First-year veterinary student Simran Nagi listens to a horse's organs during an equine OSCE. Dr. Mariya Pitel, instructor of rural veterinary practice, grades the exam. Photo by Jens Odegaard.

March 26, 2024
Words by Jens Odegaard. Photos by Jens Odegaard and Dr. Lilian Wong.

A veterinary visit starts with a physical exam. Which means that knowing how to perform one on an animal is a key skill that all veterinarians need. 

Dr. Lilian Wong joined the faculty of the Oregon State University Carlson College of Veterinary Medicine as a clinical skills instructor in fall 2022. Her role is to ensure students have the foundational skills needed for everyday veterinary practice. 

She quickly realized that although exam skills had always been taught in the college, they came in bits and pieces throughout a variety of classes. It would be helpful to institute an objective, comprehensive approach to teaching how to perform a thorough physical exam.

As colleague Dr. Kate Schoenhals, instructor of rural veterinary practice, put it: “I think the physical exam is probably the single most common and probably most important, diagnostic that you have as a veterinarian. It's the one irreplaceable component when you're in practice. The technician can't really do it for you. The client can't do it. You have to be able to do it and interpret it.”

Offering OSCEs
Borrowing on best practices in both human and veterinary medicine, Wong decided to start offering Objective Structured Clinical Exams for all first-year veterinary students. “The goal for OSCEs are to set clear objectives on hands-on skillsets that students need to show proficiency and ability to do before they move on to the next step in their curriculum,” said Wong. 

Schoenhals added: “I think doing this at the beginning, my hope, my dream is that it will allow them to build on it, so by the time they get to fourth year, they're much more capable of interpreting abnormal and recognizing the range of normal that exists.” 

The OSCE consists of each student performing a full physical exam to assess the overall state and health of a patient while being observed and graded by a veterinarian using a matrix assessment tool for every step in the exam. An animal handler is also present to help hold and/or restrain the patient while the student performs the exam. 

This presents a logistical challenge as it takes enough physical space, animals, veterinary evaluators and handlers to give each student the experience.

To get the ball rolling, Wong decided to focus on OSCEs for two of the most common species in veterinary practice: dogs and horses. 

For the first time, the college would offer canine OSCEs at the end of the fall term 2023 and equine OSCEs at the end of the winter term 2024. Each OSCE segment would be delivered on one day with upwards of six students performing exams on different animals at the same time.  

It Takes a Village  
She reached out to the college’s teaching faculty and veterinary alumni for volunteers to serve as evaluators and asked the college’s veterinary technicians, assistants and upper-class members to volunteer as handlers. More than 30 folks volunteered to help. 

For the canine OSCEs, students volunteered their dogs for the exams and Wong utilized a large indoor space at the Oldfield Animal Teaching Facility in OSU’s College of Agriculture. For the equine OSCEs, she was able to utilize the Carlson College’s teaching herd and exam barn.  

To prepare students for the exams, Wong and faculty colleagues incorporated training and practice elements into the clinical skills curriculum throughout the terms leading up to the exams. “They get an introduction to the basis of physical exams,” said Dr. Jorge Vanegas, associate professor of rural veterinary practice, who helps teach clinical skills. "In the fall quarter, we start with just the basic guidelines of how to perform and examine multiple species.  And with respect to horses, we do a demo by acclimation first and then in winter term, the students have the opportunity to come twice a week and rotate through the different horses, so they can differentiate the behaviors of each of them and follow the methodical steps of the physical examination.” 

College alumni were enthusiastic for the chance to help students put that practice to the test during the OSCE exams at the end of the terms. 

Dr. Dan Lewer, DVM ’08, owns two clinics in the Willamette Valley, Wilvet Salem and Wilvet South in Springfield and is affiliated with Viking Veterinary Hospital in Nampa, Idaho. 

He brought a team of Wilvet folks to help with the canine OSCEs including fellow alumni Dr. Kristin Peterson, DVM ’09 (Wilvet Salem co-owner), and Dr. Erica Harmon, DVM ’13 (Wilvet South medical director). Wilvet also donated supplies for the exams. 

“We had an amazing time working with the doctors to be. It is exciting to be able to work with the incoming group of veterinarians such that we can best prepare them for what is both a tremendously rewarding career and tremendously arduous career,” Lewer said. “Teaching them tricks of the trade early on lets them build upon the fundamentals we have crafted so that they are more ready for the real-world clinical demands earlier in their career. Overall working with the students and sponsoring the event brings joy to all of us at WilVet, and we are excited to see what these soon-to-be veterinarians do once they graduate.”

Dr. Natasha Stanley, DVM ’12, is the owner and chief medical officer of Viking Veterinary Hospital. She made the trek to Corvallis from Nampa to help with both the canine and the equine OSCEs.  

“After volunteering for the OSCEs, I found myself reflecting on my time at OSU. In all honesty, while I was in the thick of it, the vet school experience wasn't always sunshine and roses. The workload, the pressure, the intensity was all incredibly demanding. Looking back now, though, I can see how much I missed in the moment,” she said. “Now, I realize just how formative those years were which ultimately helped me become the veterinarian I am today. Oregon State provided me with an exceptional education. The dedicated faculty, the curriculum, the hands-on experiences – it all laid the groundwork for my success. Now, as a practicing veterinarian, the stress may still be there, but there's also a deep sense of fulfillment. In today's world, the headlines and articles talk about the challenges in our field, the burn out, the high caseload etc. But that is why I wanted to give back. Despite the hurdles, veterinary medicine can be an incredibly rewarding path filled with amazing moments. This career isn't only about helping animals, it's also about supporting each other and fellow veterinarians along the way. I really enjoy seeing the student's passion, dedication and hard work, and I am honored to be part of their exciting journey.”

Dr. Kate Schoenhals, instructor of rural veterinary practice, observes first-year veterinary student Sharon Lee's leading technique during an equine OSCE. Photo by Jens Odegaard. 

First-year veterinary student Enjhalika Esmena (center) performs a canine OSCE while second-year student Murdock Millwood (right) handles his dog whom he volunteered for the exam. Dr. Erica Harmon (left) grades the exam while Dr. Laura Couser Bennett observes. Photo by Dr. Lilian Wong.  

First-year veterinary student Kelly Lindemann counts a horse's heartbeat during an equine OSCE. Dr. Natasha Stanley grades the exam while Dr. Lilian Wong holds the horse. Photo by Jens Odegaard.

Lessons Learned
For the first-year students taking the OSCEs, the experience was a realistic look at their future in veterinary practice. “Most of my experience before I came to vet school was with small animals, and so I’d never done physical exams on horses before,” said Kelly Lindemann. “It was really interesting to apply the things that I’ve learned in small animal to large animal and figure out the differences.” Classmate Megan Schuster added: “I appreciated getting feedback on ways I can improve for when I’m doing it in real life.” 

Prema Nissinen and Amy Steeneck, both third-year veterinary students who helped as animal handlers, didn’t have OSCEs during their first year. “I feel like it was easy when we were doing this class [clinical skills] to be more hands off,” Nissinen said. “But this way they’re each having to make sure they all have the physical exam down.”  

Steeneck also felt that adding the OSCEs was a positive change. “I think the opportunity for students to get to practice physical examinations hands-on and to get feedback in real time, especially from clinicians that are actually practicing, is really helpful for reinforcing the knowledge that you learn. It's easy to talk about it in lectures and imagine yourself going through it, but to actually do it is a different experience, especially with people watching you. I think it's a really cool change.”  

Moving forward, Wong plans to continue canine and equine OSCEs in the clinical skills course and would like to expand to more species as time and resources allow. 

"It has been wonderful to witness the transformational growth in a such a short period of time!” Wong said. “There are so many advanced diagnostic tools available in veterinary medicine these days, but one cannot dismiss the value of a thorough hands-on physical exam. For some clients, that might be all they can afford. The first round of OSCEs could not have happened without the tremendous support of so many dedicated individuals willing to sacrifice their time to help the Class of 2027 grow. It is an honor to be part of such a collaborative community that strives beyond veterinary competence and aspires for excellence.”