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Additional Perspectives in Veterinary Public Health Education |
| ABSTRACT |
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Key Words: undergraduate education curriculum veterinary public health officials food control working life career path
| INTRODUCTION |
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European veterinary faculties are currently undergoing a major review as part of an effort to ensure a more integrated higher education.3–6 The area of public health has been evaluated by veterinarians, employers, and consumer associations as a growing employer of veterinarians.2,7 Furthermore, new curricula being developed at many veterinary schools are emphasizing student-centered learning over instructor-led teaching. These new curricula are also characterized by a reduction in the teaching of basic theory, a broader knowledge base, less didactic instruction, a greater emphasis on developing problem-solving skills and practical competence, increased use of multidisciplinary approaches, and an emphasis on improved communication skills.3,4
In addition, new challenges for the veterinary curriculum for VPH tasks are set out in recent EU legislation. Regulation 882/2004 of the European Parliament and European Council lays down general rules for official controls applying to all feed and foodstuffs, as well as to animal health and animal welfare, while Regulation 853/2004 outlines specific hygiene rules for products of animal origin.8,9 Both regulations contain a new detailed list of the knowledge and skills sought in an official. In Regulation 882/2004, "official control" means any form of control that the competent authority or the European Community performs for the verification of compliance with feed and food law or animal-health and animal-welfare rules.8 "Control tasks" are the various duties assigned to each official to fulfill the needs of official control performed by the national or local authority. Although the EU legislation lists the subject matter for training of staff who perform official controls, it does not define the extent to which these different areas should be included in the undergraduate or post-graduate veterinary curriculum.8 This choice depends on the organization of official control within each country and on whether a post-graduate education is obligatory for a particular position. In Finland, all newly qualified veterinarians (50–55 each year) are allowed to work as official veterinarians employed by either a municipality or the state. Therefore, the undergraduate curriculum must provide a good preparation for official control tasks.
Of the 1,100 actively working Finnish veterinarians, 36% hold positions as official municipal veterinarians. Another 11% work as state officials, and 3% in full-time meat inspection.10 The role of veterinarians in municipalities is either a combination of official control tasks and clinical work or a full-time position in food hygiene. From an international perspective, for a municipality to employ an official veterinarian is unusual. Finland is a unitary state (without a federal arrangement like that of the United States or Germany); the country is divided into municipalities, the administration of which is based on self-government by their inhabitants, who can levy taxes on their own behalf.11
To evaluate how well the undergraduate veterinary curriculum for official control related to VPH prepares graduates for work as food-hygiene officials and how the curriculum should be further developed, an electronic survey was sent to 204 Finnish veterinarians employed in the field of food hygiene. The experience of graduate veterinarians can provide valuable input for universities engaged in reviewing a veterinary curriculum, especially when the needs of society and forecasts for the future are clearly highlighted as challenges for the current curriculum. Since EU legislation in this area focuses on knowledge and skill needs, especially for food-hygiene control tasks, the survey was targeted at veterinarians who spend a significant proportion of their working hours in the field of food hygiene. In addition to prioritizing the knowledge and skills to be provided in the undergraduate curriculum, respondents were asked about motivations and work challenges.
| MATERIALS AND METHODS |
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The survey consisted of 27 questions covering current education, opinions on current working life, and career-path expectations as well as the prioritization of the undergraduate curriculum. In addition to multiple-choice questions, it included five open-ended questions and gathered basic information about respondents (for translated questionnaire, see Appendix). It was constructed using e-lomake and hosted on a University of Helsinki Web page.
Statistical Analysis
Descriptive statistics and two-tailed Spearman rank-correlation analyses were carried out using Microsoft Excel 2003b and SPSS 12.0.1.c For each question, individuals who did not respond were dropped from the analysis, resulting in varying respondent counts (n) for the different questions. To identify simple prioritization patterns of among education items, a factor analysis was performed by extraction, using principal components analysis and Varimax rotation with Kaiser normalization (6 iterations).
| RESULTS |
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Our respondents had considerable experience, having worked an average of 22.3 years (SD = 10.9 years); most of this working time (61% overall) was spent working for municipalities (see Figure 1). Respondents mean time in their current position was 10.8 years (SD = 9.0 years). At the time of the survey, 70 of 89 respondents (79%) were responsible for VPH control tasks, spending on average 67% of their working hours in this field. Most of this time was spent on inspections and sampling as well as leadership and management (see Figure 2). Legislation directly targeting the protection of public health covered, on average, 60% of respondents working hours (see Figure 3).13–15
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Evaluation of Current Education
A score for the ability of the current veterinary curriculum to prepare students for VPH control tasks was given by 84 respondents; the mean was 2.9 (1 = very poorly, 5 = very well) and the standard deviation 0.8. A higher number of working years correlated positively with positive scoring of the current education system (0.3, p < 0.001). Post-graduate training in food hygiene showed only a slight positive correlation with positive scoring of the current curriculum (0.2, p < 0.05).
In addition, 50 respondents provided written comments on education in response to the open-ended questions. Extensive education and good knowledge were most often mentioned as strengths of the current system (see Table 1). Those who graduated between 1979 and 1990 mentioned these more often (9/18, or 50%, and 7/18, or 39%, respectively) than their colleagues who graduated earlier (3/11, or 27%, and 2/11, or 18%, respectively) or later (1/21, 5%, and 4/21, 19%, respectively). This same group mentioned no problems in motivating students toward the field of VPH control tasks, whereas to three of 11 respondents who graduated before 1979 (27%) and five of 21 respondents who graduated after 1990 (24%) reported such problems.
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Improvements in the area of social aspects of VPH work (e.g., in administrative processes and decision making, leadership and management, and communication and cooperation skills) were suggested by 24 of the 50 respondents (48%). As a veterinarian who graduated in 1991 (score 2) wrote, "Studies concentrate on laboratory work, food-borne pathogens, and so on, and real leadership as head of food control, planning of control work, and municipal administrative processes did not get any attention."
Working Life
Overall, respondents were content with the various aspects of their current work and felt even more positively about their own positions (see Figure 4). They scored their jobs highest on independence, co-workers, challenges, variety of work, and importance of the work to society. Most of the challenges encountered were related to a wide field of activity, changes in organization, financial resources, organization of substitutes, and collaboration with decision makers.
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According to their responses, 68 of 89 respondents (76%) wanted to work in clinical practice immediately after graduation, whereas at the time the questionnaire was sent in 2005 only 20 (23%) wanted to do so (see Figure 5). Conversely, while only 7 of 89 respondents (8%) wanted to work in VPH control tasks immediately after graduation, 36 (41%) wanted to do so 10 years after graduation. At the time of the survey, VPH was preferred by 31 of the 46 respondents currently spending 60% or more of their working hours on VPH control tasks (67%) and by 21 of the 28 spending almost all their time (90–100%) in VPH (75%). Of those 43 respondents currently spending less than 60% of their working hours in VPH control tasks, only two indicated it as their favorite career choice. Interest in international work increased from zero at the time of graduation to 9% (8/89) at the time of the survey.
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My career has mainly been influenced by family and coincidences. First I worked as a clinician, both on emergency duty and in private practice. Gradually I became interested in more complex issues and took a post-graduate specialist degree in food and environmental hygiene. During the last 10 years, I have been drifting from one job to another. I was keen to get my current job, since its scope is quite extensive but concrete. In addition, I can benefit from my versatile experience.
A challenging and extensive area of operation was also a driving force for working in VPH control tasks for seven respondents. Other factors mentioned were health problems, a decrease in clinical practice, and a desire for change. One respondent stated that
during my studies, I was very oriented toward clinical work and not interested in VPH control. I worked a lot as a substitute, without vacations, and got a bit tired doing only clinical work. Nowadays, I find VPH control tasks and food control much more challenging compared with rural practice.
Prioritization in the Veterinary Curriculum
Based on the demands set forth in EU Regulation 882/2004 and on the social aspects of working as an official veterinarian, respondents were asked to prioritize 23 different teaching items: "How should the following items be prioritized in the undergraduate veterinary curriculum to prepare students for work in the field of VPH control?" (see list of items in Table 2; 1 = highest priority, 4 = lowest priority in undergraduate education, 5 = should be available only in post-graduate education). The highest priority was given to legislation (mean = 1.6, SD = 0.7); in-house control systems (mean = 1.8, SD = 0.8); risks to human, animal, and plant health (mean = 1.8, SD = 1.0); organizations and responsibilities (mean = 1.9, SD = 0.9); state and local decision making (mean = 2.0, SD = 0.9); the role of the public servant (mean = 2.0, SD = 1.0); hazards in feed, animal, and food production (mean = 2.0, SD = 0.9); different control techniques (mean = 2.1, SD = 1.1); planning and targeting of control (mean = 2.1, SD = 1.3); legal proceedings and implications of controls (mean = 2.3, SD = 1.2); and leadership and management (mean = 2.4, SD = 1.4) (see Figure 6).
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To identify those items in the undergraduate veterinary curriculum that most warrant attention, the prioritization of teaching items was combined with the four education areas identified by the factor analysis. The left-hand column of Figure 6 identifies the teaching items in each of the education areas (A–D) that the respondents would prioritize most highly in the undergraduate veterinary curriculum. For instance, in the area of social factors, the respondents suggested that special attention be paid to state and local decision making, the role of public servants, and leadership and management.
| DISCUSSION |
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Respondents considered the main challenges in their current work to be social ones: organizational changes, financial resources, organization of substitutes, and collaboration with decision makers. By contrast 83% of respondents gave a positive evaluation of their own know-how (see Figure 4). In the United States, several similar types of competence gaps (e.g., managing human resources and decision making, organization/prioritization, supervisory skills, leadership, conflict management, team building, interpersonal skills, and oral and written communication) have been identified among veterinary professionals.16 More generally, this broader perspective of competence accords with Hager and Gonczi, who define competence as the possession of knowledge of appropriate sorts and skills as well as abilities such as problem solving, analysis, communication and pattern recognition and appropriate attitudes.17 It is not surprising, therefore, that in the area of social factors to be covered by the undergraduate curriculum, respondents prioritized state and local decision making, the role of public servants, and leadership and management (see Figure 6). Furthermore, 16 of 50 responses to open-ended questions on education (32%) mentioned decision making and, especially, local administration as areas requiring improvement in undergraduate education (see Table 1).
In addition, the results reveal very clearly that motivation to engage in VPH tasks was not high immediately after graduation even among respondents who currently work in this field (see Figure 5). This fact poses a challenge to the education system, since motivation is a key element for successful learning. In order to increase curricular attention to social aspects of veterinary work and to improve students interest in VPH, students who began their education in autumn 2004 took a course entitled The Veterinarian as an Authority during their third year of studies, beginning in 2007. This course was allocated 3 credits within the European Credit Transfer and Accumulation System (ECTS), a student-centered system based on the student workload required to achieve the objectives of a program—objectives preferably specified in terms of learning outcomes and competencies to be acquired.18 The new course covers three areas: (1) legal aspects of working as a veterinary officer, (2) leadership and management, and (3) communication. Situated in the middle of the six-year curriculum, before the clinical phase begins, it is intended to continue to motivate students as they enter their sixth year of studies.
Respondents to the VET 2020 survey prioritized deeper practical and clinical experience among improvements in veterinary education.2 Our survey results indicate that the practical experience gained during undergraduate studies should also be extended to cover the VPH control tasks of veterinarians. Experts from ministries, central authorities, provinces, and municipalities could be valuable teachers in this area; if these practical components are to be properly integrated into the curriculum, however, veterinary faculties themselves must also be able to provide basic research-based teaching. In the Finnish undergraduate curriculum, an introduction to interpreting and applying legislation has now been extended with practical exercises. Furthermore, problem-solving skills are developed through control cases typical for a municipal official veterinarian. Students solve these cases in small groups and present the results to other students and teachers in a poster session.
The four different education areas identified for the VPH control tasks (practical control work, social aspects, legal aspects, and identification of risks; see Table 2) and the prioritization of these areas by survey respondents (see Figure 6) clearly describe the multidisciplinary approach needed for education relating to control tasks in VPH. In a country, such as Finland, where all graduating veterinarians are considered qualified to work as official veterinarians, all these areas should be covered in the undergraduate curriculum, although they may be less important in countries where a post-graduate education is needed to perform such tasks. Even in these countries, however, the possibility of a career in VPH should be stressed to veterinary students in order to ensure that society's needs in this area are met. Our study, therefore, supports better planning of the undergraduate curriculum and prioritization of teaching areas in most countries. Since the field is extensive, tools such as the opinions of post-graduate veterinarians are very valuable in prioritizing teaching areas. Outside the curriculum, other ways to increase the competence and motivation of recently qualified veterinarians in control tasks are needed. Leighton has proposed that the small proportion of newly admitted veterinary students currently pursuing non-practice careers (10%) be increased to between 40% and 50%.19 In addition to a review of the veterinary curriculum, modification of selection processes of new students is currently under discussion in Finland.
Based on our results, both elaboration of practical aspects of control tasks (and not only those needed in clinics or in the laboratory) and the introduction of social aspects of veterinary work into the undergraduate veterinary curriculum are needed, together with traditional biological and legal training to improve students knowledge, skills, and attitudes toward VPH control tasks. These changes in the undergraduate curriculum are essential if we are to meet the needs of society, today and in the future.
| APPENDIX |
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| Footnotes |
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Riitta Maijala, DVM, PhD, Dipl. ECVPH, specialist in contagious animal diseases, docent in food hygiene, is Head of the Risk Assessment Director at the European Food Safety Authority, DUS A 02/021, Largo N. Palli 5/a, 43100 Parma, Italy. E-mail: riitta.maijala{at}efsa.europa.eu. She has led research groups on risk assessment and risk management and control tasks and is Senior Vice President of the European College of Veterinary Public Health.
Hannu Korkeala, DVM, PhD, MSocSci, Dipl. ECVPH, is professor of food hygiene and Head of the Department of Food and Environmental Hygiene at the Faculty of Veterinary Medicine, P.O. Box 66, University of Helsinki 00014 Finland. He leads a research group focusing on the diagnostics, epidemiology, and genomics of psychotrophic and spore-forming food-borne bacteria. He has published more than 170 scientific papers in peer-reviewed journals.
a Eduix/Delta Piktori Oy, 33200 Tampere, Finland <https://e-lomake.fi/> ![]()
b Microsoft Corp., Redmond, WA 98052-6399 <http://www.microsoft.com/>. ![]()
c SPSS, Inc., Chicago, IL 60606 <http://www.spss.com/>. ![]()
d Here and elsewhere, the notation (score x) indicates the respondent's rating on the five-point scale for the ability of the current curriculum to prepare students for work in VPH. ![]()
e Respondents comments have been translated into English by the authors. ![]()
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