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Evolution of the CertAVP
  1. Jill Maddison

Abstract

The RCVS Certificate in Advanced Veterinary Practice was launched in 2007. It differs markedly from the old certificates, as Jill Maddison explains

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THE RCVS Certificate in Advanced Veterinary Practice (CertAVP) was introduced in 2007 and replaced a certificate system that had been in existence for many years. The structure of the CertAVP is very different from the previous certificate.

The qualification is now modular, candidates can be enrolled for 10 years (compared with five years on the old certificate) and the RCVS has accredited universities to run the assessment process. But perhaps the greatest change is in the ethos of the CertAVP. This ethos is that for the veterinary profession to stay current and to be able to deal with the complexities and challenges of the 21st century, professional development has to be more than just focusing on enhancing discipline-specific skills.

Why the change and how does it differ?

The RCVS and others in the profession had been increasingly concerned that there was little opportunity for vets to advance their knowledge and skills other than through discipline-based certificates. The concerns about the old certificate system included the recognition that many vets started but never completed the certificate, that the quality, standard and depth varied between disciplines, and that assessment processes were out of date. Jill Maddison is director of continuing professional development at the Royal Veterinary College

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The new modular system allows veterinarians to pick and choose modules at a variety of universities. The rationale is that studying for the modular certificate allows structured, planned CPD that is learner-driven, work-based and flexible. Other key elements are that learning should be reflective (that is, learning from experience) and encourage lasting improvement in performance, and ensuring that important professional and key clinical skills are covered by everyone achieving a CertAVP regardless of the specific discipline being studied.

Although the universities are responsible for assessment and are able to modify RCVS-suggested assessment strategies to meet good educational practice, it is the RCVS and its subject boards that developed the learning outcomes and syllabus for almost all modules – universities are not able to amend these.

Candidates enrolled on the CertAVP may choose to follow an assessment-only route, where their preparation is self-directed according to their learning needs, or they may choose to enrol in the taught courses specifically targeted to various modules that are offered by some universities. Only some modules currently have taught courses to support them, and time will tell how much CertAVP-targeted CPD will flourish in the UK over the next few years. Both routes have advantages and disadvantages – there is no ‘gold standard’ that will suit everyone's learning needs, time frame and budget. Candidates should carefully research the various options offered to choose what suits them best. Learning support offered by those institutions not offering taught courses is variable and optional – it will be of benefit to some candidates and not to others.

As with any new venture there have been teething problems. The new certificate requires an enormous amount of resources from the universities and the demand for the CertAVP has been greater than expected, especially as only a few universities are fully engaged and offering large numbers of modules. The pressures that this has placed on several institutions have been considerable and some have struggled to fully meet the needs and expectations of candidates.

Those universities offering structured taught courses seem to have fared better, perhaps because they have been able to restrict their student numbers to suit their staffing resources. However, those that do not offer taught courses but enrol students to follow an assessment-only route have not been able to (or have chosen not to, so that no-one is prevented from enrolling on the certificate) restrict student numbers and this has proved challenging to say the least. It would be fitting if the profession could be patient while this enormous change in how certificates are run and achieved beds down.

How is it structured?

To achieve the CertAVP, candidates must pass the A-professional key skills module (15 credits), the B-clinical key skills module (5 credits) and at least one other B module (10 credits), together with either three C modules or a combination of B and C modules (30 credits). It is also possible to be assessed on individual modules as part of ongoing CPD, without working towards the full RCVS certificate.

Candidates who complete 60 credits may obtain a general CertAVP or a designated certificate. Designated certificates include species-based certificates such as CertAVP (equine practice; zoological medicine, etc) as well as discipline-based certificates like CertAVP (veterinary diagnostic imaging; animal welfare science, ethics and law, etc). Full details are available on the RCVS website www.rcvs.org.uk.

Module A in professional key skills requires consideration and assessment of a range of non-technical issues – communication skills, personal development, animal welfare, ethics, business and personnel management, data handling and legislation. It is currently assessed very differently at different universities. Assessment methods include online work and assessment, collaborative group learning and/or submission of essays. Candidates are urged to carefully evaluate which form of learning and assessment suits their needs best.

Module B in clinical key skills covers some of the fundamental clinical topics that the RCVS considers to be essential for all practising veterinary surgeons, regardless of the species they deal with, or the sector of the profession in which they work. It may be assessed within the practice B modules and/or through a multiple choice examination. The learning topics cover all species so that even if a veterinarian is doing an entirely small animal certificate or equine certificate the RCVS expects them to have some knowledge about public health issues.

The learning topics are clearly defined in the module outline and so should not come as a surprise to anyone who takes the time to read them.

The various practice B modules cover specific areas of practice – small animal, equine, production animal, zoo medicine, laboratory animals and global veterinary medicine. The general learning objectives of these modules are for candidates to:

▪ Acquire and develop written communication skills required to present case reports.

▪ Demonstrate an ability to communicate competence in decision making and clinical reasoning.

▪ Demonstrate reflective skills that enable understanding of the issues raised in clinical practice and the candidate's learning as a result of completing the module.

In addition there are specific ‘knowledge-based’ objectives depending on the module. Assessment strategies vary at different universities. Forms of assessment include case reports, reflective essays, discussion groups and examinations.

There are many C modules related to specific disciplines which are assessed by a variety of methods including case logs, case reports, essays, literature critiques as well as written and practical examinations. Many C module combinations are similar in depth and breadth to the ‘old’ certificates, but have a more flexible approach to assessment. Currently, there are a variety of C modules that are not offered by any university as they do not have the resources or staffing to do so.

In what order should the modules be studied?

Theoretically, according to RCVS rules, modules are stand alone and do not need to be taken in any particular order. However, pragmatically, because the practice B modules cover the principles of the different types of practice, it is wise to complete the relevant practice B module before starting C module work. For example, the B module in small animal practice covers the principles of clinical problem solving, surgery, therapeutics, anaesthesia and diagnostic imaging. Thus, it is excellent preparation for the discipline-specific work in various C modules, but should also assist in developing the candidate's skill in writing case reports, an essential component of most C modules, particularly for those who have not undertaken this type of task since their (sometimes distant) undergraduate days.

Starting module A before other modules can also be useful in helping the candidate get back into the discipline of studying and writing (where written work is part of the assessment process). Many candidates at the RVC choose to work on module A and their relevant practice B module simultaneously, while others prefer to complete module A before embarking on module B.

Conclusion

Will the CertAVP truly enhance the quality of our profession and prove to be of real benefit to a profession facing the challenges of the 21st century? Only time will tell, but early indicators are promising and the profession should be assured that all those involved are working very hard to make it happen.

Benefits of non-technical components

It is not surprising that replacement of an established qualification by a radically different one will be greeted with concern, fear and scepticism. The CertAVP is more complex than the old certificate, and there is concern that there has been a dumbing down of the discipline-specific component. However, while the CertAVP is broader in scope than the old certificate, the requirements of most C modules remain just as rigorous. Hopefully, this flexible modular approach, including the staged support provided by modules A and B, will result in more vets successfully attaining a certificate.

Many veterinarians question why they should be forced to study non-technical subjects or a broad range of clinical subjects when all they really want to do is spend their time increasing their knowledge of a specific clinical discipline. Yet, based on our experience at the RVC, module A work is seen as challenging, rewarding and in some cases life-changing for candidates. A recent candidate wrote, ‘I am a much happier vet now than I was earlier in the year, and I feel that the knowledge gained from these essays and my own critical reflections have made me a better vet too. Studying for the CertAVP and researching essays for module A has given me a much broader knowledge and I can see where there are similarities and differences between professions, and how we can learn from them to improve veterinary practice at many levels. I am really looking forward to starting modules B and C, and feel that my new approach to many areas of general practice will be of benefit to me and my colleagues for the rest of my professional life.’

Completion of the practice B module is almost universally recognised by our candidates as a beneficial exercise, even though most are aiming for a discipline-specific CertAVP. A recent candidate wrote ‘Module B has helped me to critically evaluate my protocols, approaches, and techniques across a wide range of small animal procedures. The further reading for each section has given me new ideas and increased knowledge and confidence to tackle future challenging cases, while the constructive feedback has both guided and motivated me to continue to work at the highest possible standard towards the C modules of the CertAVP.’

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