Rappie Posted November 20, 2010 Share Posted November 20, 2010 So Rappie, were they not doing them when you went through? How did you know if you hadn't tied something off right? Some of the things Boss man did when he went through, sounded pretty complex and not something I could imagine you could do on a cadaver. Do you think only working with cadavers was a disadvantage? No, they stopped a few years before I started the the course. I don't think it was a significant disadvantage, although sometimes I do think it would have been useful to have done some procedures before graduating. In honesty though, having good basic surgical skills and knowledge of good surgical technique are more important than whether you can do a Billroth II procedure or relocate an ectopic ureter by the time you graduate. In a time of high pressure, I don't know that having done something once at uni is going to make that much of a difference. There is no shame in reading a surgery textbook before doing a new procedure and they all describe the same kind of 'generic' skills - identify, dissect, ligate, divide, appose, reflect etc. Once you can do those things, the specific location is not so important. I did extramural rotations in private practice during uni to get some additional experience, including at the RSPCA. I haven't found it a significant issue in any of the jobs I've had as a vet either, mostly I've had good mentors who are happy to watch / assist when doing something new. I don't do much orthopaedic surgery, but that is not anything to do with what I did or didn't do at university, but a reflection of what comes through the doors and the fact that we have an awesome surgical specialist nearby that does an excellent job on ortho cases. So, its OK to use dogs that have been PTS at the pound, but its not OK to use dogs that are GOING to be PTS at the pound? What is the difference? They are considered to be ethically sourced. The cadavers are not PTS at the pound for the use of the university, but with the approval of the ethics committee, the uni may source cadavers from the pound for the purposes of student training. If no dogs were PTS, we learnt surgical skills in other ways - foam models, plating plastic bones etc. I think having to work with an already decomposing dog, instead of a freshly dead one, does not encourage respect for the animal they are working on. All the students treated the animals, alive or dead with great respect. We were learning surgical techniques and we wouldn't have that opportunity without them, why wouldn't we treat them that way. Apart from the 'living' status our patients we were expected to, and did, treat them as we would any other patients. Nothing unnecessary was done, wounds were always closed fully after we had finished. Even in anatomy, where one group would have a preserved cadaver for the entire semester, they never got 'dumped' on the tables, we cringed and said sorry if we had to do something particularly invasive. The fact that you get used to being around dead animals doesn't mean you care any less. We all approached that part of our studies with a sense of purpose, it wasn't any less important because our 'patients' couldn't bleed. As for the other questions about how do you deal with things that bleed - you apply pressure or swabs, find what is bleeding, clamp and ligate. You have a reasonable idea of which vessels you will come across, which ones you are ligating routinely, and if you're using careful surgical technique then there is going to be less bleeding anyway. Link to comment Share on other sites More sharing options...
raz Posted November 20, 2010 Share Posted November 20, 2010 we learnt surgical skills in other ways - foam models, plating plastic bones etc. How do you learn to tie off a gushing artery if you're using a foam model? Link to comment Share on other sites More sharing options...
Rappie Posted November 20, 2010 Share Posted November 20, 2010 (edited) we learnt surgical skills in other ways - foam models, plating plastic bones etc. How do you learn to tie off a gushing artery if you're using a foam model? You learn to ligate vessels that are not gushing. Nice, intact ones like you find doing speys and castrates. By learning good technique, you reduce the risk of being the cause of the gushing artery. I mentioned the 'how' in the last part of my post - identify, clamp, ligate. Sure, a wash of blood gets your own blood pumping a bit faster but the approach it the same, you don't just stand there are gawk at it. Edited November 20, 2010 by Rappie Link to comment Share on other sites More sharing options...
raz Posted November 20, 2010 Share Posted November 20, 2010 You learn to ligate vessels that are not gushing. Nice, intact ones like you find doing speys and castrates. I mentioned the 'how' in the last part of my post - identify, clamp, ligate. Sure, a wash of blood gets your own blood pumping a bit faster but the approach it the same, you don't just stand there are gawk at it. Sure for sure but I'm just really curious about foam models and how it prepares a vet student for blood suddenly spraying all over the ceiling. I know fx artists in the film industry who make realistic models and I cant think how Syd Uni pays for that stuff. It's really really expensive. I was talking to a phlebotomist just the other day (something totally unrelated to this thread) who said once the artery goes, it's like a bomb going off. Seriously, is a foam model going to prepare you for a real life situation and someone's family member on the table? Link to comment Share on other sites More sharing options...
Rappie Posted November 20, 2010 Share Posted November 20, 2010 Well the models were only when there was nothing else to practice on. Mainly for trying out suture patterns and seeing how they work to spread out pressure etc. Model is probably a very generous term, it was 3 different thicknesses of foam glued together and then fashioned into a tube, supposed to represent tissue layers. Elaborate, maybe not but useful for what we needed to do. Tie too tight and the foam puckers, too loose and it will spring apart. Link to comment Share on other sites More sharing options...
raz Posted November 20, 2010 Share Posted November 20, 2010 Well the models were only when there was nothing else to practice on. Mainly for trying out suture patterns and seeing how they work to spread out pressure etc. Model is probably a very generous term, it was 3 different thicknesses of foam glued together and then fashioned into a tube, supposed to represent tissue layers. Elaborate, maybe not but useful for what we needed to do. Tie too tight and the foam puckers, too loose and it will spring apart. God it's fascinating for a lay person. Thanks rappie. So as a student, would you have preferred working on a model or a live animal? What would you have thought back then would best prepare you for working on someone's family member? ( I'm just now really interested in what vet students think about how they learn and prepare for cutting open an animal in the real world) Link to comment Share on other sites More sharing options...
Rappie Posted November 20, 2010 Share Posted November 20, 2010 (edited) Really, I think the cadavers were a decent compromise. Adapting to living tissue was not as much of an issue as I initially thought it might be, in some cases, I think having the opportunity to do things in a lower stress environment is much better because there was less multitasking. When you start doing surgery, there are so many little things that stress you out - maintaining sterility, whether things will start bleeding at you, trying not to drop instruments, getting accustomed to wearing a face mask, gown, cap (it can get quite claustrophobic and incredibly hot) etc. So in the regard, doing exactly those things with a non living patient means you can concentrate on what you're doing without causing harm. The tissues are still made of the same stuff, they are found in the same places and for the most part still behave in a similar way (intestines are slippery, liver is friable etc) so you can learn how to tackle them. I know I keep going on about surgical skills being more important than having done fabulous surgeries, but there is no use being able to do awesome stuff if you tie sutures too tight, or you crush tissue with your forceps or make all the nurses hold their breath and pray when you pick up scissors or a scalpel. Obviously the first time you do surgery on a 'real' patient is stressful and you have to learn to deal with a few new things, breathing for one and bleeding for two. I guess here though everyone was aware of our limitations and we started out on easy stuff, and then you start to up skill. Cat castrates lead to dog castrates, lead to cat speys, lead to dog speys. My biggest concern was not really whether I could do something, but whether I knew what to do. I like to be prepared, I like to write lists, I like procedural algorithms. We were forever being told about 'first principles' and wondering what the hell people were talking about - with surgery it become fairly simple. If it's bleeding, stop it.. If it's closed and you need to see inside it, open it.. If it's open, close it etc. Edited November 20, 2010 by Rappie Link to comment Share on other sites More sharing options...
raz Posted November 20, 2010 Share Posted November 20, 2010 Thanks rappie. Your responses are really professional. Link to comment Share on other sites More sharing options...
Alibi Posted November 20, 2010 Share Posted November 20, 2010 Im going to put my head on the chopping block here. I work for UQ as an animal technician looking after lab animals. It is grossly misleading to compare the bad old days to what happens now. Most people who do this job are animal lovers (i was a vet nurse for 7yrs), and would not be in this industry if it was so horrific as people think. The dogs that are used for the vet school are extremely well looked after and loved untill they are used or used then rehomed. A brand new state of the art facility has recently been built with play gyms and sand pits for the dogs. The people who run it are very much for humane and respectful treatment of these animals. It is really unfair too to just pick on vets using animals in non recovery practice as human doctors use them too, these animals that i have been involved with would otherwise have ended up at the meatworks. There is no pain or suffering involved for them at all as they are treated fantastically before and during the procedures. Link to comment Share on other sites More sharing options...
raz Posted November 20, 2010 Share Posted November 20, 2010 No chopping block from me. Good on you, melt. My bro has also used live animals - so the people screaming can have their bloody children live a long and healthy life. I dont have a problem with it - no way in hell would I sign that petition Link to comment Share on other sites More sharing options...
sllebasi Posted November 20, 2010 Share Posted November 20, 2010 + 1 I am not signing the petition Link to comment Share on other sites More sharing options...
WoofnHoof Posted November 21, 2010 Share Posted November 21, 2010 Really, I think the cadavers were a decent compromise. Adapting to living tissue was not as much of an issue as I initially thought it might be, in some cases, I think having the opportunity to do things in a lower stress environment is much better because there was less multitasking. When you start doing surgery, there are so many little things that stress you out - maintaining sterility, whether things will start bleeding at you, trying not to drop instruments, getting accustomed to wearing a face mask, gown, cap (it can get quite claustrophobic and incredibly hot) etc. So in the regard, doing exactly those things with a non living patient means you can concentrate on what you're doing without causing harm. The tissues are still made of the same stuff, they are found in the same places and for the most part still behave in a similar way (intestines are slippery, liver is friable etc) so you can learn how to tackle them. I know I keep going on about surgical skills being more important than having done fabulous surgeries, but there is no use being able to do awesome stuff if you tie sutures too tight, or you crush tissue with your forceps or make all the nurses hold their breath and pray when you pick up scissors or a scalpel. Obviously the first time you do surgery on a 'real' patient is stressful and you have to learn to deal with a few new things, breathing for one and bleeding for two. I guess here though everyone was aware of our limitations and we started out on easy stuff, and then you start to up skill. Cat castrates lead to dog castrates, lead to cat speys, lead to dog speys. My biggest concern was not really whether I could do something, but whether I knew what to do. I like to be prepared, I like to write lists, I like procedural algorithms. We were forever being told about 'first principles' and wondering what the hell people were talking about - with surgery it become fairly simple. If it's bleeding, stop it.. If it's closed and you need to see inside it, open it.. If it's open, close it etc. Thanks for your input Rappie it's interesting to hear from someone whose been though the course without non recoveries, I remember when I did dissections at uni there wasn't that much difference between refrigerated cadavers that had been there for ages and live animals and as you say the skills are applicable across the board whether there is blood coming out or not. They had some dissected hooves at equitana which of course was very interesting but personally I don't see the difference between a real hoof and a picture of a dissected hoof, apart from the smell they have similar educational value. I suppose it depends on your learning style but personally I see no real need to have a smelly dead leg in front of me when a photo in a textbook will show me the same thing. I can and have treated plenty of leg and hoof injuries without having to have pulled apart a dead one. Link to comment Share on other sites More sharing options...
Staranais Posted November 21, 2010 Share Posted November 21, 2010 I've got to say there were a few animal dissections early in our course which I got little value from (doing physiology experiments with fresh rabbit intestine, for example, taught me nothing I couldn't have gotten from the text book). I could have learned that stuff just as easily from a text book. I'd rather see those dropped from the course before our non recovery surgeries got dropped. Link to comment Share on other sites More sharing options...
raz Posted November 21, 2010 Share Posted November 21, 2010 I've got to say there were a few animal dissections early in our course which I got little value from (doing physiology experiments with fresh rabbit intestine, for example, taught me nothing I couldn't have gotten from the text book). I could have learned that stuff just as easily from a text book. I'd rather see those dropped from the course before our non recovery surgeries got dropped. Interesting. How do you learn skills with say a scalpel or IV injections if you're only looking at pictures? I just cant comprehend how a student can gain any competence without hands on experience anymore so than I could learn to fly a plane by looking at graphics. As said earlier, I would not let a grad near my dogs if he or she had only looked at pictures in books Link to comment Share on other sites More sharing options...
sllebasi Posted November 22, 2010 Share Posted November 22, 2010 nothing beats practical experience and I wouldnt be too keen on a vet not having some practical experience Link to comment Share on other sites More sharing options...
Rappie Posted November 22, 2010 Share Posted November 22, 2010 We learnt to place IV catheters in live patients when we were on our anaesthesia rotation. Every patient going under sedation or GA gets an IV cath, so over a month there were plenty of chances. Same with inducing GA and intubating, we did the real thing with a member of the anaesthesia staff standing right beside us. Link to comment Share on other sites More sharing options...
raz Posted November 22, 2010 Share Posted November 22, 2010 We learnt to place IV catheters in live patients when we were on our anaesthesia rotation. Every patient going under sedation or GA gets an IV cath, so over a month there were plenty of chances. Same with inducing GA and intubating, we did the real thing with a member of the anaesthesia staff standing right beside us. Thanks Rappie. That makes sense. Link to comment Share on other sites More sharing options...
Quickasyoucan Posted November 22, 2010 Share Posted November 22, 2010 I hate the idea of animals being used for experiments for non-necessary things like cosmetics, but we are talking about a whole different thing here. My dog recently had a cruciate op at the University of Sydney Teaching hospital and they have been absolutely fantastic. The reason I mention this is one of the reasons I chose them is precisely because they ARE a teaching hospital. Every visit we had we had vet students take a history and then they presented to the specialist who did his own examination. A bit like if you ever go to hospital and get seen by a resident first. One of the registrars did say to me that some people don't like to have to see the vet students first, but I think it is so important that vet students get supervised access to live animals and live owners too!!! :D Didn't bother me at all that consults were a bit longer and in fact meant things were explained really clearly to me. I am sure that my boy had a whole host of students standing round the operating table and they were involved in after care as well. My boy got top rate surgery and after care (his recovery has been amazing) and students got to learn at the same time. Now I know that is not non-recovery surgery but I like the fact that his successful operation has had a dual benefit. ;) The dogs are in the pound because of other people's lack of care, seems a shame to put the blame on people working for the good of animals. Link to comment Share on other sites More sharing options...
raz Posted November 22, 2010 Share Posted November 22, 2010 The dogs are in the pound because of other people's lack of care, seems a shame to put the blame on people working for the good of animals. Yep I totally agree with you. Link to comment Share on other sites More sharing options...
whippets Posted November 22, 2010 Share Posted November 22, 2010 You can't learn everything from a book. When I did my Bachelors of Nursing (humans) we had 4 weeks of clinical placements in hospitals each semester. We learned: taking bloods, IDC insertions and starting IVC's to name a few. We first learned injections and IVC's on an artificial arm and believe me it is NOTHING like the real thing. Link to comment Share on other sites More sharing options...
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