gms | German Medical Science

4th InVeST – International Veterinary Simulation in Teaching Conference

14.09. - 16.09.2015, Hannover

Construction and implementation of a bovine obstetrical model as an interactive teaching method for veterinary students

Meeting Abstract

InVeST 2015: International Veterinary Simulation in Teaching Conference. Hannover, 14.-16.09.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. Doc15invest35

doi: 10.3205/15invest35, urn:nbn:de:0183-15invest352

Veröffentlicht: 10. September 2015

© 2015 Schüller et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

The acquisition of obstetrical skills in veterinary medicine is a complex learning process for veterinary students. It is important that the teaching process concentrates not only on theoretical knowledge, but also on practical skills in manual exploration and corrections of fetal dislocations. Therefore the use of obstetrical models is required and commonly used in veterinary education. Nevertheless, available commercial models (vet simulator industry, Calgary Canada) are very costly and only available overseas. It is well documented that learning is expected to be most effective when given topics are not only reproduced but also the intensive reflection on a related problem is enabled or the information is transferred from one format (e.g. printed information) into another format (e.g. manual implementation).

Therefore, the objective of this project was, to develop and construct a model for the interactive teaching of bovine dystocia in context of an elective workshop for veterinary students. The students were supposed to define the most important requirements for a bovine obstetrical model and to realize those requirements in the construction of an obstetrical model.

The project was conducted in context of 2 consecutive elective workshop modules for veterinary students in the 3rd and 5th year of veterinary education at the Freie Universität Berlin. Eighteen students were allowed to choose this elective workshop as opportunity out of a selection of clinical courses from all veterinary fields. The workshop was conducted by 2 instructors in 2 consecutive modules.

The first module was performed at seven 2 hr appointments on a weekly basis. Students were assigned to one of 5 different working groups depending on their personal interest. Working groups were defined by their anatomic structure and importance for the obstetrical process as (1) uterus, cervix and vagina, (2) the pelvis, (3) the external genital organs, (4) the outer framework, and (5) the calf. The first exercise for each group was to discuss the physiology ofthe functional structure during parturition and to define specific characteristics of the functional structures in the context of obstetrical procedures. Results of each group were presented and discussed among all students. The second exercise for each group was to determine and define specific physiological characteristics of each functional structure that needed to be implemented in the obstetrical model and to make a list of required materials that could simulate those functional structures in the obstetrical model. General requirements to the obstetrical model were availability and longevity of all materials as well as easy cleaning and disinfection of all parts. Furthermore, the budget for all required materials was limited to 200€. The functional structures were constructed in each working group and combined to the obstetrical model at the last appointment.

The second module was performed as an intensive course in a total of 7 hours on 2 consecutive days. This module was provided to the students to acquire practical experience in practicing with the constructed obstetrical model and to reflect their learning process during this workshop. All students had the chance to perform at least 2 simulated cases consisting of exploration and corrections of fetal dislocations with the obstetrical model. At the end of this workshop all students were invited to comment their learning experience during this workshop and to discuss the pros and cons of the construction of such a model as an interactive training method.

Students of group 1 defined the constriction and flexibility of the cervix as the main criterion to provide an authentic feel of the birth canal. Furthermore the application of lubricant and obstetrical instruments should be enabled to provide practical support. Group 2 defined the angulation and the maximum width of the pelvis as critical for the obstetrical procedure. Group 3 defined constriction and flexibility of the external genital organs as most important. Furthermore the full extraction of the fetus and the use of a commercially available calf puller should be possible. Group 4 defined the mobility and angulation of the extremities of the calf as most important factor for the simulation of fetal dislocations. Furthermore a defined structure of the fetal head was perceived necessary in order to apply eye hooks and other obstetrical instruments. The weight of the calf model should correspond to the weight of a newly born calf for the simulation of balance of forces during obstetrical procedures. Group 5 defined the working height and position (lying vs standing) of the cow as most important factor for obstetrical procedures. The obstetrical model should provide simulation of an upright position of the cow for manual exploration and corrections of fetal dislocations and a lying position for the extraction of the calf.

The vagina, cervix and uterus were constructed as one unit out of a flexible rubber tissue padded by a neoprene layer to simulate constriction and flexibility of the birth canal. A bone preparation of a bovine pelvis was used as a pelvis. The upper and lower part of the pelvis were replaced by an elastic rubber tissue to provide the simulation of different pelvic diameters. The external genital organs were modelled out of medical latex to provide flexibility and the possibility for a full extraction of the fetus. To provide the use of a calf puller the muscles of the hind legs were simulated by rubber tires. Group 4 concluded that the construction of a model calf that would meet the requirements identified was not possible within the scope of this workshop. Therefore the utilization of calves born dead was selected as best alternative to meet all requirements defined before. The outer frameworks was constructed out of a table and a plastic barrel that were adjustable in position for simulation of the cow position.

At the end of the second module all students described their learning experience during this workshop and discussed the pros and cons of the construction of a bovine obstetrical model as an interactive training method. All students described their learning experience during this workshop as a valuable and intense experience. The initial planning and coordination for the construction of the obstetrical model required a lot of time and intense discussions within the students. Nevertheless, the effort spent on the preparation enabled the students to perform a profound analysis about the physiology of bovine parturition and obstetrics. All constructions in this project were conducted by students so a general statement about the durability and quality of the bovine obstetric model is not possible at this time. However, reconstruction or replacement of broken parts can be applied whenever needed and easily due to ample availability and low cost of all materials utilized. Therefore, refinement and/or the constructions of a next generation model should be encouraged by providing the construction plan of the initial model. Additional benefits of the bovine obstetrical model described by the students are the full extraction of the calf and the possibility to perform extraction in a simulated lying position of the cow. Furthermore the obstetrical model enables the application of lubricant and the utilization of a wide range of obstetrical instruments (e.g. calf puller) compared to conventional obstetrical models.

The objective of this project was, to develop and construct a model for the interactive teaching of bovine dystocia during an elective course on bovine obstetrics for veterinary students. Within the scope of this project an obstetrical model was constructed by a group of veterinary students that provided an authentic feel of the bovine birth canal and the opportunity for the full extraction of the fetus. Furthermore, the application of lubricants and a wide range of obstetrical instruments was enabled. All students described their learning experience as highly valuable and intense. Further projects should provide construction plans of teaching models to enable reconstruction and later refinements for all interested students.