A keynote presentation for the Melbourne Academy for Veterinary Learning and Teaching (MAVLT) symposium, University of Melbourne, December 2 & 4, 2014 Abstract: Everyone agrees that veterinarians must be competent but what exactly is veterinary competence? Characterising veterinary competency is complicated by its context specificity, its intangible and abstract components and by the fact that it reflects social values and priorities. Yet a competency-based curriculum relies on having outcomes that are both understood and measurable. Many aspects of defining veterinary competencies are challenging, including whether they should be limited to observable behaviours, whether they should be viewed as carried by individuals or by teams, and how we can best represent the integrated holistic nature of competence. Viewing competency from different perspectives can stimulate new thinking about how to teach, assess and research this difficult concept.

1. The concept of veterinary competence:
perspectives and challenges
Liz Norman
Massey University

2. Every way of seeing is also a way of not seeing
Kenneth Burke (1935)
cited by Lingard, L. (2009). What we see and don’t see when we look at ‘competence’: Notes on a god term.
Advances in Health Sciences Education, 14(5), 625-628.

3. A competent veterinarian…
“applies knowledge, skills, attitudes,
communication and judgement to the delivery of
appropriate veterinary services in accordance with
their field of veterinary practice” (Veterinary
Council of New Zealand).
Consideration is given to performance of tasks to
an acceptable standard on a consistent basis.

4. AVBC: Essential competences
• knowledge and understanding
• skills
– information gathering
– analysis and judgment
– clinical skills
– communication and teamwork
– compassion, courtesy, respect, honesty, fairness;
– business knowledge
– self-management and group leadership;
• attitudes to
– ethics and cultural values
– animal welfare
– communication with clients
– referral
– teamwork
– balancing client needs
– role in biosecurity

5. Competency
• increasing emphasis on inclusion of more
generic aspects of competence such as problem
solving, empathy, self-monitoring and ethical
behaviour

6. Competency as behaviour
• operationalising an abstract concept
– but can we capture its essence completely?

7. Ginsburg, S., McIlroy, J., Oulanova, O., Eva, K., & Regehr, G. (2010). Toward authentic clinical evaluation: Pitfalls in the pursuit of
competency. Academic Medicine, 85(5), 780-786.

8. Competency as behaviour
• operationalising an abstract concept
– but can we capture its essence completely?
• tendency to look at it in parts
– but is the whole greater than the sum of the parts?

9. Lammers, R. L., Temple, K. J., Wagner, M. J., & Ray, D. (2005). Competence of new emergency medicine residents in the
performance of lumbar punctures. Academic Emergency Medicine, 12(7), 622-628.

10. Competency “seen” differently by
different people

11. Lavine, E., Regehr, G., Garwood, K., & Ginsburg, S. (2004). The role of attribution to clerk factors and contextual factors in
supervisors' perceptions of clerks' behaviors. Teaching and Learning in Medicine, 16(4), 317-322.

12. Competency “seen” differently by
different people
Significant differences between practice type:
• Communication skills: small animal vs equine
and mixed
• Critical and creative thinking: equine vs mixed
• Empathy: small animal vs food animal and
equine
• Sound judgment: equine vs small animal
Conlon, P., Hecker, K., & Sabatini, S. (2012). What should we be selecting for? A systematic approach for determining which
personal characteristics to assess for during admissions. BMC Medical Education, 12(1), 105.

13. Competency as complex, and
integrated
• increasing emphasis on competency as a
holistic, integrated concept where aspects are
combined in a complex combination as
specifically required by the situation
– should we look at interactions and relationships rather
than parts?
– how can we account for context?

14. Ginsburg, S., Regehr, G., & Lingard, L. (2004). Basing the evaluation of professionalism on observable
behaviors: A cautionary tale. Academic Medicine, 79(10 SUPPL.), S1-S4.

15. Levels of competency?
• minimum standards or aspirational?
• “veterinarians must be compassionate, altruistic,
and dutiful” (Walsh et al, 2001),
• “veterinarians are proactive leaders in the
profession and are recognized voices of
authority in important areas, such as animal
welfare and One Health medicine” (NAVMEC,
2011).
Walsh et al. (2001). Defining the attributes expected of graduating veterinary medical students. Journal of the American Veterinary
Medical Association, 219(10), 1358-1365.
North American Veterinary Medical Education Consortium. (2011). Roadmap for veterinary medical education in the 21st century:
Responsive, collaborative, flexible. North American Veterinary Medical Education Consortium. Retrieved from
http://www.aavmc.org/Veterinary-Educators/NAVMEC.aspx

16. Competency – individual or group
characteristic?
• implications
– knowledge acquired through interaction with people,
equipment, animals
– directs attention to skills in social awareness and
social co-ordination
• closed loop communication
• mutual performance monitoring
• adaptive and supportive behaviour
Lingard, L. (2012). Rethinking competence in the context of teamwork. In B. D. Hodges & L. Lingard (Eds.), The
question of competence: Reconsidering medical education in the twenty-first century (pp. 42-69). Ithaca, USA:
Cornell University Press.

17. Competency as identity
• is competence how we behave or is it deeper than
that?
• looking at competency from a identity perspective
enables to frame it terms of being rather than doing
• has implications for how we conceive of veterinary
training
– developmental
– socialisation
Jarvis-Selinger, S., Pratt, D. D., & Regehr, G. (2012). Competency is not enough: Integrating identity
formation into the medical education discourse. Academic Medicine, 87(9), 1185-1190

20. Competency as identity
• is competence how we behave or is it deeper than
that?
• looking at competency from a identity perspective
enables to frame it terms of being rather than doing
• has implications for how we conceive of veterinary
training
– developmental
– socialisation
Jarvis-Selinger, S., Pratt, D. D., & Regehr, G. (2012). Competency is not enough: Integrating identity
formation into the medical education discourse. Academic Medicine, 87(9), 1185-1190

21. Competency as socialisation
• clinical training provides an opportunity for
strong socialisation into the professional ways of
being as well as ways of acting
• involves a wide variety of people: other vets,
clients, technical staff, peers (both veterinary
and non-veterinary)

22. http://www.slideshare.net/liznorman