Ambulatory Dairy Herd Project-A Problem-based Learning Approach to Dairy Production Medicine
H. D. Levine, G. Saperstein, G. P. Looby and H. E. Hammerquist
From the Tufts University Ambulatory Service
P.O. Box 87, South Woodstock, CT 06267.
In the past decade revolutionary changes have occurred in veterinary medical education. Critiques of veterinary education such as the Pew Report (1) have recognized the need for schools to train students in problem solving and critical thinking. Student oriented and problem-based learning components are being implemented at several veterinary schools in an effort to emphasize data utilization rather than data memorization. Increased species specialization has developed at many schools. Food animal curricula stressing Production Medicine have been developed (2).
At the same time that the importance of veterinarians as Production Medicine Consultants has emerged, the veterinary student population has become increasingly urbanized and less familiar with livestock management or husbandry. This paper describes a program instituted in 1987 at Tufts University School of Veterinary Medicine (TUSVM) which provides a problem-based learning approach to Dairy Production Medicine.
Description of the Program
The Herd Project Investigation is part of a 4-week rotation in the Large Animal Ambulatory Service which is required for all 4th-year veterinary students at Tufts. Usual rotation group size is 5 to 7 students.
A commercial dairy farm (or rarely a beef farm) is assigned to each group. The farm is chosen from the Ambulatory Service client base and choice of farm is based on distance for student travel to the farm and willingness of the farmer to participate in the program. On the first day of the Ambulatory Rotation the students are given an orientation sheet for the Herd Project Investigation (Figure 1). The orientation sheet lists typical dairy farm management categories and suggestions for investigation. It also states that before the end of the Ambulatory Rotation, students must present a written report with the farm's current rolling herd average and an analysis of all management categories to indicate how changes could increase the farm's net income. Any suggested change must be justified economically. Additionally, each rotation group must discuss their findings in an oral presentation to the dairy farmer and the ambulatory clinicians.
Figure 1. Orientation sheet for Tufts Ambulatory Herd Project Investigation.
|Your rotation is assigned the farm to investigate. This project is required and is to be a group effort. While no grade will be placed on the report per se, the quality of your group effort may be reflected on your grades for the rotation.|
|By means of on-site investigations and interviews we want you to find out the inner workings of this farm. Management categories to be examined are listed below. Additional areas of investigation are welcomed if felt necessary.|
|After analyzing your findings we want you to present us a report (written) addressing the following points:|
|1. What is the current 305 day rolling herd average?|
|2. Review each of the management categories listed below and indicate how each could be changed to increase the farm's net income.|
|Management Categories and Suggestions for Investigation:|
|Milking and Milking System.||Observe at milking, washing of equipment.|
|Feeding System.||What is fed, how does feeding change with lactation cycle, how is feed stored, delivered to cows, etc.?|
|Housing.||How are cows housed, bedded (with what, how much, how often), what is the daily routine for each group of cattle.?|
|Barn and Barnyards.||Observe the condition of barn, sanitation, clean-up procedure, ventilation.|
|Young Stock.||How are they housed, grouped, raised?|
|Herd Health Program.||Check programs for reproduction, vaccination, deworming, mastitis.|
|Record-Keeping System.||Review management.|
|Crops and Raising Food.|
|Major Health Problems Recognized by Farmer, by You.|
The orientation sheet is discussed by an ambulatory clinician as part of the rotation orientation. During the first few days of the rotation ambulatory clinicians usually bring the group or some members of it to the farm under investigation and introduce them to the farmer and farm employees. Ambulatory clinicians help students to locate educational resources and make contacts with such key support people as nutritionists and feed suppliers, milking equipment sales and service people, dairy extension agents, and local dairy supplies sales people. Ambulatory clinicians also make computer software available for DHIA record analysis and ration balancing or evaluation. Students are instructed in the use of these software programs upon request. Clinicians make past laboratory records from the herd file available to the students.
Clinicians answer questions regarding past history on the farm but leave judgements of current management practices up to the students. For example, a clinician may respond to questions whether a herd has had problems with fat cows in the past by indicating whether Tufts Ambulatory has diagnosed any fatty liver syndrome in the past but if asked whether the cows are too fat now the clinician will in turn ask the students how they can find out and then direct the discussion toward body condition scoring the herd.
At various times during the rotation students will pose hypotheses regarding the farm to ambulatory clinicians. The clinicians will then suggest ways for the students to test or strengthen these hypotheses. During the last week of the rotation the students give an oral presentation of their findings to the farmers and clinicians. At this time clinicians may ask students to justify or clarify their suggestions on both medical and economic grounds. Clinicians also make sure that students who merely parrot the literature develop a greater understanding of their proposals in the context of the herd in question.
Student Responsibilities and Activities
The Herd Project Investigation is basically a student-driven exercise in problem-based learning. The problem is the farm management. Since most TUSVM students are not from farm backgrounds previous exposure to dairy management has been limited to lectures on prevention of various clinical problems, a field trip to a dairy farm in their second year, and 2 lectures on Dairy Management and Dairy Production Medicine. Most have little practical experience with or in-depth knowledge of dairy management. Thus in the first week most groups wrestle with clarification and definition of the problem.
After defining the problem areas to be investigated, the student group usually assigns specific management areas to individual students. The students then research these areas using resources available at the Ambulatory Service or at the main veterinary school library to identify what information is needed. Students interview farm personnel to collect information on specific management practices. The students then discuss the information, identify what is known, develop hypotheses for farm improvement and characterize additional knowledge needed. This process recycles several times over the course of the 4-week rotation.
Arrangements to visit the farm are made directly between students and farm personnel. Students try to schedule farm investigation visits around the ambulatory farm call schedule so student exposure to herd health and sick cow work is not compromised. When the ambulatory call schedule is too busy to permit "slow time," students are allowed to schedule farm investigation visits in lieu of going with clinicians on calls.
During the last week of the rotation students synthesize the information they have collected, and after discussing it as a group, write up their findings and suggestions. A presentation is scheduled based on the farmer's availability to attend. An oral presentation lasting 3 to 4 hours is made. Prior to the meeting, a clinician explains the process to the farmer and encourages the farmer to ask questions and participate in the discussion. One student acts as a group leader and prefaces the discussion by informing the farmer as to which student had what topic and the order of presentation. The student usually thanks the farmer for the past month's experience. Some of the students' presentations are enhanced by audio visual aids such as videotapes, drawings, charts, graphs, etc., as well as product catalogs, price lists and phone numbers of suppliers or service personnel. If the farmer is a DHIA subscriber, students usually obtain the access code and download the farm's data into the Tufts Ambulatory Service computer. One clinician explains how to interpret DHIA records and if students request it, they can use ambulatory software to generate reports and graphs for inclusion in their report. The discussion usually ends with the student group leader summarizing the group's major suggestions and reiterating their thanks to the farmer.
Many veterinary colleges have recognized the need to institute training in Dairy Production Medicine. Some have introduced elective courses concentrating on aspects of Dairy Production Medicine (3). Other colleges have provided certificate programs as continuing education for practicing veterinarians (4). The Dairy Herd Project at Tufts University School of Veterinary Medicine differs from both these approaches in that it integrates the time and effort students spend on Dairy Production Medicine with the demand of daily farm calls encountered in most dairy-based veterinary practices.
We believe this integration serves several purposes. First, students unfamiliar with dairy farming learn the concerns of many dairy farmers not just the farmer involved in the project. Second, students are able to compare the project farm's facilities, solutions to management problems and management styles to those on other farms in the ambulatory practice. Third, it gives the students an understanding of the demands that Production Medicine puts on the large animal practitioner in terms of effort and time management. The students experience the conflicts of Production Medicine analysis work with the demands of emergency calls. Since these conflicts are a common impediment to the development of Production Medicine programs in practice (5), we believe that learning the Production Medicine approach in a veterinary practice context prepares veterinary school graduates for the difficulties of introducing Production Medicine into a practice.
Since Production Medicine is a problem-based and problem-solving discipline, the Dairy Herd Project naturally develops into an exercise in small group problem-based learning. The Dairy Herd Project typically involves the following aspects of problem-based learning (6):
- Clarification and definition of the problem,
- Analysis of the problem,
- Identification and characterization of the knowledge needed,
- Identification of what is already known,
- Identification of appropriate learning resources,
- Collection of new information,
- Synthesis of old and new information and understanding of it by application to the problem,
- Identification of what was not learned,
- Summary of what was learned.
Student acceptance of the Dairy Herd Project has been excellent with many students citing it as the most important part of the 4-week Ambulatory Rotation. Dairy farmers usually enjoy the student involvement and the free analysis it brings. Some farmers have requested a second herd investigation in subsequent years. Most farmers have adopted some or all portions of the suggested management changes.
A program teaching Dairy Production Medicine in a problem-based learning approach was described. The program integrated a Production Medicine investigation of a dairy herd with the daily farm call schedule conducted during the Tufts Ambulatory Rotation. The format used in the course of the student investigation contained many elements of small group problem-based learning.
References and Endnotes
1. Pritchard WR: Future Direction of Veterinary Medicine. PEW National Education Program. Durham, NC: Duke University 1988.
2. Troutt HF and Osburn BI: Center of emphasis: bovine. Jour of Vet Med Educ Special Issue: 22-28, 1989.
3. Nordlund K, Oetzel G, Goodger W, and Dahl J: Special elective rotations as a means of teaching dairy production medicine skills to veterinary students. In Proceedings: 25th Am Assoc Bov Pract Conf, 2:212-216, 1992.
4. Leslie K: The development of continuing education opportunities for veterinarians in dairy health management. In Proceedings, 25th Am Assoc Bov Pract Conf, 2:217-221, 1992.
5. LaDue B: Consulting less than 50 miles from home. In Proceedings, 1st An NEDPM Symposium, 54-58, 1992.
6. Problem-based Learning Program Student Handbook. Boston: Tufts University School of Veterinary Medicine, 1990.
The authors thank Ms. Janet McKinstry for her cooperative effort in developing and conducting the Ambulatory Dairy Herd Project program.