Identity, environment and mental wellbeing in the veterinary profession

Mental health and career dissatisfaction are of increasing concern to the veterinary profession. The influence of identity on the psychological wellbeing of veterinarians has not been widely explored. Twelve recent veterinary graduates were enrolled in a private social media discussion group, and their identities investigated through narrative inquiry: a methodology which enables identity priorities to be extrapolated from stories of experience. Two distinct variants of the veterinary identity were identified: an academic, ‘diagnosis-focused’ identity, which prioritised definitive diagnosis and best-evidence treatment; and a broader ‘challenge-focused’ identity, where priorities additionally included engaging with the client, challenging environment or veterinary business. Contextual challenges (such as a client with limited finances or difficult interpersonal interactions) were seen as a source of frustration for those with a diagnosis-focused identity, as they obstructed the realisation of identity goals. Overcoming these challenges provided satisfaction to those with a challenge-focused identity. The employment environment of the graduates (general veterinary practice) provided more opportunities for those with a challenge-focused identity to realise identity goals, and more markers of emotional wellbeing were apparent in their stories. Markers of poor emotional health were evident in the stories of those with a diagnosis-focused identity

The challenges and issues of undergraduate student retention and attainment in UK veterinary medical education

Student retention and attainment has recently been identified as a key area for development in veterinary medical education enquiry. Woodfield's research on retention and attainment across the UK disciplines has yielded some unique information about the challenges and issues of students who study veterinary medicine and related subjects. The present literature review aims to expand on Woodfield's findings and explain important issues about retention and attainment across veterinary medicine. Overall, the subject of retention and attainment in undergraduate veterinary medical education needs a great deal more empirical attention, such as data on the retention and attainment of mature and widening access students, and the effects of students being placed at remote locations during their studies. Our findings also cover some unsurprising issues: the dominance of women in a profession that is principally lead by men, the underrepresentation of black and minority ethnic (BME) students in veterinary medicine, and the effects of content overload in the veterinary medical curriculum. Based on data gathered by Woodfield and our investigation of the scholarly and gray literatures, we offer an overview of gaps in current knowledge and recommendations for further research

Manifestations of professional identity work: An integrative review of research in professional identity formation

Professional identity formation (PIF) is an integral part of educating professionals. A well-formed professional identity helps individuals to develop a meaningful professional self-understanding that facilitates their transition to and sustainability in professional work. Although professional identity and its formation are well theorized, it is largely unclear how the underpinning interpretive process of professional identity work leads to observable changes in thoughts, feelings and behaviours, and how these insights can be used in educational practice. To address this gap, we conducted an integrative review of 77 empirical articles on professional identity formation and inductively developed a four-fold typology of professional identity work, through which individuals reportedly make the shift from individual to professional. The theoretical contribution of this article is a more nuanced understanding of the practical manifestations of professional identity work. As a practical contribution, the typology may be used as a heuristic through which educators of professionals can support their students’ professional identity formation, particularly where this is halted or complicated by obstructions

The influences of curriculum area and student background on mindset to learning in the veterinary curriculum: a pilot study

A student's mindset influences their achievement and response to challenge, with a ‘fixed mindset’ encouraging disengagement from challenging tasks and avoidance of learning and feedback opportunities. These behaviours resemble those reported for professional and non‐clinical curriculum areas, which are important for employability and resilience in veterinary practice. Students with a ‘growth mindset’ to learning are more persistent when faced with challenges and actively seek more demanding tasks. They also demonstrate higher levels of psychological well‐being. The objectives of this study were to explore whether variation in veterinary students’ mindset to learning exists across different curriculum areas, and to identify whether students’ backgrounds influence their learning mindset. The mindsets of veterinary students at a UK veterinary school were measured using an adapted version of the Implicit Theories of Intelligence Scale. The survey was constructed to compare mindset in clinical reasoning, professional reasoning (incorporating ethics and critical thinking), communication skills and reflection. More students demonstrated a growth mindset to communication skills (59%), reflection (84%) and clinical reasoning (83%) than to professional reasoning (34%). There were more students with a fixed mindset to professional reasoning (10%) than in other areas (0–5%). Students’ background (international or non‐traditional university access) did not appear to influence mindset to learning. Disengagement from professional studies curricula may be a consequence of students lacking a growth mindset in professional reasoning. Curriculum interventions that encourage engagement and the development of a growth mindset to learning non‐clinical competences may be beneficial

What is the Veterinary Professional Identity? Preliminary findings from web-based continuing professional development in veterinary professionalism

Professionalism and professional skills are increasingly being incorporated into veterinary curricula; however, lack of clarity in defining veterinary professionalism presents a potential challenge for directing course outcomes that are of benefit to the veterinary professional. An online continuing education course in veterinary professionalism was designed to address a deficit in postgraduate support in this area; as part of this course, delegates of varying practice backgrounds participated in online discussions reflecting on the implications of professional skills for their clinical practice. The discussions surrounding the role of the veterinary professional and reflecting on strengths and weaknesses in professional skills were analysed using narrative methodology, which provided an understanding of the defining skills and attributes of the veterinary professional, from the perspectives of those involved (i.e. how vets understood their own career identity). The veterinary surgeon was understood to be an interprofessional team member, who makes clinical decisions in the face of competing stakeholder needs and works in a complex environment comprising multiple and diverse challenges (stress, high emotions, financial issues, work–life balance). It was identified that strategies for accepting fallibility, and those necessary for establishing reasonable expectations of professional behaviour and clinical ability, are poorly developed

Cost-effectiveness of asthma control: an economic appraisal of the GOAL study

<i>Background</i>: The Gaining Optimal Asthma ControL (GOAL) study has shown the superiority of a combination of salmeterol/fluticasone propionate (SFC) compared with fluticasone propionate alone (FP) in terms of improving guideline defined asthma control. <i>Methods</i>: Clinical and economic data were taken from the GOAL study, supplemented with data on health related quality of life, in order to estimate the cost per quality adjusted life year (QALY) results for each of three strata (previously corticosteroid-free, low- and moderate-dose corticosteroid users). A series of statistical models of trial outcomes was used to construct cost effectiveness estimates across the strata of the multinational GOAL study including adjustment to the UK experience. Uncertainty was handled using the non-parametric bootstrap. Cost-effectiveness was compared with other treatments for chronic conditions. <i>Result</i>: Salmeterol/fluticasone propionate improved the proportion of patients achieving totally and well-controlled weeks resulting in a similar QALY gain across the three strata of GOAL. Additional costs of treatment were greatest in stratum 1 and least in stratum 3, with some of the costs offset by reduced health care resource use. Cost-effectiveness by stratum was £7600 (95% CI: £4800–10 700) per QALY gained for stratum 3; £11 000 (£8600–14 600) per QALY gained for stratum 2; and £13 700 (£11 000–18 300) per QALY gained for stratum 1. <i>Conclusion</i>: The GOAL study previously demonstrated the improvement in total control associated with the use of SFC compared with FP alone. This study suggests that this improvement in control is associated with cost-per-QALY figures that compare favourably with other uses of scarce health care resources

Does segmentation always improve model performance in credit scoring?

Credit scoring allows for the credit risk assessment of bank customers. A single scoring model (scorecard) can be developed for the entire customer population, e.g. using logistic regression. However, it is often expected that segmentation, i.e. dividing the population into several groups and building separate scorecards for them, will improve the model performance. The most common statistical methods for segmentation are the two-step approaches, where logistic regression follows Classification and Regression Trees (CART) or Chi-squared Automatic Interaction Detection (CHAID) trees etc. In this research, the two-step approaches are applied as well as a new, simultaneous method, in which both segmentation and scorecards are optimised at the same time: Logistic Trees with Unbiased Selection (LOTUS). For reference purposes, a single-scorecard model is used. The above-mentioned methods are applied to the data provided by two of the major UK banks and one of the European credit bureaus. The model performance measures are then compared to examine whether there is improvement due to the segmentation methods used. It is found that segmentation does not always improve model performance in credit scoring: for none of the analysed real-world datasets, the multi-scorecard models perform considerably better than the single-scorecard ones. Moreover, in this application, there is no difference in performance between the two-step and simultaneous approache