Equine gastric ulcer syndrome (EGUS) is a highly prevalent and presumptively painful condition, although the amount of pain horses might experience is currently unknown. The aims of this study were to determine if the Horse Grimace Scale (HGS) could identify pain behaviours in horses with and without EGUS and if severity would be positively associated with the HGS score. Horse grimace scale scores were assessed blindly using facial photographs by seven observers and involved evaluation of 6 facial action units as 0 (not present), 1 (moderately present) and 2 (obviously present). Lameness examination, serum amyloid A (SAA) measurement and gastroscopy evaluation were performed on all horses. Horses (n = 61) were divided into two and three groups based on the presence (yes, no) and severity (none, mild, moderate-severe) of EGUS, respectively. Presence of lameness and elevated SAA (≥50 µg/mL) were used as exclusion criteria. Inter-observer reliability was analyzed by intra-class correlation coefficients (ICC). HGS scores between groups were compared using Welch’s and Brown Forsythe tests (p < 0.05). Overall, HGS ICC was “excellent” (0.75). No significant differences (p = 0.566) were observed in HGS scores between horses with and without gastric lesions (mean, 95% CI; 3.36, 2.76–3.95 and 3, 1.79–4.20, respectively). HGS was not influenced by the presence or severity of EGUS in this current study. Further studies investigating the use of different pain scales in horses with EGUS are needed.

To investigate the psychological, physical and professional impact of veterinary patient safety incidents (PSIs) on veterinary anaesthesia professionals. We conducted an observational cross-sectional survey, inviting veterinary anaesthesiologists, anaesthesiologists in training and veterinary nurses/technicians through social media platforms from 2 June 2023 to 20 September, 2023. The questionnaire was based on Second Victim Experience and Support Survey (SVEST) and analysed using descriptive statistics and subscale scoring to assess psychological, physical and professional impacts. A total of 303 participants from 31 countries responded, including North (24%), Central (13.5%) and South America (25%), Europe (13.5%), UK (12.5%), Australia/New Zealand (8.1%) and Asia/Middle East (3.3%). A participation rate cannot be estimated. All respondents described themselves as second victims, with 70% encountering a PSI in the past 6 months. Of the 303 participants, 75% had direct involvement with the incident. Common post-incident challenges included an increased awareness for PSIs (67.1%), fear of new PSIs (62.7%), diminished confidence (56.1%), more defensive medicine practice (46.7%) and sleep disorders (43.3%). Additionally, 62.7% agreed or strongly agreed that they experienced embarrassment post-incident. After a PSI, approximately 69% of the participants reported feeling inadequate in their animal care abilities, and a similar percentage questioned their professional competence. Over half of the respondents (54.6%) became fearful of undertaking high-risk procedures. Approximately 38% of respondents considered leaving the field of anaesthesia, and over 56% harboured thoughts of leaving their job because of the stress from PSIs. Additionally, a significant proportion (69.8%) reported not taking time off work following PSIs. The study identifies a significant psychological, physical and professional impact on the surveyed veterinary anaesthesia professionals, with notable effects on their emotional well-being and professional self-efficacy. The findings emphasize the need for supportive measures and interventions to mitigate the adverse effects experienced by these individuals.

To survey anaesthetic practices and attitudes towards veterinary patient safety in Australia. This was a cross-sectional sample population from Australian veterinary practices, including first opinion small animal, mixed animal and referral small animal practices. The survey included practices' anaesthetic management, monitoring equipment and topics regarding patient safety. Responses were obtained from 310/1700 (18%) veterinary practices, with 208 respondents from small animal practices (67%), 71 mixed animal practices (23%) and 31 referral small animal centres (10%). Overall, 61% of respondents reported always having a dedicated staff member monitoring the anaesthetic, who was most commonly a certified veterinary nurse (89%). In 22% of the practices, some of the staff monitoring an anaesthetic did not have any qualification. Completion of anaesthetic plans for each animal prior to an anaesthetic was reported by 24.5% of respondents and labelling of syringes was completed in 80% of practices. Pulse oximetry (98%) and temperature (88%) were the most common clinical variables monitored. The use of capnography (46%) or an electrocardiogram (48%) was also reported by the respondents. Emergency drugs, airway and ventilation equipment are available in 96%, 88% and 59% of practices, respectively. A defibrillator was available in 11% of practices with only 54% respondents being confident in using it. Of the respondents 60% were aware of anaesthesia safety interventions and clinical guidelines regarding patient safety during anaesthesia. Despite practices showing a relative improvement over the years in the standard of anaesthesia care, most of them are still not meeting international guidelines. Areas where changes could lead to improved safety practices could include: a trained person dedicated to monitor anaesthesia, pain scoring evaluation in patients recovering from anaesthesia, an increased use of standardised handover checklists, record keeping and an increase in open discussion of adverse events by the veterinary team.

Background: Medical errors, while prominent in healthcare as one of the leading causes of mortality, remain a relatively unexplored area in veterinary medicine. The nature and frequency of such errors in this field are rarely reported or discussed, presenting a significant gap in understanding and improvement of veterinary practices. It is in this context that the importance of leadership styles emerge. Humble leadership involves acknowledging one’s own limitations, actively seeking feedback and learning from it, and appreciating others’ strengths and contributions. Such a leadership style has been linked to increased openness and error disclosure in various fields - a crucial step in mitigating medical errors. Purpose: This study investigates the association between humble leadership and error disclosure in veterinary medicine, with a particular focus on the mediating role of psychological safety and safety climate. Methods: A total of 669 responses were collected from veterinary staff across Australia to analyse the impact of leadership style on error disclosure. Model 4 of Hayes’ PROCESS macro in SPSS was employed to analyse the effect of humble leadership on staff’s attitudes towards error disclosure and the mediating effects of psychological safety and safety climate. Results: Humble leadership had a positive influence on psychological safety (β 0.66, p<0.001) and safety climate (β 0.48, p<0.001). Furthermore, both psychological safety and safety climate significantly impacted staff’s attitudes towards error disclosure (β 0.07, p<0.001; β 0.22, p<0.001, respectively). The study showed that humble leadership did not influence staff’s attitudes towards error disclosure directly. Rather, the influence of humble leadership appears to be channelled through its positive effects on psychological safety and the safety climate. Conclusion: Humble leadership fosters a safe environment and encourages a mindset of psychological safety among staff, which in turn leads to more positive attitudes towards error disclosure.

To assess the impact of a simulation-based workshop on veterinary students' perceived preparedness and confidence in performing anaesthesia-related tasks. A pre- and post-survey study was conducted among 106 final-year veterinary students to evaluate their self-reported preparedness and confidence before and after a simulation-based workshop. Students completed a survey before and after participating in a simulation-based workshop that involved two different scenarios, where they practised induction of anaesthesia. The survey included questions assessing students' perceived preparedness for induction of anaesthesia, confidence in assisting with anaesthetic procedures and perceived value of the simulation. Responses were assessed on a Likert scale from strongly agree (4) to strongly disagree (1) and are presented as mean ± standard deviation. Independent t-test was used to compare pre- and post-survey responses, with statistical significance set at p < 0.05. Improvements were observed across multiple areas following the simulation. The mean score for 'the ability of the workshop to enhance my understanding and preparation for anaesthesia rotation' (Q1) increased from 3.48 ± 0.55 to 3.87 ± 0.34 (p < 0.001). Students' perceived preparedness for anaesthesia induction (Q2) improved from 2.56 ± 0.57 to 3.67 ± 0.49 (p < 0.001). Students' confidence in assisting with critical incidents (Q3) increased from 2.09 ± 0.59 to 3.36 ± 0.61 (p < 0.001). Confidence in assisting with anaesthetic procedures (Q4) increased from 2.74 ± 0.52 to 3.57 ± 0.49 (p < 0.001). Simulation-based training improved veterinary students' perceived preparedness and confidence for induction of anaesthesia. Although these findings highlight the value of simulation exercises in building students' confidence and serving as a preparatory tool within the veterinary curriculum, further research is needed to assess their impact on hands-on skills and objective performance during live animal procedures.