Before embarking on this, or other modules, candidates must fulfil the following criteria:

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1 Ref. No. Title: Category and Value: C-SAS.1 Small Animal Surgical Practice C - 10 Credits Notional Study Hours: 100 GENERAL GUIDANCE NOTES The following applies to all C modules. Before embarking on this, or other modules, candidates must fulfil the following criteria: a) Be a member of RCVS, or hold a registrable degree. b) Have at least 1 year s postgraduate experience working as a veterinary surgeon c) Be enrolled with RCVS if intending to take the Certificate in Advanced Veterinary Practice (enrolment will be valid for 10 years) d) It is also recommended that candidates who graduated after 2007 will have already declared themselves competent in their Year One Competencies, by completing the Professional Development Phase (PDP) before enrolling for any modules. PREPARING FOR A C MODULE Before embarking on any module, the candidate is advised to plan a structured programme of continuing professional development to help them achieve their objectives. Involvement in learning sets and networks of other candidates working towards the same or similar modules is encouraged; this could be a service provided by CPD providers, or could be initiated by the candidate themselves on a less formal basis. RCVS and the University of Edinburgh consider that a candidate will need advisers/mentors to support them through the programme. The candidate is free to choose their own advisers/mentors, or they may wish to enrol on a course offered by a university or by other CPD providers, where tutorial or supervisor support is available. GUIDANCE FOR THIS MODULE Candidates working towards the designated Certificate in Advanced Veterinary Practice (Small Animal Surgery) will need to complete the following modules: A-FAVP.1 Foundations in Advanced Veterinary Practice, B-SAP.1, C-SAS.1 and at least two other C modules (from designated SAS modules) plus one other B or C module. Upon completion of all the necessary modules, a further synoptic assessment will also be required.

2 AIMS This module should be seen as a core surgery module, which provides the foundation needed for further development in the other small animal surgery modules. The objective of this module is to promote a scientific, evidence based approach to small animal surgery, and to help candidates develop both practical and theoretical skills in the field. The candidate is expected to build on the foundation skills developed when undertaking the A and B modules, and to demonstrate progression towards advanced practitioner skills. The candidate will be able to evaluate their own standards of practice and develop strategies for continuous improvement in the future. LEARNING OUTCOMES At the end of this module candidates should be able to: Thoroughly understand the anatomical, physiological, immunological and pathological processes involved in surgical disease, including the relationships between surgery and the overall health status of the patient, and understand the pathophysiological responses to trauma including surgical trauma. Show thorough familiarity with the clinical presentation of the common surgical conditions affecting dogs, cats and small mammals. Understand and promote concepts of best practice in relation to asepsis, preparation of theatre, personnel and patient for surgery, and strategies available for managing intra-operative contamination. Understand and promote best practice in post-surgical nursing, including all aspects of recovery, nutrition and post-operative rehabilitation. Understand and communicate rational choice and use of antibiotic therapy in relation to surgical cases. Identify surgical equipment and know how to package, sterilise and maintain surgical instrumentation and equipment. Review and constructively criticise current literature on surgical principles, theatre practice and post-surgical nursing, to enable them to determine its relevance to their current practice. Utilise their understanding of Evidence Based Medicine and Decision Analysis to develop practical diagnostic and treatment protocols for their patients. Use available resources and communicate with owners in such a way as to achieve optimum results in their practice circumstances in relation to surgical cases. Review the outcomes of at least part of their clinical work, using the process of clinical audit to improve performance.

3 Recognise when a case is truly unusual, and become familiar with the information resources available to enable them to deal with such cases. Recognise when a case is beyond their personal or practice capabilities, and provide an effective channel of referral. Understand and recognise the moral responsibility for advising owners when they are inexperienced with a particular type of surgery. Appreciate the importance of adequate facilities and skill necessary for advanced surgery. ASSESSMENT STRATEGY FOR THIS MODULE The assessment of this module is in two parts: a case book of three reflective case essays, and a case log. 1. Case book For each essay, the candidate must select one case from their surgical case-load and use this to illustrate one of the three topics listed below. Each essay must illustrate a separate topic from the list. The candidate must state which topic the essay is illustrating. A separate case must be used for each essay. Each essay must be a maximum of 2000 words excluding reference list, tables and figure legends. Case reports that exceed the prescribed word count will be returned unmarked. References from both the current published literature and standard reference sources should be used sparingly to support major statements in the text. The candidate must clearly indicate which topic the essay demonstrates Topic 1: Topic 2: Topic 3: Discuss the application of theory and selection of wound products using a case as an example of open wound management in small animal practice. Demonstrate the importance of surgeon and patient preparation using a case undergoing surgery in small animal practice. This may include a discussion on the rational use of antibiosis in the perioperative period. One additional case that reflects one aspect of the module outcomes (excluding topics 1 and 2) should be described.

4 The essays should be laid out in the format Title + topic number Introduction Materials and Methods or Case Description Discussion References 2. Case log A case log of 100 consecutive surgical cases should be submitted, which should include elective and routine surgical procedures including brief details of the procedures used and outcome of the case. The case log should demonstrate a variety of surgical methods. To maintain this variety, stop including surgeries after 25% of the same of any one type has been reached (e.g. no more than 25% TPLO surgeries for the treatment of cruciate disease). This equates to 25 surgeries in the C- SAS.1 module and 5 surgeries in the other surgery modules. The Syllabus Content section below and the additional Surgical Procedures document should help guide the candidate in choosing cases for the log. Simple procedures and neutering cases should be kept to an absolute minimum to demonstrate variety as advised above. Please make sure to only include cases that relate to the syllabus content for the module. Cases from C-SAS.1 can be reused for case logs in other SAS modules. The case log should include the following information: Case no. Date Patient unique identifier Species Breed Age Sex Presenting complaint Procedure Complications Outcome Differential lists should be ordered with the most likely first. Scientific terms, not lay terms, should be used throughout.

5 All cases are to have been managed by the candidate. Cases selected should demonstrate that the candidate has dealt competently with a range of commonly presented conditions or situations from the area of practice in which they are working. The case log should start from when candidate registers for this module. This is to demonstrate the range of cases seen by the candidate while studying for the module. ASSESSMENT STYLE AND FORMAT The candidate is expected to pay close attention to the specific format and style for their submission as outlined in the CertAVP Assessment Style and Format Guidelines document provided via the online learning environment. As standard, the candidate should ensure that each submitted element: Displays the word count at the start of the document (where specified) Includes the candidate s examination number Has had all other identifying details, e.g. candidate s name and contact details, removed to ensure anonymity in the marking process If the candidate has any questions on the assessment process, these should be directed to the CertAVP team at Edinburgh. Full contact details are provided at induction, and via the virtual learning environment. SYLLABUS CONTENT In addition to the specific syllabus content outlined below, candidates should review the Surgical Procedures document provided with the assessment material, and apply where appropriate to the module syllabus below. 1. Pathophysiology of surgical disease Physiology of normal and disordered bone and soft tissue healing (including tendons, muscle, nerve and other body systems) Pathophysiology of trauma 2. Diagnosis of surgical disease Review history taking, clinical examination including neurological examinations Review diagnostic methods for identification of surgical disease Screening for occult or contributory medical disease Review the impact of concurrent medical disease on surgical outcomes. Principles of decision taking with regard to surgical disease,

6 including when to refer 3. Theatre practice Instrumentation for surgery (soft tissue and orthopaedic) o Identification of instruments for specific use o Knowledge of materials used for surgical instrumentation Correct use and maintenance of surgical equipment Sterilisation of instruments using different techniques, and storage and identification of sterile packs. Preparation of surgeon and assistants Preparation of patient o Identification of level of contamination and risks of specific surgeries (clean, clean-contaminated, contaminated, infected). o Rational choice of antiseptic solutions. o Draping techniques and materials. Asepsis, management of intra-operative contamination, sterile technique Theatre design and management of theatre personnel Record keeping in theatre and the use of records to identify sources of breaks in asepsis or post-operative infections Appropriate use of perioperative antibiotics and choice of antibiotics. 4. Surgical technique Halstead s principles of surgery Principles of oncologic surgery Tissue handling techniques and setting standards Management of surgical assistants 5. Introduction to current thinking in anaesthesia for non-routine surgeries Analgesia Sedation protocols for diagnostic procedures Premedication Induction Maintenance of anaesthesia Monitoring techniques and how that information is useful to the surgeon/anaesthetist Specific issues with long anaesthetic times Specific issues with patients in shock 6. Post-operative care Thermal regulation Nutrition and fluid balance

7 Oxygen supplementation Monitoring techniques Identifying and communicating nursing requirements Management of pain and stress Physiotherapy Monitoring and record keeping, interpretation of records Identification of post-operative complications; management strategies and knowing when to refer 7. Wound management Surgical wounds Basic wound first aid Open wound management (lavage, debridement, principles of promoting healing) Primary layer wound dressings Secondary and other dressing layers (including casting materials) Disordered open wound healing Decision making in wound management 8. Surgical ethics Introduce concepts of appropriate and inappropriate surgery Decision making in surgery Communication with owners pre and post operatively; management of post-operative care instructions When to offer referral