New vet nursing exams

Re: New vet nursing exams

Mark Hedberg — Fri, 06 Sep 2013 16:10:19 GMT

Fair enough - i get so used to reading between the lines that I'm as guilty of over-interpretation as the next vet.

Re: New vet nursing exams

Anthony Todd — Fri, 06 Sep 2013 15:31:11 GMT

Gosh, another one, totally missing my point; I'll try again. [last time. I promise]

I totally completely and utterly agree that the vast majority of nurses are capable talented individuals and I'd be quite pleased to work with them in the past and the future and I do not think that the soul of nursing is being drowned. I have never said that.

But the sample questions I quoted, even if answered correctly, which many good nurses, bad nurses, physicists or officers of the RCVS might be able to do, are not the sort of questions which should make up 20% of the questions which decide whether the candidate is suitable to be a Registered Veterinary Nurse by reason of her [esoteric] knowledge of radiography.

As my nemesis said:

"We are simply examining nurses to ensure a basic level of competence."

Those two sample questions do not do that, one is bureaucratically pedantic and the other requires an advanced physicist.....

Re: New vet nursing exams

Mark Hedberg — Fri, 06 Sep 2013 14:55:52 GMT

[quote user="Anthony Todd"]

[quote user="Gillian Mostyn"]I get it.[/quote]

No you don't, my dear, not even slightly, and after umpteen explanations from more than one person.

[/quote]

Tony, my dear, she does, really. You're concerned that the hands on, the heart, the soul of nursing is being drowned in box ticking and theoretical knowledge. Your fear is that the nurse of tomorrow won't be able to hold up their end as we vets on the sharp end of the stick need every bit of help we can get to do a damn hard job in a damn hard time. I think that fear is unfounded - I've worked in the UK for fewer years, but the vast majority of nurses have been capable, talented individuals I'd be quite pleased to work with in future. But you're right, there are good nurses, there are bad nurses, just like there are good vets and bad vets. If that wasn't the case, why have a DC? :)

Re: New vet nursing exams

Anthony Todd — Fri, 06 Sep 2013 14:28:21 GMT

[quote user="Gillian Mostyn"]I get it.[/quote]

No you don't, my dear, not even slightly, and after umpteen explanations from more than one person.

Re: New vet nursing exams

Gillian Mostyn — Fri, 06 Sep 2013 13:43:43 GMT

[quote user="Anthony Todd"]

[quote user="John Flynn"]Would you rather employ someone that you knew had passed an exam with questions like those I propose that demonstrate an ability to obtain a diagnostic radiograph, or employ someone who can define haemoptysis, knows the difference between the abbreviations RPS/RPA, can tell you what type of colloid Haemacell is, knows stuff about the chemical composition of screens, can tell you that an osteochondroma is benign etc etc.[/quote]

Hallelujah,at last, much better put but, at least, that's another who gets it......

[/quote]

I get it. You seem to think the current syllabus and examination system (of which neither of you has much knowledge) is producing nurses unable to be good nurses. I disagree.

Until you base your opinion on the end product, rather than assumptions made from a few specimen questions, then I doubt we'll ever agree.

Re: New vet nursing exams

John Flynn — Fri, 06 Sep 2013 13:23:24 GMT

[quote user="Bob Russell"]RPS/RPA are pretty fundamental to X-ray legislation and responsibility when things go wrong.[/quote]

Knowing who to contact may be fundamental. Memorising the jargon of theit title seems less useful to me.

[quote user="Bob Russell"]Anything -oma being at the benign end of the spectrum v's sarcoma is fairly basic stuff.[/quote]

lymphoma, melanoma, myeloma, mastocytoma...

[quote user="Bob Russell"]Thorough knowledge of fluids fundamental![/quote]

Thorough knowledge of Haemacell composition isn't (and never was) fundamental!

Re: New vet nursing exams

Bob Russell — Fri, 06 Sep 2013 13:16:09 GMT

[quote user="Anthony Todd"]

Hallelujah,at last, much better put but, at least, that's another who gets it......

[/quote]

Yes and no!

RPS/RPA are pretty fundamental to X-ray legislation and responsibility when things go wrong. Quite appropriate for a nurse to understand fully. Anything -oma being at the benign end of the spectrum v's sarcoma is fairly basic stuff. Thorough knowledge of fluids fundamental!

The smaller the number of questions the more impact a poorly worded question will have and obviously less knowledge is tested!

Re: New vet nursing exams

Anthony Todd — Fri, 06 Sep 2013 13:05:14 GMT

Hallelujah,at last, much better put but, at least, that's another who gets it......

Re: New vet nursing exams

karen jones — Fri, 06 Sep 2013 12:55:59 GMT

I am on holiday in France and have just got wi fi. My original point was with the same syllabus but the exams have been outsourced to other awarding bodies from the RCVS nursing department, surely here must be something wrong with how the syllabus has been interpreted by the new awarding bodies if the pass rate has changed so quickly. The results are no longer posted on the RCVS website. There were apparently only one or two practice papers available. I think it is harder to 65 percent on 15 questions than on 30.

Re: New vet nursing exams

Anthony Todd — Fri, 06 Sep 2013 10:13:52 GMT

[quote user="John Flynn"]We are simply examining nurses to ensure a basic level of competence. [/quote]

So, finally, and in closing, can we agree that knowing the name of your RPS and the chemical and physical composition of intensifying screens are, perhaps, not the best two sample questions, out of a total of five, that could have been chosen to decide whether a candidate had a practical knowledge of radiography!

Re: New vet nursing exams

John Flynn — Fri, 06 Sep 2013 10:05:35 GMT

[quote user="Gillian Mostyn"]

[quote user="John Flynn"]Obviously the questions should be set by someone who is an expert in radiography[/quote]

I disagree. We are simply examining nurses to ensure a basic level of competence.

[/quote]

I agree re basic level of competence. Perhaps:

"Obviously the questions should be set by general practitioners with suitable experience/training in setting MCQs and vetted by someone who is an expert in radiography"

What I mean is that someone who really knows about the field should be checking that the question and proposed answer are actually accurate!

[quote user="Gillian Mostyn"]

This is a multiple choice paper and the students are not given photos etc( or images to interpret). I'd more expect them to gain those skills while doing their NPL, so the responsibility for competence would lie with their clinical coach. However, I'll ask them next week if they would get a question like that in the OSCEs......

Apart from which, . I didn't get questions like that in my finals. It seems to me it is overly 'wordy' and likely to intimidate an already stressed and nervous candidate. A good exam is designed to draw out knowledge in as straight-forward a way as possible. Not to trip up a candidate!

[/quote]

I'm not familiar with the different parts of the examination, but as long as the end-product is someone that you can ask to go and take radiographs and return later to find a set of diagnostic images obtained with due respect to health & safety, then I think the goal would have been achieved.

I would maybe make the clinical coach responsible for introducing the trainee to whatever jargon and TLA's they felt were necessary and show them how to type a word they didn't understand into google, that might free up some space for pictures in the exam and questions confirming that they were familiar with obtaining diagnostic radiographs

Would you rather employ someone that you knew had passed an exam with questions like those I propose that demonstrate an ability to obtain a diagnostic radiograph, or employ someone who can define haemoptysis, knows the difference between the abbreviations RPS/RPA, can tell you what type of colloid Haemacell is, knows stuff about the chemical composition of screens, can tell you that an osteochondroma is benign etc etc.

Re: New vet nursing exams

Gillian Mostyn — Fri, 06 Sep 2013 09:24:27 GMT

[quote user="John Flynn"]Obviously the questions should be set by someone who is an expert in radiography[/quote]

I disagree. We are simply examining nurses to ensure a basic level of competence.

[quote user="John Flynn"] I'm not sure I understand all the different aspects of the examination and what is covered elsewhere, but I'd ask practical, commonplace, questions:[/quote]

Re: New vet nursing exams

Gillian Mostyn — Fri, 06 Sep 2013 09:16:04 GMT

Anthony - those are good questions and similar ones will appear on nursing exams. (But be careful of having too many possible answers, or multiple correct ones - they can only give one correct answer!) Don't forget that the exam is a random selection of questions taken from 1000s of possible questions. If the students could predict the question every year then....!!!!!

Re: New vet nursing exams

John Flynn — Fri, 06 Sep 2013 00:23:41 GMT

[quote user="Gillian Mostyn"]

[quote user="Anthony Todd"]Doesn't anyone on here think there could have been two better questions which would give a better indication of the candidate's knowledge of radiography?[/quote]

For example?

(Obviously excluding positioning, image quality, restraint and other 'practical' aspects as those are very well covered in the NPL and OSCEs.)

[/quote]

Obviously the questions should be set by someone who is an expert in radiography and I'm not sure I understand all the different aspects of the examination and what is covered elsewhere, but I'd ask practical, commonplace, questions:

1) You have been asked to obtain orthogonal radiographs of a dog's stifle suspected of having a cranial cruciate ligament tear. You obtain the following lateral radiograph using your standard methods of positioning and choose the exposure settings according to your clinics usual methods and review it for diagnostic quality:

Please select the best answer:

a) You are satisfied with the radiograph - no more images need be taken.

b) The exposure is incorrect and the radiograph must be repeated with higher exposures.

c) The digital interpretation of the radiograph is sub-optimal and the image requires re-assignment / re-processing.

d) The positioning is incorrect and the stifle should be flexed more and the radiograph repeated.

e) The positioning is incorrect and a small foam wedge should be placed under the hip and the radiograph repeated.

2) You have been asked to obtain orthogonal radiographs of a dog's stifle suspected of having a cranial cruciate ligament tear. You obtain the following caudo-cranial radiograph using your standard methods of positioning and choose the exposure settings according to your clinics usual methods and review it for diagnostic quality:

Select the most likely answer:

a) The image is underexposed - increase the kV and repeat the exposure.

b) The image is underexposed - increse the mAs and repeat the exposure.

c) The image is overexposed - both the kV and mAs need to be decreased and the exposure repeated.

d) The digital processing has been applied incorrectly and a different "look-up table"/algorithm needs to be selected (e.g. by choosing "large stifle caudocranial" instead of "small stifle caudocranial") and the image reprocessed.

e) The digital processing has been applied incorrectly and the edges of the the image need to be cropped to the collimated field and the image reprocessed.

I'd have a score of 1 for the "best" answer and then scores of fractions for some of other answers, with a score of zero for any answer that shows no understanding of the question at all.

Sorry - images not uploading, but you get the idea!

Re: New vet nursing exams

Anthony Todd — Thu, 05 Sep 2013 23:19:57 GMT

[quote user="Gillian Mostyn"]For example?[/quote]

1. The purpose of intensifying screens in cassettes is to:

protect the animal from excess radiation, increase the exposure necessary, decrease the exposure necessary, shorten the developing time, increase the developing time, give better definition to the Xray.

2. Increasing the KV will:

increase the definition of bone, decrease the definition of bone, lessen the exposure time, reduce the definition of soft tissue, increase the definition of soft tissue, increase the exposure time.

3. And a similar one on development and fixing if there's room.

4. And one on the relationship between distance from the anode and exposure time or similar.

Answer those correctly, or something better constructed, [which I'm not sure I can], and the candidate understands the basics of radiography.

If they can't then, oh dear....

Re: New vet nursing exams

Gillian Mostyn — Thu, 05 Sep 2013 22:58:36 GMT

[quote user="Anthony Todd"]Doesn't anyone on here think there could have been two better questions which would give a better indication of the candidate's knowledge of radiography?[/quote]

For example?

(Obviously excluding positioning, image quality, restraint and other 'practical' aspects as those are very well covered in the NPL and OSCEs.)

Re: New vet nursing exams

Anthony Todd — Thu, 05 Sep 2013 20:24:54 GMT

[quote user="bob lehner"]I actually do think it is quite important that everyone in the practice knows who their RPS is.[/quote]

I'll bet the best practices just stick the name of the RPS on the board, and be done with it...............

But is it so important that it is 20% of the theoretical paper on radiography and another 20% is on the chemical and physical composition, not the function of intensifying screens?

Doesn't anyone on here think there could have been two better questions which would give a better indication of the candidate's knowledge of radiography?

That's what I've been on about and what others have been on about.

Re: New vet nursing exams

bob lehner — Thu, 05 Sep 2013 16:17:44 GMT

[quote user="Anthony Todd"]

I can't believe any vet now agrees that 20% of the questions on radiography should be whether the person in charge is a RPO or a RPA [one of two] or a RPS. Is that really of practical or even theoretical use?

A sensible question might be "if you have any questions or problems with the X-ray equipment in your practice who should you turn to?"

[/quote]

Which would of course be the RPS (who must be a suitably qualified and knowledgeable individual) - and will be identified as such in the 'Local Rules', drawn up by your RPA, and which will, of course, be prominently displayed on the wall of your X-ray suite......

I actually do think it is quite important that everyone in the practice knows who their RPS is.

Re: New vet nursing exams

Rob Loxley — Thu, 05 Sep 2013 15:06:11 GMT

[quote user="Anthony Todd"]

[quote user="Thomas Johnson"]Under the current training system that would be entirely the fault of the practice they trained at.[/quote]

So they aren't examined on the really useful things vets need them to know, like clipping up a cat-spay?

[/quote]

The point is that they can only qualify having been assessed at competent over a variety of tasks in the NPL - including clipping-up - by their training practice. So if they have qualified and can't clip up, this is the fault of the training practice wrongly 'signing them off'' on that task.

Re: New vet nursing exams

Bob Russell — Thu, 05 Sep 2013 11:07:29 GMT

Should have added that here they would have been chatting and less rude to face someone you are talking to!

Not sure what the correct answer is for that!

Re: New vet nursing exams

Bob Russell — Thu, 05 Sep 2013 11:05:46 GMT

I have to admit that I think they are pretty good questions. They are tough and a few have more than one acceptable answer but I assume the course teaches a set protocol that may not be followed in practice. Examples such as two scrubbed up staff 'crossing' caused a bit of a debate as to whether they should be back to back or facing each other here!

Handing a scalpel over was interesting but again perhaps something that needed to be learnt from the book.

Re: New vet nursing exams

John Flynn — Wed, 04 Sep 2013 22:44:34 GMT

[quote user="Anthony Todd"]

[quote user="John Flynn"]Do you have answers, Anthony.[/quote]

Yes, they're on the last sheet of the .pdf in each of the papers, I didn't include them 'cos I thought all vets would know the answers.....

Are they the sort of questions you think should be asked in VNing exams?

[/quote]

I don't work with any VNs, so I'm probably not best placed to comment ... but I'm going to anyway

The questions are esoteric to me, but that's possibly just because of my general ignorance of vet nursing (and possibly vetting too!):

Q1) I've never heard of any of these people and don't know what a "self-care" model of nursing is, nor what it's relevance might be.

Q2) I think that's a reasonable question. (As much as I hate jargon)

Q3) I don't think that's a term I'd expect a nurse to use/know (maybe I just don't use if cause can't pronounce it, also "coughing blood" is less syllables)

Q4) I can't see relevance to general nursing (also never diagnosed it yet...)

Q5) I think that's a reasonable question. (As much as I hate jargon)

Q6) Probably reasonable (I think should know gingivitis, not sure about blepharospasm)

Q7) Reasonable I think

Q8) I had to look up "depraved"

Q9) Probably reasonable, but not a word I find myself using really.

Q10) Reasonable as term is commonly used (and not always correctly by members of public)

Q11) As I've never diagnosed an osteochondroma and don't think knowledge of the -oma vs -sarcoma suffix is generalised enough to be helpful, I'd not have included this question.

Q12) Reaonable I guess (but again "incarcerated" ain't a word I catch myself using)

Q13) Reasonable (though I'm now wondering what the difference with "tetraplegic" is...)

Q14) Reaosnable (though I've only done it once...)

Q15) Reasonable (though a little random?)

Q16) Probably reasonable

Q17) I know it's either (a) or (b), but have never used the product (nor am likely to!)

Q18) Reasonable

Q19) I'm torn between (c) and (d)?

Q20) Sorry, but what's a "standard antiseptic solution" and is there really some consensus on this?! Considered by whom?

Q21) Reasonable

Q22) I tend to pick up my own scalpel, but I'm guessing (b)?

Q23) I think it's (a), but never called them that - ever.

Q24) (c)? Does anyone ever have a collection of these lying around and shout to the nurse to get the "Mayo" ones? I'm genuinely intrigued, but can't honestly say that I see a practical implication of this piece of trivia.

Q25) Reasonable

Q26) Reasonable

Q27) Do nurses in UK regularly pass needles through parenchymatous organs (or use the word parenchymatous)?

Q28) Reasaonable

Q29) A GOOD question (!)

Q30) Reasonable

I didn't think any of the radiation questions were reasonable other than Q2 about mAs. (In fact I couldn't answer the other 3...)

Re: New vet nursing exams

Hanna Bennett — Wed, 04 Sep 2013 22:22:35 GMT

as someone has already said, the practical stuff is the training practice's responsibility not the training college - we have taken on second year students who are rubbish practically cos they haven't been supported appropriately - they catch up quick enough with us - our nurses are registered so they are aware that it is their professional standing at risk when they sign off a task as competent - give them responsibility and they prove themselves...

Re: New vet nursing exams

Gillian Mostyn — Wed, 04 Sep 2013 22:20:27 GMT

[quote user="Anthony Todd"]There was a saying by some veterinary employers "God save me from the academics"[/quote]

Re: New vet nursing exams

Gillian Mostyn — Wed, 04 Sep 2013 22:18:57 GMT

[quote user="Anthony Todd"]Not having a shot at you or your practice Gillian but I think this might explain why the pass rate has plummeted.[/quote]

Has it? Really? Not in my practice.

With respect, your lack of working knowledge of the current system and candidates makes your arguments theoretical.

[quote user="Anthony Todd"]In order to create this we have to raise the standard of "nurse training" to a much higher theoretical level, with a higher pass mark, and, I submit, as a result the practical training is regarded as a given.[/quote]

The 'pass mark' (???) is no higher than it always has been. The course is simply longer and more thorough.

As someone who runs a current TP, was an A1 assessor and is now a clinical coach, I have not seen any evidence of a drop in standards.

[quote user="Anthony Todd"]I'm not sure this will lead to a much better level of care for the patients[/quote]

I guess you have a better idea of where nursing care used to be. In my limited experience, older nurses tended to have a very poor underlying knowledge base and although they may have had boundless enthusiasm and empathy, with excellent hygiene and cleaning skills, they would be poor at a lot of the basic tasks that most modern nurses can do effortlessly; calculating deficits and maintaining fluid lines; ensuring correct calorific intake; choosing, placing and maintaining dressings; advising clients on behaviour etc etc. Nobody wants mini-vets but I don't think nurses want this either. They just want to be really good nurses.