The class will be asked to divide itself into groups of four. Check which group you are in.
To be a successful vet in practice, you must be able to work in a team and be able to delegate work to others.
During the year, the material presented in formal lectures should be revised through group discussion of cases included in the notes at the end of most sections of the notes. The primary purpose of these work groups is to help you develop problem solving, reference searching and decision making skills necessary for competent therapeutics. The work groups will also help your learning of the course material, and help you develop a sense of the priorities to attach to different parts of the curriculum.
The groups are expected to write one assignment each semester.
The essays should be written on a word processor. If your essay is ready to submit, email it to me with Pharmacology-essay-1 in the subject line, or just click this link which will do it for you. Please do not put this in the subject line if you are just asking questions about the essays!!! If you do not get an acknowledgement the next working day - assume that it has not got through the Massey email system and try again.
It will be assumed that everyone has contributed equally - everyone in the in the group gets the same marks. It is up to you to ensure that this happens.
In the first semsester, each group will be given the titles of two papers, one scientific and one clinical, covering different aspects of the same subject.
The object of the exercise is to determine the major findings of the papers and their clinical relevance and reliabilty.
You should go to the library, find the papers, read them closely, decide on the major findings, reliability and relevance to veterinary medicine and write a critical essay on the papers (3000 words). You will be expected to comment on the experimental design and the authors' interpretation of their results. This involves obtaining some background knowledge about the subject, but is mainly a matter of careful thought.
Ask yourself a number of questions:
How you write your essay is up to you. You may decide to split the papers up into their component parts and have each person write one part, or you may decide to have different people write about the good points and bad points of each paper. Whatever way you do it, the group's essay should be concise, incisive and interesting.
Check what topics other people are doing.
In the second semester, the groups will also be expected to research and write a major review of a topic related to pharmacology. This will build on the skills you used in semester 1 in your review of papers. You will have to go through a similar process but do not need to write it all down. In the disseration, you only need to include your conclusions after looking at the evidence, for instance, “Smith (1989) compared drug x and drug y, but inadequate controls and a small number of animals mean that no firm conclusions can be drawn from this work.”.
Dissertations should be written as a short review paper and consist of (i) Summary, (ii) Introduction, (iii) Main Discussion, (iv) Conclusions, (v) References.
This is worth some thought. Ideally it should be a subject about which there are both scientific and clinical papers published. Choose a narrow topic and examine it in depth rather than taking a superficial look at a broad subject, but on the other hand do not choose a subject that is so esoteric that only one paper has been published about it! You will be expected to include all the relevant papers on the subject in your review.
Try to avoid vaccines and immunology, as they come under Microbiology rather than Pharmacology. You do not have to confine yourself to purely veterinary pharmacology; anything from basic science to human use of drugs can be considered.
You may get ideas from cases you have seen in practice, or from personal experience. We will attempt to guide you but the choice of subject is yours. One approach is to compare a new or experimental treatment with an established treatment for a specific condition, another approach is to look at all aspects of a new drug and suggest possible uses in veterinary practice.
This should be concise but convey as much information as possible, including the species where appropriate.
(1page of A4 maximum)
This should contain a concise statement of the problem. The objective of treatment should be clearly defined. If you are examining a new drug then it should be compared with something, usually conventional treatment. This should be briefly described, including any problems encountered. You should say a bit about the new drug and why it might be better than conventional treatment. This should all form a coherent story leading up to the main discussion.
This is where you should examine the evidence in detail. If you are looking at a new drug you should describe its mechanism of action. You should be able to predict its therapeutic and side effects from this, even if they are not reported.
Next look at clinical trials. In veterinary pharmacology, these are usually appallingly badly done. Apply the same sort of analysis as you did for the 3rd year disseration. You do need to write all this down : just say what you thought the papers showed. Make sure you search the literature for all the relevant papers!
These should be your conclusions drawn from an examination of the evidence. They may not necessarily be the same conclusions as the authors of some of the papers. You should be able to defend your conclusions if asked about them.
These should follow the NZVJ format.
Avoid non-peer reviewed references if possible. If you cannot find any better reference than this study guide, you have not been searching hard enough!
The purpose of references is to allow the reader to look up the original work: if they are not written in such a way as to allow this then they are merely a waste of paper.
The dissertation should be prepared on a word processor. This makes it easier for us to read and makes it more valuable as a revision aid for you. Dissertations should not exceed 4,000 words in length (excluding references). Try to be concise. The dissertations should be written on A4 paper. They should conform to the style required for the New Zealand Veterinary Journal (http://www.vetjournal.org.nz/pub.html)
During your research for the disseration, you will have read your way through a lot of turgid crap. Try not to add to this. Follow the rules of style written by George Orwell many years ago:
You will work in teams of three or four and submit a single dissertation for the team. Marks will be allocated on the assumption that each member of the team has contributed equally to the dissertation; it is up to the team to ensure equitable distribution of the work.
In order to allow the rest of the class to benefit from your work, each team will be expected to present a poster of their work and be available to answer questions about it. Posters should consist of pages of A4 paper; one each for the title and authors, introduction, conclusions and main references, and two for the main discussion. The writing should be large enough to be read easily from a distance (at least 18 point). Do not go overboard with these posters, they should involve a minimum of extra work.
Due dates This does not mean that you do not have to do any work on it until the week before - get started as soon as you can. Come and talk to me as soon as you have any ideas about what you want to to so that I can point you in the right direction.
The poster presentation will be in the foyer. At least one person from each group will be expected to man their poster to answer questions about it.
These assignments are designed to make you think about the evidence (or lack of it) behind clinical practice. “Evidence based medicine” has become the watch word in human medicine, but has not caught on yet in veterinary medicine. When you give a drug to an animal, it is likely to have both good and bad effects. You are expected to balance these and ensure that the good effects outweigh the bad. You must have some rational basis for this decision - “but Chambers said, back in the good old days when I was a student...” is unlikely to wash when the owner wants to know why their animal has died.
“Evidence” comes in several different forms:
Drug company marketing and web sites can fall into any of these categories, but tend towards the bottom of the list!
What you really need to know is what your drug will do to the animal you want to treat, but there is no way of answering this definitively without giving the drug. The next best thing to know is what the drug does to the mythical “typical” animal. In human medicine, this is often expressed as the “number needed to treat”, or the number of animals you would have to treat to see a useful effect. If the drug works every time, the NNT is 1, if it only works in one animal in 20, the NNT is 20. The “number needed to harm” is calculated in the same way. These numbers are usually calculated from metanalyses of large numbers of controlled trials, so they are not often used in veterinary medicine (yet?).
The ultimate object of the exercise is to develop a way of using drugs which provides the best outcome for the animal and the vet. After you have gone through the process described below, you will realise that it is not usually practical to do this in general practice. The medical profession has gone some way to writing evidence based guidelines for practitioners. This process is only just starting for vets. You can make better use of these sort of guidelines if you have some idea of what goes into them.
You have to be able to give appropriate weight to different pieces of evidence and be able to apply it to real situations. You may be surprised at how little evidence there is to support widely used treatments.
In order to allow the rest of the class to benefit from your work, each team will be expected to present their work. more
An example of the sort of thing you should be aiming for is here (although this is much longer than I expect from you).
Critical appraisal for clinicians. A useful paper from Vetscript by Mark Stevenson.
There is a very useful series of papers in the BMJ by Trisha Greenhalgh (one a week, starting BMJ 1997;315:180-183 (19 July)) which is well worth looking at.
How to read a paper: The Medline database
How to read a paper :Getting your bearings (deciding what the paper is about)
How to read a paper: Assessing the methodological quality of published papers
How to read a paper: Statistics for the non-statistician. I: Different types of data need different statistical tests
How to read a paper: Statistics for the non-statistician. II: "Significant" relations and their pitfalls
How to read a paper: Papers that report drug trials
Introduction to clinical trials and systematic reviews
etc, etc, etc.