Setting Up a Veterinary Medicine Skills Lab in Germany
Identifieur interne : 001F66 ( Pmc/Curation ); précédent : 001F65; suivant : 001F67Setting Up a Veterinary Medicine Skills Lab in Germany
Auteurs : Marc Dilly [Allemagne] ; Andrea Tipold [Allemagne] ; Elisabeth Schaper [Allemagne] ; Jan P. Ehlers [Allemagne]Source :
- GMS Zeitschrift für Medizinische Ausbildung [ 1860-7446 ] ; 2014.
Abstract
The amendments introduced to the current Veterinary Licensing Ordinance (TAppV) by the Veterinary Licensing Regulation (TAppO) have brought a high degree of skills orientation to fill the gap between academic study and preparing for a wide range of professional skills. In order to improve the veterinary skills of students while conveying fundamental methods in a structured and reproducible way, the University of Veterinary Medicine Hannover, Foundation, has set up the first central veterinary skills lab in Germany.
Practical training is provided by means of a three-tier delivery approach. This involves around 40 simulators on an area of approx. 800 m² under the guidance of 6-8 staff members, along with supplementary resources such as posters, text instructions and YouTube videos. Since it opened in March 2013, there have been 769 visits to the skills lab and 30,734 hits on YouTube.
Initial results show that the skills lab helps to maintain student motivation by teaching them practical skills at an early stage of the basic study-based acquisition of knowledge, whilst reinforcing skills acquisition per se in competence-based teaching. It enables veterinary students to prepare for their first examinations and treatments of live patients in a manner compliant with animal welfare.
Url:
DOI: 10.3205/zma000912
PubMed: 24872855
PubMed Central: 4027805
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<front><div type="abstract" xml:lang="en"><p>The amendments introduced to the current Veterinary Licensing Ordinance (TAppV) by the Veterinary Licensing Regulation (TAppO) have brought a high degree of skills orientation to fill the gap between academic study and preparing for a wide range of professional skills. In order to improve the veterinary skills of students while conveying fundamental methods in a structured and reproducible way, the University of Veterinary Medicine Hannover, Foundation, has set up the first central veterinary skills lab in Germany.</p>
<p>Practical training is provided by means of a three-tier delivery approach. This involves around 40 simulators on an area of approx. 800 m² under the guidance of 6-8 staff members, along with supplementary resources such as posters, text instructions and YouTube videos. Since it opened in March 2013, there have been 769 visits to the skills lab and 30,734 hits on YouTube.</p>
<p>Initial results show that the skills lab helps to maintain student motivation by teaching them practical skills at an early stage of the basic study-based acquisition of knowledge, whilst reinforcing skills acquisition per se in competence-based teaching. It enables veterinary students to prepare for their first examinations and treatments of live patients in a manner compliant with animal welfare.</p>
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</TEI>
<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">GMS Z Med Ausbild</journal-id>
<journal-id journal-id-type="iso-abbrev">GMS Z Med Ausbild</journal-id>
<journal-id journal-id-type="publisher-id">GMS Z Med Ausbild</journal-id>
<journal-title-group><journal-title>GMS Zeitschrift für Medizinische Ausbildung</journal-title>
</journal-title-group>
<issn pub-type="ppub">1860-7446</issn>
<issn pub-type="epub">1860-3572</issn>
<publisher><publisher-name>German Medical Science GMS Publishing House</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24872855</article-id>
<article-id pub-id-type="pmc">4027805</article-id>
<article-id pub-id-type="publisher-id">zma000912</article-id>
<article-id pub-id-type="doi">10.3205/zma000912</article-id>
<article-id pub-id-type="pii">Doc20</article-id>
<article-id pub-id-type="other">urn:nbn:de:0183-zma0009124</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Setting Up a Veterinary Medicine Skills Lab in Germany</article-title>
<trans-title-group xml:lang="de"><trans-title>Etablierung eines Skills Labs in der Tiermedizin in Deutschland</trans-title>
</trans-title-group>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Dilly</surname>
<given-names>Marc</given-names>
</name>
<xref ref-type="corresp" rid="COR1">*</xref>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tipold</surname>
<given-names>Andrea</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Schaper</surname>
<given-names>Elisabeth</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ehlers</surname>
<given-names>Jan P.</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
University of Veterinary Medicine Hannover, Foundantion, Clinical Skills Lab, Hannover, Germany</aff>
<aff id="A2"><label>2</label>
University of Veterinary Medicine Hannover, Foundation, Clinic for small animals, Hannover, Germany</aff>
<aff id="A3"><label>3</label>
University of Veterinary Medicine Hannover, Foundation, Competence centre for E-Learning, Didaktic and Education in Medicine, Hannover, Germany</aff>
<author-notes><corresp id="COR1">*To whom correspondence should be addressed: Marc Dilly, University of Veterinary Medicine Hannover, Foundantion, Clinical Skills Lab, Bischofsholer Damm 15, 30173 Hannover, Germany, Phone: +49 (0)511/856-8360, Fax: +49 (0)511/856-828360, E-mail: <email>marc.dilly@tiho-hannover.de</email>
</corresp>
</author-notes>
<pub-date pub-type="epub"><day>15</day>
<month>5</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="collection"><year>2014</year>
</pub-date>
<volume>31</volume>
<issue>2</issue>
<elocation-id>Doc20</elocation-id>
<history><date date-type="received"><day>16</day>
<month>5</month>
<year>2013</year>
</date>
<date date-type="accepted"><day>02</day>
<month>4</month>
<year>2014</year>
</date>
<date date-type="rev-recd"><day>08</day>
<month>10</month>
<year>2013</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2014 Dilly et al.</copyright-statement>
<copyright-year>2014</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-nd/3.0/"><license-p><pmc-comment>CREATIVE COMMONS</pmc-comment>
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc-nd/3.0/">http://creativecommons.org/licenses/by-nc-nd/3.0/</ext-link>
). You are free to copy, distribute and transmit the work, provided the original author and source are credited.</license-p>
</license>
</permissions>
<self-uri xlink:type="simple" xlink:href="http://www.egms.de/en/journals/zma/2014-31/zma000912.shtml">This article is available from http://www.egms.de/en/journals/zma/2014-31/zma000912.shtml</self-uri>
<abstract><p>The amendments introduced to the current Veterinary Licensing Ordinance (TAppV) by the Veterinary Licensing Regulation (TAppO) have brought a high degree of skills orientation to fill the gap between academic study and preparing for a wide range of professional skills. In order to improve the veterinary skills of students while conveying fundamental methods in a structured and reproducible way, the University of Veterinary Medicine Hannover, Foundation, has set up the first central veterinary skills lab in Germany.</p>
<p>Practical training is provided by means of a three-tier delivery approach. This involves around 40 simulators on an area of approx. 800 m² under the guidance of 6-8 staff members, along with supplementary resources such as posters, text instructions and YouTube videos. Since it opened in March 2013, there have been 769 visits to the skills lab and 30,734 hits on YouTube.</p>
<p>Initial results show that the skills lab helps to maintain student motivation by teaching them practical skills at an early stage of the basic study-based acquisition of knowledge, whilst reinforcing skills acquisition per se in competence-based teaching. It enables veterinary students to prepare for their first examinations and treatments of live patients in a manner compliant with animal welfare.</p>
</abstract>
<trans-abstract xml:lang="de"><title>Zusammenfassung</title>
<p>Mit Änderungen der Ausbildungsordnung der Tierärztlichen Approbationsordnung (TAppO) zur jetzigen Tierärztlichen Approbationsverordnung (TAppV) wurde der starken Kompetenzorientierung in einem Spannungsfeld zwischen akademischem Studium und der Vorbereitung auf ein breit gefächertes berufliches Aufgabengebiet Rechnung getragen. Um tierärztliche Fertigkeiten (Skills) zu verbessern und Basistechniken strukturiert und reproduzierbar zu vermitteln, wurde an der Stiftung Tierärztliche Hochschule Hannover das erste zentrale Skills Lab für Tiermedizinerinnen und Tiermediziner in Deutschland eingerichtet.</p>
<p>Die praktische Ausbildung erfolgt dort anhand eines dreistufigen Vermittlungskonzeptes. Unterstützt wird das Konzept von ca. 40 Simulatoren auf ca. 800m² unter Anleitung von 6-8 Mitarbeitenden und zusätzlichen Ressourcen wie Postern, Textanleitungen und Youtube-Videos. Seit der Eröffnung im März 2013 konnten 769 Besuche im Skills Lab und gut 30.734 Aufrufe des YouTube-Kanals verzeichnet werden.</p>
<p>Erste Ergebnisse zeigen, dass die Etablierung des Skills Labs einerseits dazu beiträgt, die Motivation der Studierenden zu erhalten durch frühes Erlernen von Fertigkeiten neben dem Wissenserwerb in den Grundlagenfächern und andererseits im Rahmen der kompetenzbasierten Lehre den Fertigkeitserwerb per se stärkt. Studierende der Tiermedizin können so tierschutzgerecht auf erste Untersuchungen und Behandlungen am lebenden Patienten vorbereitet werden.</p>
</trans-abstract>
<kwd-group><kwd>Skills Lab</kwd>
<kwd>Veterinary education</kwd>
<kwd>Clinical skills</kwd>
<kwd>Practical skills</kwd>
<kwd>Open educational resources</kwd>
<kwd>Simulation</kwd>
</kwd-group>
</article-meta>
</front>
<body><sec sec-type="intro"><title>Introduction</title>
<p>In recent years, veterinary studies in Germany have changed greatly with the various amendments to the training regulations introduced by the Veterinary Licensing Regulation (TAppO [<xref rid="R1" ref-type="bibr">1</xref>
]) to the current Veterinary Licensing Ordinance (TAppV [<xref rid="R2" ref-type="bibr">2</xref>
]). This has brought a high level of skills orientation to fill the gap between academic study and preparing for a wide-range of practical professional skills. Veterinary studies give students the scientific knowledge to enable them to practise in a wide range of areas. More than 58% of students go on to practise as veterinary surgeons after graduating [<xref rid="R3" ref-type="bibr">3</xref>
]. Practising veterinarians often complain of the low levels of clinical skills that recent graduates bring with them when they are first appointed [<xref rid="R4" ref-type="bibr">4</xref>
]. In the past, clinical skills were only taught in the last third of veterinary courses, primarily by means of demonstrations which only gave a small number of students the opportunity for hands-on practice. The first step to improving the teaching of practical skills was the introduction of a practical year incorporating external placements with checklists to be completed [<xref rid="R5" ref-type="bibr">5</xref>
], [<xref rid="R6" ref-type="bibr">6</xref>
]. The European Association of Establishments for Veterinary Education (EAEVE) evaluates and accredits veterinary educational establishments and has defined the aims of veterinary studies in terms of "day-one skills". These aims, in addition to important competences such as knowledge and attitudes, focus largely on practical skills [<ext-link ext-link-type="uri" xlink:href="http://www.eaeve.org/fileadmin/downloads/sop/SOP_Annex4.pdf">http://www.eaeve.org/fileadmin/downloads/sop/SOP_Annex4.pdf</ext-link>
]. Various concepts and orientation aids are being set up and evaluated for this purpose [<xref rid="R7" ref-type="bibr">7</xref>
], [<xref rid="R8" ref-type="bibr">8</xref>
](see table 1 <xref ref-type="fig" rid="T1">(Tab. 1)</xref>
).</p>
</sec>
<sec><title>Aim</title>
<p>The aim of the project is to set up a skills lab to convey clinical skills in veterinary teaching in Germany for educational and training purposes.</p>
</sec>
<sec><title>Description</title>
<p>Veterinary studies at the University of Veterinary Medicine Hannover, Foundation (TiHo), cover the statutory 3,850 teaching hours as well as providing 1,100 extra hours in external placements (clinical training, nutritional studies, animal welfare etc.). Practical clinical teaching on live animals accounts for 382 hours. In addition to hands-on teaching, students spend 460 hours at clinics and institutes in their clinical practice year. This provides a total of 842 hours of practical studies where students gain first-hand experience of a wide range of activities, in particular during the “practical year”, during which they get as much hands-on experience as possible [<ext-link ext-link-type="uri" xlink:href="http://www.tiho-hannover.de/studium-lehre/studium-der-veterinaermedizin/downloads/">http://www.tiho-hannover.de/studium-lehre/studium-der-veterinaermedizin/downloads/</ext-link>
]. Because of the large number of students (1,608 during the winter semester 2011/2012) compared with the number of animals that welfare regulations allow the university to house, not all students can be given the same opportunities to independently and repeatedly practise their skills on all animal species [<xref rid="R9" ref-type="bibr">9</xref>
]. When they start their studies, they only have a small amount of clinical practice and few classes on general procedures with animals, with practical teaching being confined mainly to semesters 4-11. However, it has been shown that early introduction of practical activities and dealing with issues of veterinary practice help to maintain the high initial levels of student motivation throughout their period of study, in spite of their considerable workload [<xref rid="R10" ref-type="bibr">10</xref>
]. This process can be facilitated by setting up a veterinary skills lab to additionally prepare students for their external placements and the practical year.</p>
<p>The aims of the TiHo skills lab are:</p>
<p><list list-type="bullet"><list-item><p>Early and ongoing practical exposure over the course of study</p>
</list-item>
<list-item><p>Acquisition of practical skills before performing interventions on live animals</p>
</list-item>
<list-item><p>Building and developing clinical practice competences in veterinary education</p>
</list-item>
</list>
</p>
<p>In human medicine, clinical skills have been taught in skills labs for many years now [<xref rid="R11" ref-type="bibr">11</xref>
], [<xref rid="R12" ref-type="bibr">12</xref>
], [<xref rid="R13" ref-type="bibr">13</xref>
]. Numerous studies have confirmed their effectiveness in conveying practical skills in tandem with the possibility of checking the competences acquired [<xref rid="R14" ref-type="bibr">14</xref>
], [<xref rid="R15" ref-type="bibr">15</xref>
], [<xref rid="R16" ref-type="bibr">16</xref>
], [<xref rid="R17" ref-type="bibr">17</xref>
]. As well as the variety of training opportunities on offer, it has also been shown that the concept of training students in skills labs contributes to an improvement in procedural competences [<xref rid="R18" ref-type="bibr">18</xref>
]. As well as delivering the required theoretical knowledge, the acquisition of practical skills requires intensive practice with the possibility of repetition. In order to teach basic veterinary techniques and skills in a structured and reproducible way, students should be increasingly offered opportunities to acquire practical skills and to train. To this end, a training programme based on the "day-one skills" concept recommended by the EAEVE was developed and integrated into a structured concept (seeTable 2 <xref ref-type="fig" rid="T2">(Tab. 2)</xref>
[<ext-link ext-link-type="uri" xlink:href="http://www.eaeve.org/fileadmin/downloads/sop/SOP_Annex4.pdf">http://www.eaeve.org/fileadmin/downloads/sop/SOP_Annex4.pdf</ext-link>
]). In agreement with individual clinics and institutions, learning aims were defined and arranged in a three-tier delivery approach for skills acquisition. The aim of the approach is to develop a dynamic structure by which clinical skills can be taught and acquired. To this end, a wide variety of skills will be arranged and taught in a three-tier system (general clinical skills, special clinical skills, professional clinical skills). Didactic methodological guidance will be implemented to impart the skills required by the relevant target groups at each particular stage of their studies. These skills will then be offered either as optional subjects or incorporated into the existing mandatory curriculum. </p>
</sec>
<sec sec-type="results"><title>Results</title>
<p>The delivery approach combines elective courses in basic veterinary techniques for complementary or recurring aspects of studies with mandatory training provided in collaboration with TiHo clinics and institutes. However, elective practice and reinforcement of practical skills in small groups and the possibility of intensive preparation and follow-up of teaching content through independent study are still the main tools for learning. The increasing inclusion of self-teaching elements will focus increasingly on the acquisition of practical competencies. The approach will incorporate various forms of teaching, including peer-assisted teaching, cognitive apprenticeships, workshops (with a maximum of 8 students per group) and problem-oriented learning (POL). To this end, special teaching materials (guidance notes, display panels, posters, case studies etc.) are designed and complemented by open educational resources (OERs). This involves using resources such as WikiVet [<xref rid="R19" ref-type="bibr">19</xref>
], [<xref rid="R20" ref-type="bibr">20</xref>
]. Some documents (text, images and videos) will be made available to other universities under creative commons (CC) licences via WikiVet, Vetipedia or in the form of e-books. Existing video podcasts produced by the skills lab will be the focus of the OERs. Clinical skills learning through simulations on models (low-fidelity, medium-fidelity) will be accompanied and complemented by videos available from the YouTube channel (<ext-link ext-link-type="uri" xlink:href="http://www.youtube.com/user/TiHoVideos">http://www.youtube.com/user/TiHoVideos</ext-link>
) which was set up in April 2012. Training videos for classes and to demonstrate particular skills on models/simulators and on live patients are continuously being created. To date, 52 videos have been created with 116 subscribers and 30,734 hits (see Figure 1 <xref ref-type="fig" rid="F1">(Fig. 1)</xref>
, as at 30 September 2013). The videos are useful not only as preparation for a session in the skills lab, but also as a chance to verify or reinforce particular skills. </p>
<p>The skills lab opened in February 2013 and since then has been available to students during and between semesters. Initial evaluations of the 769 visits to the teaching stations from March to September 2013 show that there was a high level of interest, and not just during semesters, in the elective teaching on offer in the skills lab of the University of Veterinary Medicine Hannover, Foundation (se Figure 2 <xref ref-type="fig" rid="F2">(Fig. 2)</xref>
). The largest user group is students in semesters 7-8, as they are approaching the practical year in semesters 9-10. </p>
<p>At the time of writing, our investigations have not found any other veterinary educational establishments in Germany with skills labs, in contrast with other countries (both in Europe and further afield), which offer numerous training centres and use veterinary simulators as part of their curriculum [<xref rid="R21" ref-type="bibr">21</xref>
], [<xref rid="R22" ref-type="bibr">22</xref>
], [<xref rid="R23" ref-type="bibr">23</xref>
], [<xref rid="R24" ref-type="bibr">24</xref>
], [<xref rid="R25" ref-type="bibr">25</xref>
], [<xref rid="R26" ref-type="bibr">26</xref>
], [<xref rid="R27" ref-type="bibr">27</xref>
]. To date, there are no reports or experiments on establishing training centres in application of the Veterinary Licensing Ordinance (TAppV). The reasons for this can only be speculated – on the one hand, the TAppV and the related range of competency requirements is diverse, and not all day-one skills can be taught in a skills lab [<xref rid="R7" ref-type="bibr">7</xref>
], [<xref rid="R28" ref-type="bibr">28</xref>
]; on the other, veterinary studies in the past tended to focus exclusively on imparting knowledge, while practical education and skills training was normally carried out at the initiative of the universities themselves, using their own animals and patients in their own clinics [<xref rid="R6" ref-type="bibr">6</xref>
], [<xref rid="R29" ref-type="bibr">29</xref>
]. The required resources and the specific nature of local structures are decisive when setting up a skills lab. In addition to the cost of the necessary premises, the equipment itself (simulators, devices etc.) and the overheads (staff, consumables etc.) are very costly [<xref rid="R11" ref-type="bibr">11</xref>
], [<xref rid="R18" ref-type="bibr">18</xref>
]. Currently the TiHo skills lab has more than 40 models. In addition, devices and diagnostic equipment (ultrasound, endoscopy etc.) as well as a haptic trainer for transrectal examinations are provided [<xref rid="R24" ref-type="bibr">24</xref>
]. The estimated costs totalled some EUR 480,000. 6-8 student research assistants are currently engaged in the maintenance and coordination of the teaching content, along with one full-time member of the teaching staff who provides veterinary guidance in the skills lab. We were only able to cover this significant outlay thanks to financial support from the Federal Ministry of Education and Research (BMBF) as part of the teaching quality package (Qualitätspakt Lehre). Thanks to the transfer of the Small Animals Clinic, some 21 clinical standards-compliant rooms with a total floor area of 800 m2 became available for the skills lab.</p>
</sec>
<sec sec-type="discussion"><title>Discussion</title>
<p>The inclusion of a skills lab as part of the training for veterinary students as described in this project should improve teaching outcomes and students’ practical skills. The benefits are earlier training in hands-on skills, a structured delivery concept and supervision of students, whilst simultaneously ensuring that all training in clinical skills can be constantly repeated in a motivating atmosphere [<xref rid="R17" ref-type="bibr">17</xref>
], [<xref rid="R30" ref-type="bibr">30</xref>
]. This also serves to improve animal welfare, as direct interventions on animals can be either reduced or, where they are carried out by students, performed as more routine interventions thanks to the repeatability of individual skills [<xref rid="R31" ref-type="bibr">31</xref>
]. The continuous and elective nature of the training offer as well as an earlier start to practical skills (from semester 1) mean that the teaching concept is not time-restricted with regard to skills acquisition on different study routes. The future effectiveness and increase in the competences of students will lie decisively in individual teaching outcomes derived from the EAEVE's catalogue of day-one skills. In future, in accordance with the "Praktische Fertigkeiten im Medizinstudium“ [Practical Skills in Medical Studies] consensus statement, all learning goals will be set based on fixed levels of experience of clinical skills [<xref rid="R32" ref-type="bibr">32</xref>
]. The benefits of the skills lab concept are its established structure and the possibility of standardised practical training achieved through simulations. However, the inclusion of simulation-based teaching in medical curricula does have certain limitations [<xref rid="R30" ref-type="bibr">30</xref>
], [<xref rid="R33" ref-type="bibr">33</xref>
]. Not all models and simulators provide sufficient feedback to allow them to replace conventional classes. Clinical training on patients and the interrelation between complex clinical processes cannot be taught in a skills lab or by using simulators alone [<xref rid="R34" ref-type="bibr">34</xref>
], [<xref rid="R35" ref-type="bibr">35</xref>
]. On the other hand, the use of models in structured learning concepts for the acquisition of practical competences is highly suited for incorporation in skills lab training. A recent study has shown that training provided in a skills lab can help to reduce anxiety about surgical interventions among veterinary students [<xref rid="R36" ref-type="bibr">36</xref>
]. Other benefits of skills labs include the efficiencies provided by standardised practical training and the positive impact such training has on the surgical performance and learning outcomes of students [<xref rid="R12" ref-type="bibr">12</xref>
], [<xref rid="R14" ref-type="bibr">14</xref>
], [<xref rid="R15" ref-type="bibr">15</xref>
], [<xref rid="R18" ref-type="bibr">18</xref>
], [<xref rid="R27" ref-type="bibr">27</xref>
], [<xref rid="R37" ref-type="bibr">37</xref>
]. Future evidence-based studies will have to show whether comparable effects can be achieved through the use of veterinary skills labs. Discussions on the extent to which skills labs can and should be implemented in veterinary medicine curricula are currently underway in Germany and on an international level [<xref rid="R38" ref-type="bibr">38</xref>
], [<xref rid="R39" ref-type="bibr">39</xref>
]. </p>
</sec>
<sec sec-type="conclusions"><title>Conclusions</title>
<p>By implementing the measures described in this project, the teaching of practical skills to students in treating domestic and farm animals can be carried out with improved levels of animal welfare. Incorporating independent learning elements into veterinary studies prepares students early for the lifelong learning which veterinarians are obliged to undergo even after they have been awarded their licences.</p>
</sec>
<sec><title>Competing interests</title>
<p>The authors declare that they have no competing interests.</p>
</sec>
</body>
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<floats-group><fig id="T1" position="float"><label>Table 1</label>
<caption><title>Thematic summary of practical skills classed as day-one skills for veterinary medicine (taken from the recommendations of the European Association of Establishments for Veterinary Education, EAEVE; X = training/teaching stations in the skills lab</title>
</caption>
<graphic xlink:href="ZMA-31-20-t-001"></graphic>
</fig>
<fig id="T2" position="float"><label>Table 2</label>
<caption><title>Clinical skills lab delivery concept; MCQ = Multiple choice test; OSCE = Objective structured clinical examination; POL = Problem-oriented learning; Workshops* max. 8 participants</title>
</caption>
<graphic xlink:href="ZMA-31-20-t-002"></graphic>
</fig>
<fig id="F1" position="float"><label>Figure 1</label>
<caption><title>Hits for videos on the YouTube channel (TiHoVeodeos) from April 2012 to September 2013. A total of 30,734 hits were recorded for 52 videos (as at 30 September 2013).</title>
</caption>
<graphic xlink:href="ZMA-31-20-g-001"></graphic>
</fig>
<fig id="F2" position="float"><label>Figure 2</label>
<caption><title>Analysis of the number of visits to all of the teaching stations in the skills lab at the University of Veterinary Medicine Hannover, Foundation, from March to September 2013 (total number of visits: 769).</title>
</caption>
<graphic xlink:href="ZMA-31-20-g-002"></graphic>
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