Health Management I, VETM*3400 Fall Winter Credits

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1 Calendar Description Health Management I, VETM*3400 Fall Winter Credits The course is the first of two comprehensive and integrated courses that will span the first two phases of the DVM program. Both courses are intended to establish the foundation for, and contribute to the students' achievement of selected DVM competencies in the context of the principles of health management. The primary emphasis of this component is to establish the historical perspective and basic tools required for health promotion and disease prevention. Administered by the Department of Population Medicine. Course Coordinators Dr. Todd, Rm 2536 Population Medicine, Ext , Dr. Kerry, Rm Deans Office, Ext , Instructors Dr. Cate Dewey, Veterinary Public Health Population Medicine, Rm 2509 Ext , Dr. Todd, Evidence Based Medicine and Decision Making, Clinical Epidemiology and Small Ruminants Dr. Derek Haley, Applied Ethology Population Medicine, Rm 2539 Ext , Dr. Cathy Gartley, Companion Animals Population Medicine, Rm 2544 Ext , Dr. Jessica Gordon, Beef Cattle Population Medicine, Rm 2538 Ext , Dr. Michele Guerin, Avian Poultry Population Medicine, Rm 203 Clinical Research Ext , Dr. Claire Jardine, Ecosystem Health Pathobiology, Rm Ext. 4656, Dr. Dan Kenney, Equine OVC HSC, Rm 2522 Ext , Dr. Kerry, General Health Management and Dairy Cattle Dr. Lee Niel, Applied Ethology Population Medicine, Rm 2526 Ext , Dr. Terri O Sullivan, Swine Population Medicine, Rm 205 CLRE Ext , tosulliv@uoguelph.ca Dr. Dale Smith, Non-traditional companion animals and alternative livestock industries Pathobiology, Rm 4843 Ext , dalesmit@ovc.uoguelph.ca Dr. John Tait, Companion Animals Clinical Studies, Rm 101 Ext , johntait@ovc.uoguelph.ca Dr. Pat Turner, Laboratory Animals Pathobiology, Rm 2163 Ext , pvturner@uoguelph.ca

2 Administrative Information For questions regarding academic consideration, continuation of study, academic misconduct, safety, confidentiality, and experiential learning involving use of animals, please refer to the appropriate sections in the introduction of the Phase Information on the web site. Course Description The course will be delivered as a series of industry and discipline blocks. Each species block will contain lectures designed to describe the structure and goals of each industry. Students will be introduced to current productivity, economic or disease issues important to the industry in the lectures. The lab sessions will include the use of a clinical case(s) or research paper(s) structured around the principal areas of health management. Discipline blocks will similarly reinforce the principles of health management as well as supplying students with a toolkit of knowledge and techniques. To achieve the learning objectives, students will be provided with a variety of learning experiences (lectures, laboratories, and computer based resources). The various industries and disciplines will be presented and discussed in such a way that students will be exposed to the breadth of knowledge and the opportunities for career development. Greater depth will be presented in subsequent courses in the Health Management series. Health Management: Definition Health management is the promotion of health and prevention of disease in animals within the economic/business framework of the animal owner/industry, while addressing the issues of animal welfare, human safety and environmental impact. Health Management: Principles 1. Promote optimal health. 2. Accommodate business/economic realities. 3. Promote animal welfare. 4. Promote human and food safety. 5. Consider potential environmental impact. Health Management: Delivery Health Management is a dynamic process in which selected management areas of importance to the animals, the industry and the animal owner are identified and monitored. Decisions are made and plans are developed and implemented. The outcomes are then measured and evaluated. This process is called the Health Management Cycle. Course Objectives Goals: The overall goal of this course is to present the students with an integrated approach to the disciplines of medicine, epidemiology, ethology, public health and animal husbandry in order to achieve the stated learning objectives. This course will also provide the foundation for more indepth coverage of these topics in subsequent courses (Phase 2-Health Management II and Phase 3- Health Management III). Health management programs strive to optimize health and solve disease problems in individuals and populations. This requires veterinarians to have skills in finding and critically appraising

3 information, problem solving, and calculating and interpreting quantitative measures. To provide effective health management services veterinarians must also know and understand the structure, function and goals of the various animal industries. The learning objectives for Health Management are expressed in five (5) major categories that are covered in the Health Management courses in Phases 1, 2 and 3. The five major categories are as follows: Animal Industries, Public Health, Animal Welfare, Animal Behaviour, and Evidence-based Decision Making in the Promotion of Health and Prevention of Disease. The following learning objectives outline what a student should know and be able to do at the end of the Health Management 1 course in the DVM Program: Animal Industries define basic industry terminology and describe the relative importance of each industry in Canada with respect to size and veterinary engagement identify common breeds of animals within common animal industries describe the production cycle for common animal industries from birth until death. describe the role of the veterinarian and how it differs between different species groups explain the important issues relating to health management across different species groups. state important industry benchmarks for measuring performance calculate some common measures of assessing performance for the various animal industries identify and describe the scope, structure and function of the relevant animal industries, including production norms and the major inputs and outputs Public Health explain the interrelationships between veterinary medicine, human health and well-being identify the main categories of human health risks from animals explain how use of veterinary drugs could adversely affect human health explain the main principles of zoonotic disease prevention and control identify important national and international veterinary public health organizations describe the responsibilities of veterinarians with respect to reportable diseases describe the rationale and main principles of risk analysis and HACCP Animal Welfare At the end of HM 1, and using your knowledge from AVM 1 about the welfare of animals a student should be able to: Understand how behavioural management, behavioural needs and domestication affect the welfare of animals Animal behaviour List and describe the importance of animal behaviour as it relates to health management, animal welfare and the veterinary profession Identify and describe various factors that cause and influence the behaviour of individuals and groups of animals (4 why s, motivation, learning, physiology, domestication)

4 Evidence-Based Decision Making in the Promotion of Health and Prevention of Disease Evidence-based veterinary medicine serves as the basis for effective decision making in the promotion of health and prevention of disease. explain the significance of the Principles of Health Management as they relate to the various animal industry groups define the term evidence-based veterinary medicine and explain the strategies involved in the practice of evidence-based medicine. critically appraise scientific literature to weigh evidence on opposing views compare and contrast the approaches to making a diagnosis describe the sequence of steps in making a diagnosis using the hypothetico-deductive method describe the historical context for the development of epidemiology and health management within veterinary medicine describe the Health Management Cycle and explain the significance of each component describe the importance of host-agent-environment interactions for both the cause and prevention of disease calculate incidence and prevalence of events in populations calculate sensitivity, specificity, predictive values, kappa and likelihood ratios explain the implications of using tests in combination describe the effect of changing cut-points for tests with continuous data explain the importance of tests and changing population prevalence to the diagnostic process

5 Evaluation There will be two formative midterm examinations in this course worth 15% each and a final comprehensive exam worth 70%. Midterm 1 Midterm 2 Final Exam 15% 1 hour Includes material from lectures 1-34 (up to and including Ecosystem Health ), associated labs and relevant web resources. 15% 1 hour Includes material from lectures 35 56, (up to and including Equine ), associated labs and relevant web resources. 70% During College Final Exam period The final exam is comprehensive. (i.e. covers material from all lectures, lab sessions and relevant web resources). The final grade will be based on the weighted average of the midterms (30%) and the final exam (70%). Students who miss any of the midterms are required to provide the appropriate documentation for academic consideration to the Associate Dean - Students. Once academic consideration has been granted a decision will be made by the course coordinators, on a case-bycase basis, on how to deal with missed midterms. A student who receives an overall failing grade in this course will be required to repeat Phase 1 of the DVM program.

6 Resources Course notes will be posted to the D2L course web site. In addition to posted notes, there are Resources posted for each species. Students are not responsible for all material posted in the Species section. However, material relating to the species timelines, breed information and glossary of terms will be used on both the midterms and final exam. Suggested Reference Texts: Clinical Epidemiology: A Basic Science for Clinical Medicine, 2nd ed. Sackett DL, Haynes RB, Guyatt GH, Tugwell P. Toronto: Little, Brown, and Company, Handbook of Evidence-Based Veterinary Medicine. Cockroft P.D. and Holmes M.A. Blackwell Publishing, Herd Health - Food Animal Production Medicine. 3rd Edition. Radostits O. M., W.B. Saunders Company, The Ethology of Domestic Animals: An Introductory Text, Second Edition, Jensen, P. (Ed.), CABI Publishing, Clinical Field Experiences: Students will have an optional opportunity to accompany field service clinicians during a final year core or elective health management rotation. Self-study Problem Sets: Two question and answer modules, covering descriptive and clinical epidemiology, will be posted to the course web site to coincide with the lecture material.

7 Lecture Lecture Topic Principle/Issue 1 Introduction Administration 2 Health Management General Principles 3 Applied Ethology 4 Ethology and veterinary medicine Instructor Haley Applied Ethology Explaining behaviour Haley 5 Applied Ethology Physiology and behaviour Niel 6 Applied Ethology Domestication and learning theory Haley 7 Applied Ethology Motivation, and animal welfare Haley 8 Introduction to Decision Making Introduction to Epidemiology: Historical Perspective Descriptive Epidemiology: Host, Agent, Environment Descriptive Epidemiology: Host, Agent, Environment Measuring Disease Risk: Dichotomous variables Measuring Disease: Counts and Prevalence Measuring Performance: Continuous variables 15 Small Ruminant-Sheep Industry/Role of Veterinarian 16 Small Ruminant -Goats Industry/Role of Veterinarian 17 Small Ruminant - Case Diagnostic Process/Rates 18 Swine Industry Industry Overview 19 Swine Industry Industry Overview 20 Swine Industry Role of Veterinarian 21 Swine Industry - Case Measuring Performance 22 Swine Industry - Case Measuring Performance Non-traditional companion animals and alternative livestock industries Hot Topic #1 Role of Veterinarian TBA O Sullivan O Sullivan O Sullivan O Sullivan O Sullivan Smith 25 Avian Industry - Poultry Industry Overview Guerin

8 26 Avian Industry - Poultry Role of Veterinarian 27 Lab Animals Role of Veterinarian Guerin Turner 28 Veterinary Public Health: Role of Veterinarian 29 Veterinary Public Health: Role of Veterinarian 30 Veterinary Public Health: HACCP Private Public Risk Dewey Dewey Dewey 31 Veterinary Public Health: Human Safety Zoonoses 32 Veterinary Public Health: Human Safety Residues 33 Ecosystem Health Role of Veterinarian 34 Ecosystem Health Role of Veterinarian 35 Beef Industry - Cow Calf Industry Overview 36 Beef Industry - Feedlot Industry Overview Dewey Dewey Jardine Jardine Gordon Gordon 37 Beef Industry - Case Introduction/Discussion Gordon 38 Beef Industry - Cow Calf Role of Veterinarian 39 Beef Industry - Feedlot Role of Veterinarian Gordon Gordon - Midterm #1 Formative Assessment 40 Clinical Epidemiology: Diagnostic Process 41 Clinical Epidemiology: Sensitivity and Specificity 42 Clinical Epidemiology: Predictive Values 43 Clinical Epidemiology: Post Test Probability 44 Clinical Epidemiology: Agreement /Likelihood Ratios Critical Appraisal of the Scientific Literature Critical Appraisal of the Scientific Literature 47 Companion Animal Industry Overview 48 Companion Animal Industry Overview Gartley Gartley

9 49 Companion Animal Industry Overview 50 Companion Animal Industry Overview Tait Tait 51 Hot Topic # 2 TBA 52 Equine Industry - Pleasure Industry Overview Kenney 53 Equine Industry - Competitive Industry Overview 54 Equine Industry Role of Veterinarian 55 Equine Industry Role of Veterinarian 56 Equine Industry - Case Infectious Disease Control 57 Dairy Industry Industry Overview 58 Dairy Industry Role of Veterinarian 59 Dairy Industry Role of Veterinarian Kenney Kenney Kenney Kenney - Midterm # 2 Formative Assessment 60 Dairy Industry: Case Tying it all together 61 Dairy Industry: Case Tying it all together

10 Lab Schedule Lab Lab Topic Principle/Issue #1 Swine Industry: Paper (Host/Agent/Environment) #2 Beef Industry: Case - Feedlot Respiratory Disease #3 Companion Animal Industry Critical Appraisal and Use of Tests #4 Dairy Industry: Paper (Sensitivity/Specificity/ Predictive Values) Descriptive Epidemiology Calculating Risk and Rates Evidence Based Veterinary Medicine Clinical Epidemiology Field Trip Schedule TUESDAY Oct. 27 BUS # 1 BUS # 2 TIME / GROUP A B C D 13:30 Everyone meets outside of LA Clinic Admissions to board buses 14:00 Arkell Poultry Arkell Swine Elora Dairy Elora Beef 15:30 Arkell Swine Arkell Poultry Elora Beef Elora Dairy 17:00 Everyone meets to board buses to return to OVC 17:30 Arrive back at OVC THURSDAY Oct. 29 BUS # 1 BUS # 2 TIME / GROUP A B C D 13:30 Everyone meets outside of LA Clinic Admissions to board buses 14:00 Elora Dairy Elora Beef Arkell Poultry Arkell Swine 15:30 Elora Beef Elora Dairy Arkell Swine Arkell Poultry 17:00 Everyone meets to board buses to return to OVC 17:30 Arrive back at OVC Approved August