Evaluating Communication Training at AVMA COE-Accredited Institutions and the Need to Consider Diversity within Simulated Client Pools.
J Vet Med Educ. April 2023;50(2):192 - 204. 
Elizabeth Soltero1, César D Villalobos2, Ryane E Englar3, Teresa Graham Brett4 1 University of Arizona College of Veterinary Medicine, 1580 E Hanley Blvd., Oro Valley, AZ 85737 USA.; 2 Office of Diversity and Inclusion, University of Arizona College of Veterinary Medicine, 1580 E Hanley Blvd., Oro Valley, AZ 85737 USA.; 3 Associate Professor of Practice, University of Arizona College of Veterinary Medicine, 1580 E Hanley Blvd., Oro Valley, AZ 85737 USA.; 4 Diversity, and Inclusion, and Assistant Professor of Veterinary Medicine, University of Arizona College of Veterinary Medicine, 1580 E Hanley Blvd., Oro Valley, AZ 85737 USA. 
 Abstract
The push for competency-based veterinary medical education by accrediting bodies has led to the inclusion of non-technical skills within curricula. Communication, self-awareness, and cultural humility are considered essential for post-graduate success. To facilitate skills development, veterinary educators have incorporated a variety of modalities including lecture, group discussions, virtual and peer-assisted learning, role play, video review of consultations, and simulated clients (SCs). The overarching goal is developing students into self-reflective practitioners through exposure to clinical scenarios that enhance and embody diversity. Decision making about case management is subject to stereotypes, bias, and assumptions. Racial and ethnic disparities reported in health care can adversely impact patient outcomes. This study was conducted to evaluate communication training and diversity among SC pools within veterinary colleges. A questionnaire was electronically disseminated to assistant/associate deans and/or directors of curriculum/education at 54 American Veterinary Medical Association Council on Education-accredited or provisionally accredited colleges of veterinary medicine. Twenty-one institutions are represented within the data set. Participating institutions summarized their communication curricula: 18 (85.71%) used SCs. Over 55% of these did not track SC demographic data or social identities; among institutions that did track, SCs were primarily monolingual English-speaking (77%), non-disabled (94.2%), white (90.4%), non-Hispanic/Latinx (98.6%) women (57%) over age 56 (64%). Sixteen institutions agreed with the statement "I do not feel that our SC pool is adequately diverse." Respondents shared that lack of time and capacity for recruitment were barriers to diversifying SC pools and proposed strategies to improve outreach.  
 Keywords
 
barriers to diversity;
client communication;
diversifying simulated client (SC) pools;
diversity;
simulated clients (SCs);
simulation-based education (SBE);
social identity;
  
 
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