Comparison of anaesthesia 'day 1 skills' expectations between veterinary anaesthetists and general practitioners.
Context: 'Day 1 skills' (DOS) were introduced by the Royal College of Veterinary Surgeons (RCVS) in 2006 as a guideline for the minimum competency level required of a veterinary graduate. The DOS are broad and are designed to provide a general guide to the standards and principles students must achieve before graduation, in order to ensure they are safe to practise. The breadth of the RCVS DOS list allows a wide range of opinions to be held among teaching staff about the relative importance of more detailed, specific skills. This is particularly apparent in anaesthesia, as the DOS give little detail on the skills required for working with different species. For example, skill such as tracheal intubation may be deemed essential in dogs, but rarely required in cattle practice. This study aimed to test the hypothesis that the veterinary anaesthesia DOS considered most important by veterinary surgeons in practice and veterinary surgeons with a specialist interest in anaesthesia in the UK and Ireland would differ. In addition, the study explored current opinions on veterinary undergraduate anaesthesia training among these two groups. Main conclusion: There is agreement between veterinary general practitioners (GPs) and veterinary anaesthetists that new graduates should not be expected to be omnicompetent across species in anaesthesia. However, it is clear that pain assessment is considered an essential competency in all species, by the majority of both veterinary GPs and anaesthetists. This study has also revealed discontent among veterinary GPs with the level of practical anaesthesia teaching and 'hands on' experience currently provided to veterinary undergraduates. Approach: A comparative study design was used to collect data from veterinary GPs and anaesthetists between July 2011 and July 2012. Questionnaires for anaesthetists and GPs were developed. Respondents were asked to categorise anaesthesia DOS as 'essential', 'desirable' or 'unnecessary', in the domains of knowledge of equipment and its use; species-specific anaesthesia skills (dogs and cats, horses, farm animals, rabbits and exotics); and pharmacological knowledge and experience. In addition, the questionnaire captured free-text data in response to open-ended questions about the anaesthesia skills of new veterinary graduates. Results: One hundred members of the Association of Veterinary Anaesthetists responded (31 per cent response rate), of which 55 were UK-based. A randomised sample of veterinary practices stratified by county generated 234 general practitioner responses (30 per cent response rate) and a convenience sample targeted at veterinary specialists in the UK generated 161 general practitioner responses. There was close overall agreement between the two groups of veterinary GPs and anaesthetists on essential anaesthesia DOS. All anaesthesia DOS, apart from 'ability to perform CPR' and 'use of local anaesthetic techniques', were considered to be essential for working with dogs and cats. However, expectations varied with species - they were greatest in cats and dogs and lowest in exotics. Many respondents commented that new veterinary graduates lack practical skills and should not be expected to be omnicompetent across all species.