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| VETE0467-2 | Learning how to take decisions in complex situations in veterinary medicine
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| Duration : | 57,5h PCL |
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| Number of credits : |
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| Lecturer : | Collégialité, Pascal Gustin |
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| Coordinator : | Pascal Gustin |
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Language(s) of instruction :
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| French language |
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Organisation and examination :
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| All year long |
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Course contents :
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| The great number of professional situations, very different in appearance, can be grouped into families that share a similar decision-making approach. The learning objective is thus simplified and based on the acquisition of a general approach applied to each family.
If this approach clarifies the objectives, it does not solve the problem of integrating knowledge and techniques that have become bloated in the process of decision making.
The families are qualified as "complex" not in the sense of the difficulty of the medical case to be resolved but because the number of parameters to be integrated to make an decision, medical but also economic, legal, societal, psychological, ethical ...
In most cases, the veterinarian is called to make quick decisions. This has several consequences which affect, in practice, the decision process. The objective of this module is to train the students to this process.
Each of us with our level of knowledge and skills, must make decisions. Students are expected to be able to respond quickly and implement to make a quick decision, never forgetting that these decisions can always be improved. They are taken by mobilizing internal resources (knowledge, skills and attitudes) in the context of a complex situation. The basic rule is to never take irreversible decisions, dangerous and overly expensive. We must immediately raise the question of risk (animal health, public health, economic, legal liability ...). Whatever the decision, it is essential to communicate it to the stakeholders.
After this first decision and risk analysis, students are encouraged to clarify their doubts which may lead to reconsider the original decision.
The higher the risk is high and doubt, the more the decision maker should seek to improve its decision on the basis of new information by following the process proposed by the Evidence Basedb Medicine. EBM, refers to conscious and explicit use of the best scientific evidence and information to make a decision. During this process, the veterinarian combines the best personal experience with evidences found in the literature.
Students must possess the skills required to get complete information and knowledge to optimize an initial medical decision, knowing that the the time to make it is limited. Students must not waste time to find not essential information to make à good decision, and conversely, must not miss out crucial information that will make the difference between good and poorer medical decision.
The decision maker is better informed about certain aspects of the problem and it should eventually modify its original decision. This new decision is not yet perfect, but given the realities, it is currently acceptable.
Concepts
Competency framework: which format for which target. Vandeweerd JM., Cambier C., Romainville M., Perrenoud P., Desbrosse F., Dugdale A., Gustin P. J. Vet. Med. Education. in press.
Understanding veterinary practitioners' decision-making process: implications for veterinary medical education. Vandeweerd JM., Vandeweerd S., Gustin C., Keesemaecker G., Cambier C., Clegg P., Saegerman C., Reda A., Perrenoud P., Gustin P. J Vet Med Education. 39, 142-151, 2012. |
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Learning outcomes of the course :
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| The first objective of the multidisciplinary module is to train the students to integrate their knowledge and knowhow gained in the first four years of their cursus. A reflexive and methodical process will help the students to prepare themselves to perform better decision making process
The second objective is to train the students to use the Evidence Based Medecine (EBM) approach in the context of clinical and non clinical decison making.
The learners should be able to
- Search the appropriate literature,
- Assess the internal validity of the information found in the literature.
- Assess the external validity of the information (is it applicable to the case)
- Apply the principles of cursory reading of the literature (reading by "layers")
- Understand and explain what is a bias and a random error,
- Identify the future applications of EBM in their practice,
- Integrate EBM in the process of decision making
- Understand the different elements of decision making by integrating them in a multidisciplinary context
- Produce a concept map to solve the problem that has been submitted.
- Synthesize the elements and justify the final decisions
In summary, the students must be able to apply the making decision process as described above. |
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Prerequisites and co-requisites/ Recommended optional programme components :
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| All disciplines taught during the first four years of the curriculum must be integrated into decision-making. Specific tools such as literature review, evidence-based medicine and English are essential to this process. |
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Planned learning activities and teaching methods :
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| Each week, each group must make a decision following the process described above regarding one situation. The exercise will be repeated 4 times. The first day, the group must make a quick decision to explain it to to the stakeholders. Then the group will conduct self-criticism and self-assessment under the control of supervisors who assist the students in the process of decision making and in collaboration with experts acting as resource persons. At the end of the process leading to the verification of the first decision , students will probably have to change substantially some elements of the initial decision. It is not yet perfect, but given the realities, it is currently acceptable
As part of the module, the clarification of doubts, risks and review of the decision is crucial. If the excess of certainty is wrong, excessive caution is equally bad because it can also lead to accidents. Difficult to find the right balance! The teacher's role is to help you in your approach. A meeting with one or more experts will help the students to assess the risk-taking. Contradictions will appear. It is normal that students manage them, decide and argue for their choices. That's life!
During the final presentation, students should communicate their efforts and decisions to stakeholders. They will be invited to discuss their decisions with experts who are not there to assess the knowledge but the decision making process. If disagreement arises, it is for students to justify their choices by taking into account all elements of the context.
The approach proposed in this module is not to answer the question, "Faced with this situation, what will you do? "but:" Faced with this situation, you made a initial decision. What do you do now to improve this decision and, how to explain these changes? ".
On the final day, students must explain their choices.
With a panel of experts, they will discuss:
- initial choices
- risk analysis
- validity of the evidence
- correction of the initial choices |
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Mode of delivery (face-to-face ; distance-learning) :
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| The learning method is based on the PBL technique but whose objectives and process are suitable for decision making in complex situations. Detailed information is provided to students early in the first week. Each group will have to manage 3 situations (a situation / week) and will discuss with an owner during the week. Every Friday, each group presents its decisions to the expert panel in the presence of three other groups. |
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Recommended or required readings :
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| Lecture conseillée
Guide pratique de médecine factuelle vétérinaire : De la preuve scientifique à la décision clinique
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Editeur : Editions du Point Vétérinaire (15 septembre 2009)
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Collection : Sine qua non
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Langue : Français
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ISBN-10: 2863262858
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ISBN-13: 978-2863262856
Understanding veterinary practitioners decision-making process implications for veterinary medical education. Vandeweerd JM, Vandeweerd S., Gustin C., Keesemaecker G., Cambier C., Clegg P., Saegerman C., Reta A., Perrenoud P., Gustin P.J. Vet Med Education.39, 142-151, 2012
mandatory
Teaching commitments distributed to students early in the first session and family of situations (E Campus). |
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Assessment methods and criteria :
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| The evaluation is based on the presentation and oral defense of an individual work, on the decision-making. The subject will be given at the beginning of summer session.
An exemption from the examination can be obtained based on the realization and
success (note> 9) of group work during the academic year. The score for this work is individual.
The score for this work is individual. If a student / group score is <= 9 / 20, each student must present an examination during the first session in the form of individual work to present and defend orally at the end of the year when session in May-June
The module is compulsory. If the
absence is not justified, there will be a sanction and the grade will
be changed accordingly. Students should be in time at the course. A
delay of more than 15 minutes will be considered as an absence. All
documents that justify the absence should be submitted to the department the day that follows the absence.
In case of unjustified absence at the presentation on Friday, the student's score will be zero. The student (s) will therefore present a personal first session, whose topic will be determined by supervisors. If there is a justification for absence to the presentation on Friday, the student (s) will present the work of the group
individually on a date to be agreed with the supervisors.
The final grade will be calculated as a mean of the 3 grades obtained each week. |
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Work placement(s) :
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Organizational remarks :
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| The presence of students is required every day for four weeks of training to benefit from the guidance of teachers who have to oversee the process of decision making, to help students in the use of specific tools as EBM, literature review and concept maps and coordinate contacts with experts (resource persons) who can be contacted by a special procedure provided during the training. |
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Contacts :
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| Pr P GUSTIN |
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| Items online : |
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| Notes |
| Documents describing the learning outcomes, the teaching methods and evaluation. |
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