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Students explore One-Health exercise

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Toxoplasma gondii life cycle

April 26, 2013

As a 40 year old pregnant organic farmer, ‘Laura’ wasn’t the typical patient that most veterinary students would see in clinic. But after reading a blog about the risks of Toxoplasma gondii to her unborn child, she urgently wanted to know whether she should get rid of her cat (as the disease is transmitted to humans via contaminated cat feces). As Laura answered questions about her life on the farm, it became clear that other risk factors and exposures in her rural lifestyle posed a much greater risk to her fetus than her cat.

‘Laura’ was actually a character actor participating in a One Health Vet-Med joint case session with the 2nd year veterinary class in the Immunology and Infectious Disease block and the third year medical students in the Doctoring course from the School of Medicine (led by Dr. Michael Wilkes). In this half-day role play scenario, the students divided into 14 small groups of veterinary and medical students with 4th year medical students and faculty facilitators from each of the schools, and were sent off to classrooms that would serve as a ‘clinic’. Different actors were assigned to each group and one medical student was selected to conduct the standard patient interview.

During the interview process, the medical student could ask for a ‘time out’ to ask questions of the group and get feedback on issues that should be addressed further. While in ‘time out,’ the actor closed her eyes and pretended she wasn’t there. The veterinary students suggested the ‘doctor’ find out more about Laura’s farm—what kind of animals she raises, and whether she pasteurized the cheese, yogurt and milk from her goats. Were her cats indoor or outdoor? Did she use animal manure in her compost for the vegetable garden? How did she handle and eat the vegetables, milk products and meat that she produced on her farm? Were her animals regularly immunized and seen by a veterinarian? All of these questions would help determine Laura’s risk factors for toxoplasmosis and other diseases, such as brucellosis, cryptosporidiosis, and salmonellosis, which could also have a negative impact on her or her fetus.

Throughout the interview process, the veterinary and medical students realized they often used different terminology when talking about their human and animal patients. Medical students were surprised to hear Laura refer to abortions when she described how some of her goats in the milking herd had lost their pregnancies—what the medical students would more commonly refer to as a miscarriage. Many of the medical students were also unaware of how many zoonotic disease risks were present on a farm. They realized how important it would be in their future careers to determine whether a patient lives in a rural or urban setting and what type of animals they keep. Veterinary students had a chance to see how the medical students honed their doctoring skills as they interacted with the standardized patient actors and advised ‘Laura’ on testing for Toxoplasma.

The inspiration, motivation and selection of the case for this joint session came from the Students for One Health Club, with a special push from 3rd year veterinary student Jenna Winer and 3rd year medical student Keisuke Nakagawa and assistance in case preparation by 4th year medical student Lauren Brown.

“We're excited about this session because it provides an opportunity for us to get students from the two schools together to address a One Health zoonotic disease problem,” said Patricia Conrad, a professor at the School of Veterinary Medicine and co-director of the One Health Center of the UC Global Health Institute. “As our global community continues to face more diseases that occur at the intersection of humans, animals and the environment, it is increasingly important that we train our future medical professionals to practice a holistic approach to health.”

 


 Trina Wood, communications (530) 752-5257, tjwood@ucdavis.edu