I recently had the opportunity to mentor a colleague in how to provide good feedback to veterinary nursing students. The experience reminded me of when I had my teaching evaluated by a respected colleague. Her report about my teaching was pages long and at first I was shocked and afraid of what I might find when I read it. However, her feedback identified not just my weaknesses, but also my strengths and ways to improve. Even more valuable were her titbits of experience that she peppered throughout the report; I could see that she cared, and that she really knew what she was talking about. The way she presented her feedback let me know that her experiences were her own, that there were many ways of doing things, and that my ways were not bad. As I read the report, I felt empowered, even as she presented things that I could do better.
Giving and receiving feedback is a life skill that takes time to master and is an important part of being a reflective practitioner. Our approach to continual improvement and our willingness to see our own weaknesses is how we develop and improve.
Medicine is an ever changing field, and the body (human or animal) is unique and not always predictable in the ways that it reacts to treatments. It is important then, that our community is always investigating and researching as well as reevaluating the way we do things and not just taking feedback from colleagues, but also using scientific evidence to guide our thinking.
This week a VN sent me a query indicating that her supervisor was advocating the use of a surface disinfectant on the skin of animals prior to doing a surgical scrub. She began by reflecting on the safety margin of the chemical, pointing out that it could be very harsh to skin. She also sought to find evidence for acceptable use with this chemical, and of course as it was a surface disinfectant, she had a hard time finding evidence to support its use on skin. I pointed out that it isn't the lack of evidence that should guide use, but rather the strong evidence for more suitable antiseptics that are labelled for skin and have noted safety margins.
Using evidence to guide our processes is important for providing comprehensive and holistic care. While it may be hard to find abundant evidence about skin antiseptics preventing surgical site infection in animals, there is extensive evidence in human studies. Reading all available evidence in an area such as this is revealing. The varying cohort and study size, the varying methods and materials, and the varying conclusions make for interesting reading, but one thing is sure, we know beyond a shadow of a doubt that there are a couple of antiseptics which are routinely used on skin and are known to prevent SSIs. To not use these in favour of an off label solution with little or no evidence to back it up, is certainly not ideal.
Often things are done a certain way, as ‘that is the way it has always been done’, yet this is possibly one of the most worst ways to approach our work. We should always be questioning things and be willing to consider options. We should listen generously, and be open to feedback. We should do our own investigations and be guided by robust scientific evidence. This is how we ensure we are reflective practitioners and how we adapt to an ever changing field.