"Do we value only that which we can measure or should we rather seek to measure what we value?" - Veterinary Practice
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“Do we value only that which we can measure or should we rather seek to measure what we value?”

My daily walk north of our village takes me down a track with a field on one side and a wood on the other. I say a wood, but when we arrived in the village 25 years ago it was a field just like any other, but one the farmer decided to set aside long term. He would probably say that the land which continues as a field is productive; far more productive than the one set aside. At present, the green tips of a wheat crop are just showing from otherwise barren soil. Over the next few months, this will grow to a full crop, duly harvested before returning to bare ground. That’s productive for the farmer for sure – the best way of turning sunlight into food for us to eat and a profit for him without a doubt. But all through the summer nothing else grows there, does it? Pesticide ensures that other plants, insects and their predators don’t get a look in. Listen and all you hear is the occasional sky lark overhead and some crows in the distance. Contrast with the set-aside land. It’s a climax woodland that I remember learning about in A level biology, a range of different trees and shrubs, with a veritable cacophony of buzzing and chirping of the wildlife there. Far, far more productive to my mind than the field which only produces its one crop. Which got me thinking…

In my ambulatory services to around 40 veterinary practices, I see quite a range of approaches to productivity. There are a fair few – “no names: no pack drill” as they used to say – with graphs on the wall indicating the number of cases seen per month for last year and the profit per month… and importantly how that compares with this year. Business productivity on display for all to observe. Interestingly you don’t see graphs of the number of thank you cards and appreciative phone calls! Or the number of clients grumbling because they can’t see the same vet each time they come as employees are rotated around different branches. The trouble is that it’s really difficult to quantify those sorts of responses compared with profit and loss accounts. Which got me thinking again…

I’m a governor in a local state secondary school here in Cambridge, and when I started, I was required to go on an induction day course about secondary schools and what governors are there for – being a critical friend. And one lecture, just before lunch, was about measuring school performance. Lots of graphs of value-addedness (though I’m sure they didn’t call it that – the squiggly red line from the computer under the word I’ve just typed tells me it doesn’t really exist!) and ways of measuring performance from student attendance to exam grades and so on. So, after an hour’s worth of PowerPoint, I decided it was time to be a critical friend. “You haven’t included whether the school kids are enjoying themselves,” I piped up. “Ah,” came the reply. “Well, that’s a lot more difficult to measure,” which turned into an interesting discussion: do we value only that which we can measure or should we rather seek to measure what we value? But the lecturer thought I was being far too critical, I think, and not anything like as friendly as I should be – so we broke for lunch! It has to be said that we chatted over our sandwiches about ways of asking the students what they appreciated and how they thought the teachers could do better and the lecturer came back after the break with a few ideas on doing exactly that. And truth be told, I’ve seen just such methods used in the excellent school for which I’m a governor. The same issues come up, of course, in tertiary education.

How do we assess the veterinary students at the very end of their course? I’ve just been marking short answer questions on ophthalmology from final years. Because the written exams were online this year under COVID restrictions, I was able to include gruesome pictures of eyes as a basis for my questions and ask for a diagnosis and potential treatments if the owner didn’t have the financial wherewithal to go for referral. And that gives us some clue as to whether they are competent to go out into the real world and deal with such patients. But how can I assess whether they can explain the issues to the client? We have OSCEs (objective structured clinical examinations) on client communication, but really the best way of evaluating these students has been to work with them through their final year, and see how they deal with such situations when they are asked to chat to owners. Only then can we really see how they do and help them in doing better. And indeed, the best thing is to see students who I remember from their interviews and their entry into vet school, and delight in how they have progressed to the stage where I would be happy having them seeing my pet and caring for them and me. And that’s what makes teaching in a vet school worthwhile – a real sense of productivity on their part and mine as well!

David Williams

Fellow and Director of Studies at St John's College, University of Cambridge

David Williams, MA, VetMB, PhD, CertVOphthal, CertWEL, FHEA, FRCVS, graduated from Cambridge in 1988 and has worked in veterinary ophthalmology at the Animal Health Trust. He gained his Certificate in Veterinary Ophthalmology before undertaking a PhD at the RVC. David now teaches at the vet school in Cambridge.

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