questionnaire regarding method of recollection, influence of individual types of educational input, and homework preparation. Furthermore, we observed students performing an orchiectomy in a terminal pig lab. Preparation for the pig lab consisted of homework (textbook, online material, including videos), lecture, cadaver lab, and toy animal models in a skills lab. In the instructional video, a detail was used that was not described elsewhere. Results show that 60% of the students used a visual dynamic method as their main method of recollection and that video was considered the most influential educational input with respect to recollection of a specific procedure. Observation of students' performance during the orchiectomy showed no clear association with students' method of recollection but a significant association (p.002) with educational input. Our results illustrate the power of a visual input and support prior findings that knowledge is constructed from multiple sources of information.

When veterinary students face their first live animal surgeries, their level of anxiety is generally high and this can affect their ability to recall the procedure they are about to undertake. Multimodal teaching methods have previously been shown to enhance learning and facilitate recall; however, student preferences for recollection methods when translating theory into practice have not been documented. The aim of this study was to investigate veterinary students' experience with recollection of a surgical procedure they were about to perform after using multiple methods for preparation. From a group of 171 veterinary students enrolled in a basic surgery course, 26 students were randomly selected to participate in semi-structured interviews. Results showed that 58% of the students used a visual, dynamic method of recollection, mentally visualizing the video they had watched as part of their multimodal preparation. A mental recipe was used by 15%, whereas 12% mentally visualized their own notes. The study provides new information regarding veterinary students' methods of recollection of surgical procedures and indicates that in Danish veterinary students, a visual dynamic method is the most commonly used. This is relevant information in the current educational situation, which uses an array of educational tools, and it stresses the importance of supporting the traditional surgical teaching methods with high-quality instructional videos.

The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination Skills); both courses were offered in multiple classes (with a total of 171 students in 2009 and 156 students in 2010). All classes in 2009 participated in the SSL stage of the Basic Surgical Skills course before performing live-animal surgery, and one class (28 students) in 2010 did not. Two validated anxiety questionnaires (Spielberger's state-trait anxiety inventory and Cox and Kenardy's performance anxiety questionnaire) were used. Anxiety levels were measured before the non-surgical course (111 students from 2009) and before live-animal surgery during the surgical course (153 students from 2009 and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p<.001), and that practicing in a SSL helps reduce anxiety before live-animal surgery (p<.005).

A surgical educational environment is potentially stressful and can negatively affect students' learning. The aim of the present study was to investigate the emotions experienced by veterinary students in relation to their first encounter with live-animal surgery and to identify possible sources of positive and negative emotions, respectively. During a Basic Surgical Skills course, 155 veterinary fourth-year students completed a survey. Of these, 26 students additionally participated in individual semi-structured interviews. The results of the study show that students often experienced a combination of emotions; 63% of students experienced negative emotions, while 58% experienced positive ones. In addition, 61% of students reported feeling excited or tense. Students' statements reveal that anxiety is perceived as counterproductive to learning, while excitement seems to enhance students' focus and engagement. Our study identified the most common sources of positive and negative emotions to be “being able to prepare well” and “lack of self-confidence,” respectively. Our findings suggest that there are factors that we can influence in the surgical learning environment to minimize negative emotions and enhance positive emotions and engagement, thereby improving students' learning.