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Observing consultations

The aim of this study was to identify commonly encountered patients, presentations and conditions in first opinion small animal practice. Using eight of our sentinel practices, data were collected by direct observation of consultations, for two weeks in each practice. Feedback sessions were conducted with the practices to gain practitioners’ opinions on the results.

Key findings:

• Consultations often involved the discussion of multiple problems, particularly when preventive medicine was the reason for presentation.
• Definitive diagnoses were rarely reached during the consultation; however a wide range of actions, particularly involving therapeutic treatment or management advice, was frequently taken.
• The results highlight the complexities of the first-opinion small animal consultations, and of the decisions made during these consultations.
• The findings will be used as a starting point to direct future research by identifying commonly encountered scenarios in veterinary practice for which good quality evidence may be lacking.

This work was carried out by Natalie Robinson, one of the CEVM’s first PhD students. Natalie's thesis is available via the University of Nottingham eTheses archive.

For further details follow the links to see poster presentations given at SVEPM 2011, SVEPM 2014, ISVEE 2012 and Evidence Live 2013.

References:

• Robinson N.J., Dean R.S., Cobb M. & Brennan M.L. (2014). Consultation length in first opinion small animal practice. Veterinary Record 175, 486.
• Robinson, N. J., Brennan, M.L., Cobb, M. & Dean, R.S. (2015). Capturing the complexity of first opinion small animal consultations using direct observation. Veterinary Record 176, 48.
• Robinson, N. J., Dean, R.S., Cobb, M. & Brennan, M.L. (2014). Diagnostic testing in first opinion small animal consultations. Veterinary Record, ePublication ahead of print.
• Robinson, N. J., Brennan, M.L., Cobb, M. & Dean, R.S. (2014). Clinical examination and weighing of patients in small animal consultation. Veterinary Record, ePublication ahead of print.
• Robinson, N. J., Dean. R.S., Cobb, M. & Brennan, M.L. (2015). Investigating common clinical presentations in first opinion small animal consultations using direct observation. Veterinary Record, ePublication ahead of print.
• Robinson, N. J., Brennan, M.L., Cobb, M. & Dean, R.S. (2015). Agreement between veterinary patient data collected from different sources. The Veterinary Journal, 205, 104-106.  
• Robinson, N. J., Brennan, M.L., Cobb, M. & Dean, R.S. (2016). Investigating preventive-medicine consultations in first-opinion small-animal practice in the United Kingdom using direct observation. Preventive Veterinary Medicine, 124, 69-77. 
• Robinson, N. J., Dean, R.S., Cobb, M. & Brennan, M.L. (2016). Factors influencing common diagnoses made during first-opinion small-animal consultations in the United Kingdom. Preventive Veterinary Medicine, 131, 87-94.
• Robinson, N. J., Brennan, M.L., Cobb, M. & Dean, R.S. (2017). Common decisions made and actions taken during small-animal consultations at eight first-opinion practices in the United Kingdom. Preventive Veterinary Medicine, 139, 1-9.  

Contacts: Natalie Robinson, Rachel Dean, Marnie Brennan, Malcolm Cobb