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

The Future of Healthcare

The Future of Healthcare

The Future of Healthcare

The Future of Companionship

The Future of Food

The Future of Food

The Future of Food

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?

Isthistheend

ofveterinary

schoolaswe

knowit?

Oristhisan

opportunity

toreimagine

veterinary

medical

educaJon?

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

Competency-Based Time-Variable Educa8on

JeffreyJ.Selingo

ChronicleofHigherEduca;on

August18,2017

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

What’sthepoint?

• Veterinarymedicineisaglobalpublicgood

•  ThequalityofveterinaryservicesisdirectlyrelatedtothequalityofeducaJon

• AccreditaJonensuresthateducaJonisbasedoncompetenciesthatmeetsocietalneeds

• AccreditaJonpromotesacultureofconJnuousqualityimprovement

• GlobalrecogniJonofaccreditaJonsystemswillimproveeducaJonworldwide

“Weareallinthistogether”

The future of veterinary medicine