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The Future of Veterinary Medical Education Andrew T. Maccabe, DVM, MPH, JD Chief Executive Officer International Conference on Veterinary Eligibility and Education
Tokyo November 21, 2018
International Membership
49VeterinaryMedicalColleges• 30intheUnitedStates• 5inCanada• 6inEurope• 5inAustraliaandNewZealand• 3inMexicoandtheCaribbean
25AffiliateMembers• 14DepartmentsofVeterinaryScienceandComparaJveMedicine
• 11CollegesofVeterinaryMedicinenotaccreditedbyCOE
• UniversityofTokyo,Japan
• SeoulNaJonalUniversity,Korea
• CityUniversityofHongKong
• RipahInternaJonalUniversity,Pakistan
• UniversityofLahore,Pakistan
• UnitedArabEmiratesUniversity
Mission Statement
AAVMCpromotesandprotectsthe
healthofpeople,animalsandthe
environmentbyadvancingveterinary
medicaleduca;onandprovidingnew
genera;onsofveterinarianswiththe
scien;ficknowledgeandskillsto
meettheevolvingneedsofa
changingworld
Areas of Emphasis
EducaJonProvidingqualitycareforpeopleandanimalsinarapidly
changingworlddemandseduca;onalexcellence
ResearchVeterinarymedicineplaysanessen;alroleinbasicandappliedresearchthatadvancesanimalandhumanhealth
RecruitmentVeterinarymedicinerequiresthebestandbrightest
studentsfrommanydifferentbackgrounds
DiversityAchievinggreaterdiversityandraisingawarenessofdiversity-relatedissuesimprovesqualityofcare
OneHealthCrea;ngsynergyamonganimalhealth,humanhealth
andtheenvironmenttoaddressGlobalGrandChallenges
Achieving Educational Excellence
Providingqualitycareforpeopleandanimalsinarapidlychangingworlddemands
educa;onalexcellence
• FacilitateinstrucJonalexcellence• VeterinaryEducatorsCollaboraJve(VEC)• PrimaryCareVeterinaryEducators(PCVE)
• Traintoday’sveterinariansfortomorrow’schallenges
• CompetencyBasedVeterinaryEducaJon(CBVE)
• EntrustableProfessionalAcJviJes(EPA)
• FosterinternaJonalengagement• CouncilonInternaJonalVeterinaryMedicalEducaJon(CIVME)
The Social Contract
Inreturnforaccesstotheirextraordinaryknowledgeinma\ersofgreathumanimportance,societyhasgrantedprofessionalsamandateforcontrolintheirfieldsofspecializaJon,ahighdegreeofautonomyintheirpracJce,andalicensetodeterminewhoshallassumethemantleofprofessionalauthority
DonaldSchon,Educa;ngtheReflec;vePrac;;oner(1987)
The Social Contract
ThepublichasgrantedusextraordinaryandexclusivedispensaJontoadministerdrugstopeople,eventothepointofunconsciousness,tocutthemopen,todowhatwouldotherwisebeconsideredassault,becausewedosoontheirbehalf–tosavetheirlivesandprovidethemcomfort.
AtulGawande,BeIer(2007
Is the veterinary medical profession mee8ng its end of the bargain?
The Social Contract
Arewebenevolentguardians
ofknowledgeandexperJse,
providingaccessiblecare?
Arewejealousgatekeepers,
fencingoffservicesinalegal
monopolythatlimitscompeJJon?
The Future of the Professions
• ExperJse(specializedknowledge)isthemostimportantcharacterisJcoftheprofessions
• KnowledgeisnowwidelyaccessibleandisbecomingdemocraJzed
• TechnologywillchangethewaythepublicgetsaccesstoprofessionalexperJse
Increasinglycapablesystems
The Future of the Professions
The Role of Technology
• ExponenJalincreaseintechnologieslikecomputers,geneJcs,nanotechnology,roboJcs,andarJficialintelligence
• Technologicalsingularityintheyear2045,apointwhereprogressissorapiditoutstripshumans'abilitytocomprehendit
LawofAccelera6ngReturns
The Role of Technology
The Role of Technology
• ExponenJalincreaseintechnologieslikecomputers,geneJcs,nanotechnology,roboJcs,andarJficialintelligence
• Technologicalsingularityintheyear2045,apointwhereprogressissorapiditoutstripshumans'abilitytocomprehendit
LawofAccelera6ngReturns
The Role of Technology
How We Learn
Uniquely Individual- Abstract thought- Active learning- Higher order cognition
Personalized Teaching- Customized- Instant feedback- Self-paced- Adaptive
The Future of Teaching and Learning
How We Learn The Future of Higher Educa8on
Higher education is ripe for disruptive innovation
• Not much has changed in 150 years• Inefficient and conflicted• Education is disfavored• Innovation is stifled
Institutional isomorphism
How We Learn The Future of Higher Educa8on
What technological
advancements have changed the nature of education?
How We Learn The Future of Veterinary Medical Educa8on
Competencybased
Timevariable
OpenLoop
“Humanics”
Diversity
“The intended output of a competency-based program is a health professional who can practice medicine at a defined level of proficiency, in accord with local conditions, with local needs”
- McGahie, W. C., et al (1978)
“Competency-based education is an approach to preparing professionals for practice that is fundamentally oriented to graduate outcome abilities and organized around competencies derived from an analysis of societal and patient needs.
- Frank, J.R., et al (2010)
Competency-based Training and Assessment
“The intended output of a competency-based program is a health professional who can practice medicine at a defined level of proficiency, in accord with local conditions, with local needs”
- McGahie, W. C., et al (1978)
“Competency-based education is an approach to preparing professionals for practice that is fundamentally oriented to graduate outcome abilities and organized around competencies derived from an analysis of societal and patient needs.
- Frank, J.R., et al (2010)
Competency-based Training and Assessment
Focusonoutcomes,emphasizeabiliJes
ShihfromJme-basedtrainingto
competency-basedassessment
Shihfromfaculty-centeredteachingto
student-centeredlearning
Outcomesassessmentmeasuresthataddressthecollegemissionmustbedevelopedandimplemented.Outcomesassessmentresultsmustbeusedtoimprovethecollegeprograms.
ApprovedJune2002
OutcomesoftheDVMprogrammustbemeasured,analyzed,andconsideredtoimprovetheprogram.Studentachievementduringthepre-clinicalandclinicalcurriculumandahergraduaJonmustbeincludedinoutcomeassessment.
VeterinarygraduatesmusthavethebasicscienJficknowledge,skills,andvaluestoprovideentry-levelhealthcare,independently,attheJmeofgraduaJon.Ataminimum,graduatesmustbecompetentinprovidingentry-levelhealthcareforavarietyofanimalspecies.
ApprovedSeptember2011
Council on Education, Standard 11 Outcomes Assessment
1. ComprehensivepaJentdiagnosis(problemsolvingskills),appropriateuseofdiagnosJctesJng,andrecordmanagement
2. ComprehensivetreatmentplanningincludingpaJentreferralwhenindicated
3. Anesthesiaandpainmanagement,paJentwelfare
4. Basicsurgeryskillsandcasemanagement
5. Basicmedicineskillsandcasemanagement
6. Emergencyandintensivecarecasemanagement
7. UnderstandingofhealthpromoJonandbiosecurity,prevenJonandcontrolofdiseaseincludingzoonosesandprinciplesoffoodsafety
8. ClientcommunicaJonsandethicalconduct
9. CriJcalanalysisofnewinformaJonandresearchfindingsrelevanttoveterinarymedicine.
Council on Education, Standard 11 Outcomes Assessment
1. MulJspeciesknowledgeplusclinicalcompetencyinoneormorespeciesordisciplines
2. OneHealthknowledge(animal,humanandenvironmentalhealth)
3. CommunicaJon
4. CollaboraJon
5. Management(self,team,system)
6. Lifelonglearning,scholarship,valueofresearch
7. Leadership
8. DiversityandmulJculturalawareness
9. Adapttochangingenvironments
NAVMEC (2011)
1. Epidemiology
2. Transboundaryanimaldiseases
3. Zoonoses,includingfoodbornediseases
4. Emergingandre-emergingdiseases
5. DiseaseprevenJonandcontrol
6. Foodhygiene
7. Veterinaryproducts
8. Animalwelfare
9. VeterinarylegislaJonandethics
10. GeneralcerJficaJonprocedures11. CommunicaJonskills
OIE (2012)
1. Clinical reasoning and decision-making 2. Individual animal care and management 3. Animal population care and management 4. Public health 5. Communication 6. Collaboration 7. Professionalism and professional identity 8. Financial and practice management 9. Scholarship
AAVMC Working Group
1. Clinical reasoning and decision-making 2. Individual animal care and management 3. Animal population care and management 4. Public health 5. Communication 6. Collaboration 7. Professionalism and professional identity 8. Financial and practice management 9. Scholarship
AAVMC Working Group
“AAVMCCBVE”hBp://www.aavmc.org/competencybasedveterinaryeduca6on/cbve-framework.aspx
• NotanalternaJveforcompetencies,butameanstotranslatecompetenciesintoclinicalpracJce
• Competenciesaredescriptorsofveterinarians
• EPAsaredescriptorsofwork• EPAsusuallyrequiremulJplecompetenciesinanintegraJve,holisJcnature
tencate,O.Nutsandboltsofentrustableprofessional
acJviJes.JGradMedEd,March2013.
EntrustableProfessionalAc=vi=es
Competency-Based Education
• De-emphasize time-based training– Develop students’ abilities– Flexible, individually-oriented curriculum
• Promote learner-centeredness– Students take responsibility for their own learning– Develop skill in seeking and providing feedback
Competency-Based Educa8on
How We Learn Humanics
NewLiteracies
• Dataliteracy• Technologicalliteracy• Humanliteracy
CogniJveCapaciJes
• Systemsthinking
• Entrepreneurship• Culturalagility• CriJcalthinking
The Future of the Professions
EmergingSkillsandCompetencies
• Taskanalysis,disintermediaJon,reintermediaJon
• RelaJonshipwithtechnologyandmachines
• Masteryofdata
• Designthinking• Systemsengineering
• DiversificaJonintonewdisciplines
The Future of the Professions
Importance of Diversity
CogniJve
RouJne
DataEntry
CogniJve
NonrouJne
MedicalResearcher
Manual
RouJne
AssemblyLine
Worker
Manual
NonrouJne
NursingHome
Worker
IdenJtyDiversity
• Race
• Gender
• Age
• SexualorientaJon
• PhysicalcapabiliJes
CogniJveDiversity
• InformaJon
• Knowledge
• RepresentaJons
• Mentalmodels
• HuerisJcs
DiversityBonus
• Teamsofpeople
• Complexdisciplines
• Complexissues
Veterinary medicine is a global public good
GlobalFoodSecurity
IncreaseproducJvity
Improvedlivestockhealth
Robustpublicandprivateveterinaryservices
Highqualityveterinarymedicaleduca=on
Gainaccessto
internaJonalmarkets
IncomegeneraJon
PovertyReduc=on
Controltransboundary
animaldiseases
Reduceendemic
animaldiseases
Improveanimal
husbandry
OIEPVSPathway
• Goodgovernanceofanimalhealthsystemsbasedonaclosepublic/privatepartnershipistheresponsibilityofallgovernments.
• Ifonecountryfails,itmayendangeritsneighboringcountries,theregion,theconJnentandpotenJallytheenJreplanet.
Veterinary medicine is a global public good
Purpose of Accreditation
• AssurethequalityofeducaJon• PromoteconJnuousqualityimprovement
Develop a well-educated veterinary workforce to protect human and animal health
Purpose of Accreditation
WhoBenefits?
• Society–qualityofveterinaryservices• Students–investmentineducaJon
• Profession–competenciesofgraduates
• Schools–ongoingprocessimprovement
Elements of Accreditation
• ObjecJvestandards• InsJtuJonalself-study• Peerreview,sitevisits• Statusdecision• Monitoringandoversight
• Dueprocess,controlofCOIs
Accreditation and Quality Assurance
Promotesacultureof
ConJnuousQualityImprovement
• Data-baseddecisionmaking
• CompeJJvebenchmarking
• ChangeandinnovaJonareencouragedandvalued
Customerorienta;on
Employeeempowerment
Accreditation and Quality Assurance
EnsureseducaJonis
relevanttosocietalneeds
• Stakeholderinput• Periodicreview• Competency-based
• Outcomesassessment
Veterinary Accreditors
ABOVEK–Korea
BAPHIQ–TaiwanCHED–PhilippinesJUAA–JapanMVC–Malaysia
VCT–Thailand
AVBC–Australia
andNewZealand
EAEVE–EuropeanUnion
RCVS–UnitedKingdom
CONEVET–Mexico
COPEVET–LaJnAmerica
MercoSur–SouthAmerica
AVMA-COE–United
StatesandCanada
What if …. ?
• GlobalmarkofrecogniJon
• ImprovethequalityofveterinarymedicaleducaJonworldwide
• Protecthumanandanimalhealth
Global Recognition
“Anindependent,transparentandrigorousmethodofensuringthat
accredita;onofmedicalschoolsworldwideisataninterna;onally
acceptedandhighstandard.”
• WFMEdoesnotaccreditindividualmedical
schools
• WFMEevaluatescomplianceofaccrediJng
agencieswithpre-definedcriteria
• WFMEgeneratesmuch-neededdataabout
UGMEinternaJonally
• Veterinarymedicineisaglobalpublicgood
• ThequalityofveterinaryservicesisdirectlyrelatedtothequalityofeducaJon
• AccreditaJonensuresthateducaJonisbasedoncompetenciesthatmeetsocietalneeds
• AccreditaJonpromotesacultureofconJnuousqualityimprovement
• GlobalrecogniJonofaccreditaJonsystemswillimproveeducaJonworldwide
“Weareallinthistogether”
The future of veterinary medicine