Authenticity

Authenticity is fundamental to effective teaching in veterinary degree programs. Authentic learning involves a clear connection between essential graduate attributes and the learning activities, teaching methods, and assessment of the course (Barrows and Tamblyn, 1980; Boud and Falchikov, 2006). These need to reflect the complexities and variabilities of the real world, while still providing students with a supportive scaffold to ensure effective learning (May and Silva-Fletcher, 2015). Through this, students can be progressively equipped with practical skills and knowledge that they can easily adapt to address the issues they will face after graduation.

Authenticity usually leads to greater learner motivation and engagement, as the benefit and future application of the knowledge are explicit (Hafen et al., 2015). For technical skills such as suturing or venipuncture, the importance of the skills rarely needs explanation. Depending on the competence being taught, scaffolding of the learning activity may be required either to highlight the real-world relevance and importance of required skills and knowledge (e.g., detailed interpretation of clinical pathology data in diagnostic investigation), or to demonstrate the need for more extensive competence than the student currently has (e.g., clinical consultation skills and hand hygiene practices) (Hafen et al., 2015).

Achieving authenticity goes beyond the simple inclusion of case material within learning activities. Authenticity encompasses teachers genuinely sharing both their limitations and their expertise, creating engagement and connection with learners that enhance learning outcomes (Kreber and Klampfleitner, 2013). Teachers striving for authenticity in their curricula need to balance the relevance of learning activities with what is practical, sustainable, and achievable given the resources available (see Box 9.2). In taking this pragmatic approach, however, it is important to ensure that the fundamental disciplinary basis is not sacrificed to expediency.

Constructive Alignment

Constructive alignment is the meaningful connection between the desired learning outcomes, learning activities, and assessment of the course (Biggs and Tang, 2007). Central to this in a veterinary degree is the understanding that all three elements need to be authentic and directly relevant to the skills and knowledge required of a graduate veterinarian.

In a constructively aligned course, the learning activities meaningfully illustrate and allow exploration and practice of the desired skills and knowledge (Kurtz, Silverman, and Draper, 2005), enabling students to construct meaning through discovery and actions rather than simply receiving information from the teacher. As Shuell (1986, p. 429) discussed over three decades ago:

“Without taking away from the important role played by the teacher, it is helpful to remember that what the student does is actually more important in determining what is learned than what the teacher does.”

The role of the teacher in this context is to create the culture, structure, and assessment tasks that stimulate student engagement and learner success. Assessment tasks need to explicitly provide a genuine and accurate evaluation of student achievement of the intended learning outcomes (Taylor, 2009).

The easiest way to create constructive alignment is to honestly to consider and express in the form of a clearly written learning outcome what is reasonably achievable and expected of students at the completion of each course (Taylor, 2009). These course-level learning outcomes are then explicitly linked to program-level outcomes expressed as a statement of desired new graduate attributes (Taylor, 2009). The next step is to review all of the available learning activities that allow students to explore and practice their abilities through learning activities that nurture the desired knowledge, skills, and attitudes in each area. Offering a range of different learning activities allows students to practice and demonstrate their knowledge in ways that best suit their needs as learners (Ramsden, 2003). Finally, to focus the students on achieving the learning outcome in a way that is meaningful for their future practice, the design and nature of assessment tasks need to reflect the expectations of a new graduate veterinarian. In contrast to common assessment methods that evaluate lower-level knowledge and disparate skills, assessment of the higher-order learning outcomes expected of new graduates requires students to synthesize and apply their knowledge and skills in practice (Cheek and Lamb, 2010) (see Box 9.3). The consequences of misaligning learning outcomes, learning activities, and assessment tasks are that students may be unable to apply disciplinary knowledge to practical problem-solving in the workplace, despite potentially attaining good grades throughout the course.

Integration

Being an effective veterinarian requires integration of knowledge, skills, and professional attributes. Therefore, effective teaching of veterinarians requires the integration of theoretical and practical material, and development of professional attributes, to achieve the intended learning outcomes (Baillie, Pierce, and May, 2010). This requires thoughtful sequencing of teaching materials, learning activities, and assessment tasks to ensure that preclinical and paraclinical disciplines are learned in a manner that facilitates their use in clinical decision-making (May and Silva-Fletcher, 2015). This contextualization or integration of preclinical, paraclinical, and clinical learning activities creates authenticity in learning, and is effective in engaging learners in the underlying basis of disease (Krockenberger, Bosward, and Canfield, 2007).

The key to integration that is often overlooked in clinical teaching is the fundamental discipline-specific detail that underpins a deep understanding of diagnostic processes and clinical case management. The analogy of the iceberg is relevant here. While it may be true that the analytical use of the preclinical and paraclinical disciplines in diagnostic reasoning utilizes a relatively small knowledge base, it is increasingly understood that this relies greatly on intuitive thinking that utilizes a much larger body of knowledge (Canfield et al., 2016). Therefore, the exposed tip of the iceberg of clinical knowledge requires the submerged bulk of detailed preclinical and paraclinical knowledge to position and contextualize the clinical knowledge into a useful relevant resource. Integration therefore has two overt levels that potentially require two approaches: the acquisition of contextualized fundamental knowledge; and the advanced integration of specific discipline-based knowledge in authentic problems. The success of the second, more advanced integration relies heavily on the fundamental groundwork of the first approach. Encouraging students to consider overtly how they interact with clinical problems and the investigative approach will allow them to utilize the tools at their discretion to arrive at appropriate conclusions (Canfield and Malik, 2016; Canfield et al., 2016). This applies as much to learning in the laboratory as it does to clinical learning (see Box 9.4).