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Sunday, October 22, 2017

Tactile learning with positive veterinary care - from learning to doing

ranger and  Emily
Hands on practice only takes a few minutes

 As I am leading handling labs in Low Stress Handling, I have come to realize the tremendous impact hands on learning has to actually feeling confident using Low Stress handling techniques.  This type of learning is also called tactile learning - because you literally feel the process of what you are learning.  When I think about providing health care to animals, it is primarily based on touch.  One must touch an animal to lead them to an exam area, to listen to their heart,examine their skin, look in their mouth and more.  For many of us, touching the fur, feathers or scales of an animal is very calming to ourselves.  This is part of what attracts us to veterinary practice, shelter care or training.   Through Low Stress Handling, we can now be more aware of how we provide a calming effect through our touch to any animal.  The knowledge  of an  animal's body language, past and new memory,  physical and emotional health lay the foundation for delivering low stress care.  The next step is actually handling the animal using this knowledge.  
 
That is where the handling labs come in - the opportunity to actually try out the knowledge you have gained from seminars, webinars and certification programs.  As I am leading these labs to various groups, I am realizing some important elements to have in place for a good learning experience.   This list is based on my experience training faculty who are certified in Low Stress Handling, staff at a large shelter who while not certified have been using the skills, and general veterinary staff who are starting to learn to use these techniques.   While this is a diverse range of students,  there are some common needs in learning  to feel confident to use these skills:  
 
Technique check Am I doing this right?
teaching blood draw  
technique points for low stress jugular blood draw
  - students need a coach who actually uses these handling techniques, and directly observes the student for hand placement, body position and approach.  The coach needs to think  of ways to adapt these techniques based on the animal's body or the handler.  In leading a session,  I found reminding the students of the anatomical points of placement  for head holds, cowl holds, blood draws, or positioning from standing to lateral and had them compare touching on their own body these points. That small step helped them recognize how important bony points are in handling and not holding against soft tissue.  This  improved their confidence immediately.   As I would see the " gaposis" as I call it - arms splayed out along side a cat in a towel wrap where the cat might wriggle free - then move the handlers arms in and remind them to close the gap - BINGO!  They understood how thier body placement of both the handler and animal  mattered.   I use the Low Stress Handling, Restraint, and Behavior Modification et al book by Dr Sophia Yin  as my guide, as well as some of the instructional DVD's from Cattledog publishing.   With these resources at everyone's side, they too can quickly look up a point for review and use these resources at home.  
 
Stuffed animals - fun support from  peers.
having fun in handling lab  
Laughing is part of handling labs
  When you have a stuffed animal you have the security of knowing if you mess up it won't hurt anyone.  You have peers who are also practicing technique first on the stuffies then moving onto real animals. The group collaborates, sharing how the holds and  body placement feels and what they find works in their situation.  It is safe to make  mistakes and even the most skillful will share what they find difficult.  With the live animal in this practice environment,  the stress is off if you miss the vein on a blood draw, or the animal is escalating  and you are not recognizing it.  Certified coaches  will kindly point it out an  alternative approach for the second try.  Often here is where fellow students  will share the stories of animal stress escalation that they did not see or appreciate.  Now they can see it, the coach can point out what touch,noise or is particular to this patient has been part of the escalation to make a better handling situation.  I love these moments because it is like we are all on even ground learning in the moment.  
 
Special situations - Not every practice, shelter or animal care setting is the same. Often we discuss  ways to organize space, or manage an animal holding area to decrease stress.  With each presentation, I have found more and more ways to help animal care providers create a less stressful handling situation based on the behavior knowledge that is the foundation of Low Stress Handling. It is when the students are sharing ideas and stories that solutions are thought of and tried out.  Staying in contact with these students to hear how the ideas work out is what continues development of more Low Stress Handling techniques.   
spay scar check  
figuring out a less stressful way to check for spay scar
 
I will be leading a handling lab at the Illinois State Veterinary Medical Convention in Lombard Il November 3.  The lab is full, but I am working on dates for handling labs in 2018. Below I have a survey I would like for you to fill out.  There is an opportunity for me to develop a place to have handling labs in an actual practice setting.  We would have lectures, and practice animals in exam rooms, treatment areas and run areas just like a practice.  The point of a space like this would be to learn in a space that is close to where you actually have to do these skills - in a practice.       
 
Thanks !  
Sally J Foote DVM CABC-IAABC