Plus-Hex CLINICAL if they had more practical experience with rabbits . The suggestion that RVNs are apprehensive about anaesthetising rabbits because they see fewer of them compared with cats and dogs [ 11 , 12 ] can be supported by these data , as confidence was higher in those RVNs who saw more rabbits per month to be anaesthetised . Additionally , the median number of rabbits anaesthetised each month was extremely low ( three rabbits per month ), raising questions as to why so few rabbits are seen at UK veterinary practices when they are popular pets [ 4 ] . It may be that the public are fearful of taking their rabbits to the veterinary surgery in general , not just for anaesthesia , as previously discussed [ 13 ] . However , this figure may be inaccurate , due to the survey design allowing recall bias ; a retrospective study design analysing veterinary records may have been more accurate to ascertain numbers of rabbits seen monthly . Without increasing the number of rabbits seen in practice , it is difficult for RVNs to increase their confidence and improve their clinical skills through practical experience .
The number of rabbits seen in a month was influenced by practice type : RVNs in referral hospitals saw the lowest number of rabbits per month , with a median of 0 , compared with those in primary care practices , with a median of 3 . Despite this disparity in the number of rabbits anaesthetised monthly , and the increase in confidence as more rabbits were anaesthetised , confidence in rabbit anaesthesia was not significantly affected by practice type . However , only 18 respondents ( 6.3 %) worked only at a referral practice , so the sample size may be too small to accurately reflect the opinions of all the RVNs working in referral centres across the UK . It may be that referral RVNs were less interested in answering the survey if fewer rabbits are seen at this practice type , so future research should recruit more referral RVNs to obtain more accurate statistics . Although the survey was posted online for all types of RVNs to view , sending it directly to referral practices might have obtained a higher proportion of this group to accurately gauge their confidence .
Initial education and CPD
Lack of education and training about rabbits was a definite perceived barrier to confidence . Most respondents agreed they had not received sufficient education about rabbit anaesthesia ; in those who felt they had , anaesthesia confidence was significantly higher . This finding coincides with previously suggested theories that veterinary surgeons and RVNs do not have enough education about rabbits [ 14 , 15 ] . This result was not influenced by the training route or number of years qualified , suggesting that all education routes have provided limited education about rabbit anaesthesia throughout the years . However , RVNs who qualified more recently felt they had some of the best and the worst training , with clusters of both ‘ strongly agree ’ and ‘ strongly disagree ’. This suggests that teaching has improved in some areas but might have been more consistent between different training centres in previous years . More attention should therefore be given to improving teaching about rabbit anaesthesia during initial training to improve RVNs ' confidence .
This survey highlighted that airway management was a definite barrier to confidence , in agreement with previous evidence that endotracheal intubation is difficult in this species [ 2 , 8 , 20 , 22 , 23 ] . Despite numerous studies evaluating the safest medications to administer to rabbits [ 38 – 41 ] , fewer than 50 % of RVNs were confident with induction and maintenance protocols , perhaps suggesting that this area was not taught adequately during initial training . In addition , in a case series of 15 rabbits that underwent cardiopulmonary resuscitation , 10 were as a direct result of anaesthesia [ 42 ] , so it is concerning that 50 % of respondents lacked confidence in emergency protocols .
Of the RVNs who responded , 88 % were confident at administering medication , including intravenously ; however , there was no specific mention of confidence in intravenous catheter placement in the questionnaire , and including another specific Likertscale statement could have helped to substantiate opinions that intravenous catheter placement is difficult in rabbits [ 21 , 24 , 25 ] . These results indicate that additional education during initial SVN training should cover induction and maintenance protocols , airway management , intravenous access and emergency procedures , to improve the confidence of newly qualified RVNs .
It has been suggested that rabbit fatalities can be attributed to the belief that they are more difficult to anaesthetise [ 15 ] . Although this study cannot prove a correlation , 21.4 % of respondents did agree that the negative opinions about rabbits reduced their confidence , and 6.6 % suggested trying to reduce the stigma around them . Better education during training may aid in reducing this stigma , as will the inclusion of rabbit anaesthesia on the Nursing Progress Log ( NPL ) or portfolio , so students become more comfortable with – and less fearful of – the process of anaethetising rabbits .
A frequently mentioned recommendation was to send students on day release to exotics practices to provide them with hands-on experience with rabbit anaesthesia . Practices might not be keen to have inexperienced SVNs treat their patients , but in a veterinary student rabbitneutering clinic where final-year students were closely monitored by an experienced VS and anaesthetist , neither mortality nor morbidity were increased [ 43 ] . A similar arrangement for SVNs could help them to gain confidence in rabbit anaesthesia .
RVNs from VT had higher confidence scores than those who had trained in HE . This group also had a smaller range in scores , suggesting the education was more consistent between VT centres than between universities . The VT group may have had greater
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